day ninety three

This week has involved many life lessons, some funny and others harsh... let me share with you.

Firstly, I learnt that whilst there might be stima (electricity), it is not always strong enough to power the appliances. From Saturday afternoon until even now, the electricity has been waning between enough to recharge your phone to absolutely nothing... either situation the power was not strong enough to power the water heater in my shower. Meaning that for about 10 days I didn't wash my hair. Yes, I washed my body, don't go thinking I'm a disgusting smelly mzungu, but I struggled to wash my hair using a bucket. The lesson learnt here was that baby powder and hairspray are best friends to my blonde hair, with some people even commenting that my hair looks better in this state of unwashed. Yeah no, I am not willingly going to not wash my hair for that long again... my scalp was super itchy. 

my hair at about day five of not being washed...

Secondly, I have learnt that unless you have knowledge in ark building, make sure you are somewhere safe and dry when the rains come. This week I was coming back from the matatu stage walking towards home when the rains started... actually I wouldn't call them rains, I'd call it buckets of water being poured on me. I have only ever been that soaked once before, on the Gold Coast when there was a tropical storm coming in and we were stuck at that shopping centre that is outdoors... anyway, I was drenched all the way through, and my poor shoes took two days to dry out. Umbrellas don't do a thing when the rain is like that. 

Thirdly, I have learnt that if you are tough and speak in Kiswahili, then the mzungu price disappears. Three or four times this week I've turned around and said "Sitalipa bei ya mzungu"(I'm not paying mzungu price) and argue back the price with my limited knowledge of numbers and hazaah, the price melts away and becomes more reasonable. For example, this morning we had to take the car to be fixed as the window had come off the track. I know that the price should be 200Ksh, because my host brother had it fixed previously at that price. However, at the completion of the work, the fundi tried to charge me 350Ksh... ha! Using my ever growing Kiswahili knowledge, I basically told him to get real and go away, only paid him 200Ksh, and drove off. Mwah ha ha ha.

Fourthly, I learnt that I am addicted to my mobile phone and feel like I'm dead without it. Unfortunately I dropped my phone one too many times and the colour leaked out... it started with a black spot in one corner which slowly moved across the screen until I could no longer see anything. The glass is fine and the touch-screen still works but I couldn't see anything... waaaaaah. I didn't have whatsapp for 24 hours and I felt so out of touch with the world. I have borrowed R's second phone so I have contact with the outside world, but I don't have everyone's numbers so don't feel mad if I haven't gotten a hold of you.

Finally, I learnt that I need to grow thicker skin, become deaf to gossip, and be slower to trust. Maybe I've been sheltered or maybe it's the culture, I don't know, but this week has been harsh. I don't want to get into specifics because it's not important, but it's been a good lesson.

Yeah, some of the names for the "share a coke" campaign here in Kenya are super weird...

day eighty eight

This last week has been a huge eye opener into my own personal reactions to situations – I am easily exasperated, frustrated and irritated… not the best characteristics to have, but the first step to change is acknowledgment, right? So here’s to learning to calm down, speak slowly, and walk away when I can’t get my point across in a respectful and unruffled manner.

Friday was my “quarter-term retreat” which was a chance to take a break from everything – work, home, Kakamega – reflect on the past three months, plan for the next three months, and eat some tasty food. We (being the FSD site team and I) headed to Kisumu in the morning, first to the Immigration office to extend my visa for another three months, then to the Kisumu museum, lunch at Kiboko Bay resort, and then a quick trip to yet another delightfully huge Nakumatt (I love Nakumatt).

The visit to the immigration office was nerve-wracking and whilst waiting for the lady the paranoia set in… what if they refused to extend my visa? What if I was deported? Or fined for something? There was a huge Indian family in the queue before me, and they were really nice, explaining how the system works and just being generally friendly. Finally the lady came and took me to her office, where I filled in a form, wrangled my way out of a small hole - they didn’t believe this was my first time in Kenya as my Kiswahili is too good for someone who has only been here three months, which I told them I lived in a village where I had to know Kiswahili to understand what everyone was saying – had a laugh about living in a village, paid my 2000Ksh (about $25AUD) and got a new stamp in my passport. Phew!

Then we headed to the Kisumu museum… riveting stuff! Well, the baby tortoise was anyway. There was an aquarium, a traditional village, a kitchen garden, and a snake pit… yeah I didn’t stay near that one for too long. But how cute is the baby tortoise?! Awwww

After this educational experience we were super hungry, so we drove out to Kiboko bay resort on the shores of Lake Victoria. The breeze coming off the lake was so relaxing and calming, I wish I was there right now. My chicken cordon bleu was super tasty, and the beer was baridi and refreshing. The discussions with the FSD site team reassured, inspired and guided me so in a way that was constructive and encouraging and exactly what I needed. I also bought myself a small soapstone hippopotamus.

From there we headed to Nakumatt so I could change phone carriers from Safaricom to Airtel – sorry Safaricom, but your data bundles suck! For around $15 AUD a month I get unlimited whatsapp, facebook, Instagram, twitter, emails and sms… whereas previously I was spending about that in a fortnight because I would always go over my daily data allowance. Rachael and I then wandered around and found incredible goodies, including balsamic vinegar and Don Simon sangria… score!

The last bit of excitement was on the way home – just near my house the Police always do licence and registration checks. When we pulled up the policeman saw me, said hi and waved us on, to which my boss was impressed and told me I’m becoming a real Kenyan now.

day eighty one

Sometimes it's hard to explain to someone exactly what it's like being me, being here, doing this. I know that sentence was rather vague and ambiguous, but that's what I mean - I cannot describe just how hard, exciting, heartbreaking, fulfilling, lonely, soul-destroying, amazingly incredible this journey is. Every day I wonder am I really cut-out for this? Can I really be a development worker? Am I too soft, too aggressive, too bossy, too arrogant, too needy to make it on the field? Or should I just go home and do my PhD in something? 

But then I go to work and someone has requested one of the new methods and I think  maybe they are listening to me? Maybe I am making a difference? Maybe at the end of all this the laboratory and public health teams will have benefited from my knowledge and not just my jokes? 

You'll see what I mean in a minute... apologies in advance for the intense laboratory/medical jargon. 

Last week I gave a talk to the staff here at my hospital about some new laboratory methods we're now performing and how they will increase their ability to prescribe appropriate drugs rather than just empirical treatment. We're now going to be performing Gram staining for all urines that have ++ or +++ pus cells (i.e. an indicator of infection) to differentiate any potential bacterial pathogens. With that I explained the importance of collecting a mid-stream urine (MSU) early in the morning. I also reminded them that we can Gram stain almost any sample - sputum, pus, high vaginal swabs, urethral swabs... anything that might be able to give any helpful information where we can differentiate from normal flora and potential pathogens. I also explained how we're now going to be performing auramine staining for faecal samples for the detection of Cryptosporidium spp, and also titrate the serological samples rather than just provide results as "slightly/moderately/highly reactive". 

Those that attended seemed to be attentive - thing is none of the clinicians were there. None of those that treat the patients, that prescribed the drugs, that read the laboratory results, that deal with treatment failures... they weren't there. None of the Public Health officials were there, those that look at the data, look at outbreaks, look at the trends, that recommend changes... they weren't there. I'm sure that there was something else important going on that morning, 

Even those that were there hadn't listened - we're supposed to now titrate out any positive samples for serology, but rather than actually perform the titrations, the lab staff are visually assuming the ratio according to the amount of agglutination. So basically instead of saying "highly reactive" they're assuming that is "1:320"... 

I know that change takes time. But how can you change when you don't even listen?! Assumptions, quick fixes, band-aids... how can they be broken and removed if there are so many excuses? 

For example, anyone with a fever automatically gets a blood smear for malaria and serology testing for S. Typhi using the Widal technique - even if they have diarrhoea. See, if someone has Typhoid fever, the majority of cases are constipated. So why aren't they collecting a faecal sample to determine the cause of the diarrhoea? A myriad of reasons... the laboratory don't like testing, the patient doesn't want to pay for it, you can't just ask a patient to poop on demand, it's what the patient is asking for, you can't expect me to ask every patient with diarrhoea to be tested...

I have replies to all of those reasons, but they are falling on deaf ears. Possibly because in trying to get this across I'm probably coming off aggressive and know-it-all. Possibly because I'm female, white and not medically qualified. Possibly because people just don't like to be questioned, to be seen as doing something wrong. 

Then this morning I came in and when dealing with a rape case the Doctor had taken a high vaginal swab and requested not just the ordinary wet prep, but also the gram stain. So maybe they are listening? Maybe change is coming? As Peter (my awesome boss) keeps telling me "pole pole Anita, this is Africa". 

That's why I came for twelve months - because change takes time. Rome wasn't built in a day, but it was built eventually yeah?

day seventy five

It's hard to believe I've only been here ten weeks! Whilst I finally feel like I'm starting to fit in here, this week I have also become distinctly aware that I will never really fit in and someone will always look at me as a mzungu and try and take advantage of our "friendship".

Last week I had the extreme honour to go with one of our Community Health Volunteers (CHVs) to perform house visits. Whilst I live here in the community, I know I'm sheltered somewhat as I live in a really nice house with a concrete floor, glass in the windows and a big compound fence, whilst the vast majority of people live in houses constructed of mud with tin roofs and shutters as windows.

On our way to a house visit walking through some maize crops

Where I live in Western Kenya is what somewhere between urban and rural - imagine people having smallish houses on 1/2 - 1 acre plots and the land is farmed, every square inch of it. The main crops are maize, beans, tomatoes, onions, and tea. People also grow mangoes, bananas, avocados and coriander. Whilst people aren't rich by any sense, they aren't dirt poor either. However, in saying that, there is a lot of families living hand-to-mouth, and so when the torrential rains come they can't work in the fields and so don't earn any shillings that day.

So Jacob and I went a visiting - pregnant mothers due any day now, children who have dropped out of school, injured villagers and generally said hello to everyone. As a CHV Jacob records whether each household has a latrine with handwashing facilities, whether people are sleeping under mosquito nets, the level of education achieved by each household member, any illness experienced etc etc. Maternal and infant health is a big part of a CHVs workload, counselling mothers on breastfeeding and encouraging mothers to attend a health facility for regular check-ups during her pregnancy.

Finding a hard surface to write on

Demonstrating the water filtration system

Checking the ANC book

It was incredibly eye opening to what can be done just at the ground level in terms of public health action, but also the element of community and welcoming friendliness that I experienced was astonishing - there is no way that someone could come knocking on your door and perform a health survey for you and your family. There is such a sense of belonging and family that extends beyond the immediate blood relatives... nipenda (I like it). I seriously love it here, every day I am blown away by my beautiful surroundings. Hopefully it's not just a case of "the grass is always greener on the other side"

day sixty nine

So you want to know what happened this rest of my long weekend eh? Sawa I shall tell you

The last post left of with R and I arriving back in Kakamega after what was a ridiculous matatu ride and slowly made our way through the marketplace, where R bought 3 avocados for 10Ksh (like 15c AUD) and then with my new found confidence, R bought a backpack which we managed to haggle down the price 200Ksh... yeah take that! I also tried out my skills on the guy selling pretty gumboots but he wouldn't have a bar of it. Shame.

At the moment the weather is like Springtime in Melbourne - it can start off cold and windy, then get hot and muggy, followed by torrential rains. At this time of the adventure it was hot and muggy so we decided a cool refreshing beverage might be a good idea... Purple Fanta anyone? Holy shit guys this stuff is the business! I never used to be a big drinker of soft drinks but over here this stuff is cheaper than water (35Ksh compared to 50Ksh) and can substitute a meal (for the budget conscious). Whilst enjoying our drinks in the comfort of Yakosupermarket along with samosas and doughnuts the sky turned black - literally - dark and scary and ominous.

In hindsight I should have done two things - bought those gumboots (they weren't that expensive anyway) and waited out the storm in Kakamega. But instead I did neither of those. Once I saw those clouds I said goodbye to R and headed back to my village - about a 40 minute matatu drive from Kakamega. During this time the inevitable happened - the clouds broke and the rain bucketed down like rhinos and elephants along with some rather sizeable hailstones which leave small bruises when they hit you.

Yeah... my bus stop is in the middle of nowhere and so when I got off I got soaked. Luckily there is a small structure which I took shelter under along with three boys who were laughing at their ngombe (cows) stuck in the rain. But the storm wasn't the biggest challenge I faced when headed home - no, it was the creek that runs at the bottom of the hill which had decided to flood. In flooding, the creek had washed away a few layers of topsoil and so what would normally be a shallow puddle ended up being water to my knees. By the time I made it up the hill to my compound I was drenched through and my shoes squelched with each step. To top it off there was no electricity so I couldn't have a hot shower. Yep.

Eventually the rains stopped and we made a fire outside where the boys cooked a cows head... yes, a whole cows head, brains and eyeballs and ears and everything. So disgusting. I just toasted marshmallows instead. During this time around the fire we discussed sex, which is where I learnt that apparently condoms can be used, emptied and then used again during the same session, that foreplay and other bedrooms acts are not really known, and that HIV is feared but they don't know anything else about other STIs. I'm sure this is not representative of all of Kenya, but it was certainly enlightening and hilarious when trying to explain certain *ahem* things. I seriously love my host brother and cousins, such good value.

Sunday saw me exploring the whole expanse of Kakamega County from Ivonda all the way to Lugari, with stops in Kakamega, Mukumu, Malava Forest and even Webuye. After the rains the previous day there was some flooding but that didn't stop Kevo from driving through those puddles. The landscape of this county is ridiculously breathtaking. These photos do no justice.

Road trip time!

Obligatory kuukuu in the car

The baboons of Malava Forest just chillin' roadside

No puddle to big to stop this beast of a car

Seriously breathtaking

That was my epic weekend. Add to this an undercurrent of stomach illness, restless sleeping and mosquito bites and you've got the picture. 

day sixty five

For many countries around the world May 1st is celebrated as International Workers Day, aka Labour Day here in Kenya, which brings with it two magical words... long weekend! And now that I have a partner in crime (that is, another female mzungu) we decided to let our mischief loose on the fifth largest city of Kenya - Eldoret. 

The Lonely Planet guide is rather pessimistic when it comes to this home of marathon champions and cheese... "for the traveller, there is little to see, and even less to do" mentioning that the only attraction is the Doinyo Lessos Cheese Factory. Well when it costs you almost ten aussie dollars to buy 250g of cheese, the prospect of free tastings and discounted prices is well worth the two hour bus ride to only see the cheese factory. I think the ultimate lesson for this weekend was don't read the Lonely Planet guide.

After a comfortable ride in the front seat of the shuttle we alighted in the middle of Eldoret CBD and went in search of food, specifically Will's Pub and Restaurant which had been described as an "English pub in Kenya" serving western food and friendly service. Yeah nah, not again. Nothing terribly bad, but there are definitely better options. Our first choice of pizza was dismissed as it was not currently available so we ended up consuming chicken sandwitches and chips. Meh.

Now that we're feeling revived with food we headed to the famous cheese factory, dreaming of walking through piles and piles of cheese and tasting several samples before purchasing large quantities of the delicious glory... *splat* that was the sound of our hopes being squashed by the women inside the small factory shop staring at the wazungus asking for a tour. The price list left us confused meaning we both left after purchasing one piece each - R got some hard cheese with pepper and I bought a tub of cream cheese... mmmm cream cheese frosting here I come!

We then walked around town with no real purpose in which we stumbled upon a glorious sight - a cosmetics warehouse! Hair extensions and giant bottles of shampoo and stacks and stacks of nail polish... we spent at least an hour wandering around this place and ended up purchasing superfluous products including nail polish which glows in the dark. 

Our accommodation for the night was in the White Castle Hotel which when safely in the confines of our room we made plenty of inappropriate mzungu jokes. The room was comfortable and the security was great and it was placed centrally which meant we could walk everywhere around town. We headed to Nakumatt to get ourselves some wine and returned to our room to watch crappy tv and drink our very tasty South African Rose. 

The second purpose of our visit to Eldoret after purchasing some cheese was to eat pizza - and after reading some reviews online we headed to Pizza Bistro and finally something lived up to it's hype. Free wi-fi, decent coffee and a menu to drool over. We shared a hawaiian pizza and drank iced coffees... so good. 

Our initial plan was to head to Sam's Discotheque however after a recommendation from a local friend we headed to Club Four One One and instantly knew that was a good choice. Our disco diva nail polish glowed and the Tusker beer flowed and we danced the night away. Oh my goodness, some Kenyan men can dance! PHWOAR they are HOT on the dancefloor! Some of them were also ridiculously good looking also (black skivvy guy? mmmmm). Sure there were some ridiculously creepy old men but mostly the club was full of gentlemen. There were also too many wazungus for my liking - anything more than two in one place has become too many for me. Actually, to be honest, sometimes I forget how white I am. But back onto the club, it was fantastic! The music was so good, will have to source it for myself because I'm getting sick of the repetitive reggae music my host brothers like to play at home. I was fortunate enough to find a cute local who translated the swahili for me whilst teaching me the moves. Can't wait to go dancing again!

The next morning I woke up after only four hours sleep - living in a rural area makes you susceptible to city noises and Eldoret likes to wake up and make sure everyone can hear that they're awake. R and I headed for breakfast and enjoyed fresh fruit, eggs and bread... yeah make sure when in Kenya you ask for your bread to be toasted. After this we headed to what we thought was another shuttle back to Kakamega however it ended up being a matatu, meaning it stopped every five minutes and was so squashed and hot I was sweating more than I did it the club the night before. Feeling nauseous and dizzy with a lack of caffeine in my system didn't help the trip go any faster either - it took three and a half hours to get back when it only took two hours to get there. On top of that the conductor tried to charge us 400Ksh which I said "sitalipa bei- miatatu bob" (I won't pay that price, 300 bob). BAM - I win! 

So that is the story of how we went to Eldoret on Labour Day. I will tell you about the rest of the weekend in another post - stories of being attacked by huge hail stones, flooding, campfires and cows heads, sex education lessons, monkeys and visiting family.... this weekend definitely wasn't boring!