Misawa Uru,
So today is thursday. And once again, I am dealing with more IRB headaches (hence the title of this blog - which translates into the equivalent of "oh my god.."). In Kisumu yesterday, we finally got a straight answer from the Kenyan Medical Research Institute on what we needed to do for approval. It shouldn't be too bad, but it does mean more days in front of the computer instead of more days spent helping at the clinic or in the schools - or my personal favorite, looking at poop. The Vanderbilt IRB is a whole other story... and let us just say, walalalalalalo (which means "we're in trouble"... the more "la"'s you insert, the more worry you have).
So. Basically, I don't have all that much new to report other than I'll be back in Kisumu tomorrow to hopefully look at some more stool samples (practice practice practice). I hope to get this project started ASAP.
On tuesday, I actually went to one of the schools to start measuring children for malnutrition proxies. The school, while very excited to see me, was also very upset that I had not started collecting stool as promissed. I had explained about the microscope, but i think they were so eager for us to do something for their children, that they had gotten a little impatient. Completely understandable. As such, they insisted I measure every single child in the school (i think they were maybe afraid that I wasn't going to come back). 100 kiddos. Height, weight, age, and arm width. Typical: i could not get an accurate birthday for any child. The headmaster simply insisted he knew everyone's age, but it was clear that he was guestimating as each child walked in. Also typical - scale is probably about 5-7 lbs off. Hopefully the consistency of it all will correct for itself in some way.
What else? We have 10 msungus on the Ochieng' homestead now. Yep, 5 kids from vandy undergrad, Dr. young and his daughter, my friend Andrea (Dr. Dre), katie, and myself. I am not so sure that people really thought about what it would be like to have all these american's running around such a small place, but lord knows, we'll make it work. It is very different dynamic now, however, as meals that used to be sort of intimate family time now consist of "food for the army" and a lot of "planning conversations" to keep everyone occupied. Also, Katie and I being referred to as "Resident Experts" in Lwala... now THAT is a hoot. I guess the fact that we carry buckets of water on our heads and know how to n'gweno our kuon maybe led a few people astray... but as a so-called "expert" i guess I'll tell you a little bit about what a regular day in Lwala is like, since I don't think i have done that yet.
1. If we are not traveling (to kisii, rongo, or kisumu - and therefore don't need to get up extra early to beat the sun on a 5 mile walk to the main road), we usually get up when we get up. There's a lot of noise from roosters, cows, goats, and early-morning risers (most children get up around 5:30 or 6 to cook, clean, and get to school on time. If they are late to school, they are caned by the professors). We get up, use the pit latrine etc... and head down to the main house where we try to help with the dishes from the night before.
2. we then have breakfast - usually either bread and jam/butter (we have made peanut butter a staple as well), or left overs from the previous day (rice and beans, ugali, eggs etc). Chai (tea - which is really hot water and milk with added leaves, coffee powder or milo mix) is also a mandatory part of breakfast.
3. Then it's dishes again... and maybe we'll head into town. Maybe we'll clean the house. Maybe we'll go to the clinic.
4. The clinic is always teeming with people - and is currently staffed by only one nurse (they used to have a clinical officer but he left for a government job and to be closer to his family - this is a big problem being so far away from large cities/towns - getting health workers who are committed to stay). As such, Rose, our nurse, is entirely overwhelmed. We try to give her a hand by taking temperatures and weighing people... but it's not easy... our language skills are not quite up to par to take a history, and if you think small children has Msungu fear to begin with, try coming at them with a sharp-looking instrument (aka thermometer). Still, rose seems to appreciate our help, so hopefully, we can continue with that.
5. Everyone always breaks for lunch. As grace once told me after a big breakfast followed by a very big lunch, "baby, this is Kenya - when there's food, you eat." And eat we do. No one eats between meals, so we have leaned to pack it in when we do chiemo (eat). I have now learned to say, "baby, don't cheat yourself" to anyone who is going easy on their food portions (bwana, kik iwondre) - it always gets a good laugh. Everyone in the family (including kids who come home from school) comes together at every meal - it's really nice. We usually eat ugali (maize derivative), sukuma wiki (kale), eggs, any left overs, beans, rice, lentils, etc. If we have gone to the market we might have some beef stew or goat. (Omundi loves his beef).
6. afternoons are similar to the mornings (although this week has been packed with trips to kisii and kisumu)... and usually around 5 or 6 we do some exercise - usually to the amusement of the kids passing home from school. Then, we go walk about 500-600 yards, and down a big hill into a big field to get our water from the pump that was dug for the clinic. Now that the rainy season is over, and the man-made well by our homstead is too low, we have to fetch our water from the pump. It's quite a trek - and heck yes, we carry it all the way back on our heads.
7. Then we take turns with the bucket - bath. It's a lot of splashing water all over yourself until you think the soap is gone. There's not much light at that point, so it's a bit of guess work.
8. by this point it's dark. We usually read, play chess, play cards, hang out, and/or help out with dinner.
9. We usually eat dinner between 9 and 10... and by 10:30, I am usually passed out, upright in one of the chairs... they don't call me geri for nothing. Dinner is similar to lunch - with lots of delicious warm foods, good family time, and a lot of laughter.
10. After some more cards and chess, fred, kate and I all head back to our house for group teeth brushing and bed-time nonsense.... and then we pass out under our wonderful mosquito nets. and that is prettty much our Day!
Other important notes to consider... we did indeed throw a surprise party for fred - and baked him a multi-colored multi-layered cake on the open fire... it was pretty impressive. The Ochieng' Cake recipe is not to be beat. I think we will head back to kisumu tomorrow (5 mile walk, 3 hour matatu, 10 minute bike taxi) to get some more help from the Walter Reed People. This has been the only facility where fred and i can find reliable teaching/training. The sad but very true reality is that the quality of medical instruction here is very poor. Most lab technicians are not well trained at all. As good intentioned as they may be, they really do not know what they are doing in many cases of microscopy - but are diagnosing infections at will. As a result, nurses or CO's who rely on the lab techs are doing the same. In the case of Lwala, we don't have a lab tech (because we have yet to find one with competant training), so Rose is forced to make a lot of blanket diagnosis. Anyone with fever and chills and joint ache : malaria. Anyone with intestinal cramping and diarrhea: worms. Bad LRI/URI : give antibiotics. It's very challenging to agree with, but at the same time, we all understand that at the moment, it is the best option. It would be worse to be stingy in the diagnoses and miss something life threatening. It is all very tricky.
And this blog is so very long. We have a pretty big trip back to Lwala, so i think we should head out. Hope you are all doing well - it's incredible to think that I will be home in one month. I look forward to catching up with you all.
Uchiop ma ber.
Jobaby
Thursday, June 28, 2007
Monday, June 25, 2007
Stick this up your IRB and approve it!
Oyawore Uru!
Greetings from Kisii, once again, where Fred and I have camped out in the efforts of finishing this IRB (institutional review board) approval process once and for all. The last thing we want to do is get in trouble with Vandy and/or the Kenyan government (goo!). So as they say in the South - gittteeerrrrduuuunnnn. Tomorrow we head out to Kisiien to try to plead/beg/seek approval from the Kenyan Medical Research Institute. Wish us luck!
As such, the poopology project has researched a bit of a stale mate. Since I last wrote, the following has happened.
1. returned to lwala, chock full of poop supplies, and sheepishly asked around to see if I could get some Ochieng' friends and relatives to give me some 'practice samples'. People seemed willing to participate, but i was concerned that they might be embarrassed or not "feel the urge". To my sheer delight, the next morning, I was awoken by Omundi, Fred's eldest brother (who is absolutely hilarious) at 6:30 am screaming, "Hey, jobaby! I have my sample! And I have packed the vile FULL! Hey! You People! Let me in!!" This was followed by 6 other eager vollunteers. It was great.
2. went to see my lab tech friend to help me analyze the samples... unfortunately... turns out, he doesn't know poop from petunias. I have to say, I was very pleased with my first year medical knowledge - which turned out to be good enough for me to call his bluff when he insisted thata neutrophil was a malaria parasite. no, no, my friend.
This was actually a really upsetting realization. Japollo, this lab tech is kind and helpful and very well intentioned. It is clear that his training is simply insufficient. As a result, he is prescribing medication to people who don't need it... or perhaps need something else. This is the frightening reality that we have been seeing over and over again here in Kenya. If you see a patient with fever, chills, aches, they are almost automatically treated for malaria... but the fact is, about 50% of the time, they have a simple virus. Think about all the costs involved in treating someone for the wrong ailment - only to have them return to the clinic a few days later because they still don't feel well. This is why fred's research will be so valuable to the clinic.
3. As a result, I dont yet feel comfortable with my worms-diagnosis skills - it's actually quite tricky (though I did correctly identify one case of round worm). So, on a whim, i went with fred to the Walter Reed Institute in Kisumu to see if they could help. They are an American institution doing some top of the line malaria research - and it was really nice to see such a well-run, well-organized, and well-trained facility. ps... they had toilets! with seats!
4. traveling to kisumu is quite an adventure... we walk 5.5 miles to the main road... ride a mutatu with about 15 people (and all their sacs of rice etc) for about 2-3 hours, and then either walk 20 minutes or take a bike taxi to Walter Reed. Yes, I rode a bike taxi - which can only be described in person, so as to recreate all my facial expressions... sorry.
5. We received some hope at Walter Reed - there is a doc comining this week who might be able to help me out - or even include Lwala is his big diarrheal study which would be great. If he can't help, some Peds. docs might be able to, so it looks like fred and i and maybe kate might go back to Kisumu on wed. Oy vey! But it's actually pretty fun - we spend a lotof time on our little hoemstead in lwala - so it's really nice to get out and see the rest of the country side.
6. we have to go backto kisumu anyway to fix the microscope... while it survived the trip toKenya a-ok, it blew a fuse recently. typical. But we're rolling with the punches as they say.
7. so then it was the weekend. Weekends are generally pretty quiet - not many people work, the clinic is closed, so usually, we just hang out around the house, do laundry, read, etc. But this weekend, kate and I were on a mission - a mission for soapstone. Allow me to sum up with this... 11.5 miles of walking... and NYC meets Kenya in bartering skills. Totally bad-a.
8. hung out with harrison our dholuo tutor who took us to a mountain that overlooked the village - made lots of friends - a few children who even insisted on holding our hands as we walked - and felt great seeing lwala from a whole new perspective. And now, I can count to 10 in dholuo.
ok - fred and I have much to do so I must run - but will report back as soon as I can...
tonight we hope to celebrate Fred's Birthday - and we have been tought how to Bake a cake the Ochieng' Brothers way - so it should be a hoot! can't wait
big smooches all around
Jobaby
Greetings from Kisii, once again, where Fred and I have camped out in the efforts of finishing this IRB (institutional review board) approval process once and for all. The last thing we want to do is get in trouble with Vandy and/or the Kenyan government (goo!). So as they say in the South - gittteeerrrrduuuunnnn. Tomorrow we head out to Kisiien to try to plead/beg/seek approval from the Kenyan Medical Research Institute. Wish us luck!
As such, the poopology project has researched a bit of a stale mate. Since I last wrote, the following has happened.
1. returned to lwala, chock full of poop supplies, and sheepishly asked around to see if I could get some Ochieng' friends and relatives to give me some 'practice samples'. People seemed willing to participate, but i was concerned that they might be embarrassed or not "feel the urge". To my sheer delight, the next morning, I was awoken by Omundi, Fred's eldest brother (who is absolutely hilarious) at 6:30 am screaming, "Hey, jobaby! I have my sample! And I have packed the vile FULL! Hey! You People! Let me in!!" This was followed by 6 other eager vollunteers. It was great.
2. went to see my lab tech friend to help me analyze the samples... unfortunately... turns out, he doesn't know poop from petunias. I have to say, I was very pleased with my first year medical knowledge - which turned out to be good enough for me to call his bluff when he insisted thata neutrophil was a malaria parasite. no, no, my friend.
This was actually a really upsetting realization. Japollo, this lab tech is kind and helpful and very well intentioned. It is clear that his training is simply insufficient. As a result, he is prescribing medication to people who don't need it... or perhaps need something else. This is the frightening reality that we have been seeing over and over again here in Kenya. If you see a patient with fever, chills, aches, they are almost automatically treated for malaria... but the fact is, about 50% of the time, they have a simple virus. Think about all the costs involved in treating someone for the wrong ailment - only to have them return to the clinic a few days later because they still don't feel well. This is why fred's research will be so valuable to the clinic.
3. As a result, I dont yet feel comfortable with my worms-diagnosis skills - it's actually quite tricky (though I did correctly identify one case of round worm). So, on a whim, i went with fred to the Walter Reed Institute in Kisumu to see if they could help. They are an American institution doing some top of the line malaria research - and it was really nice to see such a well-run, well-organized, and well-trained facility. ps... they had toilets! with seats!
4. traveling to kisumu is quite an adventure... we walk 5.5 miles to the main road... ride a mutatu with about 15 people (and all their sacs of rice etc) for about 2-3 hours, and then either walk 20 minutes or take a bike taxi to Walter Reed. Yes, I rode a bike taxi - which can only be described in person, so as to recreate all my facial expressions... sorry.
5. We received some hope at Walter Reed - there is a doc comining this week who might be able to help me out - or even include Lwala is his big diarrheal study which would be great. If he can't help, some Peds. docs might be able to, so it looks like fred and i and maybe kate might go back to Kisumu on wed. Oy vey! But it's actually pretty fun - we spend a lotof time on our little hoemstead in lwala - so it's really nice to get out and see the rest of the country side.
6. we have to go backto kisumu anyway to fix the microscope... while it survived the trip toKenya a-ok, it blew a fuse recently. typical. But we're rolling with the punches as they say.
7. so then it was the weekend. Weekends are generally pretty quiet - not many people work, the clinic is closed, so usually, we just hang out around the house, do laundry, read, etc. But this weekend, kate and I were on a mission - a mission for soapstone. Allow me to sum up with this... 11.5 miles of walking... and NYC meets Kenya in bartering skills. Totally bad-a.
8. hung out with harrison our dholuo tutor who took us to a mountain that overlooked the village - made lots of friends - a few children who even insisted on holding our hands as we walked - and felt great seeing lwala from a whole new perspective. And now, I can count to 10 in dholuo.
ok - fred and I have much to do so I must run - but will report back as soon as I can...
tonight we hope to celebrate Fred's Birthday - and we have been tought how to Bake a cake the Ochieng' Brothers way - so it should be a hoot! can't wait
big smooches all around
Jobaby
Tuesday, June 19, 2007
Don't Pack in the Poop!!
Misawa Uru!
Greeetings from the world's worst internet cafe! It has now been 2 weeks since we left from the states - and everything is going well.. a lot of big things have happened but I don't even know where to begin. How about a funny?
The other night for dinner we had a chicken. Katie, education committee extraordinair and dartmouth alum and (now former vegetarian), Was mustering the strength to have her first bites of meat in the past 4 years. We eat dinner mostly from the light of a single, dim, oil lamp, so it's not so easy to see what you are doing. Katie, however, very methodically selected her own piece of meat from the bowl... and set to work on her carniverous adventure. A few minutes later, Omundi looked over and innocently commented, "oh, so you like the head?" Katie looked down, caught a glimpse of beak and eyes, shreiked and nearly jumped into Omundi's lap in sheer fear. Bare in mind, katie grew up with chickens and is fluent in chicken calls. It has been a source of laughter ever since.
Ok, so since the last time I wrote, we have made some progress, but are still moving at the beloved African Time pace. The last two days have been pretty big for my project. I was originally going to test only the Lwala Primary school for worms - about 450 children. Just recently, however, a new school with about 100 pupils heard of our deworming program and has pleaded that we include them. So yesterday we set out to initiate communications with each school - and it looks like I'll be analysing about 600 samples. EVERYONE wants to be tested! Even the teachers. People are very concerned about their children's health - and especially with the idea of worm infections and getting rid of them - everyone is very excited about the idea of a regular deworming campaign - and actually seem almost relieved that we will be starting this up. In just a day here, you can see that children are so pricelessly important to this community. They all attend primary school all day, return home to cook lunch, and then later dinner, water the cows, work in the fields, and then study by candle light. They often seem like a backbone to the community. It's remarkable - we can get the medicine to deworm 1000 children for 300 kenyan shillings (about 50 us Dollars)... it's so simple and cheap - but unfortunately, intestinal worm infections will continue until we can improve water sources and sanitation. The regular dewormings (scheduled to take place at school - every three months) will help to keep the "worm burden" low, however, and that will serve to ameliorate the children's symptoms.
I have made friends with a near by pharmacist who has helped us get a discount on supplies and is going to help me practice my technique - when he heard about how excited everyone one was to be tested for worms, he said you must be careful! You will ask for a small - toothpick size sample and people will pack your entire vile full of poop! They will be so proud of the amount they give you! So, lesson of the day, folks, when giving your stool samples, don't pack in the poop!
There are a lot of other elements to consider. For example, we are pretty sure that one of our friend's baby has a round worm infection - but deworming children under 1 is not commonly done. Also, people hear of my study - and they want the Msungu (the white person) to treat them and their children for everything! It's tricky because the fact is, while we do have some cursory information under our belts - we are not doctors, and we cannot treat people. One man came to the clinic the other day and asked to be treated by the Msungus and the msungus only. We all wish we could do more. Thankfully Dr. Young will be here in a week - and he will undoubtedly be a a huge asset. Hopefully, we will also be able to make an impact with our worms and malaria research.
the clinic is doing incredibly well - just yesterday, they saw 80 patients. Word is spreading about the clinic and their kind nurse and responsible staff, and more and more people are seeking treatment which is wonderful. Everywhere we go, people are interested and impressed with the clinic's work and are trying to help. Just today, the supermarket we were shopping at gave us a juice donation and said they would like to help us more in the future. The ochieng's are doing a truly wonderful thing.
Other than that, our days have been filled with reading, studying, laughing, and exploring. We saw the boys play soccer. we have been reading college essays and helping other people in the village study for SAT's. A lot of people are interested in applying to colleges like middlebury, bates, and dartmouth, so we have been trying to help them with those applications as well. Our language skills are still coming along, slowly, but surely. As soon as we leave Lwala, however, we're lost - because Kenya has 44 different languages! Yawatho! but as they say in dholuo, onge wach (no worries).
Ok, i think that is all for now - hopefully i will have more clinical news to write next time. All i have for now is a fear of packed poop, an excitement about a project, and a sighting of some pretty severe elephantitis. In my future days at the clinic with poop project 07, i think i will be able to help out Rose, the nurse-wonder, and i will have more to share. I will keep you posted.
Love and miss you all so much...
sorry for the scattered entry...
Jobaby
Greeetings from the world's worst internet cafe! It has now been 2 weeks since we left from the states - and everything is going well.. a lot of big things have happened but I don't even know where to begin. How about a funny?
The other night for dinner we had a chicken. Katie, education committee extraordinair and dartmouth alum and (now former vegetarian), Was mustering the strength to have her first bites of meat in the past 4 years. We eat dinner mostly from the light of a single, dim, oil lamp, so it's not so easy to see what you are doing. Katie, however, very methodically selected her own piece of meat from the bowl... and set to work on her carniverous adventure. A few minutes later, Omundi looked over and innocently commented, "oh, so you like the head?" Katie looked down, caught a glimpse of beak and eyes, shreiked and nearly jumped into Omundi's lap in sheer fear. Bare in mind, katie grew up with chickens and is fluent in chicken calls. It has been a source of laughter ever since.
Ok, so since the last time I wrote, we have made some progress, but are still moving at the beloved African Time pace. The last two days have been pretty big for my project. I was originally going to test only the Lwala Primary school for worms - about 450 children. Just recently, however, a new school with about 100 pupils heard of our deworming program and has pleaded that we include them. So yesterday we set out to initiate communications with each school - and it looks like I'll be analysing about 600 samples. EVERYONE wants to be tested! Even the teachers. People are very concerned about their children's health - and especially with the idea of worm infections and getting rid of them - everyone is very excited about the idea of a regular deworming campaign - and actually seem almost relieved that we will be starting this up. In just a day here, you can see that children are so pricelessly important to this community. They all attend primary school all day, return home to cook lunch, and then later dinner, water the cows, work in the fields, and then study by candle light. They often seem like a backbone to the community. It's remarkable - we can get the medicine to deworm 1000 children for 300 kenyan shillings (about 50 us Dollars)... it's so simple and cheap - but unfortunately, intestinal worm infections will continue until we can improve water sources and sanitation. The regular dewormings (scheduled to take place at school - every three months) will help to keep the "worm burden" low, however, and that will serve to ameliorate the children's symptoms.
I have made friends with a near by pharmacist who has helped us get a discount on supplies and is going to help me practice my technique - when he heard about how excited everyone one was to be tested for worms, he said you must be careful! You will ask for a small - toothpick size sample and people will pack your entire vile full of poop! They will be so proud of the amount they give you! So, lesson of the day, folks, when giving your stool samples, don't pack in the poop!
There are a lot of other elements to consider. For example, we are pretty sure that one of our friend's baby has a round worm infection - but deworming children under 1 is not commonly done. Also, people hear of my study - and they want the Msungu (the white person) to treat them and their children for everything! It's tricky because the fact is, while we do have some cursory information under our belts - we are not doctors, and we cannot treat people. One man came to the clinic the other day and asked to be treated by the Msungus and the msungus only. We all wish we could do more. Thankfully Dr. Young will be here in a week - and he will undoubtedly be a a huge asset. Hopefully, we will also be able to make an impact with our worms and malaria research.
the clinic is doing incredibly well - just yesterday, they saw 80 patients. Word is spreading about the clinic and their kind nurse and responsible staff, and more and more people are seeking treatment which is wonderful. Everywhere we go, people are interested and impressed with the clinic's work and are trying to help. Just today, the supermarket we were shopping at gave us a juice donation and said they would like to help us more in the future. The ochieng's are doing a truly wonderful thing.
Other than that, our days have been filled with reading, studying, laughing, and exploring. We saw the boys play soccer. we have been reading college essays and helping other people in the village study for SAT's. A lot of people are interested in applying to colleges like middlebury, bates, and dartmouth, so we have been trying to help them with those applications as well. Our language skills are still coming along, slowly, but surely. As soon as we leave Lwala, however, we're lost - because Kenya has 44 different languages! Yawatho! but as they say in dholuo, onge wach (no worries).
Ok, i think that is all for now - hopefully i will have more clinical news to write next time. All i have for now is a fear of packed poop, an excitement about a project, and a sighting of some pretty severe elephantitis. In my future days at the clinic with poop project 07, i think i will be able to help out Rose, the nurse-wonder, and i will have more to share. I will keep you posted.
Love and miss you all so much...
sorry for the scattered entry...
Jobaby
Tuesday, June 12, 2007
Lwala day 5!
Misawa Uru!!
So, 8 hours later, we finally made it to Lwala... we picked up Grace, Fred's younger sister - who is fantastic! - and hit the road... it was great to drive to lwala as we got to see a bunch of different towns and groups of people... we saw/drove through the great rift valley - saw zebra, baboons, and antelope - and even some masai with their cattle and sheep.
The roads we're bumpier than i can ever put into words - mostly unpaved and riddled with ruts and mud - by the time we got to Lwala, i think we all felt like we'd been shaken like a polaroid picture and then some. The final road to lwala was quite tricky due to mud and I wasn't sure if the car would even make it... makes it easy to understand how an ambulence for the clinic -while very necessary - would be quite a challenge. When we arrived, we were greated with wonderful and sincere hugs from Sarah, Fred's grandmother, and a few of his other neighbors.
Since we arrived around the time of the weekend - we've been taking things pretty slow and getting ourselves oriented... katie, fred and I all sleep in fred's house which is great - and just a few yards, some cows, and a few goats away from the main house where we eat all of our meals together... the other night though, the rain was so strong that we ended up getting stuck in fred's house for about an hour and a half before we could actually leave and go to the main house for dinner... so - what else is there to do? we shut off our flashlights, closed our eyes, snuggled up on the couch and took a nap until the rain let up... the roofs are made of tin so the rain sounds wonderful when it falls - but can be quite deafening when it storms.
The food is wonderful - and I have become a big fan of chipatti - and even helped make some the other night... Grace and her cousins do most of the cooking so katie and i have been trying to help as much as possible - though I think they're on to us and relaize that we don't actually know what we are doing. we also eat a lot of kale (sukoma wiki) and had a chicken the other night for dinner that Dani (grandma) gave us for dinner... watching all the little kids catch this thing was a hoot and a half... then my little friend Apio, a 6 year old girl with possibly the world's best giggle, killed the chicken herself - and even let her 2 year old brother Rasto help out... unreal. ergo, my hero.
The ochieng's have a very close family - and they are absolutely wonderful - their cousins and neighbors are often at the house and are quite eager to play with us and help us learn Dholuo.. by day 2, we had hello and how are you down pat, and many people were convinced we could speak the mother tongue! Ha! We have picked up some key phrases though, and are on our way to making sentences which feels great! The kids are a ton of fun to hang out with as well, and one boy, Harison has agreed to be my Dholuo tutor. bring it on. Yesterday in the midst of an impromptu volley ball game, i got into a pretty intense tickle fight with a few of the kids (tobi, apio, onyanga, and rasto) who had a SERIOUS advantage over old gimp leg over here, as i had to peg leg around while they pinned me down to the ground - it was a hoot.
The old knee is holding up quite arlight (although the toilets with no seats are a bit tricky) - in fact just walked the 5 mile dirt road to the main road where we met Omundi (the eldest brotehr) met us for a ride into Kisii where we are now for internet, shopping etc. I think we might come in here about once a week or maybe a little less. Kisii is quite busy and hectic with people every where with wheelbarrows, shops, stands, taxis etc. We just walked through a maze of an open market to get to this internet cafe - in which they were selling fresh fruit and vegetables, goats, chickens (alive or slaughted - you're choice), and burning garbage... etc - it's a lot to take in at once.
Speaking of taking in a lot - we went up to the clinic yesterday to drop off our donated materials (pretty sure the microscope made it one piece).. it's about a five minute walk from fred's house - and we make lost of friends a long the way. At 9 am, the line for the clinic was already out the door. In one day, they saw 85 patients. Unbelievable... Omundi seems to think that once word spreads about our presence in the village even more people will seek treatment at the clinic - which is good and bad. Since we are white, most people assume we are doctors already... sadly, we are far from it. yesterday at the clinic, we saw a little girl with a very swollen face and we found ourselves so frustrated because we had no idea how to help her. Thankfully, the Clinic has a wonderful staff of some very dedicated and helpful people. Just yesterday, Rose, the nurse, was instituting a Vit. A and Albendazol (deworming) treatment day for all children under five... it seemed like they had a pretty good turn out... which is terrific since those supplements are crucial at that age. Fear not, my researching friends, I will still have plenty of children to deworm as I will be targeting school aged children. I made a very cute little friend who tooka liking to hugging my legs as he told me he was sad that there were no sweets - apparently, rose had told him that the Albendazol would taste just like candy, but mama dind't raise no fool - and that boy knew he'd been had. we hugged a lot. The rest of the clinic looks great - extremely organized and clean - and well stocked with good meds. We are working on patient records and establishing a laboratory and a maternity recovery room - all very exciting.
My project has yet to "take off" quite yet as there is a lot to figure out - how to acquire the poop, how to analyze the poop, how to get kids to poop on command etc. Little by little, step by step, I'll get me a translater and a bonefied research project... and i can't wait to get this all started and rolling. Like most good things, however, we must be patient.. and I know with a little more persistence etc this will all come together.
hhhmmm... I think that's about all for now - Ihope you all are doign well and I cannot wait to see you soon in just a few weeks... 7 to be exact... I am sorry if I don't repsond to emails much - but the internet is quite slow and a little finicky... know that I am thinking about everyone a ton and miss you all very much. Wish you could be here too...
And a special shout out to Daniel Riesel (the Father) for a very happy birthday! Sorry I couldn't call you last night - battery died - but will try again today!!! Love love love and many many more!
JOBaby (as the ochieng's have affectionately adopted).
So, 8 hours later, we finally made it to Lwala... we picked up Grace, Fred's younger sister - who is fantastic! - and hit the road... it was great to drive to lwala as we got to see a bunch of different towns and groups of people... we saw/drove through the great rift valley - saw zebra, baboons, and antelope - and even some masai with their cattle and sheep.
The roads we're bumpier than i can ever put into words - mostly unpaved and riddled with ruts and mud - by the time we got to Lwala, i think we all felt like we'd been shaken like a polaroid picture and then some. The final road to lwala was quite tricky due to mud and I wasn't sure if the car would even make it... makes it easy to understand how an ambulence for the clinic -while very necessary - would be quite a challenge. When we arrived, we were greated with wonderful and sincere hugs from Sarah, Fred's grandmother, and a few of his other neighbors.
Since we arrived around the time of the weekend - we've been taking things pretty slow and getting ourselves oriented... katie, fred and I all sleep in fred's house which is great - and just a few yards, some cows, and a few goats away from the main house where we eat all of our meals together... the other night though, the rain was so strong that we ended up getting stuck in fred's house for about an hour and a half before we could actually leave and go to the main house for dinner... so - what else is there to do? we shut off our flashlights, closed our eyes, snuggled up on the couch and took a nap until the rain let up... the roofs are made of tin so the rain sounds wonderful when it falls - but can be quite deafening when it storms.
The food is wonderful - and I have become a big fan of chipatti - and even helped make some the other night... Grace and her cousins do most of the cooking so katie and i have been trying to help as much as possible - though I think they're on to us and relaize that we don't actually know what we are doing. we also eat a lot of kale (sukoma wiki) and had a chicken the other night for dinner that Dani (grandma) gave us for dinner... watching all the little kids catch this thing was a hoot and a half... then my little friend Apio, a 6 year old girl with possibly the world's best giggle, killed the chicken herself - and even let her 2 year old brother Rasto help out... unreal. ergo, my hero.
The ochieng's have a very close family - and they are absolutely wonderful - their cousins and neighbors are often at the house and are quite eager to play with us and help us learn Dholuo.. by day 2, we had hello and how are you down pat, and many people were convinced we could speak the mother tongue! Ha! We have picked up some key phrases though, and are on our way to making sentences which feels great! The kids are a ton of fun to hang out with as well, and one boy, Harison has agreed to be my Dholuo tutor. bring it on. Yesterday in the midst of an impromptu volley ball game, i got into a pretty intense tickle fight with a few of the kids (tobi, apio, onyanga, and rasto) who had a SERIOUS advantage over old gimp leg over here, as i had to peg leg around while they pinned me down to the ground - it was a hoot.
The old knee is holding up quite arlight (although the toilets with no seats are a bit tricky) - in fact just walked the 5 mile dirt road to the main road where we met Omundi (the eldest brotehr) met us for a ride into Kisii where we are now for internet, shopping etc. I think we might come in here about once a week or maybe a little less. Kisii is quite busy and hectic with people every where with wheelbarrows, shops, stands, taxis etc. We just walked through a maze of an open market to get to this internet cafe - in which they were selling fresh fruit and vegetables, goats, chickens (alive or slaughted - you're choice), and burning garbage... etc - it's a lot to take in at once.
Speaking of taking in a lot - we went up to the clinic yesterday to drop off our donated materials (pretty sure the microscope made it one piece).. it's about a five minute walk from fred's house - and we make lost of friends a long the way. At 9 am, the line for the clinic was already out the door. In one day, they saw 85 patients. Unbelievable... Omundi seems to think that once word spreads about our presence in the village even more people will seek treatment at the clinic - which is good and bad. Since we are white, most people assume we are doctors already... sadly, we are far from it. yesterday at the clinic, we saw a little girl with a very swollen face and we found ourselves so frustrated because we had no idea how to help her. Thankfully, the Clinic has a wonderful staff of some very dedicated and helpful people. Just yesterday, Rose, the nurse, was instituting a Vit. A and Albendazol (deworming) treatment day for all children under five... it seemed like they had a pretty good turn out... which is terrific since those supplements are crucial at that age. Fear not, my researching friends, I will still have plenty of children to deworm as I will be targeting school aged children. I made a very cute little friend who tooka liking to hugging my legs as he told me he was sad that there were no sweets - apparently, rose had told him that the Albendazol would taste just like candy, but mama dind't raise no fool - and that boy knew he'd been had. we hugged a lot. The rest of the clinic looks great - extremely organized and clean - and well stocked with good meds. We are working on patient records and establishing a laboratory and a maternity recovery room - all very exciting.
My project has yet to "take off" quite yet as there is a lot to figure out - how to acquire the poop, how to analyze the poop, how to get kids to poop on command etc. Little by little, step by step, I'll get me a translater and a bonefied research project... and i can't wait to get this all started and rolling. Like most good things, however, we must be patient.. and I know with a little more persistence etc this will all come together.
hhhmmm... I think that's about all for now - Ihope you all are doign well and I cannot wait to see you soon in just a few weeks... 7 to be exact... I am sorry if I don't repsond to emails much - but the internet is quite slow and a little finicky... know that I am thinking about everyone a ton and miss you all very much. Wish you could be here too...
And a special shout out to Daniel Riesel (the Father) for a very happy birthday! Sorry I couldn't call you last night - battery died - but will try again today!!! Love love love and many many more!
JOBaby (as the ochieng's have affectionately adopted).
Thursday, June 7, 2007
In Kenya!
Amosi!
Just wanted you all to know that after a most haggard 30 hours of travel, we are here in Kenya! Upon arriving in the Nairobi airport, Fred and I met up with Katie, a dartmouth grad headed for UVM med this fall who seems great! She has 2 years worth of experience sifting through gorilla poop (seriously) - so I think not only will we get a long great, but also, she could be a big asset in Project Poop, Lwala 07. Also, to the "South Africans" - within 10 minutes at the Nairobi airport - what was blaring on the stereo, you might ask? None other than Luther Vandros's "Excuse Me Miss" I take that as an excellent sign. Fred and Katie took my dancing and singing all the words as a sign that I needed sleep - and needed it bad. We'll be headed to Lwala real soon, so I have to go, but I wanted to let you all know, so far so good!
Lek Lek mamit,
Jobaby
Just wanted you all to know that after a most haggard 30 hours of travel, we are here in Kenya! Upon arriving in the Nairobi airport, Fred and I met up with Katie, a dartmouth grad headed for UVM med this fall who seems great! She has 2 years worth of experience sifting through gorilla poop (seriously) - so I think not only will we get a long great, but also, she could be a big asset in Project Poop, Lwala 07. Also, to the "South Africans" - within 10 minutes at the Nairobi airport - what was blaring on the stereo, you might ask? None other than Luther Vandros's "Excuse Me Miss" I take that as an excellent sign. Fred and Katie took my dancing and singing all the words as a sign that I needed sleep - and needed it bad. We'll be headed to Lwala real soon, so I have to go, but I wanted to let you all know, so far so good!
Lek Lek mamit,
Jobaby
Saturday, June 2, 2007
Pre-Kenya, T-4!
Oyawore!
Welcome to the Lwala Summer Blog. I have no idea how often this will be used, but I will do my best to update it as often as possible. Please feel free to leave posts as often as you would like, and I hope that I will be able to check them all and respond! For those whom I haven't spoken to in a while, I will be spending 7 weeks of this summer in Lwala, Kenya at the Lwala Community Clinic. I will be studying intestinal parasite infections in children in conjunction with their quality of drinking water. As one of many goals, we hope to institute regular "de-worming" campaigns in Lwala so as to reduce the prevalence of intestinal parasite infections, thereby improving child nutrition, health, cognition, and academic productivity and performance. We also hope to improve the quality of drinking water and sanitation so as to prevent future helmintic infections. All and any help or advice is ALWAYS welcome!
For more information about the Lwala Community clinic, please refer to the following links:
http://www.mc.vanderbilt.edu/root/vumc.php?site=lwala
http://www.hopeforlwala.com/
I hope you all are enjoying your summers - and hopefully we will be in touch soon! Wishing you all the best...
Leklek mamit,
Johanna
Welcome to the Lwala Summer Blog. I have no idea how often this will be used, but I will do my best to update it as often as possible. Please feel free to leave posts as often as you would like, and I hope that I will be able to check them all and respond! For those whom I haven't spoken to in a while, I will be spending 7 weeks of this summer in Lwala, Kenya at the Lwala Community Clinic. I will be studying intestinal parasite infections in children in conjunction with their quality of drinking water. As one of many goals, we hope to institute regular "de-worming" campaigns in Lwala so as to reduce the prevalence of intestinal parasite infections, thereby improving child nutrition, health, cognition, and academic productivity and performance. We also hope to improve the quality of drinking water and sanitation so as to prevent future helmintic infections. All and any help or advice is ALWAYS welcome!
For more information about the Lwala Community clinic, please refer to the following links:
http://www.mc.vanderbilt.edu/root/vumc.php?site=lwala
http://www.hopeforlwala.com/
I hope you all are enjoying your summers - and hopefully we will be in touch soon! Wishing you all the best...
Leklek mamit,
Johanna
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