It’s 7 am and I am waking up. This whole week I have woken up at 7 am. Actually, I wake up at 630 then start to think about how I will be leaving soon…then my heart pounds faster and I can’t fall back asleep.
I hear the roosters in the distance, and the chickens. I hear music played at night that used to keep me awake, but not anymore.
At 7am the sun is up and I can see the light through a small window above my bed. The curtain is pink, so the light casts a pink glow on me through my mosquito net. I know I have to go to the latrine, and then brush my teeth, get dressed, and walk to another hut on the compound for breakfast.
For breakfast I have either white bread, pound cake, ndazi (fried dough), or chapatti. And sugar tea. So much sugar that I am afraid I have grown so used to it I will always have to have 8 teaspoons of sugar in my tea, and one day be diabetic.
The sun is hot already, and I know I will be sweating. I also know my feet will get really dirty from walking. These things used to bother me, but not anymore.
There is a magic here that I can’t explain. How can a place draw you in like it has to me?
The faces that I know, the fresh fruit from the market, the comfort of my hut.
Never in my life have I had such a hard time saying goodbye. At home it is different when I leave a place, say a job or a nursing placement, because I know I am still close. It is in the same town. And with nursing placements there have always been other students around, it’s not just me, so I haven’t felt as close with the nurses and other staff because I’m only there one day a week and we don’t get an opportunity to know each other well on a personal level.
But here it is different.
This is life how I have grown to know it and accept it. And while of course I miss so many things about home, I am perfectly content here where I am to live without them (except for my family who I couldn’t live without for much longer).
I haven’t cried in my time here about missing Canada, and that’s because I always knew I was going back. I could measure it in time and I could rely on my memories to bring me back there when I really missed it.
In the same respect I didn’t cry at my farewell party, because somehow I know I will be back here one day. I will see this place again and the people I have grown to be great friends with, and until then, I will keep it alive through memory and staying in touch with those who have made my life here such a joy.
So here I am, taking it all in, soaking it all up, and engraining each detail into my brain.
My blog is called An African Dream. When I created the title I thought it was a bit cheesy, but was very appropriate for what I was doing and why I was doing it. It was a dream of mine for 3 years, and my call to Africa only grew stronger in the three years. And now, upon leaving Africa in a short time, I know more of why I was meant to be here, at this time, in this place. It wasn’t just a coincidence. It wasn’t just self-directed determination and hard work. It is something more, something from God, which I can’t even explain, that brought me here and which will bring me back here one day.
There are places I'll remember
All my life though some have changed
All these places have their moments
In my life I've loved them all
Saturday, August 8, 2009
Under the sun
This international placement has changed my life in ways that go far beyond my nursing practice. I have learned and experienced things here in Kenya that I could never have understood from reading a book or listening to others talk. I have developed a firmer understanding of public health and community nursing, which is what I want to pursue in my career. I have a greater understanding of how the environment helps or hinders a person’s overall health and quality of life, and how determinants of health such as culture, gender, politics, and the physical environment are intermingled and must all be addressed in order to fully solve a particular health issue.
I use the word “understanding” intentionally, not to confuse with the gaining of knowledge. One of the most important lessons I have learned is the difference between knowledge and understanding. While in school I have learned a lot about HIV and AIDS. I have also learned quite a lot about the determinants of health and how they relate to poverty and illness. However, with all this knowledge I still did not fully understand these issues which I studied. Now, after spending three months in a rural community clinic, I can confidently say that I understand HIV and AIDS, the determinants of health related to poverty, and factors which lead to illness spreading through a community. I am positive that I could not have understood these things without being here. I would have continued to only have knowledge of those areas which I studied, but I wouldn’t have actually understood, and there is a big difference.
There have been a few common issues and themes that have arisen during my time here. One thing I have been thinking about and have had the opportunity to understand better is the importance of education and awareness. From my time working in the antennal clinic I have seen many teenage mothers come in who are married and have dropped out of school because they are pregnant. In turn, they don’t reach a high level of education and don’t have very good financial prospects. Also, being out of school, they miss out on essential education that can help them make healthy choices in life. This is a huge issue, and one that I contrast to my privileged life growing up with free education, and having no pressure to get married early, or be in situation where marriage and pregnancy seem like the only ways to stabilize one’s life in such an unpredictable environment. Education is perhaps the most important element to achieving one’s optimal quality of life, and that is a realization I have made based on what I have observed and experienced here. Obviously awareness is an important element as well, which kind of follows with education in the sense that the more educated a person is it is likely they are also more aware of services offered to them, and aware of how to take care of themselves mentally, physically and spiritually.
Another important theme I have picked out, which I became more aware of because of the critical component assignment, is the importance of prevention and interdisciplinary collaboration. I have been interested in working as a public health nurse since second year, and I have gone out of my way to learn more about primary prevention and how to become involved in this kind of nursing after graduation. So I would say before coming here I was fairly educated about the importance of prevention, as it has guided many of my decisions in nursing so far. However, throughout my time here I feel I have a more solid understanding of the importance of prevention. At the health centre I have seen so many people come in with diseases that are easily preventable such as malaria and the transmission of HIV. I have realized that these diseases are much more complex than a simple preventative fix – like nets or condoms. Their transmission stems much deeper to touch on culture, misconceptions, education, awareness and finances. Because these determinants are so linked, I feel as a nurse I must focus not only on providing the supplies for prevention, but also must tackle the big issues that undermine prevention efforts. Prevention is so much more than just giving health talks and handing out free condoms. It touches all aspects of a society or community, and therefore must involve everyone, not just nurses.
The final, and perhaps most important, theme I have identified is a person being confident in knowing what they know and knowing what they don’t know. I say person because this applies to all people in all professions, nursing included. It is so important to know what you know and be able to identify what you don’t know. Troubles and issues arise when you pretend to know something you don’t, or try to be confident in a skill or setting you aren’t fully comfortable in. it is essential to know enough about yourself to say, “yes, I am good at this, I know this, I can do this”, while also being able to say, “no, I don’t know this, I need help with this, I can’t do this safely by myself”. Principles of beneficence and malificence come into play in relation to this theme. You can really hurt someone, or hurt yourself if you aren’t confident in what you know and what you don’t know. This is something I encountered personally this term, and it really made me evaluate the importance of self-evaluation and reflection. You can’t know what you are good at and what you need improvement on without reflection and self-evaluation.
The experience of being most disconnected or disillusioned with my role as a nurse came in the first couple weeks here. I had not fully comprehended the language barrier, the difference in disease and illness, and the overall impact such a drastic change in lifestyle would have on me. In my years at McMaster I have always received the feedback that I am good at communicating. This is something I think is true, and I guess I have come to take it for granted. My first week at the health centre I realized I couldn’t talk to any of the patients without a translator. With communication being so important to me, I was stunned. This had never happened before. What is nursing without communication? I wasn’t a nurse at all, I was just a personal following around others blindly. It was such a strange feeling. I asked myself many times, “Why am I here? I can’t even talk to these people, how am I supposed to learn anything?” . Not only that but I didn’t understand the diseases and illness prevelant at the health centre. I didn’t recognize any of the drugs given out, I didn’t understand any of the treatments given by the doctor, I didn’t understand how people came to get the disease or illness that plagued them. Once I remember seeing a woman with the doctor who had hypertension and I thought ,” Finally, something I recognize!”. It was just so different and something I was so unprepared for. No matter how much you read about something, like malaria or HIV, you just can’t really get a handle on it or understand it without personally being around it and seeing it with your own eyes. I feel this is something I have been aware of before, but this placement made me more aware and more appreciative of this fact.
I have learned so much from my experiences that will help me in future clinical experiences. Many of the things I have learned relate to the career path I hope to pursue, which will be in public health hopefully in both a community and policy level. I know from first hand experience what community-led development looks like, and how it incorporates all aspects of health, not just the medical aspect which we deal with at the health centre. I can point out various determinants of health which influence a person’s health in a positive or negative way. I can identify vulnerable persons in the community, and can think of strategies in how to include them in health programs and initiatives. Overall, the experience has made me want to pursue a Masters degree in Public Health so I can have a more solid foundation of knowledge, so that I can help those who are disadvantaged in Canada and abroad.
One thing I feel proud of is when I helped to train some community health workers at St. Paul’s. These workers are being trained before they go out into the community and start doing healthcare in different households. They will be a great help to reach those who are in really rural areas, are undereducated, and who may have problems with mobility. One week I worked in the ANC and CWC alone because my preceptor was away at a training session. This week two community health workers came to observe and learn in the ANC. They were very curious about the documentation system, the immunizations I was giving, how to calculate gestation and the different medications we give out (malaria prophylaxis, ferrous sulphate, and folic acid). I was able to confidently teach them and answer their questions in all the above mentioned areas. Furthermore, I was aware of my teaching style as I went along, and made a point to make sure they gained practical experience there instead of just watching me. I thought of the way that I had been taught my various nurses in school, and reflected on what made a nurse a good teacher and what made them a not so good teacher. I tried my best to adopt strategies of a good teacher; such as patience, enthusiasm in role, and confidence, and in the end I received very positive feedback from them. So this is something I was very proud of. It really made me feel like I was competent and knowledgeable.
In summary, though I have tried my best to explain my experiences and feelings throughout the past three months, I still feel as if I haven’t even scratched the surface of all the things that I have experienced. Looking back, my nursing knowledge and understanding would have been so limited without this experience. It is my sincere hope that I will return to Ugunja one day to continue learning about public health, and that I can apply this knowledge to my practice in Canada and elsewhere.
I use the word “understanding” intentionally, not to confuse with the gaining of knowledge. One of the most important lessons I have learned is the difference between knowledge and understanding. While in school I have learned a lot about HIV and AIDS. I have also learned quite a lot about the determinants of health and how they relate to poverty and illness. However, with all this knowledge I still did not fully understand these issues which I studied. Now, after spending three months in a rural community clinic, I can confidently say that I understand HIV and AIDS, the determinants of health related to poverty, and factors which lead to illness spreading through a community. I am positive that I could not have understood these things without being here. I would have continued to only have knowledge of those areas which I studied, but I wouldn’t have actually understood, and there is a big difference.
There have been a few common issues and themes that have arisen during my time here. One thing I have been thinking about and have had the opportunity to understand better is the importance of education and awareness. From my time working in the antennal clinic I have seen many teenage mothers come in who are married and have dropped out of school because they are pregnant. In turn, they don’t reach a high level of education and don’t have very good financial prospects. Also, being out of school, they miss out on essential education that can help them make healthy choices in life. This is a huge issue, and one that I contrast to my privileged life growing up with free education, and having no pressure to get married early, or be in situation where marriage and pregnancy seem like the only ways to stabilize one’s life in such an unpredictable environment. Education is perhaps the most important element to achieving one’s optimal quality of life, and that is a realization I have made based on what I have observed and experienced here. Obviously awareness is an important element as well, which kind of follows with education in the sense that the more educated a person is it is likely they are also more aware of services offered to them, and aware of how to take care of themselves mentally, physically and spiritually.
Another important theme I have picked out, which I became more aware of because of the critical component assignment, is the importance of prevention and interdisciplinary collaboration. I have been interested in working as a public health nurse since second year, and I have gone out of my way to learn more about primary prevention and how to become involved in this kind of nursing after graduation. So I would say before coming here I was fairly educated about the importance of prevention, as it has guided many of my decisions in nursing so far. However, throughout my time here I feel I have a more solid understanding of the importance of prevention. At the health centre I have seen so many people come in with diseases that are easily preventable such as malaria and the transmission of HIV. I have realized that these diseases are much more complex than a simple preventative fix – like nets or condoms. Their transmission stems much deeper to touch on culture, misconceptions, education, awareness and finances. Because these determinants are so linked, I feel as a nurse I must focus not only on providing the supplies for prevention, but also must tackle the big issues that undermine prevention efforts. Prevention is so much more than just giving health talks and handing out free condoms. It touches all aspects of a society or community, and therefore must involve everyone, not just nurses.
The final, and perhaps most important, theme I have identified is a person being confident in knowing what they know and knowing what they don’t know. I say person because this applies to all people in all professions, nursing included. It is so important to know what you know and be able to identify what you don’t know. Troubles and issues arise when you pretend to know something you don’t, or try to be confident in a skill or setting you aren’t fully comfortable in. it is essential to know enough about yourself to say, “yes, I am good at this, I know this, I can do this”, while also being able to say, “no, I don’t know this, I need help with this, I can’t do this safely by myself”. Principles of beneficence and malificence come into play in relation to this theme. You can really hurt someone, or hurt yourself if you aren’t confident in what you know and what you don’t know. This is something I encountered personally this term, and it really made me evaluate the importance of self-evaluation and reflection. You can’t know what you are good at and what you need improvement on without reflection and self-evaluation.
The experience of being most disconnected or disillusioned with my role as a nurse came in the first couple weeks here. I had not fully comprehended the language barrier, the difference in disease and illness, and the overall impact such a drastic change in lifestyle would have on me. In my years at McMaster I have always received the feedback that I am good at communicating. This is something I think is true, and I guess I have come to take it for granted. My first week at the health centre I realized I couldn’t talk to any of the patients without a translator. With communication being so important to me, I was stunned. This had never happened before. What is nursing without communication? I wasn’t a nurse at all, I was just a personal following around others blindly. It was such a strange feeling. I asked myself many times, “Why am I here? I can’t even talk to these people, how am I supposed to learn anything?” . Not only that but I didn’t understand the diseases and illness prevelant at the health centre. I didn’t recognize any of the drugs given out, I didn’t understand any of the treatments given by the doctor, I didn’t understand how people came to get the disease or illness that plagued them. Once I remember seeing a woman with the doctor who had hypertension and I thought ,” Finally, something I recognize!”. It was just so different and something I was so unprepared for. No matter how much you read about something, like malaria or HIV, you just can’t really get a handle on it or understand it without personally being around it and seeing it with your own eyes. I feel this is something I have been aware of before, but this placement made me more aware and more appreciative of this fact.
I have learned so much from my experiences that will help me in future clinical experiences. Many of the things I have learned relate to the career path I hope to pursue, which will be in public health hopefully in both a community and policy level. I know from first hand experience what community-led development looks like, and how it incorporates all aspects of health, not just the medical aspect which we deal with at the health centre. I can point out various determinants of health which influence a person’s health in a positive or negative way. I can identify vulnerable persons in the community, and can think of strategies in how to include them in health programs and initiatives. Overall, the experience has made me want to pursue a Masters degree in Public Health so I can have a more solid foundation of knowledge, so that I can help those who are disadvantaged in Canada and abroad.
One thing I feel proud of is when I helped to train some community health workers at St. Paul’s. These workers are being trained before they go out into the community and start doing healthcare in different households. They will be a great help to reach those who are in really rural areas, are undereducated, and who may have problems with mobility. One week I worked in the ANC and CWC alone because my preceptor was away at a training session. This week two community health workers came to observe and learn in the ANC. They were very curious about the documentation system, the immunizations I was giving, how to calculate gestation and the different medications we give out (malaria prophylaxis, ferrous sulphate, and folic acid). I was able to confidently teach them and answer their questions in all the above mentioned areas. Furthermore, I was aware of my teaching style as I went along, and made a point to make sure they gained practical experience there instead of just watching me. I thought of the way that I had been taught my various nurses in school, and reflected on what made a nurse a good teacher and what made them a not so good teacher. I tried my best to adopt strategies of a good teacher; such as patience, enthusiasm in role, and confidence, and in the end I received very positive feedback from them. So this is something I was very proud of. It really made me feel like I was competent and knowledgeable.
In summary, though I have tried my best to explain my experiences and feelings throughout the past three months, I still feel as if I haven’t even scratched the surface of all the things that I have experienced. Looking back, my nursing knowledge and understanding would have been so limited without this experience. It is my sincere hope that I will return to Ugunja one day to continue learning about public health, and that I can apply this knowledge to my practice in Canada and elsewhere.
Sunday, August 2, 2009
I was busy, and can't think of a creative title
The last couple weeks…
Wedding – it was interesting. In a small tin-roofed and tin-bodied church in a small slummy part of Kisumu. Lots of dancing and praising God – the ceremony is also like a sermon. The bride Esther was so beautiful and her husband George seems to be a really great guy, even though I don’t know him at all. Fun, sweaty, tiring, eye-opening…all the usual feelings of new Kenyan experiences. I didn’t find a Luo fiancée unfortunately – maybe next wedding. I was the only mzungu as to be expected, so I had a lot of children who were hanging around the church rush up to me and ask for pictures. I took quite a few.
New friends – Two volunteers from Britain came, Peter and Lucy, who have great accents, and are really friendly in general. We are getting along really well, and they make fun of me for saying pants and pop – which to them is trousers and soda. Also, they make fun of my accent (though obviously I don’t have one, it’s all them) and how they think I’m American (which cuts deep). Last week I met Steven from Australia, who is gone now because he was only here for a week. But he was really interested in water and sanitation, which I think is great considering health is so related to water, especially here in Kenya. And then this week I met Oscar from Sweden, who was here for a week already, we just never met. He works with Peter trying to get this biogas digestor to work (something to do with cow dung, water and gas), and then he is off to another park of Kenya to work with forestry and agriculture. So, overall, really cool people and I have loved meeting and getting to know all of them.
The President – Last weekend the President and Vice President were launching some kind of district in a nearby area called Ambira (about 15 minutes from Ugunja). So the whole of last week people were cleaning and preparing and worrying. On Saturday a huge banner was erected on the road he was supposed to pass on. Most people I talked to said they didn’t like the President at all, even though there are pictures of him everywhere. Maureen the librarian said she was annoyed that people went to such great efforts to clean the town – the President should see the way the town really is and how desperate people really are. It was a big deal, and then it passed. I would be interested to see the President at the Hague. That would be great.
Love for Ugunja – my love and appreciation for Ugunja and Kenya in general has increased largely the last week and extending into this week. I am trying my best to soak in every minute and make every day packed with great friends and great experiences. I will genuinely be really sad to leave. I will probably be talking about it non stop for a few months, and people will start to get sick of my stories, and I will only start to miss it more.
The most useless to the most useful – looking back on my time here, which I’m trying to do so much because it makes me sad, I have realized I have made some amazing strides. When I first arrived and started at the health centre, I felt the most useless I had ever felt in my life. I didn’t know the language, didn’t know the people, didn’t know the issues, didn’t know the land. I questioned myself why I thought it would be a good idea to even come – what could I possibly do? This week I proved to myself what I could possibly do. I ran the antenatal and child welfare clinic by myself while the nurse was off at a conference. I did the documentation, antenatal assessment, handed out medications, gave immunizations to the children and the mothers, trained some community health workers, and most importantly was confident in knowing what I knew, and confident in knowing what I didn’t know. It was the smartest and most useful I have ever felt in my life, so I feel pretty darn good.
It’s hot. I’m sitting in the library sweating up a storm and eating peanuts and this corn-bread type thing for lunch. Tonight we are making fruit salad for the family – I am really excited! Tomorrow I’m going to Kisumu with Peter, Lucy and Oscar to explore and have some fun. This weekend I will probably be reading (White Fang by Jack London), doing laundry, and overall just chilling on the compound. I look forward to it greatly – this week has been tiring.
And that’s really all I have to say. I will be writing a lot next week as I go into reflection mode. For now I’m just trying to focus 100% on the present. Every minute, every hour, just taking it in.
Wedding – it was interesting. In a small tin-roofed and tin-bodied church in a small slummy part of Kisumu. Lots of dancing and praising God – the ceremony is also like a sermon. The bride Esther was so beautiful and her husband George seems to be a really great guy, even though I don’t know him at all. Fun, sweaty, tiring, eye-opening…all the usual feelings of new Kenyan experiences. I didn’t find a Luo fiancée unfortunately – maybe next wedding. I was the only mzungu as to be expected, so I had a lot of children who were hanging around the church rush up to me and ask for pictures. I took quite a few.
New friends – Two volunteers from Britain came, Peter and Lucy, who have great accents, and are really friendly in general. We are getting along really well, and they make fun of me for saying pants and pop – which to them is trousers and soda. Also, they make fun of my accent (though obviously I don’t have one, it’s all them) and how they think I’m American (which cuts deep). Last week I met Steven from Australia, who is gone now because he was only here for a week. But he was really interested in water and sanitation, which I think is great considering health is so related to water, especially here in Kenya. And then this week I met Oscar from Sweden, who was here for a week already, we just never met. He works with Peter trying to get this biogas digestor to work (something to do with cow dung, water and gas), and then he is off to another park of Kenya to work with forestry and agriculture. So, overall, really cool people and I have loved meeting and getting to know all of them.
The President – Last weekend the President and Vice President were launching some kind of district in a nearby area called Ambira (about 15 minutes from Ugunja). So the whole of last week people were cleaning and preparing and worrying. On Saturday a huge banner was erected on the road he was supposed to pass on. Most people I talked to said they didn’t like the President at all, even though there are pictures of him everywhere. Maureen the librarian said she was annoyed that people went to such great efforts to clean the town – the President should see the way the town really is and how desperate people really are. It was a big deal, and then it passed. I would be interested to see the President at the Hague. That would be great.
Love for Ugunja – my love and appreciation for Ugunja and Kenya in general has increased largely the last week and extending into this week. I am trying my best to soak in every minute and make every day packed with great friends and great experiences. I will genuinely be really sad to leave. I will probably be talking about it non stop for a few months, and people will start to get sick of my stories, and I will only start to miss it more.
The most useless to the most useful – looking back on my time here, which I’m trying to do so much because it makes me sad, I have realized I have made some amazing strides. When I first arrived and started at the health centre, I felt the most useless I had ever felt in my life. I didn’t know the language, didn’t know the people, didn’t know the issues, didn’t know the land. I questioned myself why I thought it would be a good idea to even come – what could I possibly do? This week I proved to myself what I could possibly do. I ran the antenatal and child welfare clinic by myself while the nurse was off at a conference. I did the documentation, antenatal assessment, handed out medications, gave immunizations to the children and the mothers, trained some community health workers, and most importantly was confident in knowing what I knew, and confident in knowing what I didn’t know. It was the smartest and most useful I have ever felt in my life, so I feel pretty darn good.
It’s hot. I’m sitting in the library sweating up a storm and eating peanuts and this corn-bread type thing for lunch. Tonight we are making fruit salad for the family – I am really excited! Tomorrow I’m going to Kisumu with Peter, Lucy and Oscar to explore and have some fun. This weekend I will probably be reading (White Fang by Jack London), doing laundry, and overall just chilling on the compound. I look forward to it greatly – this week has been tiring.
And that’s really all I have to say. I will be writing a lot next week as I go into reflection mode. For now I’m just trying to focus 100% on the present. Every minute, every hour, just taking it in.
Tuesday, July 14, 2009
Turning Silent
I have already mentioned a few stories about HIV and AIDS, but I feel I had to add this one too. It was just too powerful.
I was working in the antenatal clinic (for women who are pregnant) clinic on Thursday and it is routine to give an HIV test to all new mothers who come in. The point of the testing is to establish their results, and then from there do different types of counseling. If positive, the prevention of mother to child transmission (PMTCT) is essential.
One woman came in around 11. We write down her name, age, last known period, estimated day of delivery, gestational age, and record what medications we give out (folic acid, ferrous sulphate, tetanus toxoid injections, malaria prophylaxis), etc.
The nurse then does a pre-counseling for the HIV test. Explaining what it is, why it is necessary, the different outcomes. Then the client gives consent for you to perform the test (a drop of blood on a test strip).
There is a black hardcover book where the first names of all women getting tested is recorded, along with their age, gestation, and the results. This is to be filled out for every woman, regardless of the result. So usually while the nurse is doing the test, I am filling out the book. Every time I open it, I say a little pray that the client is negative.
The 10 minutes it takes for the results to show are very hard. I can’t help but stare at the patient’s test, and stare at the book I am recording in, ready to write a “NR” for non-reactive, or an “R” for reactive.
After 10 minutes the nurse acts the woman to read her own results, so they can decipher it for themselves. The woman we saw, 20 years old, tested positive. I have somewhat learnt how to deal with this, since I have seen it fairly often in the past two months, but this time was so different. Usually the women are shocked yes, and then they ask a lot of questions and the nurse does further counseling for at least 20 minutes.
However, the woman, my age, just sat there in silence for a really long time. I was looking at her, and she was completely still, except for her eyes, which kept darting around the room, and looked like they were trying so hard to hold back tears.
I wanted to know what she was thinking.
The nurse kept asking questions, over and over, and getting no response. The woman was silent. It was so hard to deal with emotionally, because I thought of myself in that position, how I would feel, and what I would think.
Would she see her child through primary school? Would she see the child get married? Would the kids make fun of her child for having an HIV positive mother? Who would support the child when she passed? How long did she have? Maybe the child was now seen as a burden instead of a blessing. Maybe the child would be resentful and angry.
So sad and shocking. I would have been silent too. I wouldn’t have said anything.
Eventually, the nurse managed to get some whispered responses from her, and gave her a return date for 2 weeks. Usually the return date is for a month, however the nurse wanted to check up on her before that, which I definitely agreed with.
HIV is so scary. I am so afraid of it. I know that everyone who lives will someday die – but not like that, not knowing you could have lived longer without the virus. I guess it is like anything though – war, other diseases, circumstances that provoke suicide – that cuts life short. But who is to say a life is cut short? Who is to know how long their life is supposed to last?
Questions with no answers – only God can know.
But that doesn’t make it easier to deal with. I know there are stories like this around the world, with people asking the same questions, having the same feelings, having the same frustrations, wanting to know why – why, why, why – but not having any good answer to make themselves feel better. The best I can do is hope I can reach out to these people in some way in my lifetime, if not now, then when I gain more knowledge and experience.
I was working in the antenatal clinic (for women who are pregnant) clinic on Thursday and it is routine to give an HIV test to all new mothers who come in. The point of the testing is to establish their results, and then from there do different types of counseling. If positive, the prevention of mother to child transmission (PMTCT) is essential.
One woman came in around 11. We write down her name, age, last known period, estimated day of delivery, gestational age, and record what medications we give out (folic acid, ferrous sulphate, tetanus toxoid injections, malaria prophylaxis), etc.
The nurse then does a pre-counseling for the HIV test. Explaining what it is, why it is necessary, the different outcomes. Then the client gives consent for you to perform the test (a drop of blood on a test strip).
There is a black hardcover book where the first names of all women getting tested is recorded, along with their age, gestation, and the results. This is to be filled out for every woman, regardless of the result. So usually while the nurse is doing the test, I am filling out the book. Every time I open it, I say a little pray that the client is negative.
The 10 minutes it takes for the results to show are very hard. I can’t help but stare at the patient’s test, and stare at the book I am recording in, ready to write a “NR” for non-reactive, or an “R” for reactive.
After 10 minutes the nurse acts the woman to read her own results, so they can decipher it for themselves. The woman we saw, 20 years old, tested positive. I have somewhat learnt how to deal with this, since I have seen it fairly often in the past two months, but this time was so different. Usually the women are shocked yes, and then they ask a lot of questions and the nurse does further counseling for at least 20 minutes.
However, the woman, my age, just sat there in silence for a really long time. I was looking at her, and she was completely still, except for her eyes, which kept darting around the room, and looked like they were trying so hard to hold back tears.
I wanted to know what she was thinking.
The nurse kept asking questions, over and over, and getting no response. The woman was silent. It was so hard to deal with emotionally, because I thought of myself in that position, how I would feel, and what I would think.
Would she see her child through primary school? Would she see the child get married? Would the kids make fun of her child for having an HIV positive mother? Who would support the child when she passed? How long did she have? Maybe the child was now seen as a burden instead of a blessing. Maybe the child would be resentful and angry.
So sad and shocking. I would have been silent too. I wouldn’t have said anything.
Eventually, the nurse managed to get some whispered responses from her, and gave her a return date for 2 weeks. Usually the return date is for a month, however the nurse wanted to check up on her before that, which I definitely agreed with.
HIV is so scary. I am so afraid of it. I know that everyone who lives will someday die – but not like that, not knowing you could have lived longer without the virus. I guess it is like anything though – war, other diseases, circumstances that provoke suicide – that cuts life short. But who is to say a life is cut short? Who is to know how long their life is supposed to last?
Questions with no answers – only God can know.
But that doesn’t make it easier to deal with. I know there are stories like this around the world, with people asking the same questions, having the same feelings, having the same frustrations, wanting to know why – why, why, why – but not having any good answer to make themselves feel better. The best I can do is hope I can reach out to these people in some way in my lifetime, if not now, then when I gain more knowledge and experience.
Saturday, July 11, 2009
I don't know why you say goodbye I say hello
I have seen many people come and go here in Ugunja. The two Global Youth Network teams in both May and June, Ryan from Cali, I have seen Wren leave, and now recently there are two Canadians who arrived Thursday and will be leaving Tuesday. In July, I hear that even more volunteers will be coming and staying a short period of time. So I will get to say hello and goodbye many times, all the while staying stationary.
It brings different feelings. In one respect, I am jealous of those who come and go, because they make this place a part of their life for a short period of time, and then move on with their life, perhaps traveling back to their homes in Canada or the US, where I miss so many things and dream of often. Or maybe some of them, like the Canadians, will be traveling down Africa to Cape Town. All of these adventures, so many interesting things to see – and here I am, in rural Kenya, living a simple and mainly quiet life. Not that I feel sorry for myself, but part of me just yearns to lead the kind of life of these people I see come and go – staying for a bit and then going on to something different.
However, I have realized that my position is one that is very unique and one that makes me very privileged. First of all, because I have been here for 2 months, I am very accustomed to the area. I know where everything is, I know where to find things, I know people, I know how to make my way around, and most important I am comfortable in this environment now. And comfort is something that takes time – it doesn’t come in a week, it doesn’t come in two weeks – it takes a good amount of time.
Another plus about staying a long time is that you can really connect with the people, you can really begin to uncover the culture and learn how it influences and is influenced by different people, places and environmental factors. I understand why a woman has to carry water down a long dirt road, I understand why the children have to work so hard, I understand why there is so little variety in food, I understand why HIV continues to dominate, I understand why little kids call out “how are you” constantly, I understand why everyone treats me like I am famous, etc, etc.
There is a difference between knowing and understanding. You can know something without understanding it. The people who come and go can know a lot of things about a place, but may only understand a few of them. I know and understand many things here in Ugunja, and that is a blessing. After all, that’s what I came to do. And although it is hard to see people come and go, travel onward to places I wish I could go, I understand that the experience I am getting could only have happened with my staying as long as I have.
I am very lucky.
In other news, these past few days have been really great. The two Canadians are awesome women who are traveling down to Cape Town, SA, throughout the next month. They are both from Waterloo, and we have much in common, so it has been great to talk with them and share Ugunja with them. Yesterday we had a little hut party and made guacamole with Chili Lemon flavoured chips (so good!), soft buns and some chocolate. It was very fun indeed. Tomorrow I am showing them around Kisumu, which I am excited about because it feels like I haven’t been there in awhile and there are some things I need to pick up (more Quaker oats, peanut butter, and perhaps some candy!) which I can’t get here in Ugunja.
Also, I am going to a wedding next Saturday! An AFRICAN WEDDING! It’s my own! Sorry to break the news to you mom and dad – I’m coming back a married woman! Haha. Kidding! I know the woman, Esther, from the health centre, and I think it will probably be the highlight of this Kenyan adventure (well, the most fun I will have I think). So next week I am getting a skirt made for me in town, which costs about $3, and then I will wear a nice shawl I bought, do my hair all nice, get one of the girls to do my makeup, and maybe even buy some nail polish! I haven’t really dressed up my whole time here, and I love dressing up, so I am really looking forward to it.
Lastly, my brother called me today. The boy hasn’t contacted me yet, although he claims he called me when my mom visited him a month ago, but I know that it was my mom who initiated the phone call. Anyways, the last few weeks I have been fostering a brutal hatred towards him for being so emotionally incompetent – I am in a place that Google Maps doesn’t recognize and he can’t find the time to give me a little phone call? CMON!- but now I am happy. So, it has been a great day.
Off to lunch now. Oriti.
It brings different feelings. In one respect, I am jealous of those who come and go, because they make this place a part of their life for a short period of time, and then move on with their life, perhaps traveling back to their homes in Canada or the US, where I miss so many things and dream of often. Or maybe some of them, like the Canadians, will be traveling down Africa to Cape Town. All of these adventures, so many interesting things to see – and here I am, in rural Kenya, living a simple and mainly quiet life. Not that I feel sorry for myself, but part of me just yearns to lead the kind of life of these people I see come and go – staying for a bit and then going on to something different.
However, I have realized that my position is one that is very unique and one that makes me very privileged. First of all, because I have been here for 2 months, I am very accustomed to the area. I know where everything is, I know where to find things, I know people, I know how to make my way around, and most important I am comfortable in this environment now. And comfort is something that takes time – it doesn’t come in a week, it doesn’t come in two weeks – it takes a good amount of time.
Another plus about staying a long time is that you can really connect with the people, you can really begin to uncover the culture and learn how it influences and is influenced by different people, places and environmental factors. I understand why a woman has to carry water down a long dirt road, I understand why the children have to work so hard, I understand why there is so little variety in food, I understand why HIV continues to dominate, I understand why little kids call out “how are you” constantly, I understand why everyone treats me like I am famous, etc, etc.
There is a difference between knowing and understanding. You can know something without understanding it. The people who come and go can know a lot of things about a place, but may only understand a few of them. I know and understand many things here in Ugunja, and that is a blessing. After all, that’s what I came to do. And although it is hard to see people come and go, travel onward to places I wish I could go, I understand that the experience I am getting could only have happened with my staying as long as I have.
I am very lucky.
In other news, these past few days have been really great. The two Canadians are awesome women who are traveling down to Cape Town, SA, throughout the next month. They are both from Waterloo, and we have much in common, so it has been great to talk with them and share Ugunja with them. Yesterday we had a little hut party and made guacamole with Chili Lemon flavoured chips (so good!), soft buns and some chocolate. It was very fun indeed. Tomorrow I am showing them around Kisumu, which I am excited about because it feels like I haven’t been there in awhile and there are some things I need to pick up (more Quaker oats, peanut butter, and perhaps some candy!) which I can’t get here in Ugunja.
Also, I am going to a wedding next Saturday! An AFRICAN WEDDING! It’s my own! Sorry to break the news to you mom and dad – I’m coming back a married woman! Haha. Kidding! I know the woman, Esther, from the health centre, and I think it will probably be the highlight of this Kenyan adventure (well, the most fun I will have I think). So next week I am getting a skirt made for me in town, which costs about $3, and then I will wear a nice shawl I bought, do my hair all nice, get one of the girls to do my makeup, and maybe even buy some nail polish! I haven’t really dressed up my whole time here, and I love dressing up, so I am really looking forward to it.
Lastly, my brother called me today. The boy hasn’t contacted me yet, although he claims he called me when my mom visited him a month ago, but I know that it was my mom who initiated the phone call. Anyways, the last few weeks I have been fostering a brutal hatred towards him for being so emotionally incompetent – I am in a place that Google Maps doesn’t recognize and he can’t find the time to give me a little phone call? CMON!- but now I am happy. So, it has been a great day.
Off to lunch now. Oriti.
Tuesday, July 7, 2009
Highschool musical 800,000 times better
Hello again. I would like to share some more stories.
So as I have mentioned the compound that I live on houses many children and teenagers. About 15 of them. Of the teenagers, there is one girl I feel especially close to and her name is Beryl (Bur-ill). She is really funny, and really fiesty. She doesn;t take crap from anyone and beats up all the boys. She is really happy too, and always singing. Usually after dinner she dominates the singing, along with another teen, Steven. Steven is always dancing, and when dear MJ passed, he had a really rough time because he didn't know who his idol was going to be anymore in terms of dancing.
Anyways both Steven and Beryl are in their highschool choir, consisting of about 40 kids. Last month they went to a district competition and won, so they were off to the provincial finals being held in Kisii (about 4 hours from Ugunja).The provincial finals were held this weekend, and I expressed my desire to go to both Beryl and Steven, and asked them to ask their choir director if I could come. But like most African things, nothing ever runs on time, and they ended up not asking.
So on Saturday I walked to the highschool (a good half hour) to talk to the choir director. The highschool by the way is so beautiful, it looks like a resort. Palm trees and exotic flowers and thatched gazebos everywhere. So nice!
Anyways I talked with the director and he said I could come, we just had to sort out how I was getting there. The students were sleeping over at the highschool that night because they had to leave at 4am. So...I was thinking "ok, sleep on the floor of the highschool and wake up at 3am"....SOUNDS GREAT!
So, I pack some things, and walk to the highschool with Beryl and Steven. Beryl tells me the other students are so excited a white person is travelling with them. I was pretty excited myself! So we get there, and I am introduced to a bunch of students. When the sun went down the kids were busy making dinner, while others set up their sleeping stuff on the floor. Then some speakers were brought out along with a small television, and music started. And let me tell you, when music starts around 40 highschool students who love singing, you DO NOT want to be in the way. It was crazy, everyone was going insane with joy.
Then after dinner they put on this "movie". Haha...I put movie in brackets because movies here are NOT like movies back home. Movies here look like they were recorded on a digital camera by some first-year cameraman student. Movies here are a mix between the cheesiest soap opera you know and the worst musical video you have ever seen. With that being said, movies here are the most hilarious things I have ever seen. The plot was that a man was falling in love with a blind woman. My favourite part came when they were eating ice cream and she said in her best English accent " Why do you love me? I am blind", and he replies with, "We are all blind". Wow. It was fantastic!
Anyways, so after waking up at 2am with the rest of the students, I was pretty pumped. We go in the bus, which is like a really crappy version of a coach bus, at 4am, and drove on! I got to see the sunset around 6am which was pretty cool. A fiery orange ball rising from the green grassy hills past Kisumu. If you think of how an African sunrise should look in your head, that is pretty much how it looked.
We rolled into Kisii around 830. The provincial finals were being held at this huge mixed highschool, and all the buses were parked in this enormous feild. By 930am most schools had arrived and some were rehearsing in the feild. Never have I seen so many black students in one location. It was a sea of people, and like always, I was the only whitey.
So the students performed around 10am, and I can't describe how they sounded because it wouldn't do them justice. I had thought that being in the gospel choir and singing that music was the best music I had ever heard, and ever sung. It is so full of energy and happiness. However, I have to say, the Kenyan highschoolers were 100 times better. You just can't beat it, and you can't replicate it. They sounded so great, I was smiling the whole song.
They only had that one song to sing (the competition lasted 3 days with each school getting to perform 2 songs a day, but the students in Ugunja only had enough funding to go for the one day). Anyways, the rest of the day the students just had a good time. It is rare for them to leave home and be around so many other students, so they were loving it, and I was so happy I went.
The coolest thing I saw, apart from them singing, was a boys school performing a traditional Luo dance. They were all decked out in paint and feathers and grass skirts. They had bongos and a horn and a traingle. It was the most amazing dancing I have seen, and it was so genuine, you could tell that each move was part of who they were.
So...we left Kisii at 430pm, and I was so tired. But, the bus being as rickety as it was, and the roads being...well...Kenyan...I couldn't really sleep the whole ride home. But I did get to see the sunset, which was very nice. So overall, Kisii was great, I am so glad I went and had the opportunity to go.
So as I have mentioned the compound that I live on houses many children and teenagers. About 15 of them. Of the teenagers, there is one girl I feel especially close to and her name is Beryl (Bur-ill). She is really funny, and really fiesty. She doesn;t take crap from anyone and beats up all the boys. She is really happy too, and always singing. Usually after dinner she dominates the singing, along with another teen, Steven. Steven is always dancing, and when dear MJ passed, he had a really rough time because he didn't know who his idol was going to be anymore in terms of dancing.
Anyways both Steven and Beryl are in their highschool choir, consisting of about 40 kids. Last month they went to a district competition and won, so they were off to the provincial finals being held in Kisii (about 4 hours from Ugunja).The provincial finals were held this weekend, and I expressed my desire to go to both Beryl and Steven, and asked them to ask their choir director if I could come. But like most African things, nothing ever runs on time, and they ended up not asking.
So on Saturday I walked to the highschool (a good half hour) to talk to the choir director. The highschool by the way is so beautiful, it looks like a resort. Palm trees and exotic flowers and thatched gazebos everywhere. So nice!
Anyways I talked with the director and he said I could come, we just had to sort out how I was getting there. The students were sleeping over at the highschool that night because they had to leave at 4am. So...I was thinking "ok, sleep on the floor of the highschool and wake up at 3am"....SOUNDS GREAT!
So, I pack some things, and walk to the highschool with Beryl and Steven. Beryl tells me the other students are so excited a white person is travelling with them. I was pretty excited myself! So we get there, and I am introduced to a bunch of students. When the sun went down the kids were busy making dinner, while others set up their sleeping stuff on the floor. Then some speakers were brought out along with a small television, and music started. And let me tell you, when music starts around 40 highschool students who love singing, you DO NOT want to be in the way. It was crazy, everyone was going insane with joy.
Then after dinner they put on this "movie". Haha...I put movie in brackets because movies here are NOT like movies back home. Movies here look like they were recorded on a digital camera by some first-year cameraman student. Movies here are a mix between the cheesiest soap opera you know and the worst musical video you have ever seen. With that being said, movies here are the most hilarious things I have ever seen. The plot was that a man was falling in love with a blind woman. My favourite part came when they were eating ice cream and she said in her best English accent " Why do you love me? I am blind", and he replies with, "We are all blind". Wow. It was fantastic!
Anyways, so after waking up at 2am with the rest of the students, I was pretty pumped. We go in the bus, which is like a really crappy version of a coach bus, at 4am, and drove on! I got to see the sunset around 6am which was pretty cool. A fiery orange ball rising from the green grassy hills past Kisumu. If you think of how an African sunrise should look in your head, that is pretty much how it looked.
We rolled into Kisii around 830. The provincial finals were being held at this huge mixed highschool, and all the buses were parked in this enormous feild. By 930am most schools had arrived and some were rehearsing in the feild. Never have I seen so many black students in one location. It was a sea of people, and like always, I was the only whitey.
So the students performed around 10am, and I can't describe how they sounded because it wouldn't do them justice. I had thought that being in the gospel choir and singing that music was the best music I had ever heard, and ever sung. It is so full of energy and happiness. However, I have to say, the Kenyan highschoolers were 100 times better. You just can't beat it, and you can't replicate it. They sounded so great, I was smiling the whole song.
They only had that one song to sing (the competition lasted 3 days with each school getting to perform 2 songs a day, but the students in Ugunja only had enough funding to go for the one day). Anyways, the rest of the day the students just had a good time. It is rare for them to leave home and be around so many other students, so they were loving it, and I was so happy I went.
The coolest thing I saw, apart from them singing, was a boys school performing a traditional Luo dance. They were all decked out in paint and feathers and grass skirts. They had bongos and a horn and a traingle. It was the most amazing dancing I have seen, and it was so genuine, you could tell that each move was part of who they were.
So...we left Kisii at 430pm, and I was so tired. But, the bus being as rickety as it was, and the roads being...well...Kenyan...I couldn't really sleep the whole ride home. But I did get to see the sunset, which was very nice. So overall, Kisii was great, I am so glad I went and had the opportunity to go.
Wednesday, July 1, 2009
I love you Canada
Dear Canada,
HAPPY BIRTHDAY! I am so sad I am not there to celebrate your day of birth, but don’t you worry, I am celebrating from across the ocean. I have been looking forward to this day for a few weeks now, and I sure made some great plans. First and foremost, I would like to honor you by only eating foods that I would eat in your beloved country. So I went to the supermarket yesterday and bought the following items:
- Small muffins
- Peanut butter
- Jam
- Cookies
- Chocolate
- Chips
So, I am fully stocked to eat all Canadian foods! Next is the clothing I am wearing. I have a grey shirt with the Canadian flag on front (left to my by my dear hut-mate Wren), a red baseball cap that has the Canadian flag on the front, and I have been carrying and waving around a mini flag all day. I am so proud of you Canada, and so proud to call myself a Canadian. So I would like to honor you and show my deep love for you by writing the following “Ode to Canada”
O Canada, you are so beautiful to me
I love you for your clean streets and sidewalks
I love you for garbage disposal system, and for your recycling system as well
I love that cold milk is available everywhere
The environment boasts beautiful trials and waterfalls, that are safe to walk
O Canada, how I appreciate your seasons
The beautiful autumn, where colour-changing leaves, pumpkin treats and crisp air swirl through the land
And the cold winter, which though sometimes is annoying, allows flurries, tobogganing, hot chocolate to be enjoyed with fluffy marshmallows, snow ball fights and sparking bare trees
And then there is the spring, in which rain brings life to all the beautiful flowers and plants
And summer, which we all look forward to so much, in which we can all relax and go swimming outdoors and enjoy hot dogs and ice cream
O Canada, how I appreciate your police force, who are always there to actually carry out the law
I love you for the warm water needed for showers, and for the cold water needed for drinking
I love you for the genius availability of dishwashers and washer and dryer machines
I love so many things about you Canada, but most of all I enjoy the freedom, opportunity and choice you have given me throughout my life
Have a great birthday, and know that I am thinking of you all day today!
HAPPY BIRTHDAY! I am so sad I am not there to celebrate your day of birth, but don’t you worry, I am celebrating from across the ocean. I have been looking forward to this day for a few weeks now, and I sure made some great plans. First and foremost, I would like to honor you by only eating foods that I would eat in your beloved country. So I went to the supermarket yesterday and bought the following items:
- Small muffins
- Peanut butter
- Jam
- Cookies
- Chocolate
- Chips
So, I am fully stocked to eat all Canadian foods! Next is the clothing I am wearing. I have a grey shirt with the Canadian flag on front (left to my by my dear hut-mate Wren), a red baseball cap that has the Canadian flag on the front, and I have been carrying and waving around a mini flag all day. I am so proud of you Canada, and so proud to call myself a Canadian. So I would like to honor you and show my deep love for you by writing the following “Ode to Canada”
O Canada, you are so beautiful to me
I love you for your clean streets and sidewalks
I love you for garbage disposal system, and for your recycling system as well
I love that cold milk is available everywhere
The environment boasts beautiful trials and waterfalls, that are safe to walk
O Canada, how I appreciate your seasons
The beautiful autumn, where colour-changing leaves, pumpkin treats and crisp air swirl through the land
And the cold winter, which though sometimes is annoying, allows flurries, tobogganing, hot chocolate to be enjoyed with fluffy marshmallows, snow ball fights and sparking bare trees
And then there is the spring, in which rain brings life to all the beautiful flowers and plants
And summer, which we all look forward to so much, in which we can all relax and go swimming outdoors and enjoy hot dogs and ice cream
O Canada, how I appreciate your police force, who are always there to actually carry out the law
I love you for the warm water needed for showers, and for the cold water needed for drinking
I love you for the genius availability of dishwashers and washer and dryer machines
I love so many things about you Canada, but most of all I enjoy the freedom, opportunity and choice you have given me throughout my life
Have a great birthday, and know that I am thinking of you all day today!
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