Its good to be back together again, telling the same jokes and ordering the same soft drinks. With some more visits planned for Friday, the team decided again to split up in the morning with Zac and Sam hiring a car to visit the Maseno Missionary Hospital while Karl and Fatima went with a local healthcare officer to make home visits and learn more about what healthcare access looks like into the most rural of areas. The team planned to meet up later in the afternoon to visit a Kenyan Tea farm.
At Maseno, Zac and Sam were introduced to Dr. Gerry Hardison, an MD and a former professor of medicine at UCSD. Dr. Hardison had moved to Nyanza province along with his wife and was now in charge of the Mission Hospital. After talking to Zac and Sam for a bit and introducing them to some of the hospital staff, he invited the team to come back on Saturday to work at the Anglican Hospital’s orphan outreach program. He also asked us to say hello to the chancellors back in California for him. (Hi Chancellors!)
Meanwhile, Karl and Fatima went out on Boda Boda with Wyclef - the healthcare officer, who introduced them to lots of people including a family which included 5 men, 8 wives, and 32 children (you do the math). At one point they were also brought to a local meeting area where a bunch of mothers with their children were sitting and waiting. Karl and Fatima were not sure what was going on, but soon found out that a focus group had been organized and they would be leading it. Deciding that IRB would likely not allow for a formal interview process with taped recordings, Karl and Fatima treated it as a highly informal discussion and learned a great deal. They gathered some interesting user input concerning the microneedle device and gave away a lot of pens.
On the way back to Kisumu to pick up Karl and Fatima for a long ride to Kericho, Sam and Zac were treated to their first experience involving bribing a police officer. At one of the many police check points on the road their car was randomly pulled over for inspection. The police officer quickly noticed that Sam was not wearing his seatbelt. He immediately went into an overblown tirade about how he was going to lock Sam up and wait for a trial in a court of law. He continued to ask repeatedly why Sam had not been wearing his seatbelt. In case it wasn’t obvious to us, our driver George (who looks like Morgan Freeman circa 1994- Shawshank Redemption) leaned over and whispered, “He wants a bribe. Give me 200 Shillings.” Zac quickly pulled out two 100 Shilling notes and handed them over. George played along with the act and pleaded with the officer saying something in Swahili to the effect of, “Please forgive these ignorant mzungus who don’t understand the importance of basic road safety.” While pleading his case he discreetly flashed the 200 shillings in his hand and managed transfer without anyone noticing. The police officer continued lecturing us but then quickly forgave us and sent us on our way. All of that for less than three dollars. Zac and Sam were pleased to know that they would not be getting locked up in a Kisumu prison.
Tea farming is a major agricultural product of Kenya and many of the major tea farms also provide immunizations or other forms of healthcare for farmworkers and their families. In order to learn more about this alternative healthcare system, we went to the center of tea farm country, to a town called Kericho where we planned on visiting the Ketepa tea farm. The road to Kericho is full of potholes but it winds through some of the most beautiful land in Kenya. Sometimes driving conditions were so bad that our taxi driver George had to take to the shoulder of the road.
When we finally arrived the farm, we caught two members of Ketepa’s healthcare staff just as they were wrapping up work and ready to head home for the weekend. When they learned about our project and saw how far we had come, they were nice enough take some time out of their Friday afternoon to talk with us.
We interviewed them for about 30 minutes and after saying our goodbyes, the team members got back into George’s taxi, ready to bump their way back to Kisumu.
Day 15- Saturday, August 4th Maseno Missionary Hospital Orphan Outreach Program
We pulled into the Maseno Missionary Hospital just as the medical staff was finishing up with their final preparations for an orphan outreach program at a local parish. In addition to providing weekly medical treatment and a free meal for orphaned children, the Anglican church in that area also runs a Saturday tutoring program in which the kids were split up into five or six different classes, according to their age.
When we arrived at the church that morning, we were prepared to shake hands, meet the kids and help out wherever we could, but we were completely surprised when we were offered teaching positions for the day. Despite our lack of preparation, we tried to meet the challenge best as we could-
Mathematics, English Proverbs, English Vocabulary, Dimensional Analysis.
No subject was off limits to our team of intrepid graduate student researchers.
Meanwhile, Fatima had started helping out with the clinicians in treating many members of the community who had come to the outreach for medical treatment. After classes were over, Karl, Zac and Sam played games of frisbee and soccer with the kids, but when the boys and girls got in line to receive a hot meal, the team reconvened to head back to Kisumu.
Day 16- Sunday, August 6th There And Back Again…
After a restful spent morning spent reading books and playing snake, we went with our friend George to the Kisumu airport. The flight from Kisumu to Nairobi was extremely brief. Drinks were served in flight, but before you had time to crunch on all of the little ice cubes in your cup, we had already landed in Nairobi.
Dinner that night at Vasanth and Gita’s house was delicious. Tuna fish, Lamb biriyani, yogurt sauce, spicy lime and mango pickle, tusker beer, coffee custard. By the end of the night, we were so lethargic and heavy with food coma, it felt as though we had been drugged.
Day 17- Monday, August 7th Preparation Prevents Piss Poor Performance
Monday was all about preparation for our meeting with KEPI on the following day. Over the previous weeks, we had visited four provinces in Kenya and seen numerous healthcare facilities: large, small, urban, rural, private, public, missionary, NGO. We surveyed dozens of healthcare workers and shook countless hands. Now it was our job to put it all together.
So…
Where did we go?
What did we learn?
What did we do?
(All very good questions!)
That afternoon Sam and Fatima worked for hours crunching data at the Nairobi Java House (which may have also involved the ordering of chocolate cake).
At the same time, Karl and Zac took the #40 matatu out to Kibera to try and make contacts at the Kenya Medical Research Institute (KEMRI). This would prove to be a valuable contact because KEMRI is the leading name in Kenyan biomedical science research as well as the major measles surveillance and research station in East Africa. Karl and Zac tried looking for F.A. Okoth to no avail but after bouncing around several offices, they somehow managed to arrange a follow-up meeting with some staff members for later in the week. Karl would like it noted for the record that he in fact did spot FA Okoth from a distance, and recognized him with his darkly tinted aviator sunglasses. Karl is quite positive it is him, after admiring his picture online frequently while they were back in the states working on contacts and preparing for this project in Kenya. Zac however, in his infinite pessimism refused to approach him blindly and ask him if he was indeed the man behind the myth.
That night we stayed up until 1AM in Fatima’s room going over our data, thinking about future possibilities for the project, talking through how we should present it, and putting our powerpoint slides together. Tomorrow would be a big day.
Day 18- Tuesday, August 8th Baadaye
While Zac and Karl headed for an early meeting with the CEO and nursing staff of the Nairobi Hospital, Sam and Fatima took a trip out to Kenya Red Cross headquarters in order to learn about this very important NGO’s work in mass vaccination campaigns. While both halves of the team gathered some valuable input that morning, they came back together at the YMCA around lunchtime to get ready for their big afternoon meeting.
The most important order of business on this day - a debriefing meeting with Dr. Tatu Kamau and the lead officers of KEPI to describe the results of our work in the Western/Nyanza provinces. Furthermore, we wanted to seize this opportunity and ask questions: to gather their input on what we had done and to see how things should proceed from here. With the exception of an early projector malfunction, the meeting went fairly smoothly and brought some closure to our work in Kenya over these past few weeks.
As cliché as it may sound, its still surprising how quickly work on this project has gone by. When you factor out the time spent in travel, preparation and wrap-up, we have only really had two and a half weeks of fieldwork under our belt. Fatima leaves tomorrow night and after some wrap-up paperwork and one last meeting at KEMRI on the 10th, the boys will split up on Saturday when Karl and Sam take off for Zanzibar and Zac and his wife Stef will set their sights on Mount Kilamanjaro.
So this definitely isn’t the end for the microneedle project or even the end of our time in Africa, but for now… this is where our travel blog will end. Much love to our friends, family and loved ones back in the States (or wherever you might be reading this), we’ll be home soon
(assuming their aren’t any hiccups on our return flights, but then again TIA - no, not Sam’s last name - ‘This Is Africa’.)
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