Happy Malanka

Selling wares

Kakamega Forest - Large shallow roots

Happy Malanka to all my Orthodox friends and family.  I hope you all had a fun time at the festivities.  On our side, we went out for supper and stayed up until 10:30.  That is late for around here!

Typical stalls

Washing cars in Lake Victoria - Kisumu

Kakamega

Donkey and cart

Garbage along the side road

Alex eating a huge serving of ugali

Homa Bay

Andrew & looking at Lake Victoria

We have been settling into a real routine around here after the Christmas festivities.  Between Christmas and new years, we took a 3 day trip down to around Lake Victoria area.  We went to Kakamega Forest which is the last bit of Rain Forest in these parts which used to reach all the way across Africa at this latitude.  It is a National Park now.  We stayed in Kisumu the first night.  We drove into the city about 7:30 p.m. (already dark here by that time) and what I noticed the most, was the lack of electricity.  There were so few buildings with electricity.  And there are no street lights anywhere in  these smaller cities.  We celebrated Jim's birthday that evening with a nice dinner out.  You will see in the pictures, Andrew.  Andrew is one of our new friends.  He was introduced to us as someone whom we could trust as a taxi and we soon became friends.


We spent the next two days traveling around Kisumu area and south down the lake to Homa Bay.  Around Homa Bay are the Homa Hills. These are old volcanoes worn down after millions of years.  We climbed the highest one in the area so that we could see out across the landscape.  I won't be climbing Mt. Kenya if I don't get into better shape! We did lots of driving on the trip and saw a variety of different landscapes - rain forest, rice fields, mountains, sunflower fields, Lake Victoria.

Happy boy on first day at school in Eldoret

Since then we have been settling into school (Alex - not so well) and fully into work (me - going well).  For my eHealth colleauges, I am working as the PM, business analyst and change manager on a project.  I have 2 analysts in training working about 80% on the project with me, a system analyst about 10% and 2 quality data analysts, very part time.  We are working on a pilot project (2 sites) to transform the HIV clinics to Chronic Disease Management clinics (large modification of the health record - paper and electronic) and the current Primary Health Care clinics to a streamlined primary care centre with electronic records including reporting to the government and no paper chart. They have done some work on the initial PHC patient record already and we are coming in to streamline it and to make sure that it has all the clinical and reporting components required. The goal is to  have the pilot completed by the end of this fiscal year and use it as model for the rest of the 23 sites and their satellite sites.  At the same time, the IT group is working on a wireless network across the AMPATH region.  We are waited anxiously for this as it means that we will be able to have a networked EMR for AMPATH across all 25 sites.  Very exciting and so much opportunity for improvement!

We are also tasked to come up with a strategy for a Univeral ID for clients / patients.  This will be a more difficult task and has been one that has been one the books for a while.  A research project has just been completed with 4 sites using a Universal ID however, at this time, some patients can have up to 13 different IDs.  The research project work however will be extremely useful and one of the analysts on the project was the project assistant.


So this will be a challenging year at work but it is very exciting.  The analysts that are working with me are very smart and there is certainly great potential for leadership in this area.

As for the rest of the family, Jim has been doing some small jobs.  He is putting in a quote this weekend to the Sally Test Program (children's area at the hospital)  to build a wall of cabinets for a new centre at one of the hospitals.  Alex has been having a few issues adjusting to school and the new schedule so we have been working hard to help him. And for those who want to know, I heard from Sally Hull at Hull's Haven Border Collie Rescue and Penny is doing very well!  She has been trained  out of her aggressiveness and is now being fostered by a family who has a little boy who adores her and who has a minature  Penny to play with. If you know of anyone who wants to adopt her, please call Sally at Hull's Haven.  And we have adopted a pet here.  Tuffy the farm cat has been coming around for about a month now.  He was very skinny (ie. starving) when he first started coming around but is now well fed (better than some people here).  He has a home on the patio (box with Jim's old sweater inside) and is best friends with Jim.  He however wants to come in the house and I won't allow it.  Pretty good for a farm cat I would say.

As for coping with the culture here, sometimes it is difficult.  I often feel guilty.  We live in this nice home with all the amenities of life.  And just across the way are people who are struggling to feed themselves. There are people in town who drive Mercedes cars past the street kids.  It really doesn't make much sense. I have talked about it with my new friends and colleagues and they struggle with it plenty.  Consider this, a member of parliament in Kenya makes over $200,000 Cdn a year TAX FREE not including corruption $ (Stephen Harper makes $300,000 a year and a Canadian backbencher MP makes $150,000 and have to pay tax).  Remember the doctors who make $12,000 a year (not tax free).  Think about the worker with limited education (because their family could not afford to send them to school) who make $5 a day or about $1000 a year.  Some of the people here believe there will be an uprising one day against the rich and those are the ones who are in government.  The Northern African uprising of 2010/2011 will move south eventually.

Once again, in the mean time we do what we can.  Today I will see Ronald (the runner) at the market.  I am meeting Joshua (just graduated from grade 12) for chai (tea) or lunch.  Whether I can provide some hope or hands on support, I do not know. But I will do whatever little I can.  I will take any guilty energy I have and put it to good use. 

So I am off to enjoy the beautiful sun that is out this morning and my Kiswahili lesson before I go to the market.  I was up at 5:30 because I could not stand listening to the neighborhood dog choir anymore.  Can always take that afternoon nap as it is Saturday!

Take care all.  Enjoy the winter (LOL).

Lori

Kipkaren Hospice

CO, Rebecca, Adrian, Purity

On Friday December 23, we had a chance to go to the Living Room International hospice at Kipkaren, east of Eldoret (http://www.livingroominternational.org/kenya/).  Both adults and children live at the hospice, for short periods of time or for long term care.  Sometimes it is for palliative care but most of the time it is for healing or long term care.  I liked going there so much that I think that I will try to spend some weekend time there every month.  Alex stayed pretty close to mom and dad however later that day, he said that he liked the babies.  The staff we met were wonderful.  I would like to tell you about  the residents. 

Noah

Noah is in his late 20’s.  He has a brain injury and is paralyzed on his left side from a drowning.  Noah survived the drowning however he was not taken well care of.  When the living room staff found him, I believe that they said he was down to 30 kg.  Noah has been at the hospice now as a long term resident for some time around a year and is doing very well.  He can’t verbalize however is able to communicate simply with the staff through non-verbal communication.

Mary

We met Mary when we first came in and were getting our tour.  She was lying in her bed.  Mary is 14 or 15 and has been at the hospice for about 8 months or so.  When Mary first arrived, she could not walk and was severely malnourished.  She still does not verbalize however she is walking and has been rehabilitating well.  I do not know why she has these problems whether it is due to malnutrition or something else. You will see a picture of Mary putting on slippers.  We brought these sheepskin slippers and they fit her perfectly.  I think they will be better for walking than the flipflops she was wearing. Mary was very interested in Alex.  She communicate that she wanted Alex to come near to her and then later on when we went to the living room area, she wanted Alex to sit beside her. 

Mary in her new slippers

Purity grabbed Jim’s heart immediately.  When we came in, she went to him right away and he probably had her in his arms for two out of the three hours we were there.  Purity has only been at the hospice for about 4 weeks.  She is HIV positive and 2 ½ years old.  The staff said that she is responding well to the anti-retroviral (ARV) drugs.  She looks healthy but she is small because she has been malnourished. 

The most beautiful smile on Adrian

Mercy is also about years old and has only been at the hospice for a very short period of time.  She was severely malnourished when she came to the hospice and is only about the size of a 8 month old due to the malnutrition. She is eating well at the hospice and seems to be managing well.

Adrian.  Beautiful  Adrian.  Apart from our friend Michael, he has the most beautiful smile in the whole world.  Adrian arrived at the hospice about one week before we visited.  He is 5 years old and has been blind since birth.  Adrian is HIV positive and is quite sick right now.  Jim was rubbing his back and Adrian’s caregiver had to tell Jim to stop because it was causing him pain – Adrian has boils all over his back.  That tells me that he certainly has AIDS symptoms.  However, they have started him on the ARVs so hopefully they will start to fight the virus soon.  We brought some presents and gave Adrian the St. Bernard dog that you see him with in the pictures.  It was nice and soft.  When he felt it the big beautiful smile came onto his face.  Adrian’s smile was my Christmas present. Adrian felt all the parts of the dog as someone explained to him what they there.   Adrian wanted to take his dog for a walk so they tied a rope around the dog’s neck and Adrian took him for a walk.  With Adrian was nyanya (grandma) Rebecca.  I think Rebecca comes to volunteer at the hospice but I am not sure.

Belinda and Marcie

Little Belinda is 3 months old.    She came to the hospice with her mom shortly after she was born.  Her mom was dying of AIDS and Belinda was diagnosed as HIV positive.  Her mom died when Belinda was 2 months old.  Belinda has been started on ARVs since she arrived at the hospice and was diagnosed.  She is growing well and is healthy.  If a pregnant woman starts on certain ARV drugs when she is pregnant, the transmission of the HIV from mom to baby decreases from 50% t0 3% or so.  So part of the education and prevention process with AMPATH is to have people get tested for HIV early and often (if they are sexually active).  Unfortunately, this did not occur with Belinda’s mom.

Jacob

Jacob has been at the hospice for three months.  Before that he was in the hospital in Nairobi. Jacob is a teacher, married and the father of 3 children between 3 and 10.  I cannot remember the whole story from when I first heard it in August however Jacob was at school when someone (? a student) came into the school with a gun.  Jacob was shot in the back injuring his spinal column.  He is paralyzed from the waist down. However, his upper body is good so he can push himself around in the wheel chair.  Jacob’s family lives close to the hospice and visits him often. He was going home for Christmas week when we met him.  Jacob is a history teacher and loves to read.  His English was excellent, as you would expect from a teacher.  He reminded me of my dad.  Jacob is still in rehab.  When I asked him if he was going to teach again, he said that he thought that he would.  There is a school and residence for children which is part of the organization that the hospice belongs to, so maybe he will get a job there.  I would think that they would be lucky to get him.  We will look for some history books so that when we go back, we will take them for him.  He seems to have a very strong character and the will to continue through rehab. 

Sharlene

Sharlene is 8 years old.  She has been at the hospice for quite some time and will likely stay there for long term care.  By looking at Sharlene I think she may have Muscular Dystrophy.  She didn’t really respond but she looked healthy and well taken care of. Along with Sharlene was Marcie who is 5.  I think Marcie also has MD.  Marcie’s mom and baby sister were there while we were visiting.  Marcie was walking with the support of her mom.  

Teresa

Teresa was extremely sweet.  I spent a good bit of time with her.  She has had stroke and is paralyzed on the one side.  She is not walking at all.  Teresa certainly understood what we were saying to her but could not verbalize back.  However she certainly communicated through her facial expressions and her arm.  I love the connection that women have between each other.  No matter who you are or what physical or mental state you are in, women have a bond that is very distinct and strong.  I love feeling that bond with the women in my life.

Jacob and Paulina

I had just a little bit of time to spend with Pauline because we were leaving soon.  However, as I held her hand and talked her, Pauline responded with a big smile. I am not 100% sure of Pauline’s situation however the staff indicated that she was found at her sister’s house and was very sick.  I think she is HIV positive.  Her sister’s husband no longer wanted her sister to look after Pauline (very cultural that the wife has to basically ignore her family) so Pauline was moved to the hospice.  I cannot remember any other details however her sister does come to visit her.

Joseph

I didn’t really talk to Joseph much however Jim did spend some time with him.  Joseph’s legs are not good however he is still walking.  He was in good spirits and seemed physically healthy.

I think that is everyone who lives there.  I look forward to the next time we are able to go back and visit.

Purity

Smiling Mary

Jim and Purity