Kenya June/July Update #2

3 July 2012.  In many ways it feels as though much of the real work of the trip started today.  After a training session and trial run with a couple of farm families, we began using the survey tool today around Nehemiah.  

So the survey is a combination of suggestions of the US team and of Dr. Omoto and his staff from Siaya.  It is 6 pages in length and has roughly 45 questions of demographic data and also some "test" questions to determine the knowledge of families we are surveying in regard to basic health issues.  It includes questions on hand washing, latrines, dish rack use, mosquito nets, personal and family income, number of people living in the household and immunizations and the timing of them.  Also covered are family planning, contraception and HIV, as well as pregnancy risks.  We then measure BMI (by height, weight and age if less than 20), visual acuity, blood pressure for those over 20, and perform a dental check for missing teeth/cavities.

We met this morning at Nehemiah and split into 3 teams.  Generally one community health worker, one person from Nehemiah and a Mzungu (one of us).  We went out on foot to Karunga, Kaleng and an area close to Kibos.  We surveyed huts/homes from 9am till 5pm.  Amazingly for day one, we covered actually 59 huts/homes!  Beyond that several other children to gather BMI information as well.  We found we were welcomed into huts and offered seating.  Most seemed to answer questions without hesitation, though we all seemed to hit resistance on income and most could not identify the timing of immunizations.  

Most homes were of mud walls and flooring, with generally thatched roofs.  Many had fires burning for cooking inside the home with charcoal.  Prior to coming I was concerned about CO, or Carbon Monoxide poisoning for these people burning charcoal indoors, yet the studies I could find reflected levels of around 30 ppm of CO; whereas 200 ppm is toxic.  It appears they all have such adequate ventilation, that CO poisoning is not an issue.  It was so good to spend the day observing, in our team's case 16 huts, and the life they have.  Corn planted around the huts, some with attached latrines, or perhaps 15 feet away; but many used only the bush and no latrine even in a village area somewhat populated.  Children everywhere, happy in most cases, though my mustache and cane scared a few who began crying.  Lots of great photo opportunities which I will have to upload when home.  Most men and women adults seemed to run about 42-52 kg and roughly 160 - 165 cm tall.  I will begin to work on the calculations tomorrow.

The only real problem encountered was with the team I was with. And even then God's hand was all over that!
Shebby, Victor (our CHW), Lexi and I were approached by two older men who asked in a somewhat gruff manner what we were doing (after we had surveyed about 6 huts), and who had given us authorization. A kind explanation by Shebby did not help and they seemed intent to get rid of us. Shebby explained we had authorization from the chief, they said they had no knowledge of that and had not heard we were coming. Just then Shebby called Ken Olindo who had gotten the authorization - and at that exact moment Ken was with the chief and was interviewing him and his family for the survey! The two men with us (one an associate chief, the other a village elder of the clan) did not accept that, and one called the chief himself the next moment. The chief answered the phone, and whatever he told the assistants, they simply had a change come over their faces and both said "Sawa" and walked away......
So I guess the money was worth spending, especially since all teams will have authorization until even the larger Bainbridge group is done. We have an official signed letter from the chief as well that Ken is photocopying.

In regard to the mentioned funds.  A few days ago we found the "Miwani chief" required payment to "authorize" our survey.  This was to assure safe travels and acceptance in the area, in exchange for 3,000 KSH.  Though several felt this was again corruption at work and an abuse, I felt after all we had been through that this was not that much to pay - if it made a difference (only around $35 USD); so though it was in theory not the right thing to do (after all we are trying to help these people by learning about them and already spending a lot of money to do that), I did go ahead and pay the funds this morning myself.  It now looks like that was the right decision.

All in all everyone is encouraged!  The survey will continue in the Nehemiah/Miwani region over the next 3-4 days.  Mostly on foot, with areas to come beyond my walking strength.  I felt I held up well today, though likely because so many are praying for our team and our health. 

More soon! Thanks for reading.

A Kenyan Birthday

 1 July in Miwani, Kenya.  Thinking I would have a quiet peaceful day, but so far it seems not to be that way.  Still taking it all in.

At 0530 Kenya time I got a text from a new Sikh friend whom I met here in February.  "Respected Bro, wishing you a very happy & blessed b'day. The Lord bestow his blessings on you with happiness. Good health this auspicious day and years to come always. Johnny and family"  Then two hours later a call from him as well.  He and his three daughters are cooking Indian food to bring over to feast with us this evening in further celebration of the day.  

Then after church I seemed to have a line of people waiting to greet me.  Last Sunday was an introduction to many, and making again friendships with others.  This Sunday had several asking me directly for money to pay for their medicines, or healthcare, or food for family, or funds to start a business.  More overwhelmed with the need, and how little so many people have.  One mother with her 2 year old who has had malaria several times, now again with intermittent fever and cough with scleral icterus (jaundice) and dark urine.  All I could do was tell her I would read about this and try to educate myself on what it may be (will do that shortly).  Most seemed to think having met me once or twice, I now would be more sympathetic to their plight and give money.  It is hard to say no when my wallet is basically empty, and my heart is full.

A visiting pastor asked me to please start a medical clinic near his home of Port Victoria, Kenya.  Apparently there is a lack of medical care in his area as well.

Last, another family wanted to greet me in the church afterwards.  Thinking this again might be another financial assistance request, but no.  A widower whom we met this week, teaching pre-school in Miwani who is barely surviving I am certain (whom herself was injured falling from a Piki-Piki in 2009 and walks with a bad limp), had brought me a gift.  A colorful chicken.  A birthday chicken!  The cost for her to give that up for me, likely incalculable.  I thought of the Bible story of the widows coin - giving nearly all she had back to the church.  In this case her thankfulness for our being here and helping with a survey to study the health of the local people.  

So it is barely noon, and I am already overwhelmed by the generosity of those around me.  

More to report.

So a final update on the day's events.  Our entire group had a wonderful Indian dinner with Johnny and his family, including a traditional Kenyan beer they brought for me - Tusker.  Chocolate chip cookies put together from no-standard ingredients and baked by Hannah Berkimer were outstanding.  Overall a restful day spent with friends from the southern and northern hemispheres.

Last, medically - the 2 year old likely has recurrent malaria given the mild jaundice and ongoing illness from mother's report.  I suspect they have no mosquito net, though did ask her that and got a puzzled look only.  According to the CDC malaria website, mild jaundice is common.

Tomorrow we start training for the survey trial with 2 nurses coming from Siaya.  The days following that we will survey mostly on foot around Nehemiah.  All for now.