Thursday 30 June 2011
Fundraising Website
The Foundation for Sustainable Development has just added my project to its website! Check it out: http://www.fsdinternational.org/donate/projects/LeVee
Tuesday 28 June 2011
Fundraising Approval
My project to make a VCT center and a second Consultation Room at Shibwe Sub-District Hospital has finally been approved and is ready for fundraising! You can donate by copying and pasting this link into your browser: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=M9SBCNKUSC3ZL or by clicking on this button below:
Donations can also be made by check payable to Foundation for Sustainable Development and addressed to me at my home in California: 1231 3rd Street, Manhattan Beach, CA 90266. Please write “Alexis LeVee, Kenya” on the memo line.
Donations will be received until July 4, 2011 and are tax-deductable.
Thank you so much for your support!!
Donations can also be made by check payable to Foundation for Sustainable Development and addressed to me at my home in California: 1231 3rd Street, Manhattan Beach, CA 90266. Please write “Alexis LeVee, Kenya” on the memo line.
Donations will be received until July 4, 2011 and are tax-deductable.
Thank you so much for your support!!
Monday 27 June 2011
Lake Nakuru
This past weekend I went to Lake Nakuru and it was one of the most exciting, frustrating, and scary experiences yet. Lake Nakuru is the fourth largest city in Kenya and famous for its national park. I found out about it from my aunt Jody (shoutout!) who emailed me an article about what is said to be one of the most beautiful lakes in the world.
Many of the decisions we made this past weekend were not the smartest. For example, the nine of us interns decided to take a 4 ½ hour matatu ride at 6 PM on a Friday night. This was against the wishes of our supervisor who warned us that nine mzungus travelling at night to Nakuru was highly dangerous. Instead of taking his advice, we signed a contract giving away any responsibility of FSD.
We arrived at our hotel safe and sound despite the comments throughout the drive to remind us that “this is how NGO workers die.” However, when we got there, the hotel kindly gave away our rooms (Good luck: 0; Bad luck: 1). Fortunately, another Kenyan was also searching for a hotel at midnight, and as it turned out works at Lake Nakuru National Park and knew much about the city (Good luck: 1; Bad luck: 1). He led us to a hotel that was much cheaper and safer than the first – only in Kenya can you find a hotel room for $6 a night! It is even cheaper when splitting it between four people. Even though the pit latrine was at the end of the hall, we were at peace knowing there was a security guard stationed at the front entrance.
The next day our new Kenyan friend, Willis, bargained a deal for our group to go on a one-day safari (Good luck: 2; Bad luck: 1). The safari through Lake Nakuru was absolutely beautiful! The lake is famous for being home to a third of the world’s flamingo population. But more importantly, we saw lions, giraffes, zebra, hyena, buffalo, baboons, rhinos, and so much more! It was such an incredible sight to see these animals in their natural habitats. The animals were only feet away from us (including the lion that was sleeping)!
Here are pictures of the baboons, the buffalo, and the giraffes:
Willis then took us to a hotel within the National Park where he works as a bartender. This hotel could not have been less than 5 stars, and looked like it was taken right out of a beach in Hawaii. It seemed most out of place since just down the road were huts where the Kenyans lived, but we took full advantage, ordering cocktails and coffee. After saying goodbye to Willis and our safari driver, we went to a Chinese restaurant for dinner and to a discotheque for dancing. At the discotheque is where we really stood out. Instead of the long skirts and covered shoulders that women in Kakamega are dressed in and what we have adapted to, these urban women were wearing tight dresses and heels. It was a club straight out of Hollywood! We were shocked but had an amazing time (Good luck: 3; Bad luck: 1).
The next day is when our luck began to run out. We decided to visit the Menengai crater about a 30-minute drive from the city. We hired a matatu to take us, but about ¾ of the way, the car started steaming and we were told that “the matatu was out of fuel” (Good luck: 3; Bad luck: 2). We then proceeded to walk to the rest of the way up. The crater was so astoundingly huge that it did not even resemble a crater! It was too vast to see its entire area.
Here I am standing in front of the crater:
After the matatu had been fixed, it picked us up from the top and drove us back down. We ate a quick lunch, and went back to the matatu station for a ride home. Within minutes of being at the matatu station, one of the street kids stole the wallet out of the backpack of another Duke student, Lauren (Good luck: 3; Bad luck: 3). He was about 15-years-old and proceeded to taunt us with his stolen goods, jumping in front of me and waving the stolen credit cards. Fortunately, when he jumped in front of me, I was able to snatch the credit cards out of his hands, but he had taken the money and wallet for good. I am starting to appreciate the rural life in Kakamega compared to living in an urban city like Nakuru, because although there are a few street kids in Kakamega, they are everywhere in Nakuru and were openly sniffing their glue bottles.
The bad luck had not run out just yet. Within the first half hour of our drive, the matatu was pulled over by a cop for not having our seatbelts on (people never wear seatbelts in a matatu) (Good luck: 3; Bad luck: 4). The police officer attempted to bribe us, asking for 2000 shillings each in exchange for him not sending us to jail. I FROZE. Luckily, another officer walked up and excused our wrongdoing (Good luck: 4; Bad luck: 4). I cannot believe I witnessed Kenya’s corrupt government firsthand! Kenya never fails to surprise me. After that, it was smooth sailing and I arrived at home just in time for supper. What a weekend.
Many of the decisions we made this past weekend were not the smartest. For example, the nine of us interns decided to take a 4 ½ hour matatu ride at 6 PM on a Friday night. This was against the wishes of our supervisor who warned us that nine mzungus travelling at night to Nakuru was highly dangerous. Instead of taking his advice, we signed a contract giving away any responsibility of FSD.
We arrived at our hotel safe and sound despite the comments throughout the drive to remind us that “this is how NGO workers die.” However, when we got there, the hotel kindly gave away our rooms (Good luck: 0; Bad luck: 1). Fortunately, another Kenyan was also searching for a hotel at midnight, and as it turned out works at Lake Nakuru National Park and knew much about the city (Good luck: 1; Bad luck: 1). He led us to a hotel that was much cheaper and safer than the first – only in Kenya can you find a hotel room for $6 a night! It is even cheaper when splitting it between four people. Even though the pit latrine was at the end of the hall, we were at peace knowing there was a security guard stationed at the front entrance.
The next day our new Kenyan friend, Willis, bargained a deal for our group to go on a one-day safari (Good luck: 2; Bad luck: 1). The safari through Lake Nakuru was absolutely beautiful! The lake is famous for being home to a third of the world’s flamingo population. But more importantly, we saw lions, giraffes, zebra, hyena, buffalo, baboons, rhinos, and so much more! It was such an incredible sight to see these animals in their natural habitats. The animals were only feet away from us (including the lion that was sleeping)!
Here are pictures of the baboons, the buffalo, and the giraffes:
Willis then took us to a hotel within the National Park where he works as a bartender. This hotel could not have been less than 5 stars, and looked like it was taken right out of a beach in Hawaii. It seemed most out of place since just down the road were huts where the Kenyans lived, but we took full advantage, ordering cocktails and coffee. After saying goodbye to Willis and our safari driver, we went to a Chinese restaurant for dinner and to a discotheque for dancing. At the discotheque is where we really stood out. Instead of the long skirts and covered shoulders that women in Kakamega are dressed in and what we have adapted to, these urban women were wearing tight dresses and heels. It was a club straight out of Hollywood! We were shocked but had an amazing time (Good luck: 3; Bad luck: 1).
The next day is when our luck began to run out. We decided to visit the Menengai crater about a 30-minute drive from the city. We hired a matatu to take us, but about ¾ of the way, the car started steaming and we were told that “the matatu was out of fuel” (Good luck: 3; Bad luck: 2). We then proceeded to walk to the rest of the way up. The crater was so astoundingly huge that it did not even resemble a crater! It was too vast to see its entire area.
Here I am standing in front of the crater:
After the matatu had been fixed, it picked us up from the top and drove us back down. We ate a quick lunch, and went back to the matatu station for a ride home. Within minutes of being at the matatu station, one of the street kids stole the wallet out of the backpack of another Duke student, Lauren (Good luck: 3; Bad luck: 3). He was about 15-years-old and proceeded to taunt us with his stolen goods, jumping in front of me and waving the stolen credit cards. Fortunately, when he jumped in front of me, I was able to snatch the credit cards out of his hands, but he had taken the money and wallet for good. I am starting to appreciate the rural life in Kakamega compared to living in an urban city like Nakuru, because although there are a few street kids in Kakamega, they are everywhere in Nakuru and were openly sniffing their glue bottles.
The bad luck had not run out just yet. Within the first half hour of our drive, the matatu was pulled over by a cop for not having our seatbelts on (people never wear seatbelts in a matatu) (Good luck: 3; Bad luck: 4). The police officer attempted to bribe us, asking for 2000 shillings each in exchange for him not sending us to jail. I FROZE. Luckily, another officer walked up and excused our wrongdoing (Good luck: 4; Bad luck: 4). I cannot believe I witnessed Kenya’s corrupt government firsthand! Kenya never fails to surprise me. After that, it was smooth sailing and I arrived at home just in time for supper. What a weekend.
Monday 20 June 2011
HIV Testing and Awareness Day
Had a great weekend! On Saturday, I went into Kakamega for a workshop about the Kenyan perspectives of aid – very interesting workshop. Many Kenyans believe that the country should not receive aid because it hinders their development. It causes Kenyans to become dependent on aid, and work less hard knowing they will receive donations regardless of their work effort. Plus, much of the aid is conditional and opportunistic (such as the U.S. expecting a reduced price for exports from Kenya). However, the Site Team and the rest of the interns agreed that aid is completely beneficial in emergency situations. For example, a government cannot sufficiently support its citizens during a famine and needs overseas food sources.
After the workshop, I met my host mom in Kakamega to go to her niece’s wedding. After waiting about two hours to find out that her son’s car had broken down, we picked up a matatu and arrived at the wedding with one hour left. Kenyan weddings are amazingly similar to American ones! The church service is in the morning from 8-11 and the reception lasts from 3 to 6. When asked why the reception is so early, my host mom replied that it gets dangerous to travel at night. The reception was in the backyard of the groom’s house, where about 5 tents were set up, balloons, and pictures of the bride and groom. The bride was wearing a white gown and all the groomsmen were wearing tuxes. Because we arrived with only one hour remaining, we were only able to witness speeches from the family and the cutting of the cake. The one main difference between a Kenyan wedding and an American one was the size. It is tradition for Kenyan weddings to be HUGE. Invitations are sent out to friends and family, but when the day comes, the entire village is welcome (apparently, many come just for the free food). So there were hundreds of people there! Some were dressed up very nicely, and others not so much.
On Sunday, two of my friends and I went to the HIV Testing and Awareness Day organized by my hospital! The volunteers organized it and schedule one every three months with music, games, and of course, HIV testing. After a short discussion amongst ourselves, we agreed to be tested, seeing that we can only truly be advocates of HIV testing once we ourselves are tested. (Don’t worry – it was completely sterile!) Afterwards, we watched tug-of-war, and then joined in for the bottle race. We were supposed to walk from one end of the soccer field to the other with a glass soda bottle on our head. Believe it or not, we lost MISERABLY. I could not even walk one foot with the bottle not falling off! Apparently, my hair is too “slippery.” Not too many people showed up (a total of 18 were tested), but it was a fun day nonetheless.
Here is me getting tested:
And Dylan, Matthew, and I preparing for the bottle race:
After the workshop, I met my host mom in Kakamega to go to her niece’s wedding. After waiting about two hours to find out that her son’s car had broken down, we picked up a matatu and arrived at the wedding with one hour left. Kenyan weddings are amazingly similar to American ones! The church service is in the morning from 8-11 and the reception lasts from 3 to 6. When asked why the reception is so early, my host mom replied that it gets dangerous to travel at night. The reception was in the backyard of the groom’s house, where about 5 tents were set up, balloons, and pictures of the bride and groom. The bride was wearing a white gown and all the groomsmen were wearing tuxes. Because we arrived with only one hour remaining, we were only able to witness speeches from the family and the cutting of the cake. The one main difference between a Kenyan wedding and an American one was the size. It is tradition for Kenyan weddings to be HUGE. Invitations are sent out to friends and family, but when the day comes, the entire village is welcome (apparently, many come just for the free food). So there were hundreds of people there! Some were dressed up very nicely, and others not so much.
On Sunday, two of my friends and I went to the HIV Testing and Awareness Day organized by my hospital! The volunteers organized it and schedule one every three months with music, games, and of course, HIV testing. After a short discussion amongst ourselves, we agreed to be tested, seeing that we can only truly be advocates of HIV testing once we ourselves are tested. (Don’t worry – it was completely sterile!) Afterwards, we watched tug-of-war, and then joined in for the bottle race. We were supposed to walk from one end of the soccer field to the other with a glass soda bottle on our head. Believe it or not, we lost MISERABLY. I could not even walk one foot with the bottle not falling off! Apparently, my hair is too “slippery.” Not too many people showed up (a total of 18 were tested), but it was a fun day nonetheless.
Here is me getting tested:
And Dylan, Matthew, and I preparing for the bottle race:
Friday 17 June 2011
Gross Happenings
Forgot to mention that the other day visiting doctors came to the hospital to perform some procedures using our minor theatre (operating room). One of the nurses at Shibwe led me into the theatre and told the visiting doctors that I was an American doctor and would like to watch the procedure. I then watched a tubal ligation (aka. getting your "tubes tide") on a woman who was only given local anesthesia! Somehow, it seemed like I was in more pain watching the procedure than the woman was!
My FSD Workplan
My project idea has been approved!
It has been difficult to think of a project that would be both beneficial and long-lasting for the hospital. The Foundation for Sustainable Development emphasizes that our projects must be sustainable by building upon the resources that are available at the hospital and working to develop those resources. The organization stresses the difference between aid and development; aid is that which views the community as objects of development whereas development promotes the involvement of the community in order for local ownership to take hold and development solutions to be maintained. During the internship, FSD encourages its interns to take an asset-based approach—in which the first step is to identify the needs and opportunities available, build open those means, and work with the organization to ensure its maintenance for our projects to be qualified as sustainable development.
There are three components to my project: the first is to increase the number of patients who are tested and counseled for HIV and AIDS; the second is to improve the management, transparency, and appearance of the hospital; and the third is to enhance service provision by decreasing patient wait time and increasing privacy.
The first part of the project is to create a VCT center at the hospital. Kenya currently is home to one of the world’s largest HIV and AIDS epidemics. An estimated 1.5 million people are living with HIV; and in 2009 80,000 people died from AIDS related illnesses. The Kenyan government has gone a long way to provide HIV prevention and treatment services. In 2000, there were only three voluntary counseling and testing (VCT) sites nationwide, and by 2007 there were almost 1000. There are now VCT centers in 73% of health facilities in Kenya. In addition, the Kenyan government subsidizes all costs for VCT services and antiretroviral drugs and therapy. Despite the improvement that Kenya has made over the decade, only 48% of Kenyans in need of HIV treatment are receiving it (Avert).
Shibwe Sub-District Hospital is one of the few hospitals in Kenya to not have a VCT center. Currently at the facility, patients who are tested for HIV are sent to the general laboratory where they are counseled in front of many others. This causes the rest of the patients to be aware of each person who is being tested for HIV at the facility. Because privacy is critical during HIV testing and counseling due to the stigma and discrimination people still face from the disease, and since Shibwe lacks the ability to offer privacy, HIV testing is rarely done at the facility. Shibwe has been unable to provide both the funds and the space for a VCT center.
For my project, I would like to provide the space and the funds to advertise for a VCT center. In the past week, space has already been made available after some of the staff helped me to organize and clean out one of the storage rooms in the back of the Female Ward. I am hoping to move the Nurses’ Office that currently is in the Comprehensive Care Center (which treats HIV/AIDS patients and is where the VCT is originally supposed to be) to the back of the Female Ward, allotting the space in the CCC for the VCT. However, donations will be needed in order to provide a door, a desk, and chairs for the VCT. In addition, I would like to advertise that Shibwe now has a VCT center so residents in the village can come get tested. I hope to make signs around the village and make a promotion for the first 20 people to come for its opening to receive T-Shirts.
Shibwe has generously offered to provide the funds necessary to pay for a VCT counselor – this was by far the most crucial aspect of the project. Last Monday, I wrote up the advertisement for the need of a VCT counselor at Shibwe to post around the city, and on Friday interviewed for the VCT counselor. She has begun to work already as of two days ago, but has yet to be given office space. (She is currently working out of the Nurses’ Office.) I can’t wait for the VCT center to be implemented!
The second component to the project deals with the management and appearance of the hospital. Currently, the clinician sees patients based upon whoever sits closest to his door. Because there is no way to tell who has come first, patients are cutting each other in line and constantly fighting. Therefore, I have already begun the implementation of a numbering system at the hospital as of yesterday. I have printed out numbers and laminated them, and have taught the staff how to use them. Once the patient signs in at the registration desk, they are given a number and then called upon by the doctor by the next number in line. The new numbering system has been so successful in one day that the staff has asked for a numbering system for each ward in the hospital! In addition, I am hoping to improve the record system at the hospital because much time is wasted and a great deal of data is not reported with the current system. However, I will need to research better record-keeping systems, so no promises if this will work! The last part is to improve the appearance of the hospital by creating notice boards in each room and designing posters to provide both education of illnesses and an awareness of numbers seen at the hospital.
Last but not least, the third part of the project is to enhance service provision by decreasing patient wait time and increasing privacy. I have already conducted 100 surveys of patients to acquire information about patient needs and satisfaction, written a report of the analysis, and presented my report to the rest of the hospital staff (about 15 people). There were very pleased with the report (and the new numbering system) that by the end of my presentation they did a standing ovation. I was very happy :) Of the 100 patients surveyed, 46 had only attended primary school and the majority were either self-employed or farmers. Overall, the central findings of the survey was that patients indicated that they were not given enough privacy and that they were not receiving enough information about their illness or about their prescription (and that we need to increase the staff but there is nothing I can do about that….). Therefore, I would like to increase the amount of privacy offered at the hospital by constructing a partition within the consultation room. Patients are currently examined, diagnosed, and treated in front of others, because there are no doors between rooms or partitions within rooms. I wish to provide a partition for the Consultation Room, thereby creating two rooms for the two clinical officers to see patients in separately. This would not only provide privacy within the Consultation Room, but also allow more patients to be examined by the two clinical officers who will be able to work more easily with the separated room. In order to provide for two Consultation Rooms, donations will be needed to construct the partition and buy an extra desk and chairs. Furthermore, Shibwe has offered to contribute to this privacy initiative by adding in funds to create a door at the Labour Ward. Currently, the Labour Ward and the Female Ward are separated without a door, making it very simple for patients to watch a delivery. It is not only an invasion of privacy, but painful for some of the patients to watch! Lastly, if I have time, I would like to create pamphlets for the patients to read while they wait to see the clinician about some of the major illnesses affecting the area, means of prevention, and treatment. A pamphlet would also be beneficial for expecting mothers (who wait an especially long time to be seen by a nurse) about the danger signs related to pregnancy and childbirth since Kenyan women face a 1 in 20 lifetime risk of maternal death.
That is my work plan as of today! Hopefully, this project will meet FSD’s, Shibwe’s, and my hopes for sustainable development. The staff is just as excited for each of these project outcomes (especially the VCT center) so I am not at all worried about them being able to execute and maintain these development solutions after I leave Kenya. The work plan, however, may continually change the longer I work at Shibwe and the more I discover opportunities and bounce back ideas off the other interns.
I have sent in my Online Campaign Form to the head office of FSD in San Francisco so hopefully it will be approved in the next couple days and I can begin fundraising for the VCT center and the partition for the Consultation Room! Donations will be very, very much appreciated :)
If you have any comments or ideas about other projects, do not hesitate to tell me!
Sidenote: Yesterday afternoon, I visited my homestay aunt at the girls secondary school she teaches at. It is a public boarding school (very common here), and apparently the girls must wake up at 4:30 AM to be in class by 5! I would have dropped out immediately...
It has been difficult to think of a project that would be both beneficial and long-lasting for the hospital. The Foundation for Sustainable Development emphasizes that our projects must be sustainable by building upon the resources that are available at the hospital and working to develop those resources. The organization stresses the difference between aid and development; aid is that which views the community as objects of development whereas development promotes the involvement of the community in order for local ownership to take hold and development solutions to be maintained. During the internship, FSD encourages its interns to take an asset-based approach—in which the first step is to identify the needs and opportunities available, build open those means, and work with the organization to ensure its maintenance for our projects to be qualified as sustainable development.
There are three components to my project: the first is to increase the number of patients who are tested and counseled for HIV and AIDS; the second is to improve the management, transparency, and appearance of the hospital; and the third is to enhance service provision by decreasing patient wait time and increasing privacy.
The first part of the project is to create a VCT center at the hospital. Kenya currently is home to one of the world’s largest HIV and AIDS epidemics. An estimated 1.5 million people are living with HIV; and in 2009 80,000 people died from AIDS related illnesses. The Kenyan government has gone a long way to provide HIV prevention and treatment services. In 2000, there were only three voluntary counseling and testing (VCT) sites nationwide, and by 2007 there were almost 1000. There are now VCT centers in 73% of health facilities in Kenya. In addition, the Kenyan government subsidizes all costs for VCT services and antiretroviral drugs and therapy. Despite the improvement that Kenya has made over the decade, only 48% of Kenyans in need of HIV treatment are receiving it (Avert).
Shibwe Sub-District Hospital is one of the few hospitals in Kenya to not have a VCT center. Currently at the facility, patients who are tested for HIV are sent to the general laboratory where they are counseled in front of many others. This causes the rest of the patients to be aware of each person who is being tested for HIV at the facility. Because privacy is critical during HIV testing and counseling due to the stigma and discrimination people still face from the disease, and since Shibwe lacks the ability to offer privacy, HIV testing is rarely done at the facility. Shibwe has been unable to provide both the funds and the space for a VCT center.
For my project, I would like to provide the space and the funds to advertise for a VCT center. In the past week, space has already been made available after some of the staff helped me to organize and clean out one of the storage rooms in the back of the Female Ward. I am hoping to move the Nurses’ Office that currently is in the Comprehensive Care Center (which treats HIV/AIDS patients and is where the VCT is originally supposed to be) to the back of the Female Ward, allotting the space in the CCC for the VCT. However, donations will be needed in order to provide a door, a desk, and chairs for the VCT. In addition, I would like to advertise that Shibwe now has a VCT center so residents in the village can come get tested. I hope to make signs around the village and make a promotion for the first 20 people to come for its opening to receive T-Shirts.
Shibwe has generously offered to provide the funds necessary to pay for a VCT counselor – this was by far the most crucial aspect of the project. Last Monday, I wrote up the advertisement for the need of a VCT counselor at Shibwe to post around the city, and on Friday interviewed for the VCT counselor. She has begun to work already as of two days ago, but has yet to be given office space. (She is currently working out of the Nurses’ Office.) I can’t wait for the VCT center to be implemented!
The second component to the project deals with the management and appearance of the hospital. Currently, the clinician sees patients based upon whoever sits closest to his door. Because there is no way to tell who has come first, patients are cutting each other in line and constantly fighting. Therefore, I have already begun the implementation of a numbering system at the hospital as of yesterday. I have printed out numbers and laminated them, and have taught the staff how to use them. Once the patient signs in at the registration desk, they are given a number and then called upon by the doctor by the next number in line. The new numbering system has been so successful in one day that the staff has asked for a numbering system for each ward in the hospital! In addition, I am hoping to improve the record system at the hospital because much time is wasted and a great deal of data is not reported with the current system. However, I will need to research better record-keeping systems, so no promises if this will work! The last part is to improve the appearance of the hospital by creating notice boards in each room and designing posters to provide both education of illnesses and an awareness of numbers seen at the hospital.
Last but not least, the third part of the project is to enhance service provision by decreasing patient wait time and increasing privacy. I have already conducted 100 surveys of patients to acquire information about patient needs and satisfaction, written a report of the analysis, and presented my report to the rest of the hospital staff (about 15 people). There were very pleased with the report (and the new numbering system) that by the end of my presentation they did a standing ovation. I was very happy :) Of the 100 patients surveyed, 46 had only attended primary school and the majority were either self-employed or farmers. Overall, the central findings of the survey was that patients indicated that they were not given enough privacy and that they were not receiving enough information about their illness or about their prescription (and that we need to increase the staff but there is nothing I can do about that….). Therefore, I would like to increase the amount of privacy offered at the hospital by constructing a partition within the consultation room. Patients are currently examined, diagnosed, and treated in front of others, because there are no doors between rooms or partitions within rooms. I wish to provide a partition for the Consultation Room, thereby creating two rooms for the two clinical officers to see patients in separately. This would not only provide privacy within the Consultation Room, but also allow more patients to be examined by the two clinical officers who will be able to work more easily with the separated room. In order to provide for two Consultation Rooms, donations will be needed to construct the partition and buy an extra desk and chairs. Furthermore, Shibwe has offered to contribute to this privacy initiative by adding in funds to create a door at the Labour Ward. Currently, the Labour Ward and the Female Ward are separated without a door, making it very simple for patients to watch a delivery. It is not only an invasion of privacy, but painful for some of the patients to watch! Lastly, if I have time, I would like to create pamphlets for the patients to read while they wait to see the clinician about some of the major illnesses affecting the area, means of prevention, and treatment. A pamphlet would also be beneficial for expecting mothers (who wait an especially long time to be seen by a nurse) about the danger signs related to pregnancy and childbirth since Kenyan women face a 1 in 20 lifetime risk of maternal death.
That is my work plan as of today! Hopefully, this project will meet FSD’s, Shibwe’s, and my hopes for sustainable development. The staff is just as excited for each of these project outcomes (especially the VCT center) so I am not at all worried about them being able to execute and maintain these development solutions after I leave Kenya. The work plan, however, may continually change the longer I work at Shibwe and the more I discover opportunities and bounce back ideas off the other interns.
I have sent in my Online Campaign Form to the head office of FSD in San Francisco so hopefully it will be approved in the next couple days and I can begin fundraising for the VCT center and the partition for the Consultation Room! Donations will be very, very much appreciated :)
If you have any comments or ideas about other projects, do not hesitate to tell me!
Sidenote: Yesterday afternoon, I visited my homestay aunt at the girls secondary school she teaches at. It is a public boarding school (very common here), and apparently the girls must wake up at 4:30 AM to be in class by 5! I would have dropped out immediately...
Monday 13 June 2011
Where are all the farmers?
A few days ago, while I was eating lunch at the hospital, I was talking with a few other staff members about my life in America. We began the conversation talking about my favorite food in Kenya compared to what I like to eat back home. I was then asked how I get my food in America. I briefly explained that I buy all my food at a market that is close to my house. This idea was met, however, by shocked faces, and only begged the question: “Well, what do you farm?” I responded that I did not own a farm, and therefore must buy all my food from the market. This only further prompted the question: “But, what do each of your parents farm?” After explaining that my parents did not own farms either and that I live in a very congested city in America where there is no room for farms, one of the women quickly replied: “Oh. You are rich.”
I have not been able to stop thinking about this conversation since. I knew that coming to Africa would be an incredible, eye-opening experience for me and allow me to appreciate many of the things I take advantage of back home. Despite all that I have experienced so far – optimizing my technique while I bathe in order to not waste any water, electricity going out at least once each night, walking the couple miles to church because the bus driver tried to rip my family off by ten cents – this conversation is the one that I can’t seem to get out of my head. All of the other experiences I have gotten used to with time (and thank god I brought a flashlight!). Never would I have thought that living a life that does not entail being a farmer would be qualified as rich. (If so, America needs to seriously reassess its poverty line…) This made me realize how the majority of the food that I have been eating has been locally-grown: the milk I drink at each meal is from our cows that moo all day and night; the avocados I have been eating are from the avocado tree that has finally ripened; the chicken I eat for dinner is the one and only chicken walking around the backyard; and the ugali I eat almost every day is made from the corn in my homestay mom’s garden. I wish I could say that I have been eating healthy because of this “organic” diet, but Kenyans do not strive as we do in America for a balanced diet. Instead, my diet has been carb-overload (if only Atkins could see me eat). I have been on a steady meal plan of bread for breakfast, rice for lunch, and ugali or fried potatoes for dinner. However, dinner is usually served with meat, but I’d almost prefer if it wasn’t since they eat it chopped into small pieces with the bones and fat all in one delicious bite. They also love to give me more food past the point that I say I am too full to even walk (both at my homestay and at the hospital). I must say – Kenyans do love to eat! And, also, to “take tea.” We take tea about three times a day, served with either bread or donuts. In addition, later in the conversation, when asked what the “staple” food is in America, I had trouble explaining that we do not have one, but after awhile, resorted to saying “chicken” (since that is essentially my staple food).
I truly enjoyed this conversation we had over lunch. It is these conversations that will stay with me when I return back to America. Many of the experiences I have had in Kenya so far I have gotten used to with time, and can laugh at how inexperienced I once was (I will almost need to get used to using a toilet when I get back to America!). These conversations are the ones that are the most eye-opening and heartfelt. These are the ones that will truly make me appreciate the life I live back home.
In other news:
- I have finally finished conducting the 100 Client Satisfaction Surveys. This was after realizing that I was unable to conduct even one because the majority of the patients cannot speak English so my supervisor found four volunteers to help me. (When asked how he found these random people, he proudly said, “I can mobilize.”) The next few days I will be analyzing the results, and on Thursday, presenting them to the rest of the staff.
- I have finally figured out my work plan for the next 6 weeks at the hospital! I have submitted the official document to the FSD supervisor and am waiting for his feedback/approval. I am very excited for my project and can’t wait to share once approved. Also, I am going to start a fundraising campaign! Would love if you could donate :). More to come about that later, though.
- I skipped out on church yesterday and went to Kisumu with the rest of the interns instead. Was asked at the hospital today where I was yesterday. Whoops…
I have not been able to stop thinking about this conversation since. I knew that coming to Africa would be an incredible, eye-opening experience for me and allow me to appreciate many of the things I take advantage of back home. Despite all that I have experienced so far – optimizing my technique while I bathe in order to not waste any water, electricity going out at least once each night, walking the couple miles to church because the bus driver tried to rip my family off by ten cents – this conversation is the one that I can’t seem to get out of my head. All of the other experiences I have gotten used to with time (and thank god I brought a flashlight!). Never would I have thought that living a life that does not entail being a farmer would be qualified as rich. (If so, America needs to seriously reassess its poverty line…) This made me realize how the majority of the food that I have been eating has been locally-grown: the milk I drink at each meal is from our cows that moo all day and night; the avocados I have been eating are from the avocado tree that has finally ripened; the chicken I eat for dinner is the one and only chicken walking around the backyard; and the ugali I eat almost every day is made from the corn in my homestay mom’s garden. I wish I could say that I have been eating healthy because of this “organic” diet, but Kenyans do not strive as we do in America for a balanced diet. Instead, my diet has been carb-overload (if only Atkins could see me eat). I have been on a steady meal plan of bread for breakfast, rice for lunch, and ugali or fried potatoes for dinner. However, dinner is usually served with meat, but I’d almost prefer if it wasn’t since they eat it chopped into small pieces with the bones and fat all in one delicious bite. They also love to give me more food past the point that I say I am too full to even walk (both at my homestay and at the hospital). I must say – Kenyans do love to eat! And, also, to “take tea.” We take tea about three times a day, served with either bread or donuts. In addition, later in the conversation, when asked what the “staple” food is in America, I had trouble explaining that we do not have one, but after awhile, resorted to saying “chicken” (since that is essentially my staple food).
I truly enjoyed this conversation we had over lunch. It is these conversations that will stay with me when I return back to America. Many of the experiences I have had in Kenya so far I have gotten used to with time, and can laugh at how inexperienced I once was (I will almost need to get used to using a toilet when I get back to America!). These conversations are the ones that are the most eye-opening and heartfelt. These are the ones that will truly make me appreciate the life I live back home.
In other news:
- I have finally finished conducting the 100 Client Satisfaction Surveys. This was after realizing that I was unable to conduct even one because the majority of the patients cannot speak English so my supervisor found four volunteers to help me. (When asked how he found these random people, he proudly said, “I can mobilize.”) The next few days I will be analyzing the results, and on Thursday, presenting them to the rest of the staff.
- I have finally figured out my work plan for the next 6 weeks at the hospital! I have submitted the official document to the FSD supervisor and am waiting for his feedback/approval. I am very excited for my project and can’t wait to share once approved. Also, I am going to start a fundraising campaign! Would love if you could donate :). More to come about that later, though.
- I skipped out on church yesterday and went to Kisumu with the rest of the interns instead. Was asked at the hospital today where I was yesterday. Whoops…
Wednesday 8 June 2011
A Quick Recovery
I am feeling much better now! Possibly because I went to two church services on Sunday and then slept for the rest of the day....
On Monday, I visited Iguhu District Hospital where Matthew, one of the other interns, works. The Records Officer at Shibwe took me because she needed to drop some documents off, so I met up with Matthew and toured around his hospital. It is much bigger and nicer than Shibwe (because it is a district hospital rather than sub-district), and gave me a few ideas on how to improve Shibwe. Afterward, I took the Records Officer, Beatrice, out for lunch. She has become one of my best friends at the hospital and extremely helpful whenever I have questions. She told me that Kenya has a total of 42 tribes, meaning that there are 42 different languages in Kenya alone! She then asked me what my "mother tongue" was and was shocked that I said it was English.
Yesterday, I wrote up a 'Client Satisfaction Survey' to give out to 100 patients. My supervisor at the hospital advised me to write it, and gave me copies of surveys they have used in the past. He wants me to follow each patient that I give a survey to around with them throughout their entire time at the hospital, so the project may take a few days to finish. I am very interested to see the feedback I get!
Interesting Fact: The Kenyan government is still very corrupt. Each time I take a bus (matatu) into Kakamega, the police are stationed at various spots along the road, and force the drivers to pay them 100 shillings (about $1.30) each time they pass. My homestay uncle owns a matatu business, and was explaining to me how the cartels are very well-known and established all throughout Kenya.
I have been trying to post pictures of my homestay house/compound and of the hospital onto the blog for awhile now, but the internet connection has been too poor lately. For some reason, Facebook has been 1000x faster so I have just posted some pictures onto my Facebook if you would like to see! (Kenyans use Facebook, too!)
On Monday, I visited Iguhu District Hospital where Matthew, one of the other interns, works. The Records Officer at Shibwe took me because she needed to drop some documents off, so I met up with Matthew and toured around his hospital. It is much bigger and nicer than Shibwe (because it is a district hospital rather than sub-district), and gave me a few ideas on how to improve Shibwe. Afterward, I took the Records Officer, Beatrice, out for lunch. She has become one of my best friends at the hospital and extremely helpful whenever I have questions. She told me that Kenya has a total of 42 tribes, meaning that there are 42 different languages in Kenya alone! She then asked me what my "mother tongue" was and was shocked that I said it was English.
Yesterday, I wrote up a 'Client Satisfaction Survey' to give out to 100 patients. My supervisor at the hospital advised me to write it, and gave me copies of surveys they have used in the past. He wants me to follow each patient that I give a survey to around with them throughout their entire time at the hospital, so the project may take a few days to finish. I am very interested to see the feedback I get!
Interesting Fact: The Kenyan government is still very corrupt. Each time I take a bus (matatu) into Kakamega, the police are stationed at various spots along the road, and force the drivers to pay them 100 shillings (about $1.30) each time they pass. My homestay uncle owns a matatu business, and was explaining to me how the cartels are very well-known and established all throughout Kenya.
I have been trying to post pictures of my homestay house/compound and of the hospital onto the blog for awhile now, but the internet connection has been too poor lately. For some reason, Facebook has been 1000x faster so I have just posted some pictures onto my Facebook if you would like to see! (Kenyans use Facebook, too!)
Saturday 4 June 2011
Shibwe Sub-District Hospital
I have finally become a doctor! Well, not actually… But I have just finished my first week working at Shibwe Sub-District Hospital. The hospital is set up like a compound – there are about five different buildings that are arranged in a half-circle. The main building has the Consultation Room, the Laboratory, the Pharmacy, the Records/Public Health Office, the Injection Room, the Mother/Child Health Room, the Family Planning Room, and the Male Ward. The next building is the Female Ward, which also contains the Labor Ward. The third building is called the Comprehensive Care Center (CCC) and is where the HIV/AIDS patients go. The CCC acts separately from the rest of the hospital, though. Most of the workers are volunteers who have HIV and are the ones to counsel the rest of the patients. Interestingly enough, USAID donated the CCC to the hospital. The last two buildings are the Administrative Office and the kitchen.
The hospital does AMAZING work with the amount of resources it has. It sees more than 100+ patients a day, but only staffs about 2 nurses and 1 clinical officer at a time. There is no actual M.D. working at the hospital – only clinical officers who examine and diagnose the patients. The hospital is in great need of employing more nurses and clinical officers but does not have enough funds to do so. Therefore, the nurses who are working run back and forth between all of the rooms and wards in order to see all of the patients. They do not have one second to breathe. There is no running water in the hospital so everything is sterilized in buckets and the patients need to go outside to the pit latrines to use the bathroom. (This turns into a huge problem (as I have seen already) when patients are in the Labor Ward…) Moreover, there are not enough beds in any of the wards, so many of the patients must share with one or two others to a bed. They also do not use files to maintain patients’ medical records. Instead, patients keep their own notebook to function as their medical file and bring it each time they visit the hospital.
This past week I have mainly been observing each department in the hospital in order to learn how it is being run, and so that I can do a proper needs assessment for my project later on during the internship. I have spent most of my time, though, in the Consultation Room and the Female Ward because that is where they have let me do the most hands-on work. While I was observing the Consultation Room, the clinical officer working would let me examine the patients with him. He taught me how to measure blood pressure and how to do a full-body inspection. He would translate what the patients were saying to me and explain to me his diagnosis. The next day while I was in the Female Ward, the nurses took me on their rounds and allowed me to give out the medicines. They also taught me how to set up an IV and how to examine a pregnant mother. It’s been fun playing doctor!
It is actually UNBELIEVABLE how many patients come with malaria. My supervisor was right when he told me last week that it is easy to diagnose a patient with malaria. It is “malaria season” right now because of the heavy rains (it is winter in Kenya) so about 90% of the patients come with malaria. Some are simply treated with medicine and can go home, but others who have severe malaria are admitted to the hospital. There was one child who had severe malaria who started convulsing and stop breathing. I was so afraid that he was going to die but luckily the nurse was able to resuscitate him. The malaria medicine is free of charge (thankfully!), as well as prescriptions to children under five and to pregnant women. But the rest of the prescribed medicine must be paid for, and on average, costs only about $3. There are MANY patients, though, who cannot afford this and are unable to buy the medicine that is prescribed. I felt so tempted to give money several times to some of these patients, but FSD strictly forbids us to do this.
A few sidenotes:
1. I rode on the back of my first motorcycle (pikipiki)! It is another type of taxi here and a bit more expensive than the busses (matatus), but much more fun!
2. I may have come down with the flu today. The four-year-old, Daryl, is sick and I think may have gotten me sick too. The FSD team took me to the doctor today who tested me for malaria. Fortunately, my time for that has not come yet. I just have a high fever and a bad headache, so he gave me some painkillers and an antibiotic. (I am not sure why he gave me an antibiotic if it is the flu, though. I can’t decide if I should take the medicine.) But hopefully I should be feeling better by tomorrow.
The hospital does AMAZING work with the amount of resources it has. It sees more than 100+ patients a day, but only staffs about 2 nurses and 1 clinical officer at a time. There is no actual M.D. working at the hospital – only clinical officers who examine and diagnose the patients. The hospital is in great need of employing more nurses and clinical officers but does not have enough funds to do so. Therefore, the nurses who are working run back and forth between all of the rooms and wards in order to see all of the patients. They do not have one second to breathe. There is no running water in the hospital so everything is sterilized in buckets and the patients need to go outside to the pit latrines to use the bathroom. (This turns into a huge problem (as I have seen already) when patients are in the Labor Ward…) Moreover, there are not enough beds in any of the wards, so many of the patients must share with one or two others to a bed. They also do not use files to maintain patients’ medical records. Instead, patients keep their own notebook to function as their medical file and bring it each time they visit the hospital.
This past week I have mainly been observing each department in the hospital in order to learn how it is being run, and so that I can do a proper needs assessment for my project later on during the internship. I have spent most of my time, though, in the Consultation Room and the Female Ward because that is where they have let me do the most hands-on work. While I was observing the Consultation Room, the clinical officer working would let me examine the patients with him. He taught me how to measure blood pressure and how to do a full-body inspection. He would translate what the patients were saying to me and explain to me his diagnosis. The next day while I was in the Female Ward, the nurses took me on their rounds and allowed me to give out the medicines. They also taught me how to set up an IV and how to examine a pregnant mother. It’s been fun playing doctor!
It is actually UNBELIEVABLE how many patients come with malaria. My supervisor was right when he told me last week that it is easy to diagnose a patient with malaria. It is “malaria season” right now because of the heavy rains (it is winter in Kenya) so about 90% of the patients come with malaria. Some are simply treated with medicine and can go home, but others who have severe malaria are admitted to the hospital. There was one child who had severe malaria who started convulsing and stop breathing. I was so afraid that he was going to die but luckily the nurse was able to resuscitate him. The malaria medicine is free of charge (thankfully!), as well as prescriptions to children under five and to pregnant women. But the rest of the prescribed medicine must be paid for, and on average, costs only about $3. There are MANY patients, though, who cannot afford this and are unable to buy the medicine that is prescribed. I felt so tempted to give money several times to some of these patients, but FSD strictly forbids us to do this.
A few sidenotes:
1. I rode on the back of my first motorcycle (pikipiki)! It is another type of taxi here and a bit more expensive than the busses (matatus), but much more fun!
2. I may have come down with the flu today. The four-year-old, Daryl, is sick and I think may have gotten me sick too. The FSD team took me to the doctor today who tested me for malaria. Fortunately, my time for that has not come yet. I just have a high fever and a bad headache, so he gave me some painkillers and an antibiotic. (I am not sure why he gave me an antibiotic if it is the flu, though. I can’t decide if I should take the medicine.) But hopefully I should be feeling better by tomorrow.
Subscribe to:
Posts (Atom)