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Published: July 20th 2006
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Hello All...It has been quite the week. And I am still trying to absorb and make sense of my experiences. On Monday, Hanif dropped me off at the FACES clinic and I spent an hour in the triage office (registering new HIV positive patients). The clinic was over capacity that day -- 140 patients -- they can accommodate 100. Data is hand written and then sent to the Centre for Disease Control (CDC). I am still thinking about a better way to collect the data -- ok I can't help myself -- current process is very manual and cumbersome. Shortly after noon, I hooked up with Dennis, community health worker, to try and track down 4 patients who have not been to the clinic in months. All 4th stage (not good) HIV patients. Goal is to locate them, assess them and encourage them to return to the clinic. I hopped on a Boda Boda -- bicycle taxi -- Dennis hopped on his bike and off we went to the slums surrounding Kisumu. Thank heavens I am a motorcycle rider for I was able to handle the ducking and weaving without falling off. The roads are not great here and in some
cases not roads at all -- goat trails really! Bike was almost as comfortable as Dave's!!!(ha) Talk about a wild goose chase! There are no addresses in the slums -- you rely on people's directions which can be often misleading. Also more often than not postive status people do not disclose to their families that they are positive (there is still so much shame and fear associated with the virus) -- so the health care workers also have to be careful about disclosing why they are looking for the person. It is all a bit of a spy game. I was a good cover for Dennis on Monday -- he could say he was touring a Canadian around. I have now seen, walked and touched dire poverty. I still can't believe the conditions families live under. Mud and tin huts on top of each other with garbage and sewage flowing in the narrow streets if you can call them that...animals (pigs, goats, ducks, dogs you name it) eating the sewage and children playing in it. Charcoal fires inside the huts or strewn about on the ground. All I kept thinking was it doesn't have to be this way and where
on earth are the basic government services of sanitation, water and roads????? Of the 4 patients Dennis and I were searching for -- we located one, discovered another had lied about where they live (took us an hour to figure that out), learned that another was in the hospital with her 5 month old baby and learned the last patient had died in March -- yes of Aids. We took a moment and shed a tear! I bought Dennis lunch, meat stew with Ugali (a cross between polenta and cream of wheat -- local staple) and chapati (flat bread) for 125 shillings ($2) -- he was so grateful..so much that on our last visit we detoured and he took me to his home to meet his wife and 3 children. He lives on the fringe of the shanty town -- very modest and clean. His family is lovely. Another boda boda deposited me back to the clinic at 4 pm -- and I was completely drained. I have an open invitation to come back to the clinic anytime. George the administrator would like me to get out for other field visits and also have me spend time in other parts
of the clinic. I will definitely be taking him up on his offer.
I switched gears a little bit the last 3 days and have been attending a 3-day training course for local fishing villagers on preventing and treating HIV/Aids among fisher folk. The course is being offered by WIFIP (Women in the Fishing Industry Project) and is taking a train the trainer approach -- or Peer Education as they called it. 30 local leaders were chosen to attend this seminar (all expenses paid) and the purpose of the 3 days was to promote HIV Aids prevention, improve sexual negotiation skills particularly among women, demonstate proper condom use and disposal and promote positive and healthy living for those that are HIV positive. What impressed me most about the 3 days was this group of men and women who were tackling their age old customs and practices which in many ways are killing them. HIV/Aids is very high among the fisher folk. There is a long standing practice of Jaboyas (fishermen) demanding sex in exchange for providing fish. Women have also been property in this culture -- with no ability to say no. So HIV runs rampant. Most of the
course was given in LUO the local dialect -- but the instructors were amazing to me..making sure that I was following along and able to participate. So I am up to date on HIV transmission and its link to STDs and I can demonstrate the proper usage of a condom. I also took part in an assertiveness training module (ok don't laugh too hard!) But what an experience to be immersed for 3 days in local culture and watch these emerging leaders grapple with this profound issue. I walked away today very hopeful.
Tomorrow Munira and I are off to local village to see about a new cost effective sewage system. Hanif and I also need to check in with the orphanage to see how Josephat is doing. So it has been quite the first week. I continue to be blown away by the hospitality of my hosts and the determination of the people I am meeting in the trenches. Thank you all for your comments and well wishes -- they mean the world to me. Cheers, Jan
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Sheila
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What a week; what potential; what a challenge
Brought me to tears - makes my own issues seem very little. Lots of love, - Sheila