into the rift!

---

Salama. Hello.

Habari? How are you? Nzuri. Good.

I write today (which for me is Sunday at about 11:48 this morning) from a cyber cafe, Skylab Cyber Cafe, in the Nairobi City Centre that is located in the 20th Century building, a large high rise that spans a block in all directions. In it is also a big movie theater, lots of stores, a salon, African Express Airways, and fortunately a "ladies" which is what polite folks call the BATHROOM. A crucial lesson learned by this girl on my first day at work is that one carries toilet paper in one's bag because few restrooms here have toilet paper. Fortunately I also listened to the wise LT and also carry wipes. Not all restrooms here have towels. According to the guidebook, public restrooms in Nairobi are actually a relatively new addition to the city centre, one for which I am most thankful.

I climbed three flights of stairs to get to this small shop. It has a linoleum floor, dark tinted windows, a ceiling covered with taffeta fabric that centers on a hanging fluorescent bulb. There's a small cooler that contains the nectar of the gods, coca cola (IN BOTTLES!) in the corner. They charge 80 cents (100 cents = 1 Ksh) an hour to browse, 10Ksh to print. Fortunately for me, the nice gentleman who owns this place offers discounts on both browsing and printing for frequent fliers. When I first got here yesterday to work, Dolly Parton rang out from the radio. Today the music is more contemporary. At first techno, now Christian pop. Yesterday, the boss guy and I were getting a long quite well. Then I printed out a bunch of stuff about HIV, condoms, transactional sex and Kenyan sex workers. He had no humor or love for me when I went to fetch my articles. Even though I was dropping a bunch of cash, he tried to renig on the discounts he offered me at the beginning of my time. I was worried he might not be very excited to see me today, but fortunately I was wrong.

Very few buidlings have lifts/elevators. When I am at work at Kenyatta, I have been hosted primarily by the data office. The data office are Anne and Gerald and they manage immense amounts of data for various research studies. Anne is the data mistress. Gerald is the IT guy. Their office consisted of three cubicles in one room, piled high with file cabinets and boxes. Any flat surface contained some sort of container for paper. Data sheets from studies everywhere you turned. They moved last week to a new office in a brand new building built by the University of Manitoba, on of KEMRI's other main collaborators. People moved them and moved all of their incredibly heavy file cabinets up very narrow staircases. I caused quite a commotion by helping, something that I thought was only natural. Apparently even though it is not uncommon for women to do hard work/manual labor here it is quite remarkable for white women to lift or carry anything. In fact, given the stares, whispers and giggles I am not sure anyone around there had ever seen a white woman carry something.

I fell back on my Iowa roots and said that in Iowa we help each other and if my mom ever found out that I watched others move and work when I could very well help out that I'd be in big trouble...huge...immeasurable. People seemed to accept that reason and let me help a bit. Thanks, mom.

So I mean to write today about my Thursday and Friday adventures. Both days I ventured out of Nairobi to visit two of the four study sites for a huge HIV incidence study being conducted by KEMRI. My mentor here, Dr. Bukusi, is the PI (principal investigator = hefe = boss) of this study. The objective is to assess HIV incidence in four communities to identify populations where the incidence (new infections) of HIV is sufficiently high to be suitable for trials of a new HIV prevention strategy coming down the pike, microbicides. Microbicides would be applied in the vagina to prevent HIV transmission/infection. These are important because they would be a method of HIV prevention controlled by women and not dependent on the negotiation of condom use with male partners.

Ah, Celine Dion.

The site we visited was Naivasha, a town approximately an hour's drive northwest of Nairobi, located in the Rift Valley. The road to Naivasha passes through a few small towns. The roadsides are lined with tiny storefronts brightly painted with advertisements for Nescafe, just like billboards only painted on the buildings, or for the two mobile phone companies here, Celtel and Safaricom. The doors are frequently covered with curtains. The roofs are corrugated metal. The road is paved, anything not road is rocky red dirt. The action lies behind the storefronts. Fortunately our vehicle was high enough that I could see beyond to the dense collection of houses...small structures with the same corrugated metal roofing, perhaps concrete flooring, hopefully running water.

As I looked off toward the horizon, I just felt like we were on top of the world. I couldn't see any hills or mountains off in the distance. Then I saw just the very top of a jagged structure. As I was about to ask what that was, the trees opened up and I saw that we were driving along the edge of this incredibly huge valley, the Rift Valley. The jagged edge was actually the top of a huge volcano located in the middle of the valley. I felt similarly as I did when Maria and I were at the edge of the Grand Canyon. The Rift Valley extends over much of sub-Saharan Africa and is a lush green valley with lakes...one lake being Lake Naivasha. As we descended into this green valley we could see small farms, farmed totally by hand...sheep and an occasional goat grazed wherever they wanted, if by the roadside then they'd be tethered. Zebras also graze here. Zebras.

Naivasha is an agricultural town with huge flower farms. The flower farms employ predominately women, as they raise less of a fuss and work harder. There are also lots of men around and there is a thriving transactional sex economy here. The women who work at the flower farms and the transactional sex workers are the main targets of the study's enrollment efforts. We visited the folks on the ground who are reaching out into the community to these women, organizing community events, sporting events, forums for them to air their issues in an attempt to get them enrolled in the study. The goal is 1000 women at each of the four sites. I felt very lucky to be able to see this aspect of research work, the incredible grassroots effort to get the women needed to get the study done. Just immense. It's not even just convincing these women that talking about their sex lives is a good idea, often, quite often it's getting them to come back, occupying their children, convincing their husbands that this is a good idea. And they might be finding out that they have HIV (in which case they'd be ineligible for the study but would then be referred for treatment) or some other infection or that they get HIV. Lots of issues.

My traveling companions were Charles Muga and Francis. Francis is a driver, actually the head driver. Drivers are good folks to know as navigating the Kenyan thoroughfares is hairy under the best of circumstances. Race car driver is likely the best analogy. Charles Muga is a former teacher and headmaster who then went to graduate school for social science, mostly psychology, and now is the mobilization czar for the project. He is also, as I found out about two hours into our first jaunt, the eldest of seven in his family and one of his younger siblings happens to be Dr. Bukusi. Mr. Muga informed me early on, over our first stop in Naivasha which was for tea, that when I traveled with him that I would not be paying for anything, nothing and that I was not to even offer. I thanked him for the honor of being his guest. Later on in the day he asked me if I had been educated in a religous setting. I said I was educated in public primary and secondary schools then a liberal arts university and a public medical school. Mr. Muga is a scientist of people, individuals and how they move throughout society, culture, conversation. He just takes it in and digests. I know I will never surprise him or if I do he will never let on. I guess I could be unnerved, but I just go with it, what choice do I have?

Our "meetings" consisted of motivational chats, where basically little of what I expected would be discussed like details of the study was discussed. We caught up on the local goings on, checked in about any office drama, Charles may or may not take someone aside for a little personal heart to heart, but usually I was included in everything.

We visited a small NGO (nongovernmental organization) that works with single mothers (most of whom are forced into sex work to have enough money to feed their kids) called Life Bloom, a satellite clinic and also the district hospital. It's actually a subdistrict hospital, but the Naivasha region is so huge that it should be upgraded to a district level facility. This hospital consisted of a collection of one story buildings on grassy grounds with central parking areas. Dirt roads. The surgeon and the gynaecologist had designated parking spots as did the hospital administrator. They had psychiatry, surgery, casualty (emergency), pediatrics, dental, gyn clinics here. We passed a woman just absolutely distraught. She collapsed in the road/dirt path howling and screaming. She had either just lost someone or was mentally ill. Unfortunately I think the latter as the doctor came out and escorted her into a white truck and not back into the clinic.

We also visited the police station where Francis got out and was gone for a time. I was very curious about this side trip. Was he paying a ticket? A bribe? We seem to pass easily wherever we go. Not surprisingly, I guess, Charles seems to be one of those people who knows all the right people. But given the controversial nature of our work, I wouldn't have been surprised if we had run into some drama. Later, Charles told me that on the way home from a research site, Francis had been robbed, beaten, his phone stolen, his windshield broken. He wasn't hurt and his family wasn't with him, but he was seeking the police abstract so that his employer, Family Health International, would compensate him.

We also went to Thika, another site mainly recruiting sex workers.

Friday Charles treated us to nyama choma...the Kenyan national food...barbequed meat. In this case goat. More about that in the next installment as I just noticed the time and must hurry back to the hostel so I don't miss lunch. I have to escort Raphael, the man who makes our food, to the hospital where we're going to visit our friend Kate, a missionary from Tanzania who was staying at Flora Hostel in order to have her baby here in Nairobi. She delivered three days ago by cesarean. She's still in the hospital because baby Rajeli has jaundice. Her husband Isaac is Tanzanian and arrived at 0200 on Rajeli's day of life 1 after a nearly 24 hour bus ride here.

More soon. Asante sana for reading and for writing me. I really appreciate it. I'm feeling the distance a bit more right now, my grandmother fell and broke her leg. She had surgery yesterday and is doing well, thank goodness.

---