One of my motivations to keep at it? The gorgeous scenery!
These fields are about 5-10 minutes away from the compound and it's a nice way to start or finish a day!
Sunday, June 12, 2011
Running
One of my goals for the year was to start running more. I usually pick other activities over running since distance running for long periods of time was never my thing. I polevaulted in college so my running consisted of sprinting about 80 feet several times in a row. Anyway, I've definitely built a better running base while I've been in Kenya but I still feel like I have a lot more work to do.
One of my motivations to keep at it? The gorgeous scenery!
These fields are about 5-10 minutes away from the compound and it's a nice way to start or finish a day!
One of my motivations to keep at it? The gorgeous scenery!
These fields are about 5-10 minutes away from the compound and it's a nice way to start or finish a day!
Saturday, June 11, 2011
Day of the African Child
I bet you didn't know that was actually a day!
Tumaini staff and many of the kids got together today with children from other homes, schools, and centers. We marched through town together to the children's rescue center in Eldoret to celebrate and recognize African children. The kids had a blast and it's so great that people in town could see them in a different light today.
Here are some pictures...
Tumaini staff and many of the kids got together today with children from other homes, schools, and centers. We marched through town together to the children's rescue center in Eldoret to celebrate and recognize African children. The kids had a blast and it's so great that people in town could see them in a different light today.
Here are some pictures...
Tumaini girls in the parade
Tumaini boys
Tumaini staff...these are some of the most incredible people I have met in Kenya. Keep up the fantastic work guys!
Tree planting at the rescue center after the parade
I will miss these kids so much. They live a life on the streets that none of us could begin to imagine and yet they manage to keep smiling, singing and just being kids. As much as I would love to see them again if I come back next year, I hope that most of them are not around and have finally been sent to school!!
Friday, June 3, 2011
Garden Update
Have I mentioned how wonderful it's been to have a garden year round? This is one of the many things that I will miss about living in Kenya.
I have successfully planted and harvested the following from seed:
swiss chard (this has been growing nonstop since September...it's monster chard and I can't get enough of it)
tomatoes (3 plants yielded about 70 tomatoes in January)
carrots
peppers (Only 1 grew but I'm still hoping for more)
scallion
onions
beets
cilantro
dill
parsley
basil
spinach
mixed greens
romaine lettuce
arugula
kentucky blue pole beans
watermelon (this didn't work but it was a fun attempt)
cucumbers (also a failure...I think my soil needs work)
Here are some pictures
tomatoes
pepper
lettuce
carrots
swiss chard
Watering the garden
Wednesday, June 1, 2011
Khunyango
If you remember, the TB team went out for a field visit back in March and I had mentioned that I would hopefully have the opportunity to implement the child contact register in the small Khunyango District Hospital. Well people...dreams do come true!
Last Monday, I joined one of the AMPATH vehicles on the 3 hour journey west to Khunyango. I met with the District Tuberculosis and Leprosy Coordinator (DTLC) on Tuesday morning, and we spent the first half of the morning discussing pediatric TB, the Kenyan national guidelines, and what actually happens in her clinic.
Not surprisingly, here were some of her comments:
-Kenyan national guidelines suggest screening every smear positive household child contact. That rarely happens in Khunyango...sometimes she will ask if she remembers but she was honest and admitted that she usually does not remember.
-Kenyan national guidelines suggest isoniazid preventive therapy to children < 5 and HIV+ kids who have been exposed to TB in the home and were screened to rule out TB disease. Her response: "Well we don't really screen and right now all of the isoniazid we were given for this has expired" hmm...classic.
The second half of the morning was spent introducing the child contact register and filling in some information for the active source cases so we would be ready to go the following day when patients lined up for clinic.
On Wednesday, we saw 14 pulmonary TB patients and identified 28 child contacts. There is always 1 case that ends up shocking me the most. We met a 12 year old HIV positive girl with TB who came in with her mom and 10 month old brother. Mom and the 10 month old are also HIV positive. She has two other children who have not been tested yet for HIV despite the fact that she has witnessed her eldest daughter suffer. After several counseling sessions regarding PMTCT (preventing mother to child transmission) and the importance of delivering in the hospital, mom was still convinced by her family to deliver at home.
This brings up an important lesson that I have learned this year: culture and family will often trump doctors. This should not be a surprise to us, but instead it should be expected. It's important to just continue being patient, educate as much as possible and applaud those who take the leap towards things like pmtct. Anyway, we counseled her to bring her other children in for HIV screening, and we encouraged her to bring the 10 month old in for TB screening. Fingers are crossed.
The best part of this trip was working with someone who is really passionate about TB and the health of her patients (unfortunately, this hasn't exactly been the case in the Eldoret TB clinic). This DTLC runs the entire clinic by herself, she actually fills out all of the paperwork required by the ministry of health, and she seems to actually enjoy it. Hopefully she'll adopt the child contact register and she can help some of these kids!
The DTLC and I in the TB clinic
Here is a picture from the hotel balcony. I dragged a chair out here to read and enjoy the African sunset. :)
Last Monday, I joined one of the AMPATH vehicles on the 3 hour journey west to Khunyango. I met with the District Tuberculosis and Leprosy Coordinator (DTLC) on Tuesday morning, and we spent the first half of the morning discussing pediatric TB, the Kenyan national guidelines, and what actually happens in her clinic.
Not surprisingly, here were some of her comments:
-Kenyan national guidelines suggest screening every smear positive household child contact. That rarely happens in Khunyango...sometimes she will ask if she remembers but she was honest and admitted that she usually does not remember.
-Kenyan national guidelines suggest isoniazid preventive therapy to children < 5 and HIV+ kids who have been exposed to TB in the home and were screened to rule out TB disease. Her response: "Well we don't really screen and right now all of the isoniazid we were given for this has expired" hmm...classic.
The second half of the morning was spent introducing the child contact register and filling in some information for the active source cases so we would be ready to go the following day when patients lined up for clinic.
On Wednesday, we saw 14 pulmonary TB patients and identified 28 child contacts. There is always 1 case that ends up shocking me the most. We met a 12 year old HIV positive girl with TB who came in with her mom and 10 month old brother. Mom and the 10 month old are also HIV positive. She has two other children who have not been tested yet for HIV despite the fact that she has witnessed her eldest daughter suffer. After several counseling sessions regarding PMTCT (preventing mother to child transmission) and the importance of delivering in the hospital, mom was still convinced by her family to deliver at home.
This brings up an important lesson that I have learned this year: culture and family will often trump doctors. This should not be a surprise to us, but instead it should be expected. It's important to just continue being patient, educate as much as possible and applaud those who take the leap towards things like pmtct. Anyway, we counseled her to bring her other children in for HIV screening, and we encouraged her to bring the 10 month old in for TB screening. Fingers are crossed.
The best part of this trip was working with someone who is really passionate about TB and the health of her patients (unfortunately, this hasn't exactly been the case in the Eldoret TB clinic). This DTLC runs the entire clinic by herself, she actually fills out all of the paperwork required by the ministry of health, and she seems to actually enjoy it. Hopefully she'll adopt the child contact register and she can help some of these kids!
The DTLC and I in the TB clinic
Here is a picture from the hotel balcony. I dragged a chair out here to read and enjoy the African sunset. :)
Saturday, May 28, 2011
Last Hurrah
4 weeks left in Eldoret and I still don't think I've accepted the fact that this wonderful year will be coming to an end very soon. At least the people around me are paying attention so they planned one last longtermer trip last weekend.
We headed to Hell's Gate National Park and Mt Longonot. I've been looking forward to this trip all year since it's known as one of the best weekend trips if you live in the Eldoret area.
Why is that?
Well, Hell's Gate National Park does not have any lions or leopards so people are allowed to walk and/or bike through the park. I doubt that there are too many other places in the world where you can bike next to zebras, ostriches, buffalo, warthogs, etc.
We biked about 5 miles to a gorge and then hiked for about 1.5 hours through the gorge.
Giraffe!
Trying to get up close and personal with the zebras...
The gorge
Jump!
On Sunday, we climbed Mt Longonot which is a dormant volcano that last erupted in the mid 1800s. The hike up to the crater rim took about 1 hour and then we hiked the entire crater rim loop which took about 2.5 hours.
The rim of the crater...
The peak of the crater in the background
More Pictures
We headed to Hell's Gate National Park and Mt Longonot. I've been looking forward to this trip all year since it's known as one of the best weekend trips if you live in the Eldoret area.
Why is that?
Well, Hell's Gate National Park does not have any lions or leopards so people are allowed to walk and/or bike through the park. I doubt that there are too many other places in the world where you can bike next to zebras, ostriches, buffalo, warthogs, etc.
We biked about 5 miles to a gorge and then hiked for about 1.5 hours through the gorge.
Giraffe!
Trying to get up close and personal with the zebras...
The gorge
Jump!
On Sunday, we climbed Mt Longonot which is a dormant volcano that last erupted in the mid 1800s. The hike up to the crater rim took about 1 hour and then we hiked the entire crater rim loop which took about 2.5 hours.
The rim of the crater...
The peak of the crater in the background
More Pictures
Monday, May 23, 2011
Tumaini Barrack Screening
Before I left for the states, we organized a TB screening event in one of the street children barracks. The term 'barracks' is misleading because everyone assumes that this is an actual structure where the street children live. Unfortunately, it just refers to an area in town - either in a field, by a river, outside a store - where a group of children sleep and hang out. There are approximately 8 'barracks' in Eldoret and each one has anywhere from 10-40 children. Each barrack also has an older barrack leader who watches over the younger kids and intervenes if there are any problems.
We were a bit worried to start screening in the barracks...what would we do if we found a positive case? How could we ensure drug adherence in this difficult population? These kids are constantly moving around, most of them are addicted to glue, and many of them do not have phones. An interesting ethical issue: is it better to screen and identify with the risk that adherence will be low or is it better to avoid screening a difficult population?
We had many discussions with the Tumaini drop-in center and the TB projects office team about this issue and concluded that it would be best to confirm that it is impossible to maintain a street child on treatment before we decided to stop screening this population. We created some possible scenarios for how we could maintain drug adherence if a TB case was identified in the screening. The solutions included working closely with the barracks leader and empowering him to help find the child daily, providing incentives for the child (food, transport costs), having the health outreach worker go to the barracks daily etc.
The first screening took place at the California barracks. We chose California because the barracks leader is one of the best, and he agreed to help if we identified a positive case. He mobilized his barrack members the morning of the screening and kept them quiet during the sensitization talk. He also helped to keep them organized while the screening was taking place.
Fortunately, no positive cases were identified. It's hard to believe that we have not found a positive case yet, but perhaps this population is not affected or testing sputum is not the best test for this population.
I could not take pictures during the screening because the kids (and I!) find it disrespectful. We don't need to create any additional slumdog tourism.
I did manage to get one shot from afar as we were leaving of the entire barrack to share with you. It's one thing to hear about the street kids and it's another to actually see the conditions they live in every day.
We were a bit worried to start screening in the barracks...what would we do if we found a positive case? How could we ensure drug adherence in this difficult population? These kids are constantly moving around, most of them are addicted to glue, and many of them do not have phones. An interesting ethical issue: is it better to screen and identify with the risk that adherence will be low or is it better to avoid screening a difficult population?
We had many discussions with the Tumaini drop-in center and the TB projects office team about this issue and concluded that it would be best to confirm that it is impossible to maintain a street child on treatment before we decided to stop screening this population. We created some possible scenarios for how we could maintain drug adherence if a TB case was identified in the screening. The solutions included working closely with the barracks leader and empowering him to help find the child daily, providing incentives for the child (food, transport costs), having the health outreach worker go to the barracks daily etc.
The first screening took place at the California barracks. We chose California because the barracks leader is one of the best, and he agreed to help if we identified a positive case. He mobilized his barrack members the morning of the screening and kept them quiet during the sensitization talk. He also helped to keep them organized while the screening was taking place.
Fortunately, no positive cases were identified. It's hard to believe that we have not found a positive case yet, but perhaps this population is not affected or testing sputum is not the best test for this population.
I could not take pictures during the screening because the kids (and I!) find it disrespectful. We don't need to create any additional slumdog tourism.
I did manage to get one shot from afar as we were leaving of the entire barrack to share with you. It's one thing to hear about the street kids and it's another to actually see the conditions they live in every day.
Sunday, May 15, 2011
California!
Sorry for the lack of posts last week. Two of my dearest friends were getting married so I went back to the states for the wedding.
The ceremony was on the beach in California.
Don't they look beautiful?
The ceremony was on the beach in California.
Don't they look beautiful?
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