Finally some rain

Last night was the first time it poured in 4 weeks. We are in the middle of the dry season and although the sun is lovely, the dust is another story. I feel like I am one big dust ball by the end of the day and the dust has been irritating my eyes so much that I have been wearing glasses for the past 2 weeks (those who know me well understand that it takes a lot for me to wear them!)

Anyway, I'm sure I'll regret saying this when the wet season arrives in March, but I was thrilled to walk through puddles and mud this morning!

I took this picture on my way to work this morning...the rocks on the right are the early signs of sidewalk construction. And look at all of that water!!

Kenyan Forests

One of my longtermer friends and her husband are building a house at the edge of the Kaptagat forest (about 25 minutes from Eldoret). I have been fortunate to visit their property twice this year to see how the house building is progressing and to walk the grounds to admire the wildlife. Yesterday, we crossed the road from the property to explore and enjoy the forest a bit more. The couple is also extremely passionate about forest conservation, and I always manage to learn something interesting about the history of Kenya's forests and the importance of protecting these precious regions.

Here are some facts:
Forests currently cover only 2% of Kenya's land region, however, they contain 50% of the nation's tree species, 40% of its larger mammals and 30% of the bird population. Unfortunately, the forests are in great danger due to uncontrolled forest exploitation. The proximity of Kaptagat forest to Eldoret makes it particularly attractive for individuals who sell wood and charcoal since they can easily transport the material to town and sell it. Forests in Kenya are important for many reasons - they trap and store rain water, regulate river flow and prevent flooding, they are major habitats of wildlife, and are traditionally important for cultural ceremonies etc.

Luckily, my friends are leading the effort in Kaptagat to encourage landowners to plant their own inexpensive trees on their land to use for wood and charcoal. This could be an easy way to discourage the community from destroying the forest yet maintain the source of income the community receives from the wood and charcoal business.

A tree that is estimated to be more than 1000 years old!




Butterfly


Villagers carrying wood from the forest towards the main road

Mom Visits Kenya - Part II

After our week in Eldoret, my mom and I joined one of my good friends from Eldoret, her husband and her parents for a grand tour of Kenya. The landscape, culture, and climate change drastically as you move around the country, and we wanted our parents to experience the many different wonders that Kenya has to offer. Here is a map outline of our trip:

View Larger Map

We started out in Masai Mara Game Reserve for a 2 day safari. The landscape was gorgeous and we were able to get close to most of the big five (minus the leopard who was well hidden behind bushes).

Big Five sans leopard

Lions

Cape Buffalo

African Elephant

Black Rhino

One of the most exciting/frightening events from the Mara was when the rhino above decided that we were way too close and she turned and started to charge! Our driver quickly reversed out of her path. Cool fact: rhinos cannot turn when they are charging because their vision is poor. They focus on their target before the charge but once they start running they don't realize that their target has moved. Useful advice if you are ever face to face with a rhino!

Other animal highlights:

Cheetah

Hippos

After the Mara we made our way to Nairobi and then flew to Mombasa. From there, we drove to Watamu, a small coastal fishing village on the coast of the Indian Ocean. We were very lucky to find an inexpensive private home to rent with a pool and a cook. Fish is not readily available in Eldoret so we made sure to have fish with almost every meal! In addition to stuffing our faces, we did a lot of relaxing and enjoyed some wonderful snorkeling in the Indian Ocean.

Lunch

Dinner

Snorkeling and the beach

We all agreed that we could have stayed in Watamu forever, but we had some sightseeing to do in Mombasa before our parents had to get back to the states. Mombasa, Kenya's second largest city, is a major port in East Africa and has been a prosperous trade center since the 12th century. Control for it's economic wealth was fought over by Arab traders, the Portugese and the Brits and it was also home to Indian traders as well as the Bantus (Africans who migrated from west-central Africa to the coast over 2000 years ago). The variety of cultures are visible in the Old Town's fascinating architecture. This was one of the most interesting places I have ever visited and I could get lost in the small alleys for hours without getting bored.

small alleyways and mosques

Fort Jesus

Thankfully, everyone made it back safely to either Eldoret or the US (without malaria or any severe GI distress!)

I am feeling refreshed, energized and ready for a productive winter/spring!

I have posted all of the albums from our trip here.

Mom visits Kenya - Part I

I convinced my mom to come back to Kenya for a bit after the holidays. I use the word 'convinced' for a reason. To say that my mom works hard in the US is the understatement of the century. She is a passionate, tireless, and selfless woman who doesn't quite understand the definition of a vacation! (she is probably shaking her head in denial as she reads this). Anyway, I was not only excited to give her a taste of Africa, but I was also looking forward to spending some quality mother/daughter time. Both missions were definitely accomplished!

I must admit that I was a bit nervous to have my mother come to Kenya. Worrying is an intrinsic part of my nature so of course questions like - Will she get malaria? Will she get sick eating the food? Will something, ANYTHING, bad happen that I, her only daughter, will forever be responsible for and friends and family will look away in disgust since I was the one who convinced her to come here? Yes, I know...ridiculous thoughts...but I'm sure that most of you can relate.

Our trip started in Nairobi where we celebrated NYE at the baggage claim in Nairobi airport.













The next day, we headed to the giraffe center to get up close and personal.






















Nairobi is very westernized so my mom was shocked to see the variety of restaurants, the luxurious hotels, and the well paved and organized roads throughout the city. I took her for our first exciting food experience at Habesha, a great Ethiopian restaurant in Nairobi.













We were off to Eldoret the next morning for several days to check out where I have been living and working for the past 5 months. I think she was pleasantly surprised with the compound I'm living in and the double gated security! However, the hospital was tough to see and she could only handle 15 seconds of the ward until she did a 180 for the exit as she stated "I can't believe that people in the US complain about not having a private room in the hospital and these people are sharing beds." You can hear this time and time again, but I think to witness it first hand is an experience that changes your perception drastically. It was surreal to see my own mother go through this, and I think it helped her understand why I am so determined to work in global health in the future.

We also ventured into the market where my mom decided that she wanted to sit with the ladies selling potatoes to really get the full market experience.













One of our main goals in Eldoret was to deliver the sneakers and cleats donations that we collected for the Tumaini Children's center. THANK YOU for all who donated!!! We arranged to meet with the older boys' team to give out the cleats and watch them play soccer for a bit.



























Another highlight was our roasted goat dinner with the TB team! They gave my mom Masai fabric which she wore throughout the entire dinner.













More pictures

....and we're back!

Wow. What a month! There is no way to sum up the past month in one post so I am going to work on giving you tidbits of my travels over the next few posts. I went back to the US for the holidays and it was a whirlwind of seeing friends and family and getting my fill of America. I am not going to bore you with a play by play of my daily activities. Instead, I thought it would be fun to share with you the things that I have realized I really love about the states (most of them are food related of course!).

1) SUSHI: By the end of 3rd year, I think that I was eating sushi about 3 times a week (thanks to a restaurant that gives students amazing discounts and made my vice affordable). By last October, I was dreaming about spicy tuna and I made sure to get my fill over the holidays...on three different occasions. :)
2) Bagels: I didn't think that I missed bagels that much but when I bit into my first taylor ham, egg and AMERICAN cheese on an everything bagel sandwich my tastebuds were dancing.
3) Cheese: All of the guidebooks claim that Eldoret is known for cheese and yes, we are very blessed to have ANY cheese available. But honestly, whether you buy gouda, new highland, mozzarella or cheddar it all seems to taste the same. It was great to walk around the Wegmans cheese section and enjoy white stilton with cranberries, camembert, comte and fresh mozzarella.
4) Target: I don't typically support our western consumer habits but I will admit that I now appreciate the convenience. I must have spent an hour walking around just staring at all of the options. An entire wall of trail mix! Gizmos and gadgets for every room! toothpaste...shampoo? sure, choose from about a thousand different brands. It's a bit excessive and overwhelming but I suppose useful when you are looking for specific products.

Things that shocked me a bit:
1) How expensive everything is. I felt bad for my friend who had to listen to my rant about parking fees in NYC and how many street children we could feed with that money.
2) Cold weather and snow.

Some picture highlights...

Christmas get together with some fabulous people












Holiday cheese platter












The family at the Christmas table












Imani Workshops sale












Way too much snow

Holiday Break

I am going back to the states for the holidays so I am taking a vacation from the blog. Thanks for reading!! Please check back in mid January for a new post!

Goodbye for now Eldoret...














Merry Christmas!!!! (I found this hat in the local grocery store and thought it was hilarious...)

Child Contact Register

I realized today that it has been almost 6 weeks since I have posted about my side project. Originally, I was interested in targeting the children on the wards with TB in order to find the adult source cases in their home. However, after exploring the wards a bit, I realized that there was a lot to fix in terms of peds TB diagnosis before that project could be feasible.

Anyway, after several weeks of reading about childhood TB, I finally came up with an idea that I am really excited about! All of our active TB cases are managed in two TB clinics in AMPATH (one for the positive sputum smears and one for the negative). The World Health Organization recommends that all active cases are asked about the child contacts in their home since children are very much at risk of getting infected in the home. In fact, >60% of childhood TB cases have or had a recent positive household contact in the home! Unfortunately, TB in kids is neglected by many TB control programs because it contributes little to transmission (children are usually sputum smear negative...meaning they are not contagious) despite the fact that TB is a major cause of mortality in HIV infected children.

I really think that many of the active TB cases who are treated in AMPATH have children at home who are also TB infected or have TB disease. My side project is to create a child contact register to record information about all of the children exposed to TB in the household. A clinical officer is responsible for filling out a child contact form for each active source case, and it has actually made them educate parents more about TB symptoms in children and encourage parents to bring their children in for HIV testing!

One of the first patients who came to clinic today was an HIV+ male who had pulmonary TB. When we started asking about his children, we found out that his 6 year old daughter has been coughing for the last 2 months and she is not getting better with any medicine. Then the dad told us that she has not been tested for HIV, even though him and his wife are both positive. The clinical officer did a great job educating him, and he promised to bring his daughter back in January for HIV testing and TB screening if necessary! When the project got started, I was just excited about finding the kids who might have TB, but I also think that this will be a useful tool for getting more children tested for HIV!

We also had a hospital employee bring his children in because they had been sleeping in the same room as their uncle who has pulmonary TB. They are completely asymptomatic but check out their chest xrays! This is a classic picture of hilar lymphadenopathy that is often seen in TB in children.
Child 1 (adenopathy on the right with some atelectasis)

















Child 2 (adenopathy on the left)

















Other kids are not fortunate enough to have a father who is a hospital employee. Many children are brought in much later once they are symptomatic for several weeks or months. My hope is that the register will help us bring these vulnerable kids to care sooner rather than later.