East Africa:
Kenya and uganda
Today we are moving out of Nyanza Club and moving in with Joyce and Joseph.  We knew that the temporary ‘luxury’ (e.g. warm water and no frequent power shortages leading to days with no electricity) wouldn’t last forever...so we were busy packing in the morning and rushing to get to the office by 9am.  It must have been both a bizarre and humorous sight for the many Kenyans we passed by as we rolled our suitcases down dirt roads and over grassy mounds, taking our luggage to the office where we were going to store them for the day.  We had a meeting in the morning with our main contact person at the head office for Opportunity International Kenya, Patrick Oteng, along with the head of HR, Kim Gilsdorf.  We met Patrick in his office and we talked with him in terms of what we hoped to get out of our experience in Kenya.  Fortunately, they were very receptive to the work we wanted to do and seemed very interested in having us stay much longer than Chelsea and I had originally planned.  
We will begin our research by interviewing female clients to determine the impact of micro-loans and the increased income on the empowerment of women and on their ability to live HIV/AIDS-free by being able to require condom use and other preventative measures by their husbands and boyfriends.  Patrick expressed interest in having us compile research and design an effective program that Opportunity International could actually implement which directly addresses the HIV/AIDS crisis in Kenya. Well, we definitely have our work cut out for us!
In addition to talking with clients and trying to understand and document their needs and  find ways we can bridge the gap between the current services being provided for them, we will be meeting with local hospitals, clinics, and VCT (voluntary counseling and testing) centers to get a better understanding of the HIV/AIDS situation in the local areas and to survey what services are currently being provided.  In order to ensure that our final proposal will actually be implemented and appropriate for all of Kenya, we are going to be traveling and visiting a number of the branches (in Kisumu, Kisii, Bungoma, Eldoret, and Busia) all a few hours away from Kisumu in Western Kenya.  Each branch has several sub-branches and thousands of clients, so we plan on spending at least a week at every branch, which means we will be in Kenya for at least 4 weeks before going on to do something similar with OI in Uganda.
We started the day by getting in touch with various VCTs in the area and making appointments to meet with some of the contacts we had made in town for later in the week. Our first meeting for the day was with Mary who is HIV positive.  She teaches others how to live positively with the virus through her health center that is situated deep in the slums of Nyalenda in the Milimani district of Kisumu near where we had been staying.  We met with Mary at her house and had a chance to talk with her before we visited her health center.  She explained to us a little bit about her organization and tried to make the HIV situation in Kenya a little less foreign to Chelsea and me who were trying to suspend our Ghanaian frame of reference in order to better understand the suffering and stigma in this part of Africa.  Mary has a feeding program for children who are either HIV positive or orphaned by HIV. Fortunately, in Kenya, all testing, counseling, and ARV (anti-retroviral) drugs are provided for free by the government. While it is a great service, many of the country’s poor, unfortunately, will go for days without food, and if the drugs are taken on an empty stomach, they are counter-productive and, in fact, can be toxic. Mary does many home visits in the slums, delivering food packets to families and checking people’s health who are too weak from HIV to come to the health center themselves or really even to provide for themselves.
Today we were accompanying Mary as she went on home visits and to bring food to 5 different families throughout the neighborhood.  The first person we visited was a woman who was only 40 but could have easily been mistaken for someone well past 70 years of age.  She could barely make it out of the chair she was sitting in and her arms were composed of not much more than loose skin draped over thin bones. Her legs were in a similar condition except there were several discolored sores that covered her body from the waist down. She was complaining that in addition to having HIV, her limbs were going completely numb to the point where she can barely stand and or hold things in her hands.  We prayed for her to not give up the fight and to try and regain her strength.  While the disease of HIV/AIDS itself can be physically deadly, the stigma of having the disease is socially deadly.  There is such fear of the disease from the community that many of those who are HIV positive are ostracized from their communities and are literally left to die.  The woman we were visiting said that when she told her husband about her HIV status he just packed up and left her, even though he was most likely the one who spread the virus to her, leaving her completely alone with 7 children to take care of.  Encouragement and support is one of the most important things we learned can be given to one who is desperately trying to live positively with HIV.
The next woman we visited was huddled in the far corner of her little one room ‘home’ (that we would call ‘a shack’) that was so small we could barely fit the 5 of us who were coming to visit.  With her legs drawn up close to her face, she tried to hide her emaciated body from us.  She lay on the thin mat she used as a bed and Mary moved pieces of cardboard to make room for us to crouch.  The cardboard, she explained, was the only bedding that the woman could provide for her 5 children and 3 nephews (whose parents passed away from AIDS).  Similar to the other woman, I grossly overestimated her age based off of her appearance.  I thought she was at least in her 50s, but I was shocked to discover that she was only 28.  Mary pulled out a manila folder from below the bed and showed us the woman’s x-rayed lungs.  TB had so badly covered her lungs that there were little clear spots to allow light through.  Since she was so weak, she could not mix the HIV and the TB medication so her doctors put her on an 8-month dose of TB medication.  The only problem was the woman was only 4 months into the treatment and her body was so damaged from HIV that it was difficult to see her living another 4 months without ARVs.
Once we finished the home visits (the highlight was seeing and hearing the gratitude of the families which we delivered the vital food to), we made our way back to the interior of Nylenda to the health center.  Already 15 or so school children were lined up outside the door waiting to be given their one and only meal for the day which Mary provided for these orphaned children.  Some, she explained, came from schools over an hour away and only had time to eat before they had to run back.  Most of the children were barefoot and only a lucky few had any resemblance of shoes to call their own.  The kids poured into the small room that contained a few benches and a door which lead back to the ‘kitchen’ where we could hear the fire crackling and the emptying of pots as the meals were being prepared for the children. Surprisingly, the children were very patient and well-behaved and, interestingly, the older children were sure to pass the bowls of food to the younger children first saying that they needed the food more than they did, as explained to us by a 10 year-old boy in broken English.  By the looks of his frail body, he couldn’t afford to pass up the food, in fact, he was in desperate need of the whole pot himself! To our horror, Mary passed Chelsea and me a full bowl of mixed vegetables and ugali, a corn meal mash mixture which is the main staple food of Kenya for it helps fill empty stomachs.  As Mary refused to take back our bowls so she could feed more children, it was hard for me not to feel the sinking and guilty weight of the shillings I had in my pockets, probably more money than these kids could ever dream of having.  I did a quick conversion and estimated that I had the equivalent of about US$20, something I could easily spend on a dinner back in the US, but would feed a child for 52 days in Kenya since it costs only 38¢ cents to feed a child for one day).  We experienced poverty ‘up close and personal’ in the faces of these orphaned children.
Facing Poverty in Kenya
Monday, July 9, 2007