Wednesday, September 17, 2014

once you go you can't forget

children at Endonyolasho clinic holding up their Alabaster bracelets
































In Kenya, we saw a lot of things that had been forgotten. On our drive back to Nairobi, an abandoned tour bus sat crookedly in dried up tire tracks, evidence of a struggle to get it out what had once been mud. In Shompole, the dispensary showed signs of one-time investments that had been neglected: a broken refrigerator, an empty pharmacy shelf, a falling-in ceiling which bats flew out of at night.

It wasn't surprising to us, the things we saw, because Alabaster Mobile Clinic's mission takes its teams to those places where there has been forgetting. Shannon's vision for starting the nonprofit started nearly ten years ago with a conviction to not forget. She had lived in one of Kenya's slum communities for six weeks -- a short stint by some standards, but a lifetime when you're plunged so totally in a completely different way of life. She lived in a flimsy box no smaller than most American walk-in closets, walked the mud paths filled with garbage to get her water to bathe in, taught the women she lived around how to make spaghetti. Her "work" involved gathering stories and photos of women who made bracelets that would be sold in America. The story would be told on a tag attached to the bracelet to connect rich Americans to their Kenyan neighbors and, hopefully, cultivate not forgetting.

That kind of experience has a way of changing you. It gets into your bones. Shannon could not forget, and she didn't -- through nursing school, first her second bachelor's degree, then a master's program to become a nurse practitioner. Seven years later, she still remembered and started Alabaster Mobile Clinic. Its first site would be Kenya.

Shannon planned, raised money, found connections in Kenya, and went. Her first team included herself, two nurses and a doctor, along with two friends who took photos and video. That first trip and the next one a year later were so much about learning. She had never been to the rural Maasai communities that Girl Child Network (GCN), one of her nonprofit partners in Kenya, took her to. That first year, they slept under a mosquito net in the simple classroom of the school. Their only light in the deep darkness of night in Kenya's expanse of savannah were their headlamps -- to change at night, to see if bugs had gotten into their things, to find a place to pee. In its three trips, Alabaster teams stay in this area, in two different locations, for five days to run clinics and learn about people's needs. Few other medical groups have gone to this area to provide medical care for the Maasai. To GCN's knowledge, no others have stayed a night.

The thing that Shannon and her teams of medical professionals will tell you is that not forgetting is actually filled with much joy. Hearing about the conditions in some places in Kenya might make some people think the trip is just gritting your teeth and bearing it. But that's not the full picture because there are all those people there, and the things they are doing that you really can't forget. Like the school in Kangemi slum that started a nutrition program. At the side of the courtyard, beside the classroom buildings of blue corrugated metal painted with lessons (a map of Kenya, the digestive system, the alphabet) is a small garden of big black containers growing kale and spinach. And we met Celline, the young woman living in Shompole who is studying to be a nurse. She helped during our clinic and told us that she learned about how to assess patients better that day. And I really can't forget Michelle, the 10-year-old daughter of the health worker in Shompole who giggled a lot, wore my headlamp until the moment we left, and told us that she wants to be an neurologist.

That's the thing, once you go you just can't forget.



Sunday, September 14, 2014

cultural learning in Kenya: misunderstanding the advances of a moran

Taking photos with morans at Lake Natron
























“Oh my gosh. We are going to die.”



Albert leaned close to me and took my arm as he said this. He motioned to the two young men just ahead. I looked and saw the lean Maasai, dressed more elaborately than the Maasai we’d met at clinic the day before. The young men both carried long spears, upright, as if using them for walking sticks. Both had longer hair that was braided and streaked with dark red dye. They were decorated with white beaded necklaces and arm cuffs, and wore just a short cloth skirt.



Our team was hiking along Lake Natron, which was really more like a few large puddles in a barren expanse of dirt and rocks. Foothills rose to one side, dotted by sparse bushes that flowered pink buds. The sun was strong and persistent. The thin clouds drifting through the sky gave us relief for a few minutes, then moved on.



“They are morans,” Albert explained, still whispering in a dramatic tone. I knew only that this meant they were warriors, that they had killed lions to earn the name. It turns out that young Maasai men live apart from their community, isolated in the bush to learn to be men. During this rite of passage, they are considered morans.



Albert ran ahead to talk to them on behalf of our group, explaining to us that we would need permission before we took any photos. A few seconds after Albert started talking with them, I understood that he had hadn’t been entirely serious before.



In fact, a few minutes later, Albert was posing with one of their spears and asking us to take his photo with the morans. Someone suggested that our whole team get in the photos. I walked toward the morans, and was invited to stand in between them. They both put their arms firmly around me, then started to pinch at the softness around my waist and hips, laughing to each other.



I couldn’t be sure what the morans were saying, or what it was about my waist that made them squeeze and laugh, but it was the first time since being in Kenya that I had felt truly uncomfortable. I started to feel subconscious about my size and shape, a feeling that's familiar in America, but that I didn't think I'd have to deal with in Kenya.

“Please stop,” I said, as I elbowed their hands from my waist and took a step back. None of the rest of my team had noticed the interaction; they all stood posing for the photo or chatting excitedly to each other. I backed away quietly, eager to leave and walk back to our van.



After a few more photos, our team was ready to leave. As we started to walk away, Albert motioned to me to stop. “They want you to stay and be their wife,” he said so everyone could hear, his eyes as big and his voice as dramatic when we had approached morans. Our whole group turned to look at me and started whooping and laughing. I felt myself blush, then joined in the laughter.



As we walked on, I told Shannon the rest of the story, how I they had made me feel uncomfortable and I had told them to take their hands off me. She laughed again.



“You just told off a moran,” she said with pride and amusement.


Tuesday, September 9, 2014

the tv guy, and what he taught us about Kenyan leadership, Kenyan hospitality, and unexpected conversations

At Jimmy's, singing the Kenyan national anthem. TV guy at the far left.


He was there to fix the TV, and he slipped in while most of us weren't even paying attention. Our team was at Jimmy's apartment for dinner, our last one before we left Kenya for home. Jimmy was another gracious, welcoming Kenyan partner and friend. His 2-bedroom apartment was in a huge complex of 8,000 units near the airport in Nairobi, with gates and guards and fruit stands and kids running around the maze of streets and cul-de-sacs. When we arrived at his apartment, we smelled food and chided Jimmy's wife, Faith, for cooking for us when we'd insisted she not go to the trouble. They had already been so generous with their time and help. But of course we were not-so-secretly pleased to eat a last home-cooked Kenyan meal.

I was feeling sad and a little withdrawn, like I usually am in the last hours of a trip I don't want to end. Maybe that's why I didn't give much attention to the friend who came shortly after we arrived to fix the TV. In some ways, he was hard to miss - at least six foot tall, and built like an American football player. He took up space, especially in the already crowded living room. But he stayed quiet, focusing his attention on Jimmy's new TV that sometimes played in black and white instead of color. The rest of us waited for the food to be ready: Shannon on the computer to check us in to our flights, her husband helping her, the rest of us enjoying the alcohol Jimmy served us and recalling our favorite parts of our trip.

Soon Faith announced that dinner was ready, and the TV repair man stopped his work to join our eager line to pile the rice, beef curry, cabbage, greens and chicken onto plates. It was then, when he sat down to eat with us, that I realized that the TV guy was not just a repairman, but a friend and neighbor -- a distinction that doesn't exist in Kenyan culture (or at least not as often as it does in the West).

With empty plates and full stomachs, we all sat together -- the Alabaster team, Jimmy and Faith and Faith's friend, some of our GCN hosts, and the TV guy. Sam played his violin, and soon we were singing national anthems from all the places any of us had once, in some way, called home. That led to questions about Kenya's president, which led several of our Kenyan friends to start debating the most recent elections and whose candidate should have won. Which quickly turned into a passionate discussion of how Kenya can help its poor and isolated people get the resources and justice they deserve.

A few minutes into this conversation, I pulled out my small black moleskine and pen, and Shannon looked over at me and laughed. We had already joked that the most valuable conversations on this trip hadn't happened when I'd prepared for them. From our very first day when we drove to rural Maasailand, the things I really wanted and needed to learn about came up at unexpected times, when I had to rely on my memory to absorb the most important points or pull out my notebook and start scribbling furiously. (I had purchased a microphone for my iphone and a savvy recording app prior to the trip, but these things take a few minutes to get ready -- minutes that would have been wasted in distraction. It was also more conspicuous, a fact I was still learning to navigate.)

The discussion turned into a powerful lesson in African and Kenyan leadership. No matter which presidential candidate or party they supported, each Kenyan there was convinced that what Kenya needed was talented and committed local leaders who advocated more for what their people needed. The TV guy was perhaps the most articulate, passionate and thoughtful in his ideas. He explained that Kenya is in the midst of de-centralizing its government, which is good and needed. But leaders who are appointed to posts should be familiar with their communities and a good manager of resources -- not the "for show" politicians that, according to these men, Kenyans are all too familiar with. "They show up at cultural dances and then go home, and people are still hungry," the TV guy said. They spoke of a laptop program in schools, initiated by the Ministry of Education. But because solar panels and electricity are still lacking in some areas, politicians have used this an excuse to funnel the money elsewhere, showing a lack of integrity and genuine concern for the education of Kenya's children. This anecdote was a stark contrast to the head teachers and principals our team had met in Maasailand and in the slums throughout our trip -- men who had made great sacrifices, financially and socially and otherwise, to educate children in their community.

We had to cut the conversation short because it was 8pm, time for our team to leave for the airport. I had written down (or at least had tried to) a few things that the TV guy said, and realized I still didn't know his name. As we said our goodbyes, I shook his hand and thanked him for sharing so openly and passionately. He was helping us to learn, I told him. He smiled shyly and I asked him his name.

"Felix," he said.



Saturday, September 6, 2014

the joy that comes from dirty feet

muddy shoes, in the clinic line in Kangemi

















I packed an old pair of running shoes to wear for clinic days in Kenya. For our first five days, camping out in rural Maasailand, they were on my feet the entire time except for when we slept. The night we arrived there, the dust started settling into the mesh and seems. By the next day, it had seeped inside and coated my socks. After our hike at Lake Natron, I found dirt in between my toes. At night, I used baby wipes to clean my feet -- balancing on one foot while wiping the other. But then I looked down and realized that the only place to put by now semi-clean foot was right back in my dirty, smelly shoe.

After a few days of no running water and the baby-wipe cleaning system, my feet were a mess. And they smelled. Even though nights stayed warm, and our tent could get stuffy, I slept with my feet tucked into my sleeping bag out of respect for my teammates. Albert, one of our Kenyan hosts, kept telling us that we would stop to wade in an alkaline hot springs on our drive back to Nairobi. "All skin diseases gone!" was how he advertised the detour. As soon as we pulled up, I was untying my shoe laces and peeling off my socks. Walking through the steamy water was better than a pedicure. I hesitated to put my smelly, dirty sneakers back on, but that was all I'd packed.

My sneakers went back on my feet for our next clinic at in Kangemi slum in Nairobi. As we drove, the cloudy sky let rain drops fall, and by the time we arrived at Kangemi the soft ground had turned to thick mud. Our van pulled as close to the school where we'd hold our clinic as it could, but buildings are packed tight in slums. Walking a distance was unavoidable. I rolled up my scrub pants and did what this trip was teaching me best: to embrace being dirty.

But even more than embracing dirt, this trip was teaching me to embrace joy. As we got closer to the school, we heard children talking, playing, laughing. I smiled in my heart. Relating to and caring for kids - no matter how dirty my feet were going to get - was just about the best way I could imagine spending my day. I walked around outside the classrooms, through the mud, to take photos of children, who smiled and giggled when I showed them what I'd captured. And I learned the names of the youth in classes 7 and 8 who had helped us carry our supplies from the van. Wilberforce, the founder and principal of the school, shared with me about his determination to help kids who didn't have the means for education, how the school has grown from 2 to nearly 400 pupils in just five years, and how he named the school Light Rays because of the way that educated children can illuminate dark places.

When I went back inside, my sneakers carried a thick layer of mud underneath that I had to scrape of on the cement step. I sat down next to Shannon. She was the last "station" of the clinic that day. As children came to her, Shannon read aloud each child's name from their registration cards as she handed each one a bright orange Alabaster bracelet and a piece of candy. The gifts coaxed a smile from most of them. The litany of names reminded us, again, of the joy of knowing and remembering people who have been forgotten by most of the world, their government, sometimes their own families.

At the end of our trip, I decided to leave my sneakers in the trash at our hotel. Part of me was compelled to keep them for the sake of remembering where I had walked in them and what it was like to get dirty. But I knew that what I really needed to carry with me was the joy that came from it, which I have in my photos, in these stories, and in my heart.

Wednesday, September 3, 2014

they filled our cups

in Meru

"Coffee?"

That was Albert's greeting to me every morning during our stay in Masai land. To others he offered tea, but he quickly learned that I preferred coffee in the morning. I would grab a tin mug, pour in a few scoops of instant coffee and wait for Albert to bring me heated water or milk. He filled it to the brim, gave him my thanks, and sipped while watching the morning fire or predicting if the clouds would hang all day in the sky.

Albert always knew when to come back with hot water or milk to fill up my cup again, and I gladly accepted more.

***

During the second half of our stay, our team stayed for two nights at the up-country home of Mercy, the leader of Girl Child Network (our nonprofit partner). Her home in Meru was set back on a bumpy dirt road, with a view out the back of hills filled with banana trees and a baby goat trying to eat scraps of leaves on the ground. We had a clean tile floor and latrines and showers and home-cooked meals. After nearly 10 days of camping and then staying in a hotel, it was good to be in a home.

On our first night there, after one of our busiest clinic days, we ate dinner with some of the GCN staff. After dinner, we gathered in the living room, and eventually two of our Alabster teammates performed a piece they'd been practicing for the group, Sam on his violin and Jeff singing along. The GCN women returned the favor and sang us a few songs in their rich, bright voices, as beautiful as if they'd rehearsed for us. Then we all sang a few songs together, ones that were familiar to most of us. And then Mercy, our host, decided, "It's time for tea."

When the trays of warm tea and milk, and the cups and drinking chocolate and sugar was all brought to the table, our teammate Veena offered to serve everyone. She quickly poured into the first mug, only about half-way, and handed it to the person next to her.

Mercy laughed her deep, melodious laugh. "Oh, you have to fill it up all the way!"

Veena, always bold and direct, laughed along and answered that she was being cautious to be sure there was enough. I don't remember the words that Mercy used, but her short lesson in Kenyan hospitality taught us that, in Kenya, cups are always filled.

***

My cup overflows with blessings...
                                                   - Psalm 23:5

Tuesday, September 2, 2014

surprises in Kenya: meeting Salaash

Salaash treating a Masai patient at our Shompole clinic


























One of the many wonderful things about Africa is that it is full of surprises. We received our most valuable one on our first day on our drive to Masai land. About 10 miles from the school at Endonyo-olasho, our destination, we stopped at a dispensary in Oloika. Some of my teammates knew about this small village from a stop there last year, necessitated by a flat tire. But they hadn't seen the dispensary, and they hadn't met Salaash.

For maybe the tenth time that day, our team climbed out of the van to get a sense for what kind of services this dispensary is able to offer to patients, and to meet Salaash, who would be helping us at clinic the next day. After showing us his small two-room clinic and telling us a few details of his work, we all piled back into the van. It was getting dark, and we still had to set up our tent and make and eat dinner. We knew we had a long day of clinic ahead of us.

Early the next morning our team slowly emerged from our tent, wiped down with baby wipes, put on our scrubs. We walked the 200 meters or so to the fire pit to drink coffee and eat our breakfast of bread, peanut butter and nutella. There were no patients in sight yet, just the brown horizon against the still, cloudy sky. After breakfast we walked back to the school to set up, and Shannon assured us that patients would start appearing out of nowhere. And she was right: as we pulled desks out of classrooms and hung clinic-station signs on them, children and their parents appeared in the distance, first as small red or blue dots moving closer and closer to us. We pulled a few desks from the classrooms for our first patients to sit on as they waited, and hoped the clouds would stay to keep us all cool.

As we started to see patients, I hopped around from station to station, trying to observe how clinic worked and understand how I might gather information today. At one point I saw Shannon assessing a patient. She turned to Salaash and asked, "what would you do?" It was at that moment that I began to understand that Salaash wasn't there just to interpret medical terms for patients. He was a necessary partner in caring for patients in a way that honors and understands their cultural context.

Our whole team also began to understand that our presence there was meaningful to Salaash. Because his clinical training was paid for by the Kenyan government, he was stationed by the government at the clinic in Oloika. While he seemed to receive joy and fulfillment in serving his tribe (Salaash is also Masai, though from a different area of Kenya), it was clear that he also experienced the loneliness and fatigue that come from serving in an isolated community. We were able to provide him companionship and the opportunity to learn from colleagues - a common and integral part of the Western health system, but rare in Kenya, where the provider to patient ratio is something like one doctor per 10,000 residents.

Salaash stayed with us, for a vaccination at a nearby homestead the next morning, and the whole next day, too, for another clinic in a nearby village. Some of the Masai who came to this clinic insisted they be seen by Salaash, showing us how trusted he is in his community. He is tall and extremely lean, like most Masai, and with a soft voice that might belie his intelligence and conviction. As each patient came and sat in front of him, and he asked them why they had come to clinic, Salaash leaned forward, occasionally touched them on their shoulders, held children who were sick or would be vaccinated.

By the end of the day, we were all tired. Shannon asked Salaash about skin lesions on a child's head, which she thought might indicate something fungal. Salaash looked at Shannon with a smile in his eyes and said, "No, it's just dirt. Shannon, are you tired?" They laughed together. "Are you making fun of me, Salaash?"

***
The next morning, it was time for us to drive back to Nairobi, and for Salaash to return to his clinic in Oloika. He rode in the pick-up truck with our luggage, while our team rode in the van. We drove through the village in Oloika, past men standing in front of their small shops and a child waving frantically, joyfully with both hands as if the harder he waved the more we might remember him. Our van pulled up next to the truck, then turned around and drove through the village again. And it dawned on us that we were leaving Oloika, and that we hadn't gotten to say goodbye to Salaash. We made Chris turn the van around and drive back through the village, past the men at their shops and the child waving with both hands. We piled out of the van and ran in to meet and hug Salaash, who was already seeing patients who had been waiting for him during his three-day absence.  

Salaash photo bomb

Friday, August 29, 2014

somewhere in the middle of nowhere

on the drive out to Masai land

"You drive out to the middle of nowhere, and then end up somewhere."
- Jeff, Alabaster teammate, reflecting on what it felt like to be in Masai land

I wish you could have made the trip with us.

From Nairobi it was a six hour van drive, they said. So when we agreed to leave at 10am, I figured we'd make it there by 4pm, or maybe 5 to account for a lunch or potty stop. Though we'd just arrived in Kenya, I'd already heard some of my teammates who'd been on this trip before use the phrase "TIA" (this is Africa) to explain the unexpected and out of the ordinary that seemed to be very expected and ordinary here. But I wasn't yet applying it like I should have. Meaning, I ought to have known a 6 hour van ride was not a 6 hour van ride.

Before we left Nairobi, we all got out of the van and crammed into the tiny chemist (pharmicist) to pick up and repack more vaccines for the Masai clinics. Next we stopped at the Girl Child Network (GCN) office. This is the nonprofit we partnered with on the ground. All out of the van again and standing around in a circle, we met a few more of the staff, including the deputy director, which led to the first of many spontaneous conversations I wished I'd been ready to record (more on that later). Then back into the van and to the mall to pick up some food and snacks.

It was about 1pm, and finally we were on our way out of Nairobi.

At first the road was smooth, though there was traffic to navigate and the smell of exhaust to bear with. We all happily dug into our lunch and snacks, Shannon passing out freshly-fried samosas we'd bought at the mall. I opened a bag of chips and a coke, not realizing this would be my last cold drink for a few days (and not realizing that I would care). About an hour into the drive, the rode turned more narrow, more curvy and, eventually, filled with potholes. Chris, our driver from GCN, swerved all over the road and off the road to avoid them, but bumps and jerks were unavoidable. It reminded me of the drive to Hana when I was in Maui last summer, and the landscape, quickly transitioning from green hills to flatter arid land, was similar, too. This was part adventure, and part understanding: this is the way to the people who are in need.

Another hour or two, and we were in Magadi. This small town was built around a salt lake that an Indian soda company now owned. Buildings that looked like dorms were clustered together, and I assumed that's where the workers lived. We pulled up next to a canteen with a swimming pool and all got out of the van for our first potty break (read: the first of many holes I peed in). When we left, two Masai men jumped on top of our luggage that was piled into the back of a truck to make the rest of the journey with us. I don't remember if they were with us at clinic or if they just needed a ride, my mind so full of new ideas and details by that point in the day.

The next leg of the journey turned from potholed roads to off-roading. Evenutally what lie ahead and behind and to both sides all looked the same: brown dusty ground pocked by low, brown trees or bushes. No roads or paths or distinguishing features. I couldn't be sure how Chris knew the way, but I trusted he did. We looked eagerly out the windows for animals: a heard of zebras ran off in the distance, and we scared a pair of ostriches from behind and saw them run off in different directions.

Another stop in Kiserian to pick up a teacher for our clinic. Then another in Oloika, where we learned there was a dispensary. The clinic worker was coming with us, we also learned. Our team wanted to see the clinic, so out of the van again, and again another conversation - about government funding for the clinic and what kinds of needs they're able to meet - that I wish I could have recorded.

By now it was getting dark, which meant it was probably close to 7pm. We had added four people to our traveling group. Only about 30 more minutes of driving out in the middle of nowhere until we arrived. I felt lost with no road signs telling me how many km until the town we were headed for and no other markers to suggest any kind of life besides the animals we'd seen.

Like most things in the bush, eventually it just appeared: there was the small school building where we'd hold our first clinic the next day. Now it was dark, and we were tired from the 6 hour van ride that had turned into a full-day adventure. New solar panels on the school provided light for us to set up our tent, and a little while later Albert and Chris called us to the fire pit for our first dinner of rice with cabbage and carrots. Afterwards Veena and I peed into the dirt by the light of our headlamps, then wiped down with baby wipes and changed for bed. Even after such a full day, once we settled into our tent I couldn't fall asleep. Jetlag, excitement, disorientation kept me awake most of the night.

Do you understand now? Have I been able to tell you what it was like to be somewhere in the middle of nowhere? I'm still not sure I understand myself.