The Final Countdown

Apologies for not writing for a few days; they have certainly been busy. This post is going to be brief because (as per usual) I’m exhausted! We’re in the midst of finalizing our data and preparing our reports and presentations for Friday. It’s slowly coming together but it is certainly an exhausting process.

On Saturday we spent the day in Loitoktok, the next town after Kimana at the Boma La Tumaini. This is the same VCT Boma which we attended the group therapy session and spoke to the HIV positive Mamas. This time, we visited for a community service day. We learned how to bead Maasai jewellery and how to make soap. Beading and soap making are the two micro-finance loans that the Boma La Tumaini helps with. The beading was time consuming and difficult but quite fun! I certainly enjoyed it. The soap making was an interesting processes because while one person could theoretically complete the whole soap making process, which takes about an hour, they utilize the whole group and take turns stirring because many women are so weak from the virus. It is interesting to observe the collective nature at work here. After we made soap and beaded (we left the good ones with them to sell), we taught the Mamas how to make origami doves. When I say “we”, I mean my friend Phebe, who is extremely crafty and also conveniently almost fluent in KiSwahili, so she was able to conduct the whole instruction. The Mama’s loved it and the afternoon was filled with laughter and a great time for all. We also all made and shared lunch together, which was very nice.

Afterwards, we went to the Loitoktok market. This market was much smaller than the Kimana market, but they had so many beautiful fabrics- kongas, scarfs, blankets, etc. I have had several pieces of clothing made at the tailor here. They have all come out wonderfully! Also, I have learned to enjoy wearing colourful clothing here; at home everyone says I only wear stripes and neutrals!

The last few days have been entirely consumed with data analysis and report writing. It’s been frustrating and exhausting, but hopefully it will be worth it. It is annoying having our last week in Kimana spent mostly behind the computer screen, but if it brings any positive change it will be worth it! Also, we’re going back to Amboseli National Park on Saturday, which I am so excited about!

I keep remembering that I only have five days left in this incredible place. I am most certainly going to bawl my eyes out when I leave and I really, really hope that I will be able to return to Kenya and to KBC at some point. Besides all of the incredible situations I have already described, the staff here is absolutely wonderful. Be prepared for stories of Moses, Daniel, Sam, Sapaya, and Arthur. I am going to miss this place so much. 

I Survived Data Collection!

We finished data collection today! I’m feeling a mixture of relief and intimidation at this point. I’m relieved because I survived the past four days of getting up before 6 AM, walking excessive distances with a huge backpack for nine hours in the blistering sun and sand through prickly “wait-a-minute” bushes to administer questionnaires to Maasai Mamas. These “wait-a-minute” bushes have huge thorns that capture you from all angles and you have to wait-a-minute before separating yourself from the bush (or taking your clothes off because the bush won’t let go). Many of these Mamas were unbelievably welcoming, kind and generous; they left incredible impressions on me. On the other hand, I’m feeling intimidated because we have so much work to do before next week’s presentation. To create a presentation to the community in one week that gives justice to all I have seen, learned and experienced is near impossible. But beyond that, many of these women have given me a quest to share their stories and bring them change and I don’t want to let them down, but I don’t even know where to begin helping them.

Today, we began with the most difficult interview I have completed. Upon entering the Boma, a very old father-in-law greeted us. From the get-go, I felt very uncomfortable around him and could tell that he was resentful of my status as a white Western woman. I was waiting for some comment or problem to arise about it. Maasai men will greet me as they would a man, simply because I am white. It’s a bit uncomfortable because many of the men clearly dislike it, but are somewhat forced into it when I go to shake their hands instead of bowing my head. When he gave us permission to enter, we went to the first house where several Mamas were sitting. They immediately began to give my translator, Daniel problems about why, as a Maasai man he works bringing mzungus around to different Maasai bomas, only for the mzungus to bring the information back to America and never change anything. Eventually they agreed to be interviewed, but before we began they said “Don’t ask any questions about sex, it is not good here.” The last thing we want is any of the Mamas to be in physical danger from talking to us, so we certainly took that to heart and filtered the questions in the gender roles section. When we finished the survey, the Mama said that she wanted to ask me some questions. She began by asking about family planning. One of our questions is “Do you know about family planning- if so, which ones do you know/use/have used”. She did not know anything about it, so I told her about pills, injections, implants, condoms, etc. She was astonished when I told her that it is free at the government health facilities. Hopefully she is able to go! The main problem with access to family planning methods is that the husband controls the money that is needed to get to the Kimana health center (nearest for them) and the husbands usually don’t allow the women to use birth control. A common mentality is that since the men pay dowry (usually 10 cows per wife), they own the wives and thus can control every aspect of their lives (including their healthcare) and beat them when they see fit. After answering the Mamas questions on birth control methods and their potential complications, she asked me about rape and domestic violence in my culture. She wanted to know what would happen if it happened to me. I told her that it is not accepted at all in my culture, and men and women are supposed to have the same rights. I told her that I could get a man arrested or sue him for either rape or domestic violence. After saying this, the father in law came around the corner brandishing a rather large stick and smacking it in his hand saying “well in Maasai culture, men own their women and tie them to this tree (points to tree) and beat them whenever we want”. It was really, really difficult to look at him and politely smile saying “sowa” (okay) and “ashe oleng” (thank you) before walking away.

We interviewed another Mama in the same Boma and her two kids were playing around her. She had an 18-month-old boy and a four-year-old girl. Halfway into the interview, the boy began playing with a wooden stick and hitting some of the lambs (very normal behaviour apparently) when he quickly turned around and really whacked his sister from the corner of her eye to her forehead. The little girl collapsed in sobs and the mother’s response was to simply hug her son. I was absolutely astonished and did not understand, so I looked to my translator for help. Daniel said that this was a normal gender role “rehearsal” for a boy-girl relationship. This was an everyday activity and as this little girl with huge brown eyes, a torn up dress covered in flies and dirt was collapsed in the corner and shaking with sobs, I truly saw the implications of this male dominated society. I was rather shaken up after leaving that Boma. I wanted nothing more than to grab that girl and take her out of there.

In one of the other Bomas, we talked to a few women about the purpose of our study and understanding the implications of the closure of the Imbirikani Clinic. They repeatedly asked me to do something about the lack of healthcare. Initially, they thought I was going to reopen the clinic and were very disappointed when I said I wasn’t. However, I explained to them that what we need to figure out is a way to create a sustainable organization that coordinates the scope and rights that the government can provide, while utilizing the funding, flexibility and expertise that an NGO can provide. This brings me back to my favourite topic again: Private Public Partnerships! The women completely agreed with this, but reiterated their frustration at the lack of healthcare. Further, we discussed how a common misconception is that many women chose traditional healers over modern medicine because of preference, but in actuality it is because of necessity. When modern medicine is not available, they are forced to use the traditional medicine. While Maasai cherish their cultural traditions, when it comes to healthcare they truly desire the best care.

It’s extremely frustrating to talk to these women about the problems they are having when at home, in the US or Switzerland they are the most simple and preventable problems that aren’t even considered problems. The services that these women say they need the most are antenatal care/deliveries, child immunization services, water treatment services, inpatient treatment and referral, outpatient treatment and mobile clinic services. Most of these women have revoked to delivering at home because they have no option. They want to deliver at a facility but have no money to get there and/or don’t have a way to get there. When these basic services are not available, they perpetuate opportunistic infections, maternal and child mortality and morbidity, social stigmas surrounding the diseases and exacerbate existing problems. It’s so infuriating hearing stories of the incredible healthcare they had for nine years that was ripped away from them because of the unsustainable nature of non-governmental organizations. When they ask me what I am going to do, I struggle because I want to tell them that I am going to do all I can to help bring healthcare back to them, but I don’t want to give them false hope and broken promises. It’s a really tough situation.

Overall, I have had great experiences with directed research. I have a Maasai name, Naserian, meaning lucky or good fortune. I have been “proposed to”, invited to return, criticized, praised and so on. I’ve made at least six babies sob because of my scary whiteness and have had my hair played with by dozens of little girls. I have see more breasts (breastfeeding and boobs are not necessarily private) than I would have expected in a lifetime and more flies swarming around the eyes, lips and noses of children than I thought possible. I have learned a lot from these women who have so much less than I do, but live so much more fully. I hope beyond anything that I never forget their stories and their requests. I don’t know if I will ever be able to bring about the change that they so desperately want and need, but I will certainly try.

We are now halfway through with the directed research component of the course. I can honestly say that I don’t remember the last time I was this exhausted. It’s 9:22 PM and I’m in bed struggling to keep my eyes open. I should be entering data into the stat analysis (SPSS) that we are using, but Naom and I decided to do it tomorrow because we are so exhausted. Here is a brief snapshot of what my typical directed research day looks like:

Before I begin, I have a disclaimer: I don’t reread these posts before posting them because I am too tired and just want you all to be able have some updates! I apologize for grammar/spelling/nonsense/etc. J

The unwelcome alarm blared at 5:45, telling us to get ready for breakfast at 6. We had to leave by 6:30 this morning, so we left while it was still dark. Today Ernest drove myself, Naom, our translator Daniel, Victoria, Carolyn and their translator, Wiper. We drove back to Chuylu hills to do our research. I don’t remember if I mentioned this before, but I understand the need for insane four wheel drive vehicles after these roads (if you can call them roads). It’s a beautiful trip, with giraffes, snakes, jackals, zebras, wildebeests, etc all around.

We had seven questionnaires to collect today and each questionnaire takes about 40 minutes, not including the time it takes Daniel to convince them to talk to us. We were in completely rural Kenya, where there was absolutely no cell phone service, functional roads or towns. A few very interesting situations happened to us today.

In one of the first Bomas we went to, the Mama was so excited that a muzungu was coming into her home. She had never had a white person visiting there before. Because I am the only white person in my group, I certainly stand out. And yes, by stand out I also mean that I make babies burst into hysterical tears at my scary “whiteness”. It’s kind of funny but I do feel badly. They usually warm up after a few minutes. Anyway, in the middle of the interview in this Boma, the Mama grabs my hand and puts a handmade ring on my ring finger. She then jokes (in KiMaasai) that we are engaged, but then she says she has to change the finger because she isn’t a man. So now I have this beautiful periwinkle blue ring on my middle finger. So sweet! She welcomed us back and specifically requested us to come back. This woman never stopped smiling and was so kind and welcoming.

On our search for another Boma, we came across an armed guard. He was very curious as to why a muzungu and two Africans were wandering around this area on foot. He said that it was dangerous because of wildlife, but also because of poachers. Apparently, they have been having a big problem with Giraffe poaching (for food), but he said that the muzungu would be worth more than a giraffe and I could be “hijacked”. I never felt unsafe because I knew that Ernest and the car were always close by, but it was a little unnerving.

We finally found a little poor Boma on the outskirts of the other Bomas. This Boma stood out to me. When walking up to it, the Boma was clearly very poor; there were very few sticks/brush protecting it from wildlife and there was only one small house inside. This is very rare, as the extended family usually all lives together within the brush- fenced area. There are mini brush fences for cattle, shoats, etc. When we arrived, a young man, probably about my age came out. We saw a young child and requested to interview his mother. The child was very cute, but did not seem “right”. As she was walking around, his eyes kept drifting in and out of focus and going cross eyed. She also had deformed feet that gave him a slide waddle/limp. I felt so badly for this little girl. Her mother was also mentally challenged, or as the brother said, “not right”. Their household consisted of an elderly mother, handicapped young mother, her handicapped daughter and a son about my age. I felt so badly for this little family. We decided to interview the grandmother, but halfway through the interview a Mama from a neighbouring Boma started yelling in Maasai, apparently about a snake. Our guide, the brother, and probably every male within a 500 foot radius grabbed spears, machetes, and sticks and ran to help. I learned later that if an able bodied male had not run, he would be stigmatized and shamed for his cowardice. It turns out there was a 12+ foot green python in this neighbouring Boma. They got one spear in it, but it slithered away. Luckily we didn’t see it again.

Later in the day, we were arriving at another Boma where a cow had just given birth seconds before we arrived and began eating the placenta. This is apparently really bad for the cow, so our guide, Daniel, leapt into the enclosure and pushed the cow away from the placenta with a stick. The Mama then grabbed it with her bare hands and threw it outside of the Boma (and then proceeded to shake our hands- lovely).

The last interesting thing that happened was during an interview with a husband and wife. This is always an awkward and difficult scenario that we have to judge carefully. Because domestic violence is so prevalent, sometimes even asking questions of a sexual nature or referencing domestic violence can provoke it, and the last thing we want is to cause a woman to get beaten. Therefore, usually when the husband is present, we don’t question the Mama about gender roles and non-consensual sex. However, this time, the man and woman were very receptive, so we decided to ask. The main questions are about whether domestic violence is common or acceptable in Maasai culture, who perpetuates it, whether women are allowed to refuse to have sex with a man if they don’t want to, and so on. This couple agreed to answer these questions only if I would answer them about my country after (or if I paid them – the usual inquiry of a white person). I agreed to answer the questions after. It was very interesting and they were astonished that men and women are “technically” allotted the same rights and equal opportunities. I told them how domestic violence and rape do happen, but they are vastly stigmatized and are rare. They were astonished and perhaps didn’t believe me.

So far, the directed research has been extremely tiresome but very interesting. I have learned so much and have been put in uncomfortable situations. I think there are two parts of this that I find the most difficult. First, every day there are a few girls who are about 9 – 12 years old in the households. They are completely entranced by my whiteness and love to play with my hair, touch my skin, etc. They are so sweet and kind. You can tell that several of these girls are special and have a real spark in their eye. In school, they are learning English and will sit next to me or on my lap while I complete the questionnaire, quietly trying to read along. It absolutely breaks my heart when I remember that in a year or two these girls will be pulled out of school and married off, probably by age 13. They most likely will undergo female circumcision which a brutal process with extremely high morbidity rates and relatively high mortality rates. They will be launched into a culture of domestic violence, where women have no say in their lives or healthcare. It’s so sad, and yet again reminds me, “talent is universal; opportunity is not”. The second scenario that infuriates me beyond belief is when we are interviewing a couple, asking about domestic violence and the man answers smugly that he can beat his wife whenever he wants for whatever reason he wants. The wife (often younger than me) usually quietly giggles or looks away. It’s the most uncomfortable and enraging thing in the world and I would like nothing more than to slap the man as hard as possible.

            Despite these hard situations, there are some aspects of Maasai culture that are changing for the better, in my opinion. For instance, many families are choosing to explore family planning options, getting HIV tested, immunizing their children and many women are joking about how now women beat men instead. While I still strongly believe that violence is never the answer, seeing a woman beat up a sexist Maasai man would be extremely satisfying. Anyway, it’s 10 PM and my alarm is set for 6 for the last data collection day!

XO

Talent is Universal; Opportunity is Not

The past few days have been hectic and stressful, yet wonderful. They have been so jam-packed with activities that it’s hard to keep them straight. If I wasn’t completely exhausted I would write every night, but unfortunately that’s not the case and I am completely exhausted come nine-o’clock.

On Saturday, we went on a three-four hour hike up to the Chyulu Hills, one of the most beautiful places in Kenya. The hike was really intense, especially for someone like me who lacks endurance, knee strength and relative coordination. Also, the altitude was really high and I lost my breath quite easily. However, despite thinking to myself many times (and saying out loud), “I don’t know if I can do this”, I made it up all the way to the top- about 15 feet below the clouds! Part of our group parted off below, but I persevered and continued up to the top! I wish that I could post photos; the view was absolutely incredible. We had to climb with two Maasai guides (while Daniel and Sapaya are Maasai, they aren’t trained for the hike). These guides were trained on the best routes and avoiding/dealing with wildlife conflicts.

We were able to gain access to this exclusive hike (which people pay upwards of $1500 for) because we entered through Daniel and Sapaya’s Group Ranch. Kenya is divided up into Group Ranches; for instance, for our research we are looking at the impact of the closure of the Imbirikani Clinic on the Imbirikani Group Ranch. Anyways, Daniel and Sapaya are from a village right near the Chyulu Hills; they grew up there and went to school together and now work at SFS. They are both hilarious and wonderful (there is also a wonderful Program Assistant named Moses who didn’t drive that day). I will be so sad to say goodbye to them so soon.

Daniel talked to us about some of the challenges their region face, namely water shortages, wildlife conflicts and food shortages. The region is beautiful, but unforgiving. It is clear that in order to survive in much of Kenya, one must be tough and persevere through incredibly difficult situations. I am in awe of the people who still lead subsistence lives and literally live off of the land.

In order to get to Chyulu hills, we drove for about two hours on some of the worst roads I’ve ever been on. Sometimes, we would just drive through the open tundra on no road at all, crossing huge ravines with giraffe’s, zebras and tommy’s (little antelope things!) overlooking our strange journey. I was quite glad I had my Dramamine for this trip, but it was wonderful having Daniel and Sapaya there and we never felt lost or unsafe at all. On the way back, we saw a Jackal killing a baby goat! Sapaya spun the land cruiser around and drove at the Jackal, chasing it away from the rest of the small herd and crashing through the small underbrush. It was quite fun and interesting.

After we got back from the hike, we were all exhausted. Luckily, the Mama’s had to reschedule, so we were able to take a quick break before going out to a bar for a few drinks. It was nice to relax, but as per usual when going out with a group of Americans, one guy got extremely drunk and belligerent. It ended up being rather embarrassing and annoying. The beer was good though.

On Sunday, we met our translators and went over our qualitative and quantitative questionnaires (the quantitative are for the Boma interviews while the qualitative are for the key informant interviews and focus group discussions). I lucked out with my group for the week. My partner is Naom, a Kenyan who, obviously, speaks Swahili, which will make conversation much easier. Our translator (who will translate into Maasai), Daniel, has been translating for five years and we are very lucky to have him. Some of the other groups were not so lucky and their guides didn’t speak English very well.

We also did a practice round at a Boma across the street. It helped us identify flaws in our questionnaire or flaws in communication with the translators. This was a very helpful process. Even in the practice round, questions like rape, HIV, circumcision, gender roles, domestic violence, STIs and such raised incredibly important questions. Further, the practice round showed that many of the guides really did not speak English, so we had to do a last minute switch and hire a group of new translators.

On Monday, we spent the morning finalizing the qualitative questionnaires before going to our Key Informant Interviews. I was in the group interviewing the District AIDS coordinator in Loitoktok at the Imbirikani Health Center. It was very interesting to hear his comments, particularly with respect to the closing of the Imbirikani Clinic. The main problems he has seen following the closure are lack of sanitation, increased mother to child transmission of HIV, increased opportunistic infections (particularly TB- 50% of those HIV positive also have TB), the development of drug resistance due to defaulters on ARVs, lack of immunization programs and lack of nutrition for women and children. These are MASSIVE problems that if left unaddressed, will have unprecedented consequences. With problems like drug resistance, it is frustrating because they were actually caused by the Imbirikani clinic. While without the clinic’s existence, other problems would have continued and erupted, with the clinic’s existence and then abrupt closure, many and most HIV patients defaulted on their drugs, creating drug resistance. This is incredibly frustrating and extremely sad to see because this leads people to become hopeless, which is the worst outcome possible. People become hopeless because they see that even when they do receive help, it is unsustainable and their problems will still exist and are compounded upon when the help leaves.

I fell asleep in the middle of the previous last sentence last night. I’ve never actually fallen asleep with my computer on my lap before; I must be working hard. Today I had to get up at 5:45 for cook crew. The mornings here are so peaceful, I didn’t even mind. It stays pitch black until about 6:30, which makes it a bit bizarre to be waking in what seems to be the middle of the night. My favourite times of day are when it’s dark. It is so peaceful and the clouds or stars (depending on the cloud cover) never cease to amaze and inspire me. The night sky seems so much closer and so much more intense. I never thought anything could compare to stargazing over Cape Cod Bay, but boy was I wrong; rural Kenya has it beat by a long shot. The incredible beauty of Kenya adds to the inherent tragedy that it possesses. It’s tough to comprehend how such beauty can bring about such pain and suffering among such wonderful people. I have mentioned this before, but two quotes that are constantly (literally, constantly) running through my head are: “Talent is universal; opportunity is not” and “Where you live shouldn’t determine whether you live.” These people did nothing different than you or I to determine where we were born and which opportunities we were given, but for some reason we were chosen or were fortunate enough to be born into an incredible lifestyle with countless opportunities. The most frustrating thing is when people don’t recognize this and don’t feel some responsibility towards the less fortunate members of mankind. I think that I came to Kenya with this philosophy, and finally I am beginning to understand it and fully embrace it. Hopefully someday I will be able to live it. I don’t think I will ever be satisfied with life if I am not helping those less fortunate. It’s just that: fortune; the luck of the draw that determines where you’re born. It’s absolutely mind-blowing.

Today, we began field research. We left KBC at 7:30 and returned around 5 PM. It was a very long day of research that was taxing and frustrating, yet eye opening. We all piled into our designated trucks with our wonderful drivers (we had Daniel) and some of us also had faculty members with us (we were lucky enough to have Joyce!). We were equipped with lots of water, first aid packets (of course I added to mine), radios, and packed lunches and were dropped off outside a Boma about a half hour away from KBC for our first interview. When we entered, the Mama was reluctant to talk to us. She said that she has completed many of these interviews and/or questionnaires, yet she never sees any benefit. She didn’t see the point of participating if nothing was going to change. This was the first surprise of the day; we were not expecting the Mamas to challenge us about the actual research. I am so glad that she did because it really opened my eyes to the directed research we are doing and made me even more inspired to actually create some lasting change from it, or at least to begin the process. Our professors keep saying that our research will be utilized; we have a community forum/presentation after we finalize the data and it will help people. However, I am absolutely going to bring this up at the debrief tonight. If this research is not going to create any movement for change or positive benefit, I absolutely 100% do not agree with the ethical implications of it. It is without a doubt, completely unacceptable to hold our research methods education to a higher importance than someone else’s culture and real life problems. I’ll let you know what comes of this.

Anyways, now I’m exhausted and we’re about to have dinner and then a two-hour class on data collection methods and intros to epi info. Yay! And we leave at 7 tomorrow (that means cook crew is at 5:30; I’m glad I’m not on tomorrow).

Also, a few updates:

1.     I deleted my Facebook for the rest of the trip because I really want to utilize my time here and not think about life back home. Just an FYI. (So email me!!)

2.     If you to www.fieldstudies.org and click on the “blog” tab, you can see a little blurb I wrote for headquarters.

3.     EMAIL ME!

XO