The Last Few Days

Tomorrow is our final day at KBC. The past few days have been incredibly stressful and challenging, yet inexplicably fulfilling.

On Friday we had our final presentations. In the morning, we all rose to help cook, clean and set up for the 140+ guests who were coming to listen to our findings. The audience consisted of Maasai warriers, Maasai men, Maasai Mamas, Kikuyus, Kongas, Luos, etc. The chiefs of the regions all came, as well as the district health managers including the district AIDS manager, chief public health official and many other high level officials. This was an incredibly daunting task, to create something worthy of this audience with succinct and helpful conclusions and tangible recommendations.

We had six sub-groups who were all examining the impact of the closure of the Imbirikani Clinic on the Imbirikani Group Ranch. The topics we explored were:

1.     Regional Ecosystems and their Implications on Public Health

2.     Water and Sanitation

3.     Maternal and Child Health

4.     Maasai Culture and Gender Roles

5.     HIV/AIDS Treatment and Management Strategies

I was in the fifth group, focusing on HIV/AIDS Treatment and Management Strategies. I was so excited to be in this group because I am so interested in the social determinants of health, and a large part of the complexity surrounding HIV is social stigma. I will post our final 69 page report on here once I’m home with better internet and I will describe our study and findings more, but for now I want to tell you about the incredible experience of giving the presentation before I forget.

The presentations began at 10:30 and lasted until 4:00. They were conducted in English and translated into KiMaasai by members of our staff (Daniel, Joyce and Ernest). We were divided into groups of four; two people would present while the others did not, just to simplify the presentation. From my group, Naom and I presented.

Going into this presentation, we knew that we would face many difficulties. Firstly, there was no baseline study conducted, so we were literally on the front lines of the study. This was incredible academic and research experience.   We also knew that we were addressing issues of incredible depth, many of which have extremely strong social implications. The Maternal and Child Health, Maasai Culture and Gender Roles and HIV/AIDS groups were expected to be the most controversial. This would be particularly evident given the large number of Maasai men and Chiefs in the crowd. We knew that they would not agree with a lot of what we had to say, particularly the sexually or culturally sensitive material. Before beginning, we were all incredibly nervous to stand up in front of this intimidating crowd presenting research that has never been conducted. The directors of our program were clearly very interested to see how this would go.

During the Maternal and Child Health presentation, we began to see the true gender roles at work. Even mentioning family planning methods brought giggles and snide remarks to the men in the crowd; it seemed as though we were surrounded by 13-year-old boys. We really began to be nervous going into the gender presentation. My friends Victoria and Tory were giving this presentation and we switched to Joyce as the translator. This was a strategic move because Joyce has this incredible presence and ability to command respect in a light-hearted and loving manner. Even Maasai men will stop talking and listen to her. So, Joyce translated the gender roles presentation, touching on topics like female genital mutilation, domestic violence, sexual violence, and so on. While men were making gestures and were clearly getting annoyed, Joyce and one of our other translators, Wiper, kept the men in line. When the entire row of chiefs stood up to walk out, Wiper stood up and with one wave of his hand that sat down. Finally, it was my turn to present. The crowd was somewhat sleepy by this point, since they had been listening to presentations for hours at this point. The presentation still went very, very well. I am quite pleased with it. One of the most wonderful parts was the question and answer session. A Maasai man posed one question that stood out. He asked, “In my village, we have a tough situation. A couple has just been married and we have found out that one partner is HIV positive. What do we do? Do we allow them to remain married or should the negative partner leave the positive one?” This was fascinating and daunting because it is real. This was not a posed question or situation and I knew that my response could have an actual impact on these peoples lives. Of course, we told them that the couple can absolutely lead a normal life with proper ARV management, viral load determinants, CD4 counts and effective management of pregnancy/no breastfeeding. After we answered, the district AIDS manager stood up and supported us, which was a great feeling. Friday was an incredibly long day, following an incredibly long week, but we did it!

On Saturday we spent the day at Amboseli National Park. Big cats are very rare here, but we saw two lions!! It was amazing. At one point they were preying on and chasing some warthogs, but they got away. We also saw a herd of 18 elephants cross directly in front of our land cruisers; they are breath-taking and majestic.

Saturday night we had a dis-orientation, as SFS likes to call it. This was a very interesting experience for me because at Franklin, we never had anything like this. Basically, our Student Affairs Manager went over certain situations and feelings that we might be placed in or feel when going home: reverse culture shock. While I have heard of reverse culture shock, I realized tonight that so many feelings that I have had when returning home from school are actually common and normal. I think they will probably be exacerbated when returning from this trip. Some of these feelings include an inability to adequately articulate your feelings and explain your trip. Also, feeling disconnected from “normal” life, boredom with seemingly arbitrary tasks, isolation, having difficulty talking to friends or family about your experiences and so on. I found that I already do many of the coping mechanisms that were suggested, which is nice.

Tomorrow we will be having a debrief session, receiving our grades and having a goat roast. We bought a goat from one of the Astaris, Oleman and are going to have a slaughter and goat anatomy lesson. On Monday, we’re off bright and early to Tanzania, where we have to hang out around the airport until our flight at 8 PM from Kilimanjaro. Then I will fly to Amsterdam, landing in the morning around 7 AM and I will have twelve hours in Amsterdam to explore and wander around. I love the city and this will be a welcome break from the long travel time. Then I fly to JFK and then on to Boston. I will certainly be tired but I suppose I will happy to be home. I really wish I was staying longer, but being home, seeing friends and family and eating some good food will be welcome.