After Much Delay

July 24, 2012

It’s been a while since I’ve been able to write. My reticence has had nothing to do with time, or lack thereof… instead I have found myself tongue tied and finger twisted by the sheer crush of thoughts and whirring ideas and feelings and understanding and lenses foisted upon me in these past weeks. The end of our Kenya trip was packed to the brim with activities and responsibilities, and though I tried to capture and contemplate all of this while sitting alone for the first time in 6 weeks during a 15 hour layover in Heathrow airport… I simply could not.

To the cute fellow traveler who sidled up next to me as I sat staring at a blackened computer screen, fingers suspended over the keys, frozen… I am so sorry. Your very kind hearted attempt to pass the time stuck between from where we came and where we’re going was adorable. So was your British accent. And your floppy blonde hair. Another time, another place… I would have been totally game to transverse that path with you. Instead, I just started at you and smiled dumbly, nodding and murmuring in response until you must have thought me daft and backed away slowly.

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August 21, 2012

It’s been 7 weeks since I returned. I wrote the above two paragraphs three weeks to the day after my flight landed on US soil. It seems like a lifetime ago already. My time back in the States has already surpassed the amount of time I spent in Kenya. The life lessons already less salient. It’s amazing how that happens. How easily we mutate and blend with our surroundings without even acknowledging the change – like watercolors bleeding together on a canvas, blurring out and over distinctly drawn lines.

I’ve jumped headlong back in to this world. My world. The world of dog rescue. Filling days with phone calls and paperwork. The world of friends and family.  Attending concerts, celebrating birthdays, my own included, and drinking copious amounts of alcohol. The world of flippant materialism. Buying things I don’t actually need, wanting them for no other reason than to want. When slipping my feet in to high heels that cost more than any family in the Oloitokitok District will see in a year I feel less disgusted with myself than I did a few weeks ago.

I feel somehow more, and less, fired up about the ways of the world and its injustices. More accepting and patient. Less blindly angry and hot-headed. I feel more, and less, capable of effecting change. It’s a strange balance. One that will undoubtedly shift many times. My heart and head a see-saw in their struggle for power. This patience is in many ways hypocritical, for I am not the one suffering, waiting patiently. However it is realistic. Understanding such balances in the world blurs lines my black and white brain desperately wanted to draw. More watercolors. The water with which we cleaned our paintbrushes in elementary school, muddled grey, is now a color I’ve come to associate with this burgeoning viewpoint that can only be called adulthood.

I walked in to a West Elm store and saw a Maasai beaded necklace, glued to a stand, being sold as a decorative accessory, alongside traditional Maasai baskets… to the tune of 80 – 150 dollars. I bought the very same necklaces as gifts for 800 shillings… 9 whole dollars and 50 whole cents. No small amount of money to a people whose annual income falls well below the Kenyan national average of $300. I have called West Elm twice to inquire about their purchasing and production policies, specifically about these items. I have yet to receive anything resembling a clear or satisfactory response. I would have never made that call prior to Kenya. Not only because I wouldn’t have known about the necklaces or the baskets but also because I lacked a sense of self-efficacy. Corporations exploiting people, what else is new, I would have, shrugged disgusted, dismissively.

I know from all of this that I want to go back. I feel very strongly about that. For myself, for my career, for the wonderful people I met.

Anywho…

I do not know where to go from here with this blog. I love to write and it seems that a select few love my writing. These incredibly supportive individuals have encouraged me to continue blogging. Though, as I am sure is apparent, my current mental state is a bit scattered.

I do not wish to send inane commentary out in to the electronic universe just for the sake of doing so. It is not as if my personal life is so fascinating that an online diary would be meaningful. Similarly, it is not as if my mind and opinions are so sharp and so poignant that they need be printed for mass consumption.

I want to say something. Don’t we all? Stay tuned.

Life in Pictures: Playing Hookey

i got iced…

a round of laughter

Michelle at the market

Learning how to throw Maasai spears

Team Cobra. Picture taken right after a particularly aggressive soccer game.

amboseli and ellies

club K

maasai jewels

waterfall in Tanzania

headed to church for a sunday morning dance party

One Pint Later…

June 23, 2012

Of blood I mean.

We spent today volunteering at the famed Mbirikani Clinic. While our visit there was technically entirely charitable, we were all silently, and later outwardly, comparing Mbirikani’s facilities, services, and outreach programs to that of the Ministry of Health and CHS. Mbirikani provides free care for any and all members of the Mbirikani Group Ranch. Additionally, Mbirikani provides free HIV/AIDS counseling and testing, operates several mobile clinics, and provides free ARV treatment for life for anyone they diagnose. Mbirikani is a private, not-for-profit hospital, and is 98% funded by a private donor. To say that their work is incredible is an understatement. They employ a staff comprised solely of local Kenyan doctors, nurses, and orderlies. Their facilities are by and large the best I’ve seen in the region, and they are well stocked (I volunteered in the inventory/pharmacy) with all the essential medicines and materials. Mbirikani even employs its own community health workers, whose impacts, at least anecedotally, have been massive. I can’t really say more since our data analysis is underway and our various research outcomes remain murky. However, even when juxtaposed purely on a surface level it is clear that Mbirikani’s work and impacts far surpasses that of the MOH. And most of it comes down to money. Mbirikani simply has the funds and the leadership to provide the services and treatments that were long ago recognized as imperative in this region.

In a country rife with corruption and nepotism, money allocated to programs for the poor… the marginalized…. the long forgotten, discarded segments of society, is the most likely to grow legs, running to fill greedy pockets.

Mbirikani, like all the health facilities in the area, even those in Nairobi, continually experience blood shortages, with doctors and nurses regularly filling the hospital’s coffers. For trauma patients rapidly losing blood, or the severely ill with desperately low hemoglobin there are often, literally, no options. Given these dire circumstances, we were asked to give blood.

Many in my group jumped at the chance. I’ll admit something I am not proud of – I initially said no, passing the consent and screening forms back to the nurse unmarked. Numerous blood draws, several surgeries, and an acceptance of both as unpleasant facts of life have helped me overcome a once profound childhood fear of needles. Yet the strong aversion remains – especially when the destination of said needles is intravenous. I choose to avoid needles whenever I can, and as such I have never donated blood before. It has always seemed to fall in to the “avoidable” category… until now.

As I moved boxes and stocked inventory, the nagging guilt of my selfish decision grew louder and louder, filling my ears. I battled with myself.

Yes.

No.

Yes.

No.

You’re not going to miss a pint of your blood. Someone else needs it far more than you.

It’s ten minutes of your life, a tiny pinch, what is your problem?

Why are you such a coward?

You talk the talk Jess, time to walk the walk.

In short, I was irrationally and inexplicably afraid.

I thought of Baz Luhrmann’s  song “Everybody’s Free (To Wear Sunscreen)” in which he says: “do something everyday that scares you.”

Okay, Mr. Luhrmann. Here goes nothing.

I forced myself to fill out the forms and join the others on the benches outside of the lab where we were having a few tubes of blood drawn for pre-testing. I sat while everyone else was tested trying to talk myself in to it. I could not, still cannot, explain why I was reacting so aversely to this but I was legitimately freaking out. Bill, a BUSPH professor, father of two, and KBC’s resident father figure, walked out holding a cotton ball over his slightly bloodied wrist. They had been unable to tap a vein in his arm. I was horrified. I very rarely have such unmasked, uncontrolled emotions. Now here I was, hiding behind a pillar laughing at myself while crying tears whose flow I could not stem.

Finally, I was the only person left. The lab techs looked outside to the benches where I sat with a few of the others and called to me. Everyone was so supportive and encouraging, never treating me as the crazy person I had become. Being that we are all public health, clinically minded individuals, they talked calm, logical sense in to my panicky brain.

Once seated in the small lab I burst in to laughter while tears filled my eyes. For someone who is very uncomfortable being vulnerable in front of others – this was an entirely new experience for me. For someone who largely internalizes and compartmentalizes the majority of their emotional experiences, this outburst was hugely surprising.

Silas, the incredibly attractive lab tech, with beautiful mocha colored eyes that belied his kind, gentle nature soothed me in to the chair and tied up my arm. He was laughing at me, I was laughing at me. Yet the hot tears still came. I apologized profusely. I tried to focus on the swirled shades of chocolate in his eyes. It worked. It was over in the blink of an eye – which made my hysteria just moments prior feel even more pathetic. I feel ridiculous even recounting it now. Silas should have slapped me and told me to get over myself, to get on with it. He should have told me of the unimaginable suffering he bears witness to daily. Instead he looked me in the face and told me could see the all the night’s stars in my eyes. Instead he put his palm on my left shoulder, squeezed gently, and smiled in a way that made me feel like he had read my mind a thousand times over.

I walked out of the lab to see Jess K. and a local Maasai man splayed across the bench consumed by laughter. To quote Jess: “That was hilarious. I heard laughter, crying, shrieks, your little feet pitter pattering, and then more laughter.” “That guy and I were both listening to you, I was holding it in. We looked at each other and just cracked up.”

Mentally fabricated crisis averted – I returned to my respective volunteer position, waiting for the test results. I am pleased to report that all 17 of us are HIV, hepatitis, malaria, and syphilis free.

I offered to help set up for the impending donations. We walked through the small hospital, to a neat, newly emptied row of four beds that faced the windows of the isolation room. Where an older man, heaving chest caved with advanced tuberculosis, rasped and wheezed under a breathing mask. Somewhere in the hospital another man moaned in pain, over and over. None of us inquired about him, and I trust that the doctors were giving him the very best care possible, but from the meeting of eyes that occurred with each piercing cry I knew we all shared concern and morbid curiosity.

Another man, in a bed adjacent to us, stared woefully as I passed. His eyes were sunken in above painfully hollowed cheeks. The sharp planes of his face framing the whites of his eyes in a way that struck me at once as beautiful and tragic. A stiff white sheet was pulled up, tucked around him just below the chin. But even that didn’t hide the bony points of his skeletal frame. In spite of his state, his youth was apparent. The sheet breathed rhythmically, with labor, ever so slightly. Had it not I would have been sure I was looking in to the eyes of a corpse. We locked eyes. I realized I was staring. I realized I had stopped moving. Remorse and shame smacked me across the face and I shuffled away staring at my feet. I have no idea if he actually saw me staring, or if he just saw through me. Perhaps death was wrapped too closely around his neck, too crowded in front of his eyes, to let the living in. Often, this is a final gift granted to the dying before they are released of their suffering. I truly hope he was one of the lucky recipients.

The hot blush of shame spread down my neck and across my face as I set down a jerry can of water and sodas near the beds where I would soon lie. Ashamed I had been so fearful of a mere needle, for even toying with the idea of not donating, for crying so needlessly only moments ago, for being so healthy by comparison, for having so much…

When the four beds were prepared and the nurse readied with bags and needles, we lined up against the wall as the first four lied down next to their assigned blood bags. The next few hours had us rotating in and out of the beds and around one another’s bedsides. Alternatively caring, and being cared for. The camaraderie and affection was incredibly touching. Mere strangers a month ago I now squeezed the hands and rubbed the foreheads of newfound friends. Everyone knew how scared I and the other newbie blood donors were and let us go in the first or second shift to get it over with. An act of grace.

When it was my turn, Michelle, Nicole, and Jackie crowded around me. In spite of myself, again laughing, tears sprang to my eyes. I lied there squeezing a ball of tissues to fill the pint bag lying on the floor beside me, calming and crying alternatively each time one of my friends did something kind. A simple gesture, like holding my hand or patting my arm lovingly sent a babbling brook down my cheeks and chin. I’ve gone soft. I told them, taking futile swipes at my tears with my free hand.

Tara and Corrie went last. They wanted to race to see who could fill up their pint bag faster. I held Tara’s hand and told her stories about my travels in Morocco as Nicole timed them and hollered developments like a Kentucky Derby announcer. Tara laughed while grimacing. I’d be lying if I said the needles they used were small, or that they didn’t hurt. But pain is relative, easily paled when true pain lies all around you.

Afterwards, two of the doctors came in with huge smiles on their faces. They walked among us, shaking hands, saying thank you over and over. They picked up the bags of our blood, labeled with our blood types and names, cradling them gently as one would a beloved infant. Beaming. It would have been an odd sight. Two large white coat clad figures gingerly cupping stacked pints of blood in their hands had their faces not been so earnest.

When in your lifetime do you ever truly get to say that you directly saved a life?

Later that day, our blood was pumped in to veins of numerous individuals whose hemoglobin was at 5.1 or BELOW. There was a man with an HG count of 2. I had no idea that one could even be kept alive with such a low red blood cell count.

As I type this my blood is coursing through the veins of someone who desperately needed it far more than I ever did. Perhaps a hemorrhaging new mother or a severely ill child afflicted with malaria. Perhaps through the veins of the frail white sheet shrouded body that was once a man as alive as I am right now. If I… if we… accomplish nothing else here in rural Kenya, we at least have done this.

I am so grateful. For my health and my family and my friends. For all I’ve ever had and for all I will have. I am so grateful. For the immense understanding and kindness showered upon me today in torrents. I am so grateful. For the Mbirikani Clinic, for the woman whose willpower and wallet has created such a place, for this beacon of hope, stuck in the middle of the sorrowful sea.

I am so grateful I was able to do this small thing. Which to someone else is no small thing at all.

Ten minutes to save a life. A pinch. A slightly sore arm. An excuse to eat a few sugar cookies and take it easy for the remainder of the day. That’s all it took. The magnitude of this is seemingly minor act is so massive I tear up just thinking about it.

… hopefully whoever gets my blood will not inherit the emotion inducing, inarticulate rendering bug that’s bitten me lately.

(To read more about Mbirikani Clinic: http://www.aidforafrica.org/member-charities/africa-infectious-disease-village-clinics/)

A Summary

June 20, 2012

I had originally intended to post several separate entries detailing the rest of my experiences collecting data in the field. However after sorting through all the notes I jotted down for myself and paragraphs written hurriedly during stolen moments, I have concluded that the past days have been too densely populated with far too much to ever truly and satisfactorily create a well written record of them – and I will do nothing but run circles around myself in trying to do so. Instead I’ve written a summative, saving some of my more nuanced tales for late nights and strong drinks with close friends.

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Mbili siku (day 2) of data collection had me traipsing about Mbirikani’s arid land for hours with Ruth and Sabrina. We encountered some hilariously naughty goats and far too many thorny acacia trees.

Tatu siku, found me lost in the middle of Oloikia with Vivian and Jennifer. Vivian is Kalenjin and Jennifer is Maasai, meaning that I was the only white person present the entire day. I never stopped to consider the implications of this until several hours later when we had finally reached our first boma of the day. As it happens, I was not only the sole mzungu present but also the first mzungu any of the boma residents had ever seen. I have written about throngs of children chasing us, screaming mzungu or mzunguli (Kimaa for “my mzungu”), as if we were circus sideshows. The reactions at this boma made those encounters seem tame. Mamas old and young, and their children and grandchildren squealed in delight and horror at my appearance. I bowed my head in deference to the older mamas as is customary. Instead of the simple gentle pat of acknowledgement that I find so endearing, wrinkled hands lingered curiously upon the crown of my head. After we settled in for the interview, the children formed a semi-circle around my feet, sitting just out of my reach. Dragging little knees through the dirt they would get as close as they dared before fleeing in terror the moment I affixed my gaze their way. Fascinated but clearly frightened by my green-grey eyes, one little girl asked Jennifer in Kimaa if my “eyes from the river” could see her. The interview took an unprecedented amount of time. It was a large boma with multiple wives (the Maasai are polygamists) and upwards of 12 children (which isn’t unusual), which meant mamas and wtoto and shoats and ngombe and dogs were wandering in and out constantly. Each interruption required a new round of introductions, and a new round of exclamations and furtive discussions regarding my presence. I think Jennifer grew weary of the repetitive process but I was totally in my element. All the interruptive commotion gave me enough time to win over two of the braver children. Once I got them to share smiles and laugh at my silly faces, they pounced on me… playing with my hair, poking my face, and rubbing my skin to see if it would leave a mark on their hands… as if I was made of chalk. There was one boy who was particularly terrified of me. No matter what I did… he would not budge. At one point, eyes widening, he burst in to fearful screams and tears, rushing to hide behind his mother. As we were wrapping up our interview, he approached. I thought I had finally broken through and was elated. He instantly set his little hands to my skin, pinching my forearms with all his might before grabbing hold of my fingers and twisting, bending, and yanking. He continued despite my attempts to excoriate my digits from his gremlin grasp. When Jennifer stepped in to intervene, he told her he wanted to break my finger off to keep as a souvenir. Which made Vivian and Jennifer howl with laughter.

I spent mne siku at a health facility somewhere outside of Kimana, interviewing community health workers. Sylvester, a soft-spoken community health extension worker and nurse allowed me to help diagnosis patients after we finished our interviews ahead of schedule.

On tano siku, Jillian and I were paired with Harrison. Harrison is a massive man and it was wildly entertaining to watch him perch atop fragile plastic jerry cans and tiny Maasai stools, or cram his enormous frame in to a cramped, darkened boma, gigantic hands encircling tiny mugs, filled with chai and maziwa, that mamas had thrust upon us in greeting. The size of Harrison’s body almost rivals that of his mouth. As a result, our interviews ran well over the allotted time. In trying to hurry along the interview process Jill and I offered to help mamas with their chores and babies. We should have known better. Whenever we are together things seem to go sideways. Jillian tripped while trying to hop a ravine, successfully lodging thorns in her palms. Soon thereafter I was peed on by a three month old, as children here do not wear diapers. We encountered freshly skinned goats and pools of blood, a Maasai man who kept an old Kodak film canister, filled with a mysterious powder, lodged in his stretched out ear lobe, and shared a path with a massive shoat herd that thankfully parted around us just in time. Several hours later, after driving miles on nonexistent roads to discover us lugging water jugs and firewood uphill on an uneven path, Moses, surprised to find us in such a state of disarray, outright laughed in our faces. It’s worth noting that the bundle of wood I carried weighed only slightly less than I do. I barely managed to stagger forward under its weight. To carry it I wrapped the rough leather bindings across my neck and shoulders and used both hands for added support. As we parted ways with the mama I watched her loop the strap across her forehead, slinging the dead weight of the wood across her back with ease, and take off across the rocky terrain for what we knew to be a 5 to 8 mile walk to the river. She toted a several gallon jerry can in her left hand while gently touching the forehead of her toddler, who was strapped to her right hip. These lithe women carry themselves with the regality and grace of nobility yet posses the strength of oxen. It’s dumbfounding.

On our last day, sita siku, Adam, John and I drove even further up Mt. Kili’s broad base to the village of Ilasit. It was noticeably colder there and the increased altitude had us panting. KBC is about 4,000 feet up as is so I was pretty disappointed in my weak red blood cells for not rising to the occasion. (Har har har.) In Ilasit we encountered homes with electricity and miscellaneous items of furniture. A first for me. Ilasit is mainly comprised of the Kikuyu tribe, who in juxtaposition to the pastoralist Maasai, are largely agriculturalists. Meaning that their residences are generally permanent instead of seasonal. Despite the more formalized, traditional homes (in the Western sense), trash was everywhere, access to safe drinking water was nonexistent, and the reported disease burden, in the households I personally interviewed anyway, paralleled that of the seemingly less developed villages. I even saw a toddler with pronounced asymmetric flaccid paralysis of the legs characteristic of spinal paralytic poliomyelitis. According to the WHO, polio was eradicated in East Africa. A small reemergence has been noted in the past few years however reporting, especially in the poor, rural districts where polio is most likely to flare up, is limited – largely a function of poor attendance at and access to formal health facilities – likely masking a burgeoning incidence of the virus.

Overall, each village was observably different from the other. Regardless of where we happened to be, or whom we happened to encounter, some things remained consistent. Like the hospitality of mamas, or the unfettered, unadulterated curiosity and joy of the children. Or the haphazard smattering of bomas, dotting the earth’s tanned skin like a trail of freckles. Or the ever present flies. Or the bizarre conglomerate of once trashed items granted a second life – soccer balls made of plastic bags tied together by twine, teething rings crafted of plastic bottle caps strung along a wire or wrapped in rubber bands, rusty quartered soda cans tied to sticks forming makeshift rattles, chopped up tires tied to feet with plastic bags to form shoes… the list of ingenious rebirths could go on and on.

There’s so much more. I could talk about these days and all that was packed in to them for hours. And I am sure soon enough I will. Until then, lala salama!

Life in Pictures: Little Faces

My beloved little Grace.

Can I Get A Witness?

Data collection, and all the ensuing absurdities, has far surpassed anything I could have even begun to fathom. Broken in to pairs, and matched with a Community Health Extension Worker (who acted as our translator) we dispersed in to the surrounding villages, walking, usually miles a day, door to door administering household surveys. I have sat in the dirt, on jerry cans, in heaping piles of cow dung… with babies in my arms or clinging to my skirts… in the sun… covered in flies… and in just about every compromising position imaginable (well, maybe not every position imaginable) … all to administer our survey.

Along the way I have amassed a suitcase full of images and memories that will stay with me a lifetime, destined to be drug around my person forever, attached to my ankle like a jailer’s ball and chain. Truth be told, I am wholly unfazed by the environments in which I have found myself. I am surprised with how comfortable and at ease I feel in these surroundings, doing this work… surprised by how much fun I have had in spite of everything else. I have much I want to write about, so bear with me. I wrote a little each day, and as such, have separated my entries in to separate posts for the sake of clarity.

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June 12, 2012

Today, Tanvi and I were sent to Inkisanjani with Geoffrey. It was market day in Kimana so many of the bomas were empty save for the children playing in the dirt.

When will mama be home? We asked. When the sun is low in the sky, they replied.

I love the way things are phrased here. If your stomach hurts… it is feeling provoked… if you’re off to bed you are told “lala salama” i.e. peaceful sleep… instead of burying the dead they are planted…

Tanvi, Geoffrey, and I walked up and down, through dried riverbeds, transversing treacherously steep paths. Tanvi in her haste had worn sandals, which were no match for the thorns, rocks, and topography. She slid and slipped her way up and down the winding route, much to the delight of Geoffrey and any locals gathered to watch the foreign creatures on their journey. Tanvi grew up in India, and has a lovely, lilting British accent, which made her cries as she tried to navigate the path sound more adorable than fearful.

We wound our way around a mini-mountain to find one particular boma. The household head, we realized about half way through the interview, was ragingly drunk, which better explained his insistence that I marry him, the constant staring, and the nonstop demands that I give him my number. At the interview’s end, my “number” in hand, he thrust his angelic two month old baby in to my arms for bahati nzuri (good luck). We snaked back around the mini-mountain and through another ravine… passing a school on the way. The children ran in droves from the concrete building, bare feet pounding the dirt as they screamed, palms outstretched.

“GEEEVEEEEE, GEEEVEEEE.” “GEEEVEE MEEE.” “GEEEVEE SWEETS.”

It is not the first time I have heard such demands. And it won’t be the last. The norm here it seems, is to expect that any interaction with a mzungu will garner some sort of hand out. This prevalent belief introduces the potential for massive bias in our research findings. Our translators tell us that many individuals try to create the “right” answer in lieu of the truth. They believe in doing so that they will receive something… despite the explicit converse acknowledgement in our introductory consent form. I could say much more about this topic but frankly I don’t feel qualified enough yet to do justice to this vast and incredibly intricate and delicate subject.

Many of the school children followed us nearly all the way to our next boma, where we encountered an incredibly shy young mother, living with her two babies and her parents in a small hut. The woman, whose name escapes me, nursed her chubby cheeked six month old throughout the interview’s duration. As we were wrapping up, I flipped through her antenatal care booklet, distributed by the Ministry of Health to all pregnant mothers upon their first antenatal clinic visit, one last time. Except this time, something caught my eye – a checked box – HIV reactive. She tested positive on her second visit. Prophalyxis treatment was recommended, the margin’s notation read. A date for a follow up visit was set. Except she never went. Our young mother delivered her baby at home, with the help of her mother, (who, as a result, is possibly also HIV+) and had not received medical attention since.

As I gazed at the dirtied page, I felt the vast tracts of untamed land around me constrict. I had been sitting for the past half hour or so watching a baby innocently suckle at his death sentence. I fell uncharacteristically mute. Tanvi and Geoffrey were wrapping up the interview as I feebly shoved the booklet under Tanvi’s nose to read. We wordlessly acknowledged what was before us. I felt more helpless in that moment than I ever have before. We gathered our things and left and I was instantly overcome with a desire to turn our feet around, march back to the boma and do something – though what good I could possibly have done, or do, remains unclear. Instead I descended upon Geoffrey with questions. What now? Is there anything we can do? Was there any treatment available? Why would she knowingly skip her visit if she knew she was positive? Surely they educated her about the risks her status posed to her child? What would become of her?

There are no ARV treatment programs in this district Geoffrey told me. The Mbirikani Clinic, a private nonprofit hospital run by a woman from Chicago offers free ARV treatment for life to anyone diagnosed there… except our young mother, her feet her only mode of transportation, her responsibilities in the home paramount for day to day survival, would never be able to reach Mbirikani on foot… likely never be able to reach Mbirikani at all. She is young, ignorant, and uneducated he said. She will grow sick and die. So will her child. This is what happens here. Geoffrey either missed my crestfallen face or chose to ignore it, quickly switching topics. Riding on the same breath that sealed mother and baby’s fate, he laughed at something on the path ahead of us.

As soon as we got back to KBC I accosted Jenna. Telling her what had transpired, pleading with her to detail a different end to a story I already knew too well. Instead Jenna repeated Geoffrey’s answers, albeit far more gently. I saw myself then through their eyes: a young, naive, idealist who, like everyone else in this field, had to learn these lessons sooner or later – first hand, the hard way, the way that makes you feel like you’re drowning.

Jenna and I’s conversation turned to the multiple barriers affecting this mother’s decision. I have studied each of these convoluted, compounding factors, but it is not until the devastating results of these sociocultural and structural deficits sit 5 feet from you flowing in to the mouth of a child who may not live to see their first full year of life that they become real.

Our mama has never been to school, nor have her parents. Gaging her understanding of her condition is well beyond the scope of our research, but even if the nurses at the antenatal clinic were able to teach her about HIV/AIDS sufficiently to allow her to prevent transmission, and were able to get her on prophylactic treatment to prevent mother to child transmission (something the Ministry provides funding for) options for her own personal well-being are few and far between. HIV/AIDS is highly stigmatized. Our mama would likely find herself homeless if her parents were aware of the virus-laden blood flowing through her veins… a predicament that would kill her and her children well before the virus could. Since no one in her life can know about her illness, she is thus unable to justify shirking her daily responsibilities of caring for her children, fetching water and food, caring for her ageing parents, and so on to attend a clinic… the exact reasons she stated for missing her follow up antenatal visit. As I have previously noted, women have no personal capital with which to make financial decisions. Our mama and her family are the poorest of the poor. They farm no land, sell no crops, and own no cows. All of which are indicators of wealth. Even if they possessed the money to pay for transport to Mbirikani, our mama would be unable to access the funds to do so. Even if our mama understands that feeding her child breast milk can pass along her deadly virus. What is she supposed to do? Watch her infant starve to death? Listen to his hunger stirred screams?  It is not as if markets stocked with infant formula exist around here… it is not as if she could afford to, even once in a while, purchase some cows milk as an alternative. The irony is not lost on me – the very sustenance of this child’s life doubling as the sinister liquid pallbearer of his death.

Whenever I think about that baby I envision the childhood he will never have. The little legs he will never run on. I see his sweet, round eyes, full cheeks, and cupid bow lips cooing in pleasure… full of life. For now. It seizes my heart in a way that I am sure is akin to cardiac arrest.

My mind then, inevitably wanders to thoughts of my own mother. Her loving embrace that even now sometimes feels like the only safe place left in the world. My implicit trust in her to always have my best interests at heart. Her desire to protect my brother and I from harms way. These are traits universal to mothers around the world – a fact that in no way detracts from how incredible my mother is – however this perspective makes the plight of the young mama even more heart-wrenching. I am sure she is doing all that she can to protect her children in the best way she knows how given the options she has at her disposal and the information she possess that guide these decisions.

I want so desperately to help in a tangible way, at this very moment. To have grabbed her hand and have had an answer, a solution, a remedy.

Instead, I bear witness.

“Dear Diary, You Know What They Say…”

June 16, 2012

Lest you think our lives at KBC are all gloom and doom, I am here to assure you that my days are filled with as much quiet consideration and hard work as they are all consuming laughter. The only time I am ever alone here is when I shower… and since the showers are icy entrapments I personally choose to spend as little time in there as infrequently as possible. Sans internet and electric, and any space to be solitary, trapped together in the middle of nowhere… we are forced to entertain one another… which means we are silly beyond measure. I have laughed here to the point of crying… to the point where my stomach muscles ache the next day… to that place where you can’t breathe. can’t stop. and it hurts. your cheeks burn. and yet you keep laughing, gasping for air as you go. Most of what we laugh about cannot be shared in this forum, or would make no sense to an outsider even with a detailed explanation.

Thus, I don’t know how to detail for you, dear readers, the variegated bouts of hilarity that occur daily. We have been in the field for the past week and I have much heaviness to tell you of. Later. In lieu of attempting to construct an eloquent and impassioned post I will simply bullet point a highlights gag reel.

• Mambas galore. There have been several murders and several more escapees. I almost stepped on one while on a run around KBC’s perimeter with Shayna. She thinks the baby mambas are cute. I think she’s freaking insane. The snake sightings have grown more common. Kinyako, one of the askari, watched a 7 ft long, bicep thick cobra slither in to a hole right by our camp’s entrance. He sat for hours in a chair across the path from the hole, club in hand, but the snake eluded him.

• Speaking of Kinyako, he is literally the happiest human being I have ever met in my entire life. I see him numerous times each day, and without fail, he is ALWAYS beaming. Kinyako’s skin is the color of the darkest night, his smile the brightest most luminous moon. I am fully aware of how corny this sounds but there is really no other way to describe this man’s ebullience. After a long day in the field, there is nothing in the world like seeing Kinyako’s smile and hearing his gently shouted greetings as he ushers you through the gate back in to the confines of camp. Kinyako’s primary job is to guard camp’s entrance – a job one would think was his life long dream given the grace and joy he displays every day – I wish every short-tempered drive through window operator could see the way this man conducts himself at what is sure to be a similarly monotonous and tiresome occupation. I got back early from the field sometime in the middle of last week and was famished. As I went to stuff a banana in my face it dawned on me that I had never seen Kinyako join us for a meal. I quickly made him a butter sandwich and a butter and honey sandwich (two very common snacks here whose popularity I cannot seem to wrap my head around) and placed them in a plastic bag with a hardboiled egg and some cucumbers and peppers and hurried down the road. I found Kinyako and one of his wives sitting on the small circular stools the Maasai favor cloaked from the afternoon sun by the shade of a large acaia tree. “Jambo, mimi kufanya chakula wewe.” His wife understood my broken statement, rose from her seat and had her arms around me in thanks before I even registered what was happening. Kinyako grinned a thousand suns and shook my hand heartily. They thanked me as if I had spent hours crafting a gourmet meal when in all actuality I had spent maybe a minute spreading half solids on soggy bread. Gratitude is worth its weight in gold.

•  Many of us (include yours truly in that conglomerate “us”) have been struck with an amorphous African intestinal illness. (Michelle now calls it “The Double A Double I”). While wildly unpleasant the experience has brought our team much closer together. Secrets are few and far between when vomiting next to one another sometime in the middle of the night as mosquitoes feast upon your sweaty furrowed brows. Now that we are all fully, or nearly fully recovered the jokes about our afflictions come often. Nicole and I chugged our oral rehydration salts (life-saving tiny packets filled with a simple solution of sugars and salts that when given to severely dehydrated children and adults afflicted with diarrheal disease has the ability to bring even the most far gone back from the brink of death) like we were shot-gunning beers on a fraternity’s porch, gagging, giggling, and grumbling all the while.

• Baboons, it turns out, have a “fear hierarchy.” They fear African men the most, followed closely by African women. White men are next, regarded skeptically before darting in fear. Finally, my kind, white women, round out this strange little pyramid. This means that the majority of our team is useless against them. The vervet monkeys are no different. Both are wildly mischievous and capable of wrecking havoc. We keep a slingshot handy for the especially unruly, though my marksmanship leaves much to be desired. Dennis, the resident chumba vervet has grown ever bolder in his wild romps and raids through the chumba. The other day he managed to get half his body in to the tub we store sugar in, wildly stuffing fistfuls of the glimmering sweetness down his gullet as we lowly white women yelled and waved our arms to no avail. Dennis the vervet has since raided our banana bin, stolen and devoured a bag of chips, and thrown banana peels at unsuspecting heads. KBC’s resident baboons are a whole other story. They tear through our small gazebo chumba and across banda porches, flipping washing pails and chairs as they go, stealing shoes, howling demonically, screeching in revelry. A lesser male recently challenged the troops current leader, which led to a three day long siege that sounded like an exorcism. I was awoken in the still of the night on the second day by a stream of guttural baritone wails. I thought I was having a nightmare for a solid ten minutes before I realized that I was indeed awake, and indeed listening to what sounded like a remix of The Blair Witch Project, The Grudge, and Linda Blair in The Exorcist. The baboons and vervets are so commonplace that the locals regard them as we would squirrels… 90 lb well muscled squirrels with incisors that would stir envy in the hearts of all Twilight’s vampires.

• On Sunday (June 10^th) we took the day off and went on safari in Amboseli National Park. The weather was perfect, the animals (especially the elephants) out in full force as if to welcome us. We had lunch at one of the safari lodges and gathered around the pool afterwards to relax. We were all lazing around happily enjoying one another when Chelsey let out a blood-curdling scream. I looked over to see a vervet monkey jump on her, swipe at her coffee and leap in to tree as she screamed again. Flailing about, sending her drink, book, and other belongings skyward, Chelsey knocked herself on to the floor and burst in to uncontrollable tears… only to literally gag herself on laughter and sobs. The rest of us doubled over in communal hysterics watching the scene while the lodge’s other guests eyed us warily.

• I am by and large the biggest mosquito target at KBC. I have so many bites the running joke among us is that I have “the pox.” Anytime I wear anything that reveals any part of my calves or ankles I am accosted with jeers and good-natured teasing. I really do look diseased. Really. So much so that the other week, a mama pulled my skirt up without warning to affix a large beautifully beaded ankle cuff to my leg, caught sight of my wounds… gasped… burst into laughter, and called something to the other mamas in Kimaa (the language of the Maasai people) resulting in chimes of tittering and playful jaunts. “The mbu like your mzungu damu” Moses tells me.

• My thirst for vengeance has transformed me in to an equally blood thirty mosquito killing machine. Last week a few of us stayed up late working on our laptops. (Side note: devoid of the sounds of humans and cars and lights, the intersection of utter silence and the deafening noise of the night and her creatures is terrifying and comforting all at once.)  As we worked, we clapped pesky mosquitoes to their deaths as they alighted upon our limbs and mashed them, snatched from the air mid-flight, between hateful hands, letting out a triumphant battle cry with each murder. We piled the bodies. After one hour there sat a lump of dead mosquitoes. It was disgusting and yet somehow we took much joy and pride in the small ant hill of death we had created. It’s the simple things in life really.

• Nicole and I have been hosting toothbrush time dance parties, replete with a flashing headlamp to serve as our makeshift strobe light. Shit gets weird.