One more picture

you can't upload more than a few pictures at one time,the whole system crashes. That's Africa!

The story behind the day

Margaret was 10 years old. First,I have to say I gave it some thought as to whether or not I should post the pictures. I was trying to post them this morning when Sr.julie ran in and said to come quickly,they needed me right away in the sick room. I decided that it was right to post them after she died because I want her to be a child with a face and a name, not just another child dying of AIDS in Africa.
She had been orphaned at a very young age and left in the care of 2 aunts. One beat her,she had to live with that one because the other one's husband refused to have her in the house, so she would only come there during the day. That aunt would bring her to the clinic.They could never start her on ARVS because the aunts would not come for the training and there was no one else who would give them to her. At some point she was also molested. She was admitted to Nyumbani emergently last monday, when she came to the clinic very ill and severely malnourished, wieighing only 20 lbs, open sores on her body. I helped care for her all week. At first she would only tolerate my caregiving,she was very afraid of mizungos.Then on Friday I opened my laptop in the room and she saw the picture of Jack.I showed her and said "see my grandbaby?" she smiled and answered back "he's not a baby,he's a big boy."From that moment on we were together,she told the other nurse I was her friend. This morning Jody, my roommate,who's a new graduate nurse from the UK, and I came on duty at 6am. We stayed with her until the regular nurse came in at 8, I told her that she had been pretty much sleeping but her breathing had changed in the past half hour. The nurse reported to the staff in morning report that she was better. ??? I won't go into all what I thought should have happened here, and didn't, but throughout the morning she
was unresponsive (the last time she spoke was last night, when she said 'everyone left me."
She also was seizing this morning.
The nyumbani kids have been on school holiday and they all got to go to a real movie today.Ken really wanted to go,and he couldn't go if a nurse didn't go.he knows me the best so I decided to go with them and jody would stay with margaret. I was pretty sure she was going to die this afternoon but I really felt that I needed to do this for ken, life goes on.Jody sent me text messages throughout the movie, most of which I read while I took kids to the bathroom. I got back to Nyumbani 20 minutes after she had died. Jody and Sr.Matron were with her, her aunt actually walked out of the room as she was taking her last breaths. She told me later it was God's will that she died. We all said our goodbyes, they called the mortuary service and they took her away in the back of a pickup truck, laid her by the old tires.
But, for one week she knew she was loved.
It's been a long sad frustrating day, I have to accept how things are here. I talked to some of the Kenyans about how could a family do this to their children and they said it's all about revenge and stigma and blame. and a little girl caught in the middle.

margaret

Margaret died this afternoon,peacefully and quiet. The aunt that didn't beat her but whose husband wouldn't allow her to live in the house had come to visit,but left as she was dying. I will never understand what goes on here.

A little more update

I am at the American Embassy, arrived early for a meeting with the PEPFAR people. They have a wonderful library here with all sorts fo books, reference material etc and most importantly, fast computers! I can't bring my camera in so I can't use it to download photos, but just blogging and emailing is wonderful. Melissa and I came here for lunch with Justus Mbae, the cultural attache, they have a huge screened tv in the dining room, we got to see MSNBC! Justus told us that when we walk through these gates we're no longer in Kenya, we're in the United States. Sure feels good to me.
the overnight safari that Melissa treated me to was really spectacular, the guide said it was the luckiest safari ever. We went to Lake Nakuru, north of Nairobi and stayed at the Lion Hill lodge, set on the side of a mountain. The room was beautiful, the food bountiful and delicious (best cream of lettuce and cream of celery soups I've ever had) and we saw a leopard, baboons, girafffes, zebraas, pink flamingos, and best of all we saw 2 lions kill a buffalo. 50 meters away from our van!!I've never lived so close to the food chain or known so clearly my place on it!
Anyway, the last 2 weeks have been wonderful. I love having visitors so start saving up! I will post pictures soon, and get back to regular updates. I leave for my 10 day stay back home on May 23, arrive may 24th. counting the days.
stay safe officer timmy and xoxoxo little boy

The long rains

Dr. Melissa W left on Sunday after a great 2 weeks visiting me here. We went all over, which is why I haven't had time to blog. It was kind of like Kenya on crack, everyday was a new adventure. Since she left the "long rains" have come, it rains like I've never seen before, and everywhere what was dry and dusty has turned into thick heavy mud. There will be no quick walks to the village for a few weeks. So far though the rain hasn't washed out our internet connection! First some really good news, ken's cd4 count has increased from 1 to 16!!! We are all hoping he has turned a corner, as he feels better his spirits are improving, he's much more interactive and gives me his big smile everyday. He seems to have found the will to live again. he's eating more, though still not gaining weight. Hopefully that will come too as the arvs finally win the war against the virus. They truly are miracle drugs, it's just so sad that they were so long coming here. Unfortunately there has been a new emergent admission, 10 year old margaret. She came to us from lea toto, one of the slum clinics, She is severely malnourished, weighs less than ken, has sores all over, has been beaten and molested. Has meningitis, having seizures. I have spent time taking care of her, had to give her an injection. I cried because I couldn't find any muscle or soft tissue in which to put it. She speaks only her tribal dialect, not even swahili. Still, as ill as she is, she rubbed her hand on my hand, her first touch of mizungo skin.
On a lighter note, melissa and I had a wonderful time. Mum ann's family we're wonderful hosts, despite the lack of running water and intermittent electricity We spent time in the slums, visited a daycare with 42 children and only 2 old tires to play with. I am bringing some toys there next week. I will be going there at least twice a month to check on the kids medical condition. Should be challenging, melissa had to do her exams outside because there is no power and it's too dark inside. Still they sang us a wonderful song and cheered when we took their picture.
We also went up to Kericho, about 250 km from Nairobi. The drive is horrendous, there's about 35 miles of to put it nicely off-road quality road. You haven't lived until you've seen rickety old semis and buses crammed with people going off-road! we saw 2 overturned trucks. While we were in Kericho we stayed at the guest house for the army's walter reed project. It was a little bit of heaven, I had a hot shower and a bath! I took my clothes out of my backpack and left them on the bed, when I came back they were washed (like really clean!) and pressed! Real hot coffee in the morning, a fire in the fireplace at night. Meals were even cooked for us! Our tax dollars at work. What a gift. We toured the district hospital, met with staff and some workers at a youth center and at another orphanage. Hopefully they will be able to use my program, (I just want to get back into that guest house!). They have a big problem with disclosure of status in the rural areas, they say almost none of the 1000 children they treat at the district hospital know they're +. Which is why there are so many problems and the future looks so bleak. There were 2 other Americans staying at the guest house, an army doctor from DC, and a nurse who's there monitoring vaccine trials. She's there for a year, he for a month. We had wonderful dinner time conversations, those 2 nights will be favorite memories for me for a lot of reasons. One of the best things about this whole experience is the fascinating inspiring people I have met.
This is getting long, (so what else is new!) I will post again tomorrow, try to put pictures on later today. much to tell you about safari, the embassy, nyumbani village.
stay safe officer timmy, xoxoxo little boy happy day after your birthday Elizabeth

Checking back in

My friend, colleague, faculty advisor Dr.Melissa W.has been here since last Monday. It was so wonderful to see someone from home who came bearing all sorts of gifts! We have been so busy,to nyumbani, to the slums, to nairobi, on safari, today we're going to Kericho in the tea growing district,to evaluate some sites for the project. We've been staying at mum ann's house,they don't have internet (or running water the past 5 days) so I have had limited slow access when I can get to a computer. I will blog again with all the details and pictures next week,in the meantime keep the emails coming. Those are quicker to read,and I promise I will catch up next week. Barb K,it's a go for you as my data entry person. Details will follow! PS.Melissa misses her family, sends them love but is having a great time!

Happy Easter

It's Saturday night and everyone here is at Mass in the schoolhouse.I'm in Cottage D with awino and Ken.(she typed her name!) Ken wasn't up to going and I'm not sure why Awino isn't in church but I offered to stay here. I can hear the singing, it's very peaceful here. We started the Easter services on Holy Thursday, with an evening Mass. Some of the boys got their feet washed as part of the service, it was very sweet. Usually Mass here is quite a production, it's on Sunday morning and there's much singing and dancing. Lots of people from the community come, some people end up sitting outside. What has been wonderful about this week is that the services are at night and it's just Nyumbani, even most of the staff aren't here.It's so much more intimate, I've really enjoyed it. When it's time for the service one of the kids walks around ringing a handbell, and everyone pours out of the cottages and gathers. On Good Friday, (yesterday) they posted pictures of the Stations of the Cross on buildings around the compound and we all walked from one to the next,there was singing and praying.One of the kids was Jesus and carried a cross. He is quite a ham so it was a very theatrical performance. At the end of the service we all stood in the center and made a human cross. Very inspiring. Tomorrow will be a huge Easter Sunday Mass, they have even erected a tent next to the schoolhouse for the overflow crowd. The choir kids have been practicing all week, I'm looking forward to experiencing it. After Mass there's a big lunch, goat, salad, rice. Then an Easter Egg Hunt! There's no talk of the Easter Bunny or baskets of gifts.
The volunteers and I have been talking about the role of religion here at Nyumbani, it is a Catholic orphanage after all. We are all of different faiths, some go to the services some not. We all have different opinions about what role religion should play in the world, we all see firsthand the damage the Catholic church's stand on condoms has caused. What we have all agreed on is how these kids draw comfort from their faith, it gives them structure, a sense of community. They truly believe, and for these kids there is so little to believe in.
I will take pictures of the kids in their Easter finery and try to post them soon.
So Happy Easter, thinking of all of you.
Stay safe officer timmy, xoxoxo little boy.

Slums of Nairobi

I have never taken a camera to the slums, it's not safe. This past week however a volunteer came from the us, big, tall and mzingu and he managed to get some pictures. We all decided to use them, he was gracious enough to share, realizing how scarce they are. last week i was in the slums for 2 days. on one day I spent the morning reviewing the files of kids who had died. Then, in the afternoon the social worker took us out on some home visits. i had been before, but never so deep into them. We walked for a long time, through mazes of paths, strewn with sewage and garbge, i never would have found my way out. People stared, but we didn't feel necessarily unsafe. Kids run up and say the only English they know "how are you" The women we visited were honored to have us in their home. There is so much I can't describe, the sounds, the smells, the site of a very ill baby hidden in a pile of rags in the corner of a dark room. It has taken me days to get over that one afternoon. I will go back, but these are imges that will never leave me.
When we returned to the clinic Dr. Grant wanted me to see this baby. His name was Paul, he was 10 months old, first baby, parents were +, he was too. he made no sounds, no eye contact, barely moved his limbs, could lift his head with some lag, had rickets, weighed 8 pounds. But his mum loved him, as I held him she just beamed at me. so proud he was still alive.
On the way home we all talked about how we wanted a long hot shower and to go to a fancy restaurant. We just wanted to be somewhere where the reality wasn't.
Didn't get either.

Despite the extreme poverty and hardship they are somehow full of life, always something to sell, music playing, the sound of kids and animals. The resilience is remarkable and a tribute to the human spirit

A day in the neighborhood

most densely populated sites in the world

There is no space to live, no clean air to breathe, no clean water to drink, over 1 million people in kibera alone, there is no privacy and no protecton. Again a breeding grund for untold diseases, especially hiv and TB

Lea Toto Clinic Entrance

Fr. D'Ag and Nyumbani founded lea toto (caring for the child) in 1998. US AID joined us in 2005 with ARVS. There are 6 sites throughout the slums, some have no running water. We care for 2000 children, 800 of whom are now on arvs. 5 died last week at one site alone. The clinics are not fancy but everyone knows help and hope is inside.

Everyone walks

No one can afford cars, there are matatus, but many people can't afford those either

A place to play

kids play in garbage heaps, which are everywhere, including up against their shanty, they pick through the garbage looking for food or something to sell. There is no waste system here at all, which breeds disease

sewage system

untreated open sewage and disgusting water flows freely down the street and into people's homes, kids play in it.

laundry day

mums really try to keep everyone clean but washing with dirty water,(there's no clean water anywhere) mud garbage dust everywhere it's a losing battle.

Truly nothing to do

Nothing to play with, no books to read, most likely HIV+

Home in the slum

most of the homes are only 10x10, no plumbing, no electricity, mud floors, so when it rains.....