Swimming was really fun yesterday, and I think we will go again this weekend and probably take some video of Claire. I got a floatie seat for her at the Nakumatt, as she was trying very hard to swim by herself yesterday, totally unaware of the danger she faced. I just got a text from Casey that he is on his way home; evidently there was a freak storm that knocked trees down and transport was running late. I'm looking forward to this weekend!
Ok, so today, Lynne and I went to Mega City for some groceries. We decided to just grab a tuk tuk instead of calling our usual drivers (Owino and Washington). (Small back story: yesterday, our usual driver, Owino, was far away but said he was coming. We decided to take other transport, though I felt bad about it, we didn't want to wait an hour.) Well, when we arrived, both drivers were there as well. One of the guys waved and came over to shake hands. I started saying "sorry about yesterday, we were waiting so long..." when over walked Owino to shake hands. Awk. Ward. I mistook Washington for Owino, and I felt like a total ass, not to mention that we had "cheated" on our usual drivers with a new one. I think Claire is sucking out my brain cells with the milk today! I think Casey would have been mortified at my faux pas if he was there. Oh, me. Anyway, I don't think it was really a big deal, but it was surely awkward, and Lynne and I laughed about it for a good several minutes.
Not much more to report, except that Lynne, Claire and I had a dance party in our room, which was very fun. I find it hard to get exercise these days, but dancing around is always good for that. Also, I looked into joining the gym, and it may be reasonable for Casey and I to do so and even have personal trainers to work us out. Having Lynne available actually makes going to the gym and even out on dates (!!) real possibilities.
Friday, June 25, 2010
We're starting at the begining...
Hello everybody,
so I have gained back most of my strength, my appetite is still not quite up to normal, and these long days exhaust me a bit, but I'm getting around and am able to work which is nice.
so, the first day in the field was yesterday, and I started with the biggest facility that will be part of our pilot, the Yala Sub-District Hospital. I started off the day with a Community Health Worker (CHW) focus group where I went over the proposed software with them and got their feedback, I was able to add some specific time things in the software outline, like to send the reminder for the appointment to the CHW 3 days before the appointment itself is due, as well as to wait two days after the appointment date to see if the mother has shown up before sending another request to the CHW and that after that they should be transferred onto a list for the Ministry of Health HIV tracers to go follow up five days (three days for the reminder to get to the mother and for to her to prepare to go to the clinic and two days of potential showing up time) after that. The other big thing that came out of this was something that I had as sort of an afterthought feature but the CHWs seemed like they were very interested in. That would be the part where they could receive a request from someone in a household to have an HIV counselor to come to the house and help them disclose their HIV status to their partner, and the CHW could text in the persons info and it would generate a weekly report for the HIV counselors at the MOH site of people to go and follow up with. They thought that this would be very helpful. The more that I go and talk to people, the more I realize that this module is less about a reminding schedule (though that is still the cornerstone) and more about helping the MOH and CHW coordinate their activities for the improving of services for patients.
So the head of the HIV unit and the head nurse in charge of Maternal and Child Health at Yala both were very interested and enthusiastic about the project and said they would be willing to take on the extra workload, and in fact they were emphatic that they be included in the original 3 clinics selected for the Alpha phase of this project. So, needless to say, the day went very well indeed.
I also met some other people from SIPA who were here at the MVP field office, I was a bit surprised because I didn't know of them before this, but they were nice to talk to as I had quite some time to wait between arriving in the morning and when we would be going to Yala. And again, after Yala and lunch, I went back to the field offices and had about 2 or 3 hours to kill before the transport back to Kisumu. And of course, I had decided not to bring my laptop to work with me that day to keep my bag light, but regretted it when I was sitting here with work I could be doing, but no means to do it.
I got home around 6:30 and Katie, Claire and I decided to head to Mega City to go to Mon Ami for dinner. It was nice and we ate and hung out for a while and then headed back home around 10. I was suprised by how tired I was, by the time we got ready for bed and I laid down with Katie and Claire, I fell asleep almost immediately. It was crazy, I normally have a bit of a hard time falling asleep, but not then.
Today, it was off the the field again, with the goal of going to Sauri and Marenyo health centers. So of course, like all other days, I got to the office way too early, which was fine as I just hung out and chatted with people and got to catch up with Dickson and James, who are the programmer and head of Health respectively.
We left for Sauri and when I arrived, I found a very helpful in-charge and they of course wanted in on the alpha run as well, which works out well because they share quite a few patients with the Yala sub-Dist. Hospital. When meeting with the Maternal and Child Health Nurse (MCH), I found out that they have all the HIV+ pregnant women come in the same day once a month. This was something that we hadn't taken into account and so I'm very glad for talking to people first, as it's an easy fix, but not one I would have seen on my own. I got the information from them on their PMTCT (prevention of mother to child transmission of HIV/AIDS) and antenatal procedures, as well as their organizational structure and their TB system and joined the car to Marenyo. When we arrived it seems as though the in-charge had a commitment and had left his MCH nurse in charge off all patients, I couldn't take up her time with questions and delay care for all the patients lined up so I decided it would be best to just come back there on Monday. Even with the Malaria delay and this one, i think that I will finish the initial field research portion well ahead of schedule, which is nice. So, I arrived back to the field HQ to find it pretty well deserted, and I've commandeered a desk and am writing up this and my notes for the day and waiting for the car to Kisumu which I think arrives at 4 on Fridays.
That's about it for today, tonight we are headed to Simba Club for their famous friday night buffet, Kaniko and Yoshi from the guest house and Francis from MVP are joining us and then tomorrow we have many competing offers from people wanting to hang out, and then it's off to the bar to watch Ghana vs US on a big screen for World Cup, I've been very conflicted, but i have to keep supporting my team, and besides, it's the first African World Cup so we need an African team in the finals, so Go Black Stars! But in a way this game is the best case for me as I'll be happy even if my team loses. Sunday i think that the plan is for us to go to the market to buy a charcoal grill and some cloth and then it's off to Kiboko Bay Resort to go swimming!!! Okay, that's it for now, time to get back to work!
so I have gained back most of my strength, my appetite is still not quite up to normal, and these long days exhaust me a bit, but I'm getting around and am able to work which is nice.
so, the first day in the field was yesterday, and I started with the biggest facility that will be part of our pilot, the Yala Sub-District Hospital. I started off the day with a Community Health Worker (CHW) focus group where I went over the proposed software with them and got their feedback, I was able to add some specific time things in the software outline, like to send the reminder for the appointment to the CHW 3 days before the appointment itself is due, as well as to wait two days after the appointment date to see if the mother has shown up before sending another request to the CHW and that after that they should be transferred onto a list for the Ministry of Health HIV tracers to go follow up five days (three days for the reminder to get to the mother and for to her to prepare to go to the clinic and two days of potential showing up time) after that. The other big thing that came out of this was something that I had as sort of an afterthought feature but the CHWs seemed like they were very interested in. That would be the part where they could receive a request from someone in a household to have an HIV counselor to come to the house and help them disclose their HIV status to their partner, and the CHW could text in the persons info and it would generate a weekly report for the HIV counselors at the MOH site of people to go and follow up with. They thought that this would be very helpful. The more that I go and talk to people, the more I realize that this module is less about a reminding schedule (though that is still the cornerstone) and more about helping the MOH and CHW coordinate their activities for the improving of services for patients.
So the head of the HIV unit and the head nurse in charge of Maternal and Child Health at Yala both were very interested and enthusiastic about the project and said they would be willing to take on the extra workload, and in fact they were emphatic that they be included in the original 3 clinics selected for the Alpha phase of this project. So, needless to say, the day went very well indeed.
I also met some other people from SIPA who were here at the MVP field office, I was a bit surprised because I didn't know of them before this, but they were nice to talk to as I had quite some time to wait between arriving in the morning and when we would be going to Yala. And again, after Yala and lunch, I went back to the field offices and had about 2 or 3 hours to kill before the transport back to Kisumu. And of course, I had decided not to bring my laptop to work with me that day to keep my bag light, but regretted it when I was sitting here with work I could be doing, but no means to do it.
I got home around 6:30 and Katie, Claire and I decided to head to Mega City to go to Mon Ami for dinner. It was nice and we ate and hung out for a while and then headed back home around 10. I was suprised by how tired I was, by the time we got ready for bed and I laid down with Katie and Claire, I fell asleep almost immediately. It was crazy, I normally have a bit of a hard time falling asleep, but not then.
Today, it was off the the field again, with the goal of going to Sauri and Marenyo health centers. So of course, like all other days, I got to the office way too early, which was fine as I just hung out and chatted with people and got to catch up with Dickson and James, who are the programmer and head of Health respectively.
We left for Sauri and when I arrived, I found a very helpful in-charge and they of course wanted in on the alpha run as well, which works out well because they share quite a few patients with the Yala sub-Dist. Hospital. When meeting with the Maternal and Child Health Nurse (MCH), I found out that they have all the HIV+ pregnant women come in the same day once a month. This was something that we hadn't taken into account and so I'm very glad for talking to people first, as it's an easy fix, but not one I would have seen on my own. I got the information from them on their PMTCT (prevention of mother to child transmission of HIV/AIDS) and antenatal procedures, as well as their organizational structure and their TB system and joined the car to Marenyo. When we arrived it seems as though the in-charge had a commitment and had left his MCH nurse in charge off all patients, I couldn't take up her time with questions and delay care for all the patients lined up so I decided it would be best to just come back there on Monday. Even with the Malaria delay and this one, i think that I will finish the initial field research portion well ahead of schedule, which is nice. So, I arrived back to the field HQ to find it pretty well deserted, and I've commandeered a desk and am writing up this and my notes for the day and waiting for the car to Kisumu which I think arrives at 4 on Fridays.
That's about it for today, tonight we are headed to Simba Club for their famous friday night buffet, Kaniko and Yoshi from the guest house and Francis from MVP are joining us and then tomorrow we have many competing offers from people wanting to hang out, and then it's off to the bar to watch Ghana vs US on a big screen for World Cup, I've been very conflicted, but i have to keep supporting my team, and besides, it's the first African World Cup so we need an African team in the finals, so Go Black Stars! But in a way this game is the best case for me as I'll be happy even if my team loses. Sunday i think that the plan is for us to go to the market to buy a charcoal grill and some cloth and then it's off to Kiboko Bay Resort to go swimming!!! Okay, that's it for now, time to get back to work!
Thursday, June 24, 2010
goin' swimmin'
Today, Casey went to Sauri, the Millennium Village where he will be doing his work this summer. Claire and I are going to go swimming with Lynn at the Kiboko Bay Resort--so exciting! Kiboko is Kiswhahili for hippopotamus, and near the resort is Hippo Point, where you can take a boat 15 minutes out to see pods?/families? of hippos. I've made a list of things we want to do while in Kisumu, and that is definitely on it. There is also an impala sanctuary right across the street that is on the list as well. I think Claire will enjoy seeing the animals.
Claire is currently enthralled by an empty toilet tissue roll; I don't know why we even buy her toys! Yesterday, we got her a baby keyboard that plays kid songs, but I think Lynn and Janet are more into it than Claire, though she does like to dance to the songs.
The other day, Casey, Claire and I went to a restaurant in town called Green Gardens, where we met a Kisumu local from the Sikh community who invited us to be his guests at the Simba Club on Friday night. I think Kanako and Yoshi will come with us--it's sure to be a fun time!
It's pretty cool to be in Africa while the World Cup is going on--and USA won last night! I think Casey will feel conflicted, as USA and Ghana are up against each other on the 26th. We will have to find a big screen to watch the game on :)
Yesterday, Lynn and I had a ladies day and got pedicures. They were 500 shillings, which is about $6. Evidently, a full body massage can be had for 1000 shillings for one hour!! We will definitely be making that happen soon.
Time to feed Claire again...I really wish she would eat some food, but she is really not very interested. Let's hope that changes soon, as mtoto (baby) is wearing this mama out!
Claire is currently enthralled by an empty toilet tissue roll; I don't know why we even buy her toys! Yesterday, we got her a baby keyboard that plays kid songs, but I think Lynn and Janet are more into it than Claire, though she does like to dance to the songs.
The other day, Casey, Claire and I went to a restaurant in town called Green Gardens, where we met a Kisumu local from the Sikh community who invited us to be his guests at the Simba Club on Friday night. I think Kanako and Yoshi will come with us--it's sure to be a fun time!
It's pretty cool to be in Africa while the World Cup is going on--and USA won last night! I think Casey will feel conflicted, as USA and Ghana are up against each other on the 26th. We will have to find a big screen to watch the game on :)
Yesterday, Lynn and I had a ladies day and got pedicures. They were 500 shillings, which is about $6. Evidently, a full body massage can be had for 1000 shillings for one hour!! We will definitely be making that happen soon.
Time to feed Claire again...I really wish she would eat some food, but she is really not very interested. Let's hope that changes soon, as mtoto (baby) is wearing this mama out!
Wednesday, June 23, 2010
Malaria is over!
Hello everybody,
Well, I have recovered. I'm at like 90% full power now after spending the last few days doing varying degrees of nothing. Today was the most nothing I have done and I pretty much just ate breakfast and lunch. I have also been getting together all the stuff that I'll need to be gathering tomorrow when i head out to the field. I know I keep saying that, but this time I'm 100% sure it's going to happen. I really appreciate Katie taking such good care of me and all the love Claire gave me while I was sick, it really helped me feel better. Well that's about it for today, nothing really new to report, but tomorrow should be really cool, i'll try to post as soon as I'm home.
Well, I have recovered. I'm at like 90% full power now after spending the last few days doing varying degrees of nothing. Today was the most nothing I have done and I pretty much just ate breakfast and lunch. I have also been getting together all the stuff that I'll need to be gathering tomorrow when i head out to the field. I know I keep saying that, but this time I'm 100% sure it's going to happen. I really appreciate Katie taking such good care of me and all the love Claire gave me while I was sick, it really helped me feel better. Well that's about it for today, nothing really new to report, but tomorrow should be really cool, i'll try to post as soon as I'm home.
Monday, June 21, 2010
oh, malaria...
The last 24 hours have been much easier for me than for Casey, and I'm hoping that the malarone will kick in and drive the malaria out very quickly so he will feel better. Claire finally went down for a nap after much dinking around, and I have had a little time to myself, which is very nice. However, as there is much to do and it is difficult to do with Claire getting into everything, I will make this a short post. We made chili last night--it turned out very nice, and we made some cornbread from a recipe out of my head that turned out quite tasty. I'm not used to being the one to direct traffic in the kitchen (usually a Casey role), but as he was feverish and generally feeling craptastic, I happily did what was needed.
Needless to say, Casey's first Father's Day wasn't exactly celebratory, but we will have to make up for it when he is feeling better.
Yesterday, I ventured to the Mega City for some groceries, and I admit to being a little scared. I'm still learning so much about the culture and the area, and who I should trust/not trust. So far, so good, and I even negotiated for my tuk-tuk rides :)
Ok, off to do some wash and fix lunch--let's hope Claire stays asleep just a bit longer!
Needless to say, Casey's first Father's Day wasn't exactly celebratory, but we will have to make up for it when he is feeling better.
Yesterday, I ventured to the Mega City for some groceries, and I admit to being a little scared. I'm still learning so much about the culture and the area, and who I should trust/not trust. So far, so good, and I even negotiated for my tuk-tuk rides :)
Ok, off to do some wash and fix lunch--let's hope Claire stays asleep just a bit longer!
Friday, June 18, 2010
Meetings- Check! Field here I come!
So Thursday, 6/17, I went into the MVP offices here in Kisumu, I really wish I had my camera as the tuk tuk driver was wearing a really really inaapropriate t-shirt that I doubt he even knew the meaning of, it said "My safe word is DONKEY PUNCH"... I don't really know what to say other than wow. Anyhow, I arrived and sat down with MVP's programming team of Dixon and Moses. We ran through what I wanted to do and then we worked through the proposed system, they had some really good insights on aspects of the program and were pretty stoked on the whole thing. They pointed out a way around one of the things that was worrying me the most, what happens if the pregnant woman isn't already registered in Childcount? i was worried about having the medical center staff needing to go back through and register women who weren't already in the system, this had the added difficulty of needing to assign the appropriate CHW to the mothers record as well. Dixon and Moses pointed out that there is a CHW in each medical center already, so we can have them register any mother who is not already in the system before they see the doctor for their appointment. Problem solved.
And after a very nice tea break courtesy of Katie we're back.
They also said that they would have time to work on the coding themselves. This was fantastic news as before we had thought that they were too busy to do it. They had said that they would rather do it themselves since I was here and we could communicate more easily. So, we are set on the programming side, and the draft plan for the software is looking doable for the programmers.
After I got home, we relaxed a bit and then we prepared Saag Paneer with the local kales, it turned out nice and we all ate well. Our hosts, Janet and Lynn both enjoyed it as well, I was worried as it was pretty different than the food they are used to, but so far all the cooking has gone over well. The night before i made Guacamole and tonight We are making roasted chicken, tomorrow Thai curry and Sunday Chili and cornbread. Yum! I'm having fun cooking while I am around earlier in the evening.
Today I went in to the offices to meet with Dr. James Wariero who is the head of health here and Dr Shemsanga who is going to be the head of Health in Tanzenia, I went over the whole plan, and after talking about the preliminary research that I wanted to do, James went over the roadblocks they had come up against when trying to come up with a program in the past. As I listened I got excited because I thought that our program addressed many of those. I pitched our sketched out plan and James was satisfied and is looking forward to the program going forward.It looks like on Monday I'm on target for the beginning of fieldwork! Okay, that's all for now, I'm watching the US losing in the World Cup and Claire hurt herself :(
more tomorrow!
And after a very nice tea break courtesy of Katie we're back.
They also said that they would have time to work on the coding themselves. This was fantastic news as before we had thought that they were too busy to do it. They had said that they would rather do it themselves since I was here and we could communicate more easily. So, we are set on the programming side, and the draft plan for the software is looking doable for the programmers.
After I got home, we relaxed a bit and then we prepared Saag Paneer with the local kales, it turned out nice and we all ate well. Our hosts, Janet and Lynn both enjoyed it as well, I was worried as it was pretty different than the food they are used to, but so far all the cooking has gone over well. The night before i made Guacamole and tonight We are making roasted chicken, tomorrow Thai curry and Sunday Chili and cornbread. Yum! I'm having fun cooking while I am around earlier in the evening.
Today I went in to the offices to meet with Dr. James Wariero who is the head of health here and Dr Shemsanga who is going to be the head of Health in Tanzenia, I went over the whole plan, and after talking about the preliminary research that I wanted to do, James went over the roadblocks they had come up against when trying to come up with a program in the past. As I listened I got excited because I thought that our program addressed many of those. I pitched our sketched out plan and James was satisfied and is looking forward to the program going forward.It looks like on Monday I'm on target for the beginning of fieldwork! Okay, that's all for now, I'm watching the US losing in the World Cup and Claire hurt herself :(
more tomorrow!
Settling into Kisumu
6.17.2010
It’s been a couple of days since I wrote a blog, mostly because we have been getting adjusted in Kisumu. My initial reaction to arriving at our guest house (for about 30 minutes) was disappointment. I had it in mind that we would have more privacy and not be in such a shared situation. Then, after some processing I realized that this is actually the best possible place for our family. Our housemates are very nice—2 of them are researchers from Japan who have been here since April and will be staying through until December. There is another woman who lives in the apartment out back though I can’t recall her name as we just met last night, and there are two caretakers, Janet in the daytime and Lynn at night.
6.18.2010
We have been cooking dinners together as a “family,” and it has been really nice! It turns out to be a very nice thing to have community—we are quite happy. I’ve made a couple of trips to the shopping center called Mega City, and it does live up to its name. It makes Super Wal-Mart look like a 7-11. There is pretty much everything one might need, though the quality and selection is still better in the States for the most part. I’m happy we have it so close by though, and it is proving to be very inexpensive to live here, and would be more so if things were within reasonable walking distance. I think Kisumu proper is about a 15 minute walk, but the Mega City is 2-3K away, and with Claire and groceries it would be a tough walk.
We have hired Lynn to be my helper, which has been great! She is going to help me 4 days a week with anything I might need, and I am so grateful. When we go to the Jubilee market (gigantic farmer’s market), they see a mzunga (white woman), and the price automatically goes up. So, Lynn is helping me negotiate this, and hopefully by the time we leave I will be able to negotiate as well.
I did laundry by hand for the first time yesterday alongside of Lynn, and I have a new appreciation for what goes into this task. I no longer will call a piece of clothes dirty unless it truly is!
On Sunday, Lynn and I will go to the Sunday market and buy some cloth for Casey, Claire and I to have some clothes made. Casey starts his first full day of work on Monday, although he has had meetings this week in both Nairobi and Kisumu.
I think it is time for tea, so I am going to go fix us some—bye for now!
It’s been a couple of days since I wrote a blog, mostly because we have been getting adjusted in Kisumu. My initial reaction to arriving at our guest house (for about 30 minutes) was disappointment. I had it in mind that we would have more privacy and not be in such a shared situation. Then, after some processing I realized that this is actually the best possible place for our family. Our housemates are very nice—2 of them are researchers from Japan who have been here since April and will be staying through until December. There is another woman who lives in the apartment out back though I can’t recall her name as we just met last night, and there are two caretakers, Janet in the daytime and Lynn at night.
6.18.2010
We have been cooking dinners together as a “family,” and it has been really nice! It turns out to be a very nice thing to have community—we are quite happy. I’ve made a couple of trips to the shopping center called Mega City, and it does live up to its name. It makes Super Wal-Mart look like a 7-11. There is pretty much everything one might need, though the quality and selection is still better in the States for the most part. I’m happy we have it so close by though, and it is proving to be very inexpensive to live here, and would be more so if things were within reasonable walking distance. I think Kisumu proper is about a 15 minute walk, but the Mega City is 2-3K away, and with Claire and groceries it would be a tough walk.
We have hired Lynn to be my helper, which has been great! She is going to help me 4 days a week with anything I might need, and I am so grateful. When we go to the Jubilee market (gigantic farmer’s market), they see a mzunga (white woman), and the price automatically goes up. So, Lynn is helping me negotiate this, and hopefully by the time we leave I will be able to negotiate as well.
I did laundry by hand for the first time yesterday alongside of Lynn, and I have a new appreciation for what goes into this task. I no longer will call a piece of clothes dirty unless it truly is!
On Sunday, Lynn and I will go to the Sunday market and buy some cloth for Casey, Claire and I to have some clothes made. Casey starts his first full day of work on Monday, although he has had meetings this week in both Nairobi and Kisumu.
I think it is time for tea, so I am going to go fix us some—bye for now!
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