Home (Bitter)Sweet Home

Well, after a long 48 hours of travel and a solid day of rest, I am finally back home and settled...

Our group went to one last mass on Sunday morning before heading out. It was in English this time, and after being in Migori for over 3 weeks, I felt like a local running into people I had met during that time! They do a special little handshake whenever they see friends, so to be a part of that was a great feeling. Makes it hard to leave. 

Sam (another cook at our house) had fresh donuts on the table when we got home...Perfect last meal! 

Carley, Kate and I dragged out the packing process and small talk as much as possible, but finally had to rip that bandaid off and say our goodbyes :(  Guh, the waterworks were definitely in full force. It is just so hard to leave the people we have bonded with over the last 3.5 weeks. No matter how many pictures and stories we share with all of you back home, they are the only ones who can ever truly understand what we experienced while in Kenya. There are so many aspects involved in a trip like this - challenges, jokes, illness, tears, laughs, frustrations, joys, risks, regrets, fears, lessons, problem-solving, smells, flavors, personalities - it is impossible to capture these things in photos or words.  

It is difficult for the three of us who are leaving because we want to stay longer and keep making a difference there. It is difficult for those who are staying because the group dynamic is such an integral part of the whole experience and each person brings something different to the table. From now on, people leave every few days, so it will constantly be changing. But we have made memories in Kenya that we will never forget, and that is the reassuring part.

That being said, even within the group, we each had a slightly different experience...we were doing different jobs, facing different challenges, seeing different patients, bringing different goals, faiths and emotions with us from the very beginning...but, when it comes down to it, we were all there with similar intentions and we supported each other through some of the most intense periods of personal growth we have/will face. That is what makes a trip like this so special. 

one last group photo before saying our good-byes

...And, on the bright side, we already have plans in the works for next year's trip, so stay posted ;)

Anyhoo, a brief summary of the journey home was:
-7.5 hour drive from Migori to Nairobi
-5 hour wait at the airport (ate our first bites of the Americanized Mexican food we have been dreaming about)
-8 hour flight to Amsterdam (slept like a baby)
-8 hour layover (left the airport to explore the city for a few hours....and by "explore," I mean "eat our way through the city." Stopped at 5 places and shared various croissants, pastries, appelflaps - don't be turned off by the name, they were delicious. We got rained on, but saw a good chuck of the city...definitely have to go back sometime! Bikes & coffeeshops?!? My kind of place!)
-8 hour flight to Chicago (longest 8 hours of all time... -_-)
-1 hour drive home
-Days of culture shock.

the real one was too far away...

Central Station

Tasting our way through Amsterdam

Nothing better than eating pastries on a curb at 6am

gettin' artsy, per ush

After a few hours of reuniting and unpacking, I crashed! Slept 13 hours to try to offset the jet lag and thought I had outsmarted it...until 5:00 this morning when I was wide awake and writing e-mails. Oh well.

It is definitely nice to be home with the luxuries and conveniences of the US - hot showers, water pressure, toilets - with seats - that flush consistently, fresh fruits and vegetables, brushing my teeth with tap water, doing laundry with the push of a button, jumping in a car to go to the grocery store, seeing landscaped lawns and houses made of sturdy material, sprawling out in my own bed without getting tangled in a mosquito net, sleeping in silence without roosters and mosques waking me up at 4:00am, solid internet connections, a pantry and refrigerator with plenty of food, not having my lips taste like sanitizer and dust when I lick them, knowing which side of the street to walk on, not swerving to avoid potholes every 5 seconds, not being traumatized by the smell of chickens at the market - the list goes on.
But, despite all these things, there is such a charm about the simplicity and rustic, organic lifestyle in Africa. If you show up late...no big deal. If someone needs a lift...pick them up. If its dark...stay in. If you need to buy something...walk to the market. If you are happy...sing. This simplicity is essential to balance out the hardships they face. Otherwise, the challenges would be nearly unbearable. Africans are without a doubt some of the toughest people out there and I miss their way of life already.

Here, we have everything we could ever want right at our fingertip, but are often not truly happy. We waste, complain and stress constantly. There, they literally have nothing, but are still smiling and full of faith. They have a beautiful culture and value things that are truly important. On trips like this, you always learn more from the locals than you could ever teach them yourself.

I don't want people to think I don't like the US after reading this. There are positives and negatives to each and every place on earth, and I believe that we all have a lot to learn from each other. Traveling and being immersed with people of other cultures is, without a doubt, the best way to grow and appreciate what we have in our own lives. We are so incredibly lucky to have efficiency, sanitation, resources, education and opportunities that we do and I am blessed to live here. It is just hard to come back to this life, knowing that there are people suffering and dying because they don't have the advancements we do here. But these contrasts have always existed. It provides an opportunity for us to make a better world.

Thanks to everyone here who offered support - monetary, spiritual, emotional - and to everyone who kept up with this blog. I hope that it was able to provide at least a little insight into some of the experiences I have had.

I am glad to be home safely with my family and friends, but it is a little bittersweet - I definitely left part of myself in Kenya...

Days at the District

Alrighty, well yesterday was the definition of bittersweet.
Jaclyn, Allie & I headed to District first thing in the morning and had a full day with the nutritionists. We started out listening to a health talk about the importance of getting test for HIV during pregnancy. It was in Swahili, but they translated the main points to us and we were able to observe the mothers and their babies...too cute. They had a great turnout, thank goodness.
After the talk, we went back to the nutrition office to discuss how they assess cases, diagnose, monitor, follow-up and provide food prescriptions. Like I mentioned in the last post, they have a few different flours to make porridge - they have some for children, adults and pregnant/lactating women, as well as Plumpy Nut PB. If a child is malnourished or vulnerable, they are provided porridge. If this is the case, the parent is given food as well to ensure that they don't eat the children's food.

One of the nutritionists assessing a patient 

Pictures of malnutrition in the office

Our entire day essentially revolved around one case, so I will give you the rundown. It is one of the most heart-wrenching stories I have ever heard about, and to see it firsthand was unreal...it is one of those cases that changes your perspective on life.
The mother is 26 with mental disability, her daughter is 3 and her son is 1 1/2. By measuring their heights, weights and mid-upper arm circumferences, we determined that the daughter was normal, but vulnerable, and the son was -3 severe malnutrition. They were provided US AID porridge, as was the mother. The mother has not been preparing the porridge consistently because she only has one pot and it is not big enough to make a substantial amount. In the past, she has been known to eat it, rather than giving it to the kids as well.
The husband/father works doing manual labor, but before coming home, he stops at the local hotels to eat and drink. After spending his earnings here, he comes home with only 30 shillings worth of flour for the rest of the family to eat (86 shillings = $1.00). We did a home visit and decided that the first step needs to be talking to the father...they were planning to do this sometime this week. Additionally, a neighbor is going to start preparing the porridge because she has more space and larger pots, to ensure the children get the food.
Being at the house was unreal. It was originally part of an NGO setup, but when the project was complete, this family found the tin home and moved in. There is a lot of open area nearby, but they have not been using it to grow fruits and vegetables, which the nutritionist plans to encourage as time goes on. Anyways, the house was literally about as big as a dining room table. Not an exaggeration. There was a "bed" of potato sacks and straw(covered by a mosquito net), a 1 pot heater, a few cups, and a corner full of empty water bottles, which the mother used to sell for extra money. The kids would be left alone with no food or water while she was gone. Thankfully, there were a few neighbors that stepped in to help and have been watching over her and the children.
While we were at the home, the mother began crying because she was hungry and embarrassed. She was holding her malnourished son and began bathing him in a bucket while we were all there. We suspected the son might have malaria, for which there would be no feasible/affordable treatment. The little girl was like a magnet to us. She was hugging my leg even in the office earlier in the day, and here, she fell asleep on our shoulders. She was so beautiful and it is heart breaking to wonder what her life will be like.
The situation is just overwhelming. It is definitely a lot to process.

Home Visit

Inside of the home: bed and kitchen supplies
(I was standing in the doorway, for a little more perspective)

The rest of the day was spent doing rounds and being introduced to each of the wards. Emmanuel, one of the nutritionists, was very proud to have us working with him, but not happy I was leaving this weekend :(  He would give us a rundown of the common nutrition problems encountered in each area. The peds ward was definitely another challenge. We see pictures of kwashiorkor and marasmus in textbooks, but yesterday and today, I saw it with my own eyes and it was worse than I could have ever imagined...
There was a baby girl in the acute peds ward who was 1 year old and weighed 4.4 kg (9.6 lbs). That is birthweight. Her eyes were so sunken, her ribs were protruding - you could count each one, her arms and legs had no fat whatsoever, her whole body was cold and she didn't even have the energy to get out a cry. She was HIV+, a sickler and at risk for hypothermia because she was so small. Her mother had passed away, so her grandma was with her. She is on formula to try to replenish her, but she is so incredibly malnourished that I honestly don't know if she will be able to fight everything that is against her right now, especially being surrounded by all the other kids in the ward and being already immunocompromised. (She has her own bed, but others in the ward share beds with 2-3 other children.) I felt her ribs, arms and legs and it was one of the worst moments I have ever had. It is just something that is so unfair and that you would never wish upon your worst enemy.

Formula calculations in the peds ward

Leaving District was tough because I saw the work I could be doing if I had more time. The nutritionists were so welcoming and were so curious about how we handle nutrition in the US. I feel like we would be able to collaborate and help some of these patients if we had a chance to put our heads together. I think the frustration is the hardest part, because I want to help these kids so incredibly bad. I am not sure what the reason is that I just found about this nutrition program, but I am hoping it exists.

We had a very late lunch yesterday (due to the home visit) and then spent some time at St. Joseph's PT department. It started to rain, so we squeezed in a quick trip to the market, came back, played games in the dark (because the electricity was out again), ate cake that the PT's and their crew literally baked in the sun, made guacamole and hung out.

The PT crew with Kate's sun-baked b-day cake :)

Today, I chose to to back to District with a few kids from our group to soak up as much time as I can before leaving. I pretty much shadowed them as they cleaned wounds, placed IV's, monitored oxygen tanks and checked up on their patients. It is really inspiring to see people who are so passionate about medicine.

Tyler educating a mother in the peds ward

Lorryn, a pediatric patient who our team has been following

After the hospital, we took a total chance and went to the school to see if the kids would be hanging out there to play, but no such luck. Instead, we just took one last trip to the market, hung out at the Gilly (not by choice) and took it easy at the house.
I cannot believe this is our last night here! It is kind of a time-warp because flying into Nairobi feels like ages ago, but at the same time, I don't feel like it's time to leave yet. I definitely wish I could stay longer (may or may not have called the airline to see how much a flight change would be...), but I am excited to see the fam, use a real toilet...with a seat, take a hot shower, sleep in my bed and eat something besides carbs! It has been an incredible experience.

Saying goodbye to Martha, our amazing cook!

Rosie, our adopted (and pregnant) dog

Homestretch for Team Tusker

Frustration Station...and a baby!

So, essentially, the past two days have been a little rough.
It all started when 3 of us went to the school to teach more because we felt like that was the place where we could make the biggest impact. It was our plan to spend at least 2-3 days there this week. We showed up so excited, only to find out that they have testing ALL week, so there are no real classes going on. We asked if there was anything we could help out with, whether it be proctor exams, grade things, organize books, etc. They told us there was really nothing, but that we should come back Monday...I'll already be gone by then :(
Point Kenya.

So we went back to the hospital. Turns out St. Joseph's hospital in particular is slow on all days besides Monday and Friday because those back up to "market days" and so people generally only travel to the town on the days that they can multitask - going to the market and the hospital/clinic in one trip. Makes so much sense.
Also, this hospital does not have volunteers all the time, so they have to be able to function on their own. Aka, there is just not a lot for us to do sometimes.
Got in contact with a volunteer from Germany who is working at another orphanage. We met with her, hoping to find work for the week. Aaaaand of course, she was leaving for Nairobi the next day until July 1st...only has to go there twice in the entire year she is here...so of course it is this week!
More points Kenya.

So, yesterday, we wandered from ward to ward asking where we could lend a hand, but kept getting politely turned away (multiple points Kenya).... until we got the call about the lady in labor! We had all gone back to the house threw on our scrubs, ran over there and then sat with the mom for 2+ hours before she finally had a beautiful baby boy :) Aaaaand, the best part....she named it Tyler, after a med student in our group!!! He was the only guy in the room with us during labor, so she asked his name and we literally thought it was a joke (mainly because locals have such a tough time pronouncing his name), but she really did it...and said it perfectly! So, I think this is officially the first time there have ever been 2 Tylers in Kenya. Luckily, this moment made up for the rest of the day, because we started keeping points (US vs Kenya) and Kenya was waaaaay ahead until then. US for the win!

Peds Ward @ St. Joseph's

Pharmacy @ St. Joseph's

Crafting some foam donuts for our Bed Sore Initiative

Audrey & Baby Tyler

Started off today with some sunrise yoga!!! I channeled my inner Cyndawg and taught a class in our yard....had to use beach towels, but it did the trick. The mornings here are so refreshing! Feels good to get moving early. And almost everyone in the house joined so we had a blast :)  Plus, we all need some good stretches and twists because - well, let's just say - the beds and pillows here are not quite Tempurpedics. This back is going to need some serious adjusting when I get home.

Sunrise Yoga

After breakfast, a few girls and I went over to the Oruba Hospital because we heard they need more help. It was about 10 minutes down the backroads, so it was nice to see more of the city and how people live day-to-day. The staff at this hospital were so excited to have us and actually spent time on orientation, introductions and assignments. We did rounds on all the patients and the doctor tied nutrition into almost every case there. It was such a nice change to be able to be productive! We discussed malaria, anemia, meningitis and TB cases mostly.
The meningitis case was the hardest because the woman had a 1 month old laying in the bed next to her and had not been able to breastfeed for weeks. Because of this, the baby has only been getting water and maybe a little sugar for that entire time. She was just so tiny. Formula here is 1500 shillings, which is suuuper expensive for them. So, those of us who were there pooled money and were able to get a tin of formula to sustain her until the mother can feed again. It is just so hard to look at these beautiful little babies and wonder what their lives are going to be like.

Oruba Hospital

After rounds, we met with the TB specialist and got an intensive rundown of the entire disease process...and nutrition, again! Most hospitals here get meds via US AID, and malnutrition is such an issue here that food is truly a medicine. This location in particular provides/prescribes porridge to anyone with a BMI under 18.5 until they are a healthy weight.

Bags of porridge provided to malnourished patients

After grabbing a quick lunch at the house and studying for a bit, Jaclyn, Aly and I headed over to District Hospital, another location we had not yet been to. We had not been offered the chance to work here up to this point, but the med students went yesterday and told us that there are actually Social Work (Jaclyn) and Nutrition programs in place there. Sooooo, essentially, we should have been working here the WHOLE time, but we were never told that the programs were available...even though we had asked over and over. Could not be more frustrated.

But anyways, we took matters into our own hands, went to District and approached the Head Nurse to introduce ourselves and ask about opportunities there would be for us. She was more than excited and willing to guide us where we needed to be.
We met with the nutritionist, Christine, and she was so great! She had a small office full of educational posters and prescription foods (Chubby Nut & porridges made specifically for adults, pregnant/lactating, and children) and sat with us for almost 2 hours, explaining the products, process, her mission, issues regarding nutrition in Kenya, etc. She started this program in 2007, but before that, prescription foods were only provided to HIV+ patients. She couldn't stand withholding nutritional assistance to other malnourished people, so she was able to begin providing it. Now, the foods are even produced here in Kenya, which is a great step for them.

She and her team do outpatient counseling, diabetes counseling, inpatient/ward support and home visits. It was so bittersweet to talk to her because it is literally EXACTLY what I came here to do, but of course, tomorrow is my last day in the hospitals. GUHHH. My biggest frustration is that I asked about specific nutrition programs so many times while planning this trip and was never told about this. But anyways, I am just going to take a deep breath, make the most of it tomorrow and hope that maybe Christine turns into a great contact for the future :)

The District Hospital

Our District group looking so professional :)

Our med students had extremely challenging days at District this week as well. They have saved lives, witnessed deaths, rigged make-shift catheters, crafted oxygen masks, researched wound dressings, the list goes on and on. The conditions here, especially at District Hospital (government run), are so so so extreme. There are literally 3 and 4 kids to a bed in the peds ward...I felt like I was in a movie when I looked in for the first time. The ratio of doctors to patients is so low and the resources are so few that it is just really challenging for all of us to see some of these cases. In the US, we are so lucky to have the efficiency, technology, convenience, education, medications and adequate staff needed to save lives.

more views of the town

We lost power for a couple of hours tonight, so that made our nightly games a bit interesting.
We all need a good night's rest so that we are ready for a good, productive day tomorrow!

Hakuna Matata: Safari Weekend!

This was such a busy and exhausting weekend!!! We got up at 5:30 on Saturday morning to make the trek to the Maasai Mara Safari Reserve, one of the largest and most famous safari sites in Africa. It is 1800 square km...aka 1,080 square miles! It was definitely one of the most gorgeous places I have seen...nothing but grasses, mountains, beautiful sunsets and massive animals in their natural habitat.
The ride from Migori to Maasai Mara took about 8 hours because we had to take the long way there. Got to the lodge about 3:00pm, with just enough time to revive ourselves for our first evening game drive! We saw SO many great things in just these first 2.5 hours (you have to leave the reserve around 6:30pm because it gets too dangerous after dark). We kicked off the safari with a female lion on the prowl. She stalked a group of antelopes and we thought for sure we were going to see a kill right off the bat, but she ended up backing down after about 15 minutes. From there, we came across more lions, which were literally on the "Pride Rock" of Maasai Mara. The scene could not have been more prefect...I think the pictures will speak for themselves.

photo opp outside our hut at the lodge

Team Young Lion

vans flock whenever there is a sighting

Pride Rock

 We spotted some ostriches, hyenas, wildebeests, buffalo, zebras, black-faced monkeys, warthogs, weird birds and elephants too. Holy cow, these guys are massive!!! They walked right next to the vans and were making all kinds of noises. Kind of saw some hippos, but they stay underwater for 7 minutes at a time and then barely come up for a breath, so they are hard to see. Despite that, I am fairly certain we each took about 8,573 photos of the "I spy a hippo ear" pond. We were all so pumped this first day that cameras were flying!
Finally saw a male lion, but of course, he was sleeping...the males sleep up to 23 hours a day and only get up to eat. ugh, men! haha.
We closed out the night with an incredible sunset and another female lion. She was so beautiful to begin with and then her walking into the sunset was the icing on the cake.
Despite the ice-cold showers, we slept like babies after the delicious, sanitary meal!

We got up early again on day 2, had breakfast and were just watching the monkeys while we waited to head to the reserve, but there were some issues/delays (per ush), and so we ended up going to the Maasai village in the morning instead. The Maasai are the indigenous tribal group. They are the ones that wear blankets, stretch their ears with giant rings, drink cattle blood, jump super high, etc...if you ever watch the Travel Channel or Human Planet, you know exactly what I am talking about.
There are about 200 Maasai living in this particular village. The men greeted us with a dance, as well as a demo of how they sharpen their knives and start fires. Their dances involve a lot of jumping and chanting. At the very end they started coming towards us and it was actually super creepy, but these dances are how they win over the women. They practice polygamy and can have as many wives as they want as long as they have enough cattle to trade for them...Each woman costs 10 cows, or they can trade woman for woman. The families all stay together, but they do not intermarry within the village...instead, once a woman is married, she follows her husband. Each wife has her own house and the husband rotates, staying with each of them, so he does not have a permanent house, per se.
Men are circumcised at age 16 at a ceremony, in which they are not allowed to show any pain. They must show their "strength and manliness." damn. After that, they are considered "warriors" until age 21. At this time, they grow their hair out and prove themselves by hunting, etc. At age 21, they are allowed to get married. Women marry younger, usually age 16.
The women are the ones to build the houses. Each hut takes 2 months and is assembled out of wood and cow dung. They must move the village every 7-9 years because termites destroy the homes. (However, they have a permanent school now, so they stay relatively close). We didn't get a chance to talk to the women, but I would have loved to hear their perspectives.
We did get to go into a hut though, which was awesome! Slight panic attack as we were ducking into the hut and breathing in smoke in the pitch black. Eventually our eyes adjusted so we could see the inside a bit more and we sat low enough to avoid the smoke. This hut was tiny, but housed 5 people...as well as their baby sheep and cows, who had their own rooms!(By room, I mean extremely small cubby, but in relationship to the whole hut, it was substantial).
We waited to get out the the center of the village to buy anything, which was by far the most stressful and overwhelming experience of ALL time. The woman all set up their stands with jewelry, masks, bowls, etc, etc, etc. Most had very similar things, but because the money goes to each family individually, they are super competitive and do whatever they can to get you to buy from them. Some girls were literally surrounded by the women! They put bracelets all up your arms, pull you over, tell you to buy, and it is hard to say no at first, but eventually, you get used to it.
Despite the chaos, it is absolutely incredible that people really do live like this and I am so glad we got to witness it firsthand.
After that morning, we were definitely ready for a nice relaxing day of safari.

The entire village floor (and huts) are cow dung
#squishy

The Young Lion & his Maasai family

On day 2 of game drives, we saw a family of lion cubs lounging under a tree, more zebras, elephants, ostriches, wildebeests and water buffalo, but also saw a whole field of giraffes, a river full of hippos and crocs, a leopard in a tree (super though to spot), a reunion of a lion family and....A RHINO!!! This was a HUGE deal....there are only 15 rhinos in the whole entire reserve (1,080 square miles)!!! We were actually about to leave the reserve, when Martin (our driver, "young lion") got a call on the radio. Hearing the radio is the best thing ever because you can't understand  anything they are saying since it is all in swahili, but you can tell by the speed and volume of their voices when it is going to be something REALLY good.... then Martin puts the pedal to the metal, you fly around curves, bugs and dust hit your face, you smell the fresh African air...best feeling ever (...besides the bodyslamming the sides of the van...that's not such a good feeling, but comes with the territory) Such a rush!
When we got the call about the rhino, we lead the pack of safari cars, raced to the spot and were honestly on 2 wheels at some points! This rhino was ridiculously fast. We followed him so close through the bush and I thought he was going to charge the van a time or two! Anyways, it was amazing and completed our sighting of the BIG 5! The Big 5 include: lion. leopard, elephant, rhino and water buffalo - the 5 most dangerous. To see all of them in one weekend is extremely rare!
AND, to top it off, after the rhino chase, we came across another male lion! This time, he was up and about...also rare, because, like I said, this only happens about 1 hour a day. He walked right up to our van, in front of it and reunited with the group of lionesses and cubs waiting in the bush. There were soooo many lions and they were literally close enough to touch...unreal. The sunset was absolutely gorgeous again...bright pink. I tried to capture it with photos...no matter how well they turn out, it is impossible to capture the true scene. Words and photos just don't do it justice.
Oh, so we also went to the border to Tanzania within the reserve...this is the point where is turns into the Serenghetti.
Definitely a successful day.
Another great dinner, a warm shower this time and clean beds...amazing night's sleep.

Lazy Lions

I Spy a Leopard

16+ giraffes!

2 places at once! Tanzania & Kenya :)

Hungry Hungry Hippos

Zebra Migration

Lioness

Unreal.

This morning we tried to get to the reserve in time to see the sunrise, but it was too cloudy. We only had about 2 hours, so all we saw today was a group of lion cubs. Guhhh, I want one!!! So snuggly. The baby one was purring and it was just too much. Couldn't even handle it. Love.
We grabbed some breakfast at the resort, said our goodbyes to Katie and Justin, the first group to head home (sad day) and then hit the road for a 5 hour buuuumpy ride back to Migori. We are all so wiped out! Definitely bedtime J

One last family photo before Katie & Justin left :(