Tuesday, August 31, 2010

Complementary Feeding Sessions

The last week has been very busy! We finished the last of our Family Nutrition Seminars and have begun to present our Complementary Feeding Seminars to mothers with children 2 years old and younger. The Family Nutrition Seminars were a lot of fun, and we really enjoyed working so closely with the “champs” from each of the women’s groups. They not only prepared the food, (and taught us a thing or two about Kenyan cuisine) but they also helped us present by speaking to the women attending the session about the recipes and methods they used to prepare the foods.

The Complementary Feeding Seminars are so far not going nearly as well as the Family sessions did, and not nearly as well as we had hoped. We had planned 3 sessions at St Theresa’s hospital with the mothers from the MCH clinic, and 2 sessions with each of the women’s groups. Our first session at the hospital was a complete failure as not a single mother showed up. We scheduled a ‘make-up’ session the following Monday and had our fingers crossed that we would get a good turn out on our second try. We even posted flyers advertising the session around the hospital for mothers to see. Unfortunately, even after waiting an additional hour before starting, we only had 6 mothers attend. We are used to having around 100 people or more attend our sessions within the community so it was very disheartening to present to only 6 people. One of the nurses at the hospital was translating for us, and asked us to keep the presentation to a maximum of 30 minutes. The presentation we had planned was over an hour, so we had to think fast and simplify our key messages on the spot. Our translator knew the material fairly well since she has taught many mothers similar information at the clinic. The information they give mothers, like our recommendations, are from the World Health Organization, but the resources they have a re slightly outdated. This caused a bit of a problem because as a result, our messages were not always being translated as they should have been. But as we have learned in Kenya, “sawa sawa”! In retrospect, we should have gone over our recommendations with our translator prior to presenting to the mothers. Despite being in Kenya for the last 10 weeks, we are still learning many new things everyday, and every presentation is an opportunity to further understand Kenyan culture.

We were expecting a much higher attendance rate with the women’s groups since they had known about our presentation months in advance, however we were once again disappointed. Although it was really frustrating at first, we adapted to the small group and altered the presentation to allow for more discussion. Had we had the attendance we had hoped for, this may not have been possible. It actually ended up working well because the mothers were able to ask more questions and we were able to ensure that everything was really well understood. It also allowed us to get to know the mothers a little bit better since we were able to have conversations with the mothers, and the mothers were able to share tips and stories of their own experiences of complementary feeding to the rest of the group.

We also had a presentation in front of the hospital staff this week. We talked to them all about the various projects we have been working on since we arrived in Kenya. We shared the findings of our school lunch program research project with them and gave each staff member in attendance copies of both our Family Nutrition handout and the Complementary Feeding handout. We think the sisters were very surprised at the amount of work we had done since our arrival. Since we don’t work very closely with the hospital as this is a community placement and not a clinical placement, the sisters and hospital staff only see us on the rare occasion that we’re passing through the hospital. They never see us actually doing any work. It was great to be able to share with everyone what we have been doing and all that we have accomplished so far.

We only have a few presentations left as our time here in Kenya is quickly coming to an end. It seems unreal that in just two weeks we’ll be back on Canadian soil!

Thursday, August 19, 2010

Nurse Update

Wow, August 19th already. We've been very busy so time is flying by!

We’ve finished our handwashing and menstruation sessions at the schools. The last school we visited was Kamukatha, a primary school. As with all the schools the kids were very excited to have us and were very appreciative of the soap and the reusable menstrual pads we brought them. This visit was extra special because we were there for the official opening of the new boy’s bathroom. The bathroom was built with money raised by Kensington United Church. Prior to this, the boys were using very old and outdated “shacks” as washroom facilities. Jennifer Murogocho led the opening and the students and their parents were very excited and grateful for their Canadian friends. We were told to greet the people from PEI, especially those who belong to Kensington United Church!! We also go to see the beginning of the construction of a new cook house, which should be ready in October. Compared to the old cookhouse, this one will be much larger and more modern. It was great to see the impact that Farmers Helping Farmers has on the lives of the people here in Kenya, we wish that everyone who supports Farmers Helping Farmers could see firsthand the difference they are making in people’s lives. It is really amazing! Pictures to come with the next blog, as Kenyan internet isn’t cooperating this evening!

Last Wednesday Martin (who works with FHF) took us to Meru Methodist University where we met with the dean of Nursing. She told us about the nursing program, which was very interesting because it is very similar to our nursing program at UPEI. Martin took us on a tour of the university. It’s a beautiful campus and very modern. The students were in the middle of exams so we didn’t get a chance to meet with any of them.

We’ve been very busy working at St. Teresa’s Mission Hospital. We’ve had opportunities to work in the medical unit, surgical unit, maternity, outpatients, maternal child health clinic and the operating theatre. We are really enjoying this experience and getting a holistic approach to nursing practice. We are learning a lot as there are new learning opportunities for us to take part in. For example, having a very active role in caring for a labouring mother through labour and childbirth. We've even had some babies named after us and were asked to give newborns their English names! Last week we were asked to prepare a clinical presentation for the staff. They have them every week and it’s a really great chance for staff members to learn more about clinical practice. We chose to present on maternity care as it is the area we all seem to be enjoying the most. The staff were very interested in our presentation and were especially interested in how maternity care in Kenya differs from maternity care in Canada. The staff asked us to present again and highlight more differences in health care between Canada and Kenya so that we all learn from each other!

We have become especially close with one of the patients at the hospital. She is a ten year old girl who has been there for over six months. She has burns that cover about half of her body – on her back, her arms, the back of her neck/head and parts of her lower body. At first she was shy (maybe even afraid of us) and only speaks Kiswahili so it was difficult for us to communicate with her. Between non-verbal communication and having hospital staff translate for us, we’ve made friends with her. She’s really brave and strong and has a great sense of humour (she always laughs at us when we attempt to speak Swahili!). A few weeks ago she had a skin graft surgery that will hopefully heal the burns on her back. So far it’s looking like the grafts took, so we’re very hopeful that she will make progress soon!

Tuesday, August 17, 2010

A farewell to Kenya

It is soon time for Vionna and I to leave Kenya, although I don't know how this can be. It seems to me that we only arrived here a short while ago. The summer has just sped past leaving nothing but memory and an assortment of souvenirs. I have purchased baskets. We have discovered that I have a problem when it comes to baskets. They are so cheap and so beautiful here that whenever I see a street vendor with a pile of them I can't help but stop. I keep imagining them full of fruit and bread and yumminess. I have three so far, and I'm quite sure there will be another purchase before we fly off into the sunset.

We have been back in Nakuru since the beginning of August. It seems fitting to finish in the same town we started in. Vionna and I have developed a sort of a presence in the town. People here recognize us and the vendors don't try to trick us into buying nick nacks at outrageous prices anymore. I laughed when, on the first day, one of the market people thought he chould induce Vionna to buy a small basket for 3000 kenyan shillings. Vionna is a marvel when it comes to bartering. She got him down to I think it was 400 Ksh. Had it been me he would have taken me to the cleaners. I would be a great deal poorer if I didn't have Vionna to do my bargaining for me. I am horribly gullible when it comes to estimating an items price. The vendors I think must see me coming from a mile away and smile to themselves. They are always VERY happy to see me.

We have spent the past two weeks working at Rohi which is a privately funded charity school that takes in street kids, or kids that would have become street kids had they not been taken in. It truly is an amazing place and I am so fortunate to have met some of the students there. It astounds me the breadth of knowledge that these kids have and how polite and kind they are. In the context of their good nature, the life stories that come out of their mouths are surreal to say the least. One boy was telling me non-challantly that for the first 12 years of his life he lived off the streets and was addicted to opium and glue. Vionna and I have enjoyed working at Rohi so much and I think we have actually made a difference.

Rohi is a self sustaining school. The kids live on campus in dorms. They grow their own vegetables and keep their own livestock. Any extra produce is sold at the local market. Troy Sammons ( who we have been staying with) is the resident missionary veterinarian and we have been helping him in his work around the farm. I feel like I have learned so much from him since we have been here. Vionna and I spent the entire first day in study. It was clear that a wide breadth of knowledge would be required to look after the Rohi farm animals. I felt very ill equipped at first. We learned how to sort laying from non laying hens (the width of the pubic bones if anyone is curious), how to dehorn goats, how to castrate goats, spay and neuter cats, palpate cows, and how to raise swine properly. We have done all of these things since we have been here. It has been an eventful two weeks to say the least. However I think the most rewarding aspect of our stay has been the work we did with swine managment.

There is a community in Nakuru that squats on a very thin, rocky strip of land that surrounds the local dump. I probably don't need to say much more about the living conditions of these people. They are incredibly clever, however, in that they have capitalized on the food waste of the dump by raising pigs there. None of the farmers had ever had much formal training or education in swine husbandry however. The swine were allowed to roam at will amongst the refuse of the dump and their access to clean water was very sporadic. So Vionna, Troy, and I, along with a whole slew of Rohi students, put together a days worth presentations focused on how to raise and care for swine. Most of our first week at Rohi was spent in preperation for this conference which was set for the following tuesday. We had no idea how many, if any, of the farmers would show up. However, after setting up the chairs and having a delightful sing song to summon the flock, 50 to 60 people appeared and we had a very full house. The talks included: housing, nutrition, breeding, farrowing, water, disease mangment, zoonotic diseases, and record keeping. The talks were followed up with a quick field trip to one of the local farmers who started off at the dump with a single pig. He now owns a piece of land and raises more than 20 pigs. Quite a success story. However the real success story came a couple of days later when one of the Rohi social workers told us that the people at the dump had already started putting some of our tips into action. The farmers are not allowing their pigs to roam anymore, and they are also constructing more appropriate housing for their animals. I was blown away to think that change had been implemented so quickly. It was the crowning point of our summer for sure.

And now we are leaving. Tomorrow we will say goodbye to the Sammons and to Rohi for good. We have printed off copies of pictures taken during our stay here to give to some of the kids that we got to know quite well. After we make our goodbyes, we will spend the night at a lodge by one of the local lakes, and then return to Nairobi on thursday to fly out friday morning at the ghastly hour of 4 am. Thank you to everyone who made this trip possible. I know I can speak for both myself and Vionna when I say that it was truly life altering. We will miss all of the wonderful friends we made here. I now have a list of about 20 emails that I must add to my facebook account. To my family and friends in Canada, I miss you and I'll see you all soon!!


Monday, August 16, 2010

Muchui Women's Group Family Nutrition Seminar

Monday, we finally had our meeting with the Ruuju Champs that had been previously postponed several times. When we arrived at Ruuju, it was almost eerie because school is no longer in session and the hundreds of kids that are normally running around everywhere yelling “Mzungo!” were no where to be found. We ended up meeting with 6 Ruuju Women’s group members, but the chair, Demeris, was unable to attend. When we had to start the meeting without a designated translator, we were a little bit nervous but one of the champs quickly stepped in and made sure that everyone knew what was being said. The group of women were laughing and joking and smiling right from the start which made the session so much more fun. The meeting went exceptionally well. We created a menu for the two family nutrition seminars and designated who would prepare which meals on what days, we paid the women for the ingredients and labor required to prepare these meals. The women seemed very excited, and their enthusiasm was contagious; we got back into the car to head home with huge smiles on our faces!

Tuesday was our first Family Nutrition Seminar with the Muchui Women’s group. It was supposed to start at 10:30 am, but our driver was running on "Kenyan Time" so by the time we got to the center it was almost 11:00 am. We were expecting to walk into the center to have 30+ women sitting waiting for us, but as we entered the room, there were only about 10 women. The group was very quiet at first. It was discouraging because whenever we asked the group questions, they responded with blank stares. We’re not sure if the small group made people not want to speak up, or if maybe they just did not quite understand everything. The champs arrived and we served the food and were relieved to have a short break from presenting as it was almost painful with such a quiet and small group. As the ladies ate lunch, they all began to talk amongst themselves and became more lively. The food was sooooo good! We had Mukimo, Githeri, and Chapatti with pumpkin, sweet potato and onion in them, and we brought a fruit salad for dessert. They wanted us to bring a Canadian dish but we really struggled to try to think of something using the ingredients grown in their farms or that would be readily available to them. Cyrus, our chef, had made a really good fruit salad with pineapple, banana, orange and lime juice the night before so we ended up stealing his idea. Although the women already eat fruit, they had never had it in a salad form before.

After lunch, we had the champs explain the recipes they each prepared to the group. The champs were so awesome; they were happy and proud and smiling from ear to ear. Having the champs prepare and explain the meals was a stroke of genius. Not only are they much better at cooking Kenyan food than we are, but they were able to explain in detail their recipes to the women, and everything was prepared using methods that the women are familiar with and could relate to. Even the champs were amazed at how well our tips worked in the preparation of their dishes. For example, Katherine who prepared the Githeri, said that she soaked the beans and maize all day, starting at 8 am and had planned to cooked it overnight since the session was so early in the morning. She was shocked when the beans and maize were already cooked after only 40 minutes! It was really great for the Champs to be able to share their experiences with the women, and the women really opened up after hearing from them. The end of the session went really well, much better than the first half. After the evaluation was completed, an old woman stood up to say thank you to us on behalf of the group. She told us that she had never been able to eat unpolished maize before because she had trouble chewing it and had issues digesting it. When she tasted the foods prepared with soaked unpolished maize, she could not believe how soft and easy to eat the maize was. When she found out it was unpolished and soaked, she told us that she would never eat polished maize ever again and was so grateful that we were able to teach her a way to enjoy unpolished maize since it was so much more nutritious than the polished variety. Martin also sat in on our session and vigorously took notes the whole time. Even he stood up after the presentation and told us that we had changed his life by teaching him the tips from our session. He witnessed Katherine’s 40-minute githeri and it apparently blew his mind. Apparently men never make githeri because they work all day and then don’t have the 8 hours in the evening it takes to prepare. Now that he knows he can soak it during the day and have githeri in 40 minutes, he will teach the other men at the Barrier to make githeri, which is more nutritious than the ugali they currently eat everyday.

The Family Session was unbelievably rewarding. We were blown away by how well received we were and how appreciative the women were. They’re only request was that we give the presentation to people in the community and not just women in the Muchui Women’s Group. They told us that they would tell as many people in the community as they could about what they learned in our session. Needless to say we had the biggest grins possible on our faces leaving the center and were so absolutely pumped and empowered to have had such a positive impact on the women.