AMPATH

Alright. I guess I should explain exactly what I am doing here.  The University of Indiana Medical School partnered with a Moi Teaching and Referral Hospital in Eldoret, Kenya to enhance learning on both ends.  After the AIDS epidemic hit too close to home with the hospital in Kenya unable to treat one of its own medical students, Dr. Joe Mamlin (my neighbor and Noble Peace Prize nominee) decided that he was going to treat patients with antiretroviral drugs when everyone else in the US said it was not worth the cost.  At the time, the drugs costs around $2,500/mo and once a patient starts he or she must remain on the drugs for life…you can see why some people thought it was too expensive to treat 30M+ in sub-Saharan Africa currently living with HIV/AIDS.  Dr. Mamlin and his associates called this form of treatment and prevention program AMPATH (Academic Model Providing Access To Healthcare).  Combined with Pres. Bush’s PEPFAR announcement of $10B in aid targeted at HIV/AIDS largely in Africa, lead to AMPATH’s rapid growth.  They have treated 60,000+ HIV/AIDS patients through a network of 20+ clinics in western Kenya.  Given the Lazarus like effect of the treatment, people travel from all around Kenya and surrounding nations to receive treatment.  But remember, these patients need to stay on a strict drug regimen and therefore close to the clinic or hospital.  To support their family they need a job and want to stay busy.  That’s where my role comes.  AMPATH has a division called Family Preservation Initiative (FPI).  FPI’s main goal is to provide employment opportunity to those who are seeking work while in the critical phase of HIV/AIDS treatment.  FPI has several businesses, Cool Stream Restaurant, Passion Fruit Seedling Company, Imani Workshops, Wataluma Repair and Maintenance.  Through these and a variety of other community wide projects, AMPATH aims to make sustainable change in Eldoret and surrounding areas.  While I am here, I will be working closely with FPI but also having the opportunity to go to the hospital on rounds with some of the MDs, visiting the orphanage and travel to clinics with Dr. Mamlin as he treats patients in the most remote regions of Kenya. 

These businesses are great, but are supported through AMPATH’s grant and private donation money.  I have been asked to help implement a strategy that will steer Imani and Wataluma toward profitability.  The goal is to have these companies self-sustaining and eventually turn a profit that can be used for at large expenses for the hospital and grow enough to employ any patient seeking a job.  It is an incredible challenge and is certainly teaching me a lesson in patience.  I look forward to the challenges, opportunities and experiences ahead.

I promise the next update will include some humor.  Wednesday is Independence Day here in Kenya and this weekend I’m heading to an island camp surrounded by crocodiles, hippos and other African wildlife, what could go wrong there?

Welcome to Kenya

So the first day was a blur.  We unpacked and went to the kitchen and made plain pasta.  Later on, I met a few doctors doing their last rotations in Kenya.  Got to talking with them and they invited me out to Naiberi.  To be honest, it didn’t matter what Naiberi was, I was going to go just to see a bit of Eldoret outside of the IU Housing bubble.  Naiberi turns out to be a resort about 30 mins out of town off of a dirt road.  We took a taxi van out there, Cha Cha (our driver) is a really nice guy and helped us negotiate pricing with the guards at Naiberi (everywhere you go has guards).  Nice clean pool, great sunny afternoon and got a chance to talk with the different people working in the program.  Mostly doctors or nurses but a few outsiders including a French guy who works for Pfizer and is on a 6 month sabbatical observing pharmaceuticals in developing nations and a woman who has worked with orphaned children in Zimbabwe, Ghana, Burkina Faso, Botswana and now Kenya.  Anyway, the pool was great, food was descent, beers were somewhat cold (roughing it, I know).  The entire day cost about $15 USD.  Came back and had dinner with everyone.  Nice day to get acclimated to Kenya. 

Laying down to go to sleep was a different story, the dogs in the neighborhood like to sleep all day long, seriously I thought a few were dead when they didn’t move at all for 4 hours.  But when night rolls around, they looooovvve to bark.  Thankfully, I have a front row seat to their performance as my window faces the street and guard station.  So I am dragging from the +7 hour time change, listening to dogs bark all night and then have to deal with a rooster that thinks 4am is sunrise.  Thankfully I was already awoken by what seemed like the opening music to Angry Birds so the 4am rooster alarm wasn’t terrible.  I was pretty tired but dragged myself out of bed at 630am to eat and get ready for my first day working at AMPATH.  Pretty standard day, lots of introductions and program overviews.  

The highlight was going to the Imani Workshops (I told you all to read that book).  Basically it’s a crafts workshop that employs HIV/AIDS+ patients while they are in treatment at Moi Hospital (IU’s Kenyan partner hospital) and one of the businesses I will be working with to improve operations.  The employees made some really impressive jewelry, (I’ll take orders before I leave) and I got to sit and talk with a few workers while helping make some of the beads.  I was expecting some tough conversations along the way, but not right off the bat.  After talking about the USA and Obama, by the way they LOVE Obama.  One guy was telling me how he was distantly related to Obama’s cousin’s friend.  I heard another say he heard Obama was going to run for president of Kenya when he was done in the US.  Anyway, after pleasantries and telling them how happy everyone in America is with Obama (I didn’t want to break their hearts or get into politics in a limited vocabulary setting) one of the men asked me if I knew what AIDS was.  “Of course”, I told him we have the same number of HIV/AIDS+ people in the US as there are in Kenya (slight exaggeration 1.3M to 1.5M but grossly exaggerated as % of population).  His response, “Then why do rich Americans let Africans die when there is medicine that can save us?”  Whoa...

Talk about a loaded question.  This guy is receiving the BEST treatment possible in sub-Saharan Africa, actually getting the same drug cocktail (Antiretroviral..see Magic Johnson) as what is given for thousands $$$ per month in the US and his drugs are actually being paid for by “rich Americans” (PEPFAR and private donations).  I went the diplomatic route and explained that Americans suffer from disease too and do not have full access to any drug they want either.  He eventually expressed how happy he was that he was being treated at AMPATH but that question right off the bat was a tough one to answer.  I am sure I looked like a fool or at least stumbled through my explanation.  And I am sure that won’t be the last time I am asked a difficult question.  Practice makes perfect I guess. No major cultural gaffs to report.  Just give it a few days.  I am taking Swahili lessons while I am here so it’s only a matter of time before I say something stupid.

Check back in a few days, I'll have some updates as I get into my role here.  

Day 1 3/4

 Warning: This is a fairly lengthy update, Ill try to keep it entertaining, no promises. 

I fully expected this trip to have some cultural snafus and gaffs but I didn’t realize how early it would start.  My 40 hour journey to Kenya started out fairly normal, 12:05pm departure from Columbus to JFK, simple enough.  Although, I had to remind myself repeatedly that I was actually leaving the country for 10 weeks and not a simple domestic flight.  4 hour layover, then back on a plane for 7.5 hours to CDG-Paris.  Flight was quick and painless… sat between a student heading to France to study abroad and a dirty techno hippie with dreads from Amsterdam (Despite my assertion that he should, he didn’t know Bouk, Henry or David).   

So I land in Paris and walk through customs but made a quick U-turn just to double check that my bags were actually checked all of the way through to Nairobi. BIG mistake, I was promptly greeted by France’s finest military personnel armed with M-16s and a glare that would make the Dos Equis man cower.  After trying to explain in English what I was trying to do, I realized that it was probably best that I walk in the direction the 4 gentleman were pointing and murmuring in French.   So I exited customs without further incident only to walk out and see a group of guys dressed in red track suits laughing and pointing at me, I walked by smiling as one of them asked “American?” I shook my head and listened to the laughter bellowing from the group.  I proceeded to have a conversation with the guys in the limited 19 word vocabulary that we shared.  Turns out, they are the Madagascar National Kick Boxing Team in France for a big tournament.   Now this is an opportunity I can’t pass up, the one guy who spoke any English pointed to the bar and I obliged.  Mind you, this is 7am Paris time but just past 1am in the US so it makes it ok.  One guy told me he had been to Kenya, the rest were most likely making fun of me but I will pretend like they were laughing with me, not at me (I could have taken them).  Finished my beer, and wished them good luck.  Check in at the gate where I meet up my friend Ryan MacNeil from ND who is going to Kenya with me.  We walk to security where I promptly set off the metal detector, stupid watch.  Walk through again, BEEEEEEP, stupid belt.  Walk through again, silence, whew - free and clear….not so fast.  A gentle but firm French policeman asked if he could pat me down as if I had an option.  Made it through security and ordered a cup of black café (no milk obviously).   What I received was a semi-solid cup of coffee grounds and tar mixture.  Not the best cup I have ever had but I needed something to keep me awake.  Finally got to my gate and relaxed for the 4 hour layover waiting for my flight to Nairobi.  An hour on foreign soil and I already look like a buffoon. 

Hopped aboard Kenyan Air ‘The Pride of Africa’, it was actually pretty nice.  25% full at best, I had two seats to myself and nobody behind me or in front of me.  I was exhausted and tried to fall sleep, not sure if it was the Malaria medication or the drink cart down the aisle, but I had several violent wake ups that were compounded by confusion in what the flight attendant was asking me.  So I got a bag of peanuts and started to eat but apparently fell back asleep mid chew as the next thing I knew I woke up to the unpleasant taste of half chewed peanuts lining my gums.  Flying in to Nairobi, reminded me of flying in to Vegas.  Not the bright lights of the Strip but the absolute pitch black of the desert followed by the sprawling lights of the residential area that appears out of nowhere.  After a brief delay looking for Ryan’s luggage that was mistakenly checked through to Eldoret, we found our driver and went to the hotel.  We stayed at the Heron Court Hotel, it’s a nice Western resort with overly pleasant staff, total for the room, 999 Kenyan Shillings (about $12 USD). Had a quick bite to eat and tried to catch some sleep.  Although I’d slept a few hours on the plane (apparently while eating), I’ve been traveling now for about 30 hours since I left Columbus.  5 hours of decent sleep later and we’re on our way back to Nairobi Airport to catch the 45 minute flight to Eldoret.  I wore a pair of shorts thinking it would be comfortable for the flight only to realize that nobody in Kenya wears shorts.  Pretty much everyone had on dress pants so we changed at the airport.  (You know, tried to blend in with the locals. Although somehow I still stuck out and we still heard murmurs of Mzungu, white foreigner),   Although we were scheduled for the 10am flight our cab driver picked us up at 7am, got to the airport and through security by 730am.  They booked us on the 8am flight, without us knowing and we were about 2 minutes from missing our flight.  Thankfully we got on board and arrived 40 minutes later in Eldoret. 

If you look on a map, Eldoret is in the mountains around 7500’ elevation.  But when we stepped off the plane I realized that that John Denver is full of shit.  Flat as could be in all directions.  Thankfully our driver was at the airport early and took us about 10 miles into town and dropped us off at the IU (Indiana Univ) Housing for AMPATH workers.  After 41 hours of travel, I finally arrived to what will be home for the next 10 weeks.  We met with Dunia and Benjamin who welcomed us and showed us around.  We got cell phones and made a quick trip into the main part of town to get cash, cell phone minutes and find the Catholic Church (You’re welcome Mom! Mass is at 7, 8, 9, 1030 and 5 on Sunday so I really don’t have an excuse, I'll be sure to bring the bulletin home as proof).  I felt a bit weird withdrawing 20,000 Kenyan Shillings (KES) especially given the fact that that amount is nearly 50% of the average income in Kenya but we have a safe in the room, two guarded gates and I think its better to go to the ATM as few times as possible.  Aside from a few strange looks and stares, the busy city center was nice enough.  A total walk of about 20 minutes. Tons of shops and markets to buy whatever we need. 

View from our honeymoon suite

Ryan and I will be staying in a 12x9 bunk bed room and share an outdoor restroom with the people next to us.  The shower head is conveniently located directly above the toilet (time saver I am assuming).   

3 S's all at once!

Possibly smaller than my Miami dorm room 1st semester  Soph year (smallest room on Miami's campus)

 

Our room is called the Deja Blue Rose Bush Room.  For those keeping score at home, I met Ryan in Paris and am now staying with him in the Deja Blue Rose Bush room. 

If any of you have read the book I mentioned in one of my earlier posts “Walking Together, Walking Far” by Fran Quigley, I am staying next door to Dr. Joe Mamlin’s house.   For those who haven’t read it, shame on you.   We unpacked and got settled in.  We have all day tomorrow, Sunday, to relax and start orientation 8am Monday morning. 

Facts and Figures

As I am getting ready to take off tomorrow for my trip, I thought I'd share some points of comparison to better understand Kenya.

Population: 41 Million
Size: 360,000 square miles (Roughly 5 times the state of Ohio or twice the size of Nevada)
-- Only 8% arable land
Bordering countries: Somalia, Ethiopia, Sudan, Uganda, Tanzania
Government: Republic
GDP Per Capita: $1,600 USD (US = $47,400)
Average Income: Approximately $425
Unemployment: 40%+
 Percent below UN international poverty line of $1.25 USD/day: 19%
Percent living on less than $2 USD/day: 40%
Religion: Protestant 45%, Roman Catholic 33%, Muslim 10%, indigenous beliefs 10%, other 2%
Life expectancy: 60 years
HIV/AIDS+: 6.3% (11th highest in the world) or 1.5 million people (5th highest in the world)

I will be in Eldoret, Kenya in the western portion (Rift Valley Province) of the country near Lake Victoria.  Population is estimated at 250K but I am told it is much higher in actuality.

Sustainable Socioeconomic Growth in the Developing World

I posted a paper I wrote for a course in my MBA program located on the sidebar to the right.  It summarizes my beliefs on the role of NGOs, MNCs and Foreign Aid in developing nations.  For those interested in learning more about the hospital/organizations I will be working with, check out the book "Walking Together, Walking Far" by Fran Quigley,  its available on Amazon in Kindle ($9.99) and Paperback ($14.99). 

Kenya Dig It?

Regardless of the tongue in cheek name, I hope to share my experience in Kenya with friends and family interested in what I'll be doing for the next 10 weeks.  I am not sure how often I'll be able to post, but my goal is at least once a week.  Not sure what to expect going forward but I know it will be an experience of a lifetime.  Enjoy!