Hindsight - 2008

With 2 weeks still to go in 2008 maybe i'm jumping the gun, but whatever, its been a slow week. Going back to Jan 1, 2008, if I compare where I thought I would be on Dec 31, 2008 with where I actually will be, you’d wonder how I even manage to put pants on in the morning. But it just goes to show you how much can change in just one year’s time. It was soon after the new year that a friend told me about the IDM fellowship which started the chain of events that led to me sitting in an office on the coast of Africa n 35 degree weather as we get ready to welcome 2009.

The 2 halves of the year provided such stark contrasts and differences that its hard to believe it all happened in a span of 12 months. I remember last winter – the snow! (who doesn’t?). I remember shovelling A LOT of snow! And somewhere in between shoveling I remember the frantic week in which I put together my last minute application for this fellowship with the help of 3 people specifically (you know who you are) and the euphoria of finally sending it off. I remember taking off Vegas/LA/San Fran in February right after I had found out that I had been selected for an interview. What a blast that trip was. 3 days on the strip where I managed to at least come away with my shirt (probably lost more at the bar than I did at the casino) and then flying through the desert in a red convertible to LA to find that my head was completely sunburned from the desert sun and then the 10 hour journey up the pacific coast highway to san fran hugging the pacific ocean the entire way (when it wasn’t covered in fog). Some San Fran goodness and then the harsh return to Toronto where I was met with 40cm. of snow to shovel. I finally learned the meaning of a winter getaway!

The anticipation of waiting to hear back took over March and finally in the first few days of April, I remember picking my parents up from the airport after they returned from India and bringing them home and just casually checking my email after we got home only to find an offer for the fellowship (to which I reacted with a HOLY CRAP!). I’m not sure if I should admit this, but even after I received my offer, it took me about a week before I finally decided to accept it given my environment in Toronto. But my challenge was also my good fortune and it was only through the support of my family and friends that I decided to do this.

Sad goodbyes in May to friends and colleagues but also excitement as I arrived in Ottawa to meet my fellow interns. I remember arriving at the residence in Ottawa, only to find that my room was not ready and I had 3 hours to kill. Not knowing who was who in the building I did what any brown guy would do – search out other brown people. Enter Nadim and Khalfan who were also stuck waiting. Spending the next 3 hours waiting with them, I realized, these guys are even crazier than me (which is little more than I can say for the entire group – love you guys), but it definitely sold me to the fact that yea this is gonna be pretty cool. The next month in Ottawa meeting new people, learning new things, just like being in school again (which I totally miss, so everyone who told me I would, you’re right). Sleeping…I mean sitting through classes, and enjoying summer in Ottawa. Spending a month in Ottawa made me realize why I really do love that city (despite the winter horror). Farewell’s near the end of June to the group as we prepared to spread out across the world and as we were told “be the Canada the world needs more of”.

A relaxing month off in june/july where I spent a large amount of time sitting outside in my backyard patio/hammock/grass to enjoy the last few bits of Canadian summer and just building up in anticipation. An amazing send off at the start july where I was surrounded by my closest family and friends (and a large quantity of alcohol, which thanks to 3am pancakes didn’t result in a bad hangover) and then finally! my departure date on july 14th. The story from there on is laid out in the last 30 some odd posts.

But, the year is not over, Friday is my last day of work before 2 weeks of holidays where a bunch of friends are coming to Mombasa, followed by a safari in the Ngorongoro crater in Tanzania, and then to Zanzibar for new years. 2008 seems like such a random sequence. Do you ever stop and think about how you got to the point where you are right now? One of my roommates commented last week that it seems like we’re living a surreal life here, at first I didn’t understand what she meant but I think now it seems as if I didn’t really live it, as if someone else was actually living it and I was somehow in watching it from an out of body experience. Sound crazy? maybe...but I think I get it now. I can try and think or predict where I’ll be at the end of 2009, but..whats the point? i'm here for the ride.

Heat, Holidays, and Headlines

So its been a while since I wrote. I blame the heat. I’ve been blaming the heat for a lot of things these days, and, given the title above, the heat is one of 3 H’s on my mind. Its hot. Really hot. And its December. I feel tired, sluggish, and slow. My mind is not as sharp, I feel lazy and complacent. Hey! I fit right in with the rest of the people here. Ohh..ok..maybe that’s a little harsh. But, as if we didn’t operate slowly enough, with the seasons somewhere between hottest and scorched earth, as impossible as it is for me to believe, we’ve slowed down even more. But that’s ok, its hot to even bother. I don’t even bother doing cardio workouts at the gym anymore because its just too hot. Unless your sitting directly under a fan, or an a/c, (or you’re outside in a breeze) its hot, which is funny considering the time of year. Which brings me to the next H – Holidays.

It doesn’t feel like the holidays. Probably because it’s a balmy 35 degrees outside and xmas is about 10-12 days away. But I’m not just talking about the holiday season here, I’m talking about public holidays. We have A LOT of them! Today happens to be uhuru day or something, whatever its called, its Kenya’s independence day. Which I thought we celebrated on Kenyatta day, but I guess that’s more of a president’s day, which is what I thought we celebrated on Moi day, but… anyways, thats another story. So in October we had, Eid, Moi day, and Kenyatta day, in November we had Obama day, in December we’ve had an Eid (although it was not technically a public holiday but a lot of people took the day off) and today’s independence day, and starting dec 22nd, most businesses (including my 'little engine that could' of an NGO) will close for 2 weeks for the holidays. So that’s 6 holidays, and 2 weeks off in a span of 3 months. A little much I think, and kind of disrupts the flow of work. A lot of staff here have just taken the whole month of December off and starting next week I think there will be a total of 5 staff in our office (of 15). Oh, and an irony that I have to point out, somehow, I have had to come into work (yes, by choice, but also b/c of deadlines) on everyone of those holidays. Given that my job is not the busiest one in the world, it’s a little ironic. When I left home this morning my roommate remarked that she was going to spend the day decorating our house with some xmas stuff to at least try and make it seem a little more holiday-ish. We have a little Charlie brown xmas tree and some other stuff, but I’m not entirely sure what to expect when I get home. Gotta love her for trying…

The 3rd H is unrelated but whatever. Headlines. I read the nation newspaper here pretty much everyday so that I can keep up to date with the latest Kenyan news. A sample of the headlines will give you a taste of whats going on. The Waki commission looking at last year’s post election violence, random politics (which is huge here) food shortages and the rise in food prices making basic staples unaffordable for most kenyans, and an ad for a oxygen therapy clinic that promises to cure you of a multitude of diseases including arthritis, cancer, stroke, HIV/AIDS, heart disease……wait a sec….you can cure HIV/AIDS??? Cancer??? Does the rest of the world know about this??? The miracle of oxygen therapy!! Ok..its a lie..a big lie…and I was shocked/annoyed to read it! Shocked that this place is so unscrupulous that it would sucker people into thinking that HIV/AIDS or cancer can be cured, and annoyed that the newspaper did not feel it was responsible for editing the content of the ad to ensure that it wasn’t blatantly lying! But its just a sign of the place, time, and society. You can get all worked up about it, you can scream and shout from the rooftops, you can fight and argue and make all sorts of noise…but its too hot.

Happy Holidays to you all, wishing you a safe and enjoyable holiday season!

World AIDS Day

The AIDS virus was born somewhere deep inside the forests of the western side of Africa near the Congo. While no one can pinpoint at exactly what point the virus jumped from animals to humans, the reality is that it did sometime in the 1960’s, and the virus quickly spread as it traveled down the Kinshasa highway and from there spread across the rest of the continent and to the rest of the world. Today AIDS is a plague on the world and continues to kill millions with no cure. Every year, one day is set aside to raise awareness of this plague, Dec 1st was that day.

Kenya is no stranger to the AIDS virus. Currently, Kenya has an AIDS prevalence rate of ~5% which, with a total population of just over 30 million means that ~1.5 million people are infected with the disease. In the spirit of the day, I decided to get involved with a few other staff from CHD in the World AIDS day activities in Mombasa. CHD, as part of the Aga Khan Health Services which is a larger part of the Aga Khan Development Network joined forces with some other AKDN agencies (both development and for-profit) to create one AKDN team. Other agencies included Serena hotels, Jubilee insurance, and Aga Khan schools (its crazy just how big the AKDN really is and how many different industries it covers). The day began with a march through the streets of Mombasa from the provincial commissioners house to the Mombasa Municipal Stadium. It was a good turnout of a few hundred people, with AKDN, USAID, Afri-Aphya, VCT, and other agencies devoted to AIDS awareness. It was a scorching hot walk though with temperatures reaching 30 and above in the sun. Oh, and although we were marching through the narrow congested streets of downtown Mombasa, the streets themselves were not closed off to traffic so we marched in between and around cars, trucks, matatus and tuk-tuk’s. Is there any other way to parade?

Arriving at the stadium, we sat (in the shade thankfully) to hear speeches (in Swahili that I did not understand) and see skits/plays (which I also did not understand, but I don’t think anyone was really paying attention). Now, whats an event without some technical difficulties? See the stadium in Mombasa, is more of a field with some old concrete seats built into the grass surrounding the field. There’s actually no power in the stadium, so everything’s battery operated and of course, batteries ran out of juice. Meaning, microphones and speakers did not work. Ah well, c’est la Kenya. I couldn’t but notice and comment to my colleagues the absolute lack of attention that was being given to the speeches/performances. Makes me wonder what, if any, message got through.
Our next stop was to the streets. We had gathered boxes of bread, juice and clothing to distribute to street kids while we talked about AIDS awareness. We interacted with a group of about 50 street kids (most of whom had glue bottles stuck to their face). The unfortunate part is that the group was all male, which means that we didn’t get to interact with any females which to me is missing such a key group. After discussions the chaos ensued as we began distributing the goods we had brought. I was a little confused by the end of the day as to what exact impact we had made and whether we had really gotten the message across about HIV and AIDS. But then, after discussing with a friend, I realized that its not fair to judge the success of the day based on whatever standards (obviously developed in Canada) I may have. And to remember that, being in a society where AIDS is still highly stigmatized, perhaps the fact that the we marched through the streets, and just talked about it openly, basically the fact that event was actually held was a success in itself.

Mumbai Mentality

I write this as a tribute to one of the world’s great cities – Mumbai. A city that I became very attached to in a very short period of time and right now I can not think of anything else. As I came into work this morning and looked at daily headlines a look of horror and sadness came on my face as I saw the striking headlines about the ‘terror in mumbai’. Now, I’m not one of the 20 million mumbaikers (I think that’s what they’re called). I’m not here to write as if I understand what happened on the streets, or what a Mumbai resident in one of those chawls feels. I’m writing this as a Canadian-Indian who just 3 weeks ago spent 4-5 days in Mumbai and was totally smitten with the city. My heart goes out to those who were there, those who have lost, and those who have suffered. As I read about the places where each of the attacks took place I couldn’t help but think – I visited so many of those not long ago. To me, in my mind when I picture the taj hotel I picture a majestic Victorian building on the waterfront only dominated by the nearby gateway of India. Not a sea of terror and flames where bombs are exploding and crazy cowards are gunning down innocent people.

Some random group has come to claim responsibility for the attack. They’re a muslim-based group and to learn that only makes me sad. It is yet another chapter in the never-ending conflict between hindus and muslims. A conflict I will never understand. Mumbai is no stranger to this though. In the last decade of the 20th century the streets were rocked with hindu/muslim riots, and just in 2006 there were coordinated attacks on the city’s train system. But why Mumbai? Why always Mumbai? Of the major cities in India I think its easy to say that Mumbai has seen more than its share of violence (at least in recent years) – even more so than Delhi and Delhi is the capital! (not that I want anything to happen to Delhi). But it seems like there’s a never-ending battle for this city’s soul that comes down to the street. I wrote about the free-spirit that seems to come from the streets. To borrow a phrase from Montreal - it’s a laissez-faire mentality, but laissez-faire with a purpose. After all, besides the political capital, it’s the capital of India in every other sense and yet the people there seem at ease. Perhaps by targeting this free spirited city that caters to all and has so much potential, criminals think or hope they can break that spirit because wouldn’t that be the biggest crime of all. I think it would. It saddens me to think about what measures will be taken after this to secure the city. Unfortunately a bit of the free spirit may already have been lost.

Now here’s where I can’t speak as a Mumbai resident, but only from what I’ve seen. Mumbai is resilient and it will persist. The city is flooded every year from monsoon rains, and every year the residents persist. There are 20 million people in that city and I can’t imagine it any different from what I saw and my gut tells me that it won’t be (ok, maybe a little, but not for long). Like I said, this is not new to Mumbai, and as much as I hope this is the last time blood is spilled on its streets like this, I am not that naive. But I can only wonder, when will it end? When/where does it stop? Will hindu’s and muslim’s ever learn to co-exist peacefully across all areas of the world? Who knows, in my lifetime I would love to see that. For now, from what I saw, I am confident about one thing. Mumbai is a bright light. You can dampen it, maybe for a day, maybe for a week, maybe for months or even a year. But you can’t break it. No matter who, or how hard you try, you can not break it. It will always shine.

The 4 Seasons of Mombasa

It’s the last week of November. Usually at this point in the year, I’m awaiting for the first snowfall of the winter. From what I’ve heard, that has already come to Toronto and most of Canada (probably a bit early this year?). And it made me realize, one of the small beauties of Canadian life – 4 distinct seasons. You see, here in Mombasa, south of the equator, and a little east of the prime meridian, we do not have the usual seasons of fall, winter, summer, and spring. Ok fine, we have them in name, but really who can tell? If anything, the 4 seasons of Mombasa at least should really be called hot, hotter, hottest, and scorched earth. Right now, I would put us somewhere between hottest and scorched earth. Scorched earth is supposed to Dec-Feb when usually I am going through the dead of winter (Southern hemisphere, seasons reversed).

My roommate made an interesting comment on Saturday night as we were getting ready to go out. She remarked that usually, (coming from Ottawa), when she would be getting ready to go out at this time of the year, she would be putting on her warm winter boots, long winter coat, thick winter scarf, and maybe a toque. A far cry from the light t-shirt, light pants (long pants only to ward off the mosquitos) and sandals we wear here on a daily basis where the temperature is now 30 degrees at 8 in the morning.

Life is full of cliché phrases. It should come as no surprise to me, or anyone else, that living here, this far away from home, for 4.5 months now has made me realize just how many things I love about Canada and Toronto. But winter?? Yes its true, being here has made me realize that maybe I do like winter after all. I’ve always said I’m a summer-lovin, warm weather kinda guy. I love to be outdoors, and love the feel of a cool summer night’s breeze on a patio with a cold drink (who doesn’t?), but winter has its own beauty. When I tell people here about what winter is like, their usual reaction is a combination of disgust and surprise that any human being (let alone 32 million of us) would put up with that. But I find myself quickly defending winter, and fondly describing the beauty of the first snowfall, the scene of a blanket of white, the joys of skating, skiing, sledding, and then sitting in front of a roaring warm fire at night with a hot drink.

I think there’s more to this though. Maybe its not only the traits of a season, the colours of fall, the snow of winter, the comfort of spring, and the sun of summer but what those seasons represent. In the big picture, it’s a sign that the earth is always spinning, time is moving, life is progressing. Each season represents a new way of life, and we continue to cycle through these seasons. We have the opportunity to look back at the end of a season and look forward to the new one. We get a chance to renew ourselves, even if only in the clothes we wear. The unfortunate part is that we always seem to want the next season. In winter, we can’t wait for the relief of spring, and in summer we can’t wait for it to cool down. Well, here’s hoping that the next time I crave for the opposite season, I’ll remember my experience here in perma-hot. I don’t remember the last time I felt ‘cold’ and frankly it may take some time for my body to recognize that feeling whenever it does set in again (the irony here is that I will leave Mombasa in the hottest month and return to Canada in one of the coldest months). Anyways, so while the snow is falling in Canada, the sun continues to shine in Mombasa. But remember, winter is what makes us special. Its what people expect from us. Out of 6 billion people in this world, there are only 32 million (ok fine add a bunch-a-million more for all those scandanavian countries and those in northern Siberia) who can tough it out with old-man winter. In case you’re wondering, the forecast for tomorrow? Full sun and 32 degrees.

A dollar here, a dollar there

It has been 11 days since my last post. That’s the longest I’ve gone without posting. In some ways, maybe it’s a sign of the times. The novelty of being here is long gone, routine has set in, evaluations are done, the last project grant at work is all wrapped up, so basically the stuff that I wrote about in earlier months is now stuff that just seems normal/not worth writing about.

I recently read in an article in the globe and mail (yes I still read my Canadian newspapers – the Toronto Start and globe and mail everyday) that talked about healthcare spending in Canada. CIHI estimated that public healthcare spending by governments in Canada reached about $121 billion – and that’s just the public portion (~70% of costs). Add another $50 billion in private costs (mostly drugs and dental care) and the total healthcare spending comes to ~$170 billion. How do you even begin to wrap your head around that number, its around 10% of our GDP. But still, we’re not the highest, or the 2nd highest, or the 3rd highest, (I think we’re 4th or 5th). Anyways, it made me realize (not that I hadn’t realized it yet) the magnitude of difference. Just take the public healthcare spending figure of $121 billion, and lets say in US that comes down around $102 billion (what happened to our loony??). Public healthcare spending in Kenya? Its around $500 million US. And of that, maybe about 30-40% comes from donors so really the government’s budget is around $250-300 million for a population that just slightly higher than Canada.

Why is it so low here? Well, there’s such a small tax base and even then the amount that is collected is minimal. Stir in the corruption factor in and who knows what is actually going into gov’t coffers and what gets spent on healthcare. Add some complacency about the fact that things will never change and a lacking of education about what things can be like and you’ve got your recipe. Ok, I’m sounding cynical, and I’ve already said this before and I want to avoid sounding like a broken record. So I want to throw in another factor here – disease burden. Consider that the top diseases here include malaria, diahorrea, and various respiratory illnesses. Oh yes, and AIDS.

As part of the AKDN, all organizations within have the opportunity to undergo VCT or voluntary counseling and testing for HIV/AIDS. A great idea which will hopefully help raise awareness about this HIV/AIDS. I’ve never been directly tested for AIDS, when I donate blood my blood samples are automatically tested for AIDS, but this is the first time I underwent a direct AIDS test. Simple really, prick your finger with a needle I made absolutely certain was new and sterilized (and which hurts!) and then mix your blood into various things which produce a result – yes in my case, negative. No surprise, and for me I was just more curious about what actually happens in an AIDS test. For a few people here though, I would think that the experience was a lot more nerve wracking and I noticed some people who just refused to do it (emphasize it was voluntary). Think about it, you can go into a room and basically get a death sentence in matter of 10 minutes. How could that not be scary? But whats the alternative? Not knowing until its too late? Not knowing and then passing it onto others? On the other hand, knowing, but then realizing that the treatment you need to survive is too expensive to obtain and it slowly takes you? That is the burden that people here face all too regularly. And that’s if you survive all those other diseases like malaria, tb, and basically make it past the age of 5 (under 5 mortality rate of just over 10%). All this in a $500 million system? somewhere in there, the system has failed

Mid Term Review

I have returned to Mombasa from India. I had an absolutely amazing time in India, I was amazed to see the progress that has been made in India since my last trip in 02. Mumbai is a city like no other and I hope to return there soon. So upon my return to Kenya, in the plane as we touched down in Nairobi, the captain came on to announce Obama’s victory. Kenya is amass with Obama-mania, to the point that today (Nov 6th) has been declared a public holiday in honour of his election. Any excuse to have a holiday – go fig.

So. Its November. I have reached the halfway mark. 4 months from now, if I’m not already home, I’ll be packing up to come home. Home. What a wonderful word. That sentence in itself probably illustrates where my mindset is. Maybe because it’s the half point, maybe b/c I felt so at home in India, but the concept of home has been on my mind a lot.

But first, I’m halfway there. And frankly, I think that that in itself is an accomplishment. Whether or not you agree, its my blog and I’ll say what I want J. Its been a…well..i don’t really know what to say about the 1st half here. I think I have accomplished a lot both personally and professionally. Highlights of the first half? Well, first and foremost, safarin’ in Masai Mara and probably right up there as well is of course India. But aside from big travels, also the side trips, Malindi, Nairobi, and just up and down the coast and travelling throughout the province. I think I have seen pretty a lot of Mombasa. I’ve eaten table fulls of nyama choma (grilled meat), I’ve spent numerous afternoons on the beach, I’ve seen the fort (finally), I’ve walked the streets, I’ve partied till sunrise, and of course, matatu’s I take everyday. That’s not to say there’s nothing left, whatever’s left will just be icing on the cake.

Professionally, I’m happy to say that my org. has been successful in procuring that big grant I was talking about earlier so for now the future of CHD looks secure and I am not as concerned about what I am going to do in the 2nd half. It was a much needed morale boost for the organization and with that grant, hopefully we won’t have to let go of as many staff as first thought. I had a really great experience right before I left for India where I had the chance to spend an afternoon teaching part of a course. The course was for health professionals on proposal writing and my supervisor and I were tasked with teaching about monitoring and evaluation. Specifically my section that I taught was on indicator selection, data sources and gantt charts. It was surreal to be in front of that class, so different than any teaching experience I’ve had in Canada. My attempts to engage the class with some laughs was met with silence – woops! But just need to work them in a bit, and get them going with some exercises. As always, time does not exist anywhere and exercises that I had planned to take 20 min. went on for an hour despite my pleas to finish and present. So in the end I had to rush it a bit, but all in all, it was a challenge but something I’m really glad I got the opportunity to do.

My formal mid-term review with my supervisor went well and it was a good confidence boost. I got some validation when my supervisor indicated that I should consider the opportunity to extend my contract beyond February. That was about 2 weeks ago, and I think in those 2 weeks I have come to the conclusion (based on further discussions with my supervisor) that I will not pursue an opportunity to extend my contract and return home. So that’s my formal declaration. I’m coming back. And I know that it’s the right decision because when I say it in my mind it makes me smile and really, that’s all that matters.

So what comes next? Well, with our new EC grant there is plenty of opportunity to get involved and help make some changes in the org to prevent some of the challenges we’ve had in the past. There is a new initiative of health and schools that my director wants me to spearhead so I’m looking forward to that. In December we will get 2 weeks off for xmas in which a bunch of interns will be coming to Mombasa, and then a few of us will be going on a safari in the Ngorongoro crater (Tanzania) before we all meet again in Zanzibar for new years – I can’t wait!! And of course, the ultimate experience is still in my dream – kili.

So cheers to the 1st half and here’s to the 2nd half. May it be full of good learning, good life, and good laughs. My heartfelt thanks to everyone for their love, support, and encouragement so far. Whether you respond to my blog, post on my wall, email me, call me, or whatever, believe when I say I could not have made it this far without it, so keep it coming! The 1st half was great, not perfect, but great. It can’t be perfect, nothing’s perfect, you always make mistakes. But one of the greatest things I’ve learned (that I think I always knew but just hadn’t paraphrased yet) is that a mistake only becomes a failure when you don’t learn from it. Twende!

The A,B,C's of Mumbai

Amazing, Bumpin, Cosmopolitan, Dirty, Enticing, Fast, Gigantic, Hot...and the list goes on. All words that i would use to describe Mumbai, formely known as Bombay, affectionately known as Bollywood. Out of all the cities I have visited in India, Mumbai takes the cake. Its not hard for me to say why...the city has an incredible energy and vibe whether its 2pm or 2am. Like New York, the city does not sleep. It has the amenities i desire, great entertainment, people everywhere, amazing food, rich culture, attractive women, charm, and yes, an ocean view (well technically its on the coast of the Arabian Sea, but that sea feeds into the Indian Ocean so why split hairs). Its a city of ~20 million people. 20 million! thats more than half of Canada crammed into one city, and yet this place functions, and functions well. The contrast between Mumbai and Delhi is clear. While Delhi is more of a clean cut, properly trimmed, political capital, Mumbai is more of an ecletic melting pot of music, fashion, food, and people. If you were planting a tree in Delhi, there would be a committee of 10 people who would take about a month studying various sites and calculating exactly where it should go. In Mumbai, they would just drop it from the sky and see where it lands.
But thats what i love. There are no sharp corners and straight edges here, there is really no shape. Mumbai hugs the coast from North to South and everything in between is just waiting for you. It caters to everyone, the rich and the poor, the local and the foreign. The city is lined with apartment buildings, both luxury high rises, and low income dwellings. Tightly packed, 1-bedroom apartments make up the thousands of Chawls that line city streets. You can only imagine how many people live in these buildings, and can only wonder what their story is and what goes on in there. Having been here the past 2 days, I can't believe it has taken me so long to get here. The sites so far include the Gateway of India (built when King George came to visit India as a British Colony) and the surrounding Colaba area, stunning Marine drive and the queens necklace - a winding ocean hugging road that when lit up at night, looks like a pearl necklace, chaotic chowpatty at Juhu beach where hundreds of people enjoy the beach and the sea air till late in the night and then sample some of the most enticing array of mumbai street food from pow bhaji, to chaat, to the finest italian restaurants and of course bandra - the entertainment hub!
Being a food addict, mumbai has definetely provided me with my hearts desire. peanut vendors walking around with charcoal fires roasting peanuts on the spot for Rs 10 a pack (25 cents) that are still warm when you eat them. Fresh Juice vendors that squeeze the juice from the fruit right infront of you for Rs 20 (50 cents) and coconut vendors who in the flash of an eye will chop off the top of those sweet coconuts so that you can down the sweet nectar inside for Rs 10. Midnight buffets and all night coffee shops ensure that no matter what the time, you can get food - great food! Its a shoppers paradise here too, almost every square foot of the city centre, (besides the roads) is setup to sell you something...anything!
Probably my favourite is just walking the streets. During the day, its just as busy as it is during the night. I like to think that a city's true character comes out at night and for that Mumbai gets top marks. Its a city that has seen so much, from Islamic rule, to the Portuguese landing, to the British colonization, to the hindu/muslim riots that rocked its streets in the early 90's. It may not have the steep history of Delhi but Mumbai has taken my heart and this city can definetely tell a story or two...or 20 million...eventually, i'd like to hear them all.

The D's of Delhi

Dyanamic...Dusty....Delightful...maybe a little dirty. Multiple words that describe Delhi. India's capital city. I have spent the last week touring, experiencing, and enjoying everything this historic city has to offer. If you had to paraphrase delhi it would organized chaos. There is a mix of the historic and the modern. It has been 6 years since i last visited delhi and a lot has changed. With the impending 2010 commonwealth games being staged in delhi there is construction everywhere. But you can see signs of progress. The sparkling new metro quickly and conveniently takes delhiites from place to place in comfort, the new flyovers help spread the traffic among congested roads. roads that are no longer congested with various sorts of scooters, and rickshaws and cattle, but sparkling new cards, honda's, bmw's, mercedes, and india's own tata. yesterday i went to the emporio mall, billed as india's most luxurious shopping destination and soon to be asia's biggest mall. never before have i been in a mall that caters exclusively to the high end - armani, versace, hugo boss, and so many more. only designers, only high end. its a sign of where india has come. but intertwined in this enticing city is the opposite end. i also visited chandni chawk, delhi's oldest market (app 300 years old) where narrow gulleys offer you specialized items from jewelery to paranthas. seriously, there's a parantha gulley (delicious type of flat bread that indians make). speaking of food, its safe to say (in part because of diwali) that i have eaten as much as i possibly can.
It was a real treat to be able to spend diwali, the biggest of all events in India for the first time. Delhi sounded more like a war zone on tuesday night and all through the week you heard patakaas (fireworks) exploding everywhere. brilliantly lit markets were packed with shoppers getting their last minute items and everyone seems to great you with a smile. Other sites that i have visited include the red fort, india gate, qutab minar and connaught place. the unfortunate side of delhi is the security. it seems that everywhere you go, you must pass through metal detectors, this includes the metro, the park, and some outdoor markets. its the unfortunate reality, but in today's india, an unfortunate necessity. today's paper as well describes a series of bomb blasts in the north eastern part of the country yesterday that killed 70 people. all of which have only given me a taste of what india is and has to offer. its a sensual overload. you can spend just as much time learning about india's past as you can about its present, and maybe even more so about its future. i think its safe to say that given the amount of hindi i've been speaking here, i've forgotten all the swahili i've learned over the past 4 months, so i, or my swahili teacher, has some work to do.
Anyways, if i have to use a 5th D to describe Delhi, its done. I leave delhi tonight to head to Mumbai (Bombay) India's financial, cultural, entertainment and basically in everyway except political, capital. But here's to Delhi and all it has seen, all it has to offer, and all that will come. One of the truly remarakable captial cities of the world.

Happy Diwali!

Just a note to any and all who may read this to wish you a Happy Diwali! Hoping that there is plenty of light shining for all of you. May the new year bring you health happiness and success!

much love

The Cradle of Culture

Namaste from my motherland. If Kenya is referred to as the cradle of humanity, then I think its only fair to refer to India as the cradle of culture. I arrived in Mumbai (formerly Bombay) early Saturday morning. It has been 6 years since my last visit to India, and in between I have visited about 10 other countries. There is something definitely special about India. It is my ancestory, my heritage, my culture. It is the feeling and sensation that this is where my identity was born (for the record, I was born in Canada). It has always been both my privilege and my challenge (in a good way) to be born in Canada and come from a culture that is so rich, so colourful, so sensual. Blending the 2 together is not always the easiest and many times you can find yourself at odds when the society you live in and your roots give you two different messages.

If I could put a label to what the scent in the air is, I would say it is the scent of time. The Indus civilization is one of the oldest civilations in world, and India is the birthplace of two of the world’s major religions – Hinduism and Buddhism. Coming to India this time from Kenya, versus coming from Canada brought a very different feeling. I realize I am a first generation Canadian, born and bred in the Great White North, but as my plane touched down in India, I actually felt a sense of coming home. Whether it was because I look like everyone else here, or I understand the language even though its not English, or just the fact that after almost 4 months, I get to see family, something about being here that just feels natural right now. It was extra special to finally touch down in Mumbai which is the birthplace of my dad. Granted he only spent a few years of his life in Mumbai before moving up north, it is always nice to visit the birthcity. Actually, as I write this, I am in Delhi, the capital city of India. I arrived in Mumbai Saturday and flew directly up to Delhi later that day to spend Diwali with family. I will be returning to Mumbai on Friday and then spending the 2nd half of my trip in city affectionately known as ‘bollywood’.

Today, we went to dilihart. An outdoor market where artisians and craftspeople from all over the country come to display their crafts. Today’s theme was South India and Sri Lanka so I got a taste of South Indian culture. I had a great time exploring the hundreds of stalls to see what these creative and truly talented people have to offer. Conversing with them in hindi – even though its not my first language – brought me a strange sense of familiarity. As Diwali is upcoming, we spent the rest of the day going to various markets to gather the necessary items to celebrate the upcoming Festival of Lights. This will be the first time I get to experience Diwali in India and it is truly something special. Diwali – arguably the most celebrated festival in the hindu calendar is always a fun time. I have to confess, that I’m not the most well-versed when it comes to my Indian culture, in my defense though, it is an incredibly massive religion/culture, but Diwali is something I feel I do know and I love to celebrate.

Coming to india is a bit of a surreal experience. While I may know the superficial, surface level things about my culture, when I come here, I realize just how little I know, and just how much I wish I could/did know. I have to confess something else, when I first applied for this fellowship, my heart was in Asia. It was my hope that my placement would be in India and that I could use this opportunity to not only give something back to India, but to also spend an extended amount of time to learn about my culture. But, everything happens for a reason and let there be no doubt that I am extremely grateful and glad for the opportunity to be in Kenya, I wouldn’t trade it for the world and it has been a truly enriching experience.

But back to India. The flower markets, the mitai shops, the chaat stands, the bhajans and guzzles coming out from various places, the sabzi vendor yelling out his inventory throughout the day unnnnnnnnnnnday! (eggs), piiiiiiiage! (onions), and packed shops with people getting their last minute things for Diwali, it’s a sensual overload, and I’m loving every minute of it. Ironic to say, but in all this, as I call it, organized chaos, my mind is at peace, it’s mental and physical break where I feel like my spirit is already being renewed.

So, I guess I didn’t really get into why I think India is the Cradle of Culture, well….i could go into it, but this would get really long. Suffice to say, it just is, and if you don’t believe me, come here and see it for yourself. Right now, I may by even father away from Canada then when I was in Kenya, I may still be a foreign land where I don’t quite understand everything, or completely know my way around. But for the next week and a bit, I am home.

A Tourist in your own Town

This past weekend our friend and fellow intern from Nairobi came to visit and considering the great time I had in Nairobi, definitely wanted to return the favour by showing her a good time in Mombasa. Its funny to think about it, but really, how well do you know your own town? Like when someone comes to visit you (wherever you live) and wants to see ‘your’ city, where do you take them?

In Mombasa, the answer is – out of town! Ok fine, that’s harsh, but slightly true. Zu came in on Friday, we all went out for a late dinner and then first thing Saturday morning we were off to Malindi. Now, I’m not sure if I’ve mentioned this before, but Malindi (2 hours north, up the coast from Mombasa) is what I imagined Mombasa to be like. A relaxed Oceanside city where the water is steps away from the core, and you can walk the streets without fear of being runover. We arrived in Malindi to do a little tourist shopping, but the highlight was the marine park. We spent the afternoon on boat out in the ocean and went snorkeling in the reef. I’ve never been snorkeling, but I’m definitely hooked. Maybe a little anxious at first as I went a little too deep and a rush of salt water came down my snorkel into and into my mouth (the Indian Ocean does NOT taste good), so I made my way back to the boat to catch my breath. A few reassuring instructions later I was back in and loving it! Seeing all the brightly coloured fish of all shapes and sizes. I was moving along and had to stop as I ran into a whole school of fish swimming along and then they started to make circles around me. It was pretty cool! So thumbs up to Malindi, maybe Mombasa was like that one day not long ago, but the growth has outpaced the ability of the city to handle it.

Sunday was spent finally touring Mombasa’s main tourist attraction – Fort Jesus. It’s a Portuguese fort that was built in the 1600’s I think right on the ocean front. It’s a neat fort with multiple passage ways and little nooks and crannies, great views of the ocean. Located right next to the old town, you can see all the different colour roofs of the buildings of old town. I even finally found the Doormans. There’s 2 main restaurant chains I like in Kenya, Java and Doormans. Both are western style coffee places that are a mix between starbucks, tim hortons and your favourite breakfast place. Unfortuantely, like many things in Kenya, Java’s chain is only located in Nairobi, but Doormans finally took a chance and came to Mombasa. I had pancakes! I haven’t had pancakes in..well..a few weeks ago when I went to Java’s in Nairobi, but before that, it was at home. They were good, but nowhere near as good as my mom, my dad’s or my sister-in-law’s homemade pancakes with fresh strawberry sauce. No better way to start a weekend than with a plate of those! But, for now, doormans will do.

Anyways, it was a fun wknd, to be a tourist in your own town. Point out all the sights, and little things you’ve discovered. Gives you a chance to realize what your town has to offer. On a separate note, I’m taking off to India this Friday for a little vacation. Believe it or not, I’m reaching the halfway point of my time here. While I’m still learning a huge amount, and really soaking it in, if I’m totally honest a small part of me is starting to wear a bit, but I figure that’s normal at this point – plus the heat is really starting to set in! The timing of this India trip could not be better - I’ll be in Mumbai (Bombay) and Delhi and will be celebrating Diwali there with my cousin and my aunt and I can’t wait!!! The food, the music, the culture, just the whole atmosphere, I can already taste it, hear it, and feel it. I think more than anything though, the best part of it, will be – not having to think!

KISS

Its Thursday. When I look back on my blog, somehow, I always posted on Thursday. Except for last week, but that’s because I took off for Nairobi on Thursday (and it became Monday). Its not on purpose…I swear! I mean, I try to write here every week, and for some reason, by the time I’ve put my mangled thoughts on paper..its Thursday. This week, I don’t have a specific topic. Just more random observations. I’ve just come from a course that my supervisor was doing on Information Management. I went thinking I would be learning something new, instead, based on the material that was being presented, I ended helping him teach it.

The knowledge gap. I have underestimated it. First off, at no point do am I intending to make light of the intelligence of anyone here, or anyone who I have met. Its simply a realization of an underestimation I made. We spent the day teaching health professionals that the process is just as important as the outcome and how to interpret data and make graphs. Simple graphs that most of us do with our eyes closed. But, while at first I was a little taken back at the content, I quickly saw the beauty of it. It all begins somewhere. How important is the ability to interpret data? How important is it to be able to make evidence-based decisions? Think about the changes, and the progress that could be made if we all the ability to make informed decisions. How important are the little realizations that process and outcomes are related. What good is the outcome if the process is flawed? One of my biggest frustrations with the work I have been doing so far is the sense that people are too focused on the outcomes, and achieving results and everything that happens in the middle is just fluff. I had a lot of fun today working with the people in the class, it isn’t often I know more than the rest of the class, and especially rare that I can contribute in such a way (who we kidding, I’m probably bringing up the rear most of the time…).

Everything takes time. Kenya will progress, life will get better, things will improve. It takes time though (whether or not I have the patience to see it through is another questions). Sure it took almost an hour to make people realize that if there are 40 pregnant women in a village and we want 100% of pregnant women to be attending antenatal care classes that would be 40 pregnant women attend. But we all start somewhere. Isn’t that learning in its purest form? Like the old saying goes, everything I need to know I learned in kindergarten. I remember when I was in grade 6, we had to do this class project on something or other (I think it was pulleys and levers), and my partner and I had these grand ideas for this great crane type thing to lift cars (those little hot wheels cars). It was a complete mess, we screwed everything up, and were way in over our heads. The end result was some half-ass project that was nothing more than a piece of string attached to a hot wheels car and a block of wood somehow interspersed in it…oh and a pretty bad mark on the project. I was pretty upset after that and was wondering where we went wrong. That was when my dad sat me down to discuss the project and helped me understand the mistake I made – it was too complicated, and he taught me the simple acronym “KISS” – Keep it Simple Stupid! Work, friends, hobbies, relationships, learning,…life! Keep it simple! We’ve all heard it, but that was the first time I ever heard it, and its something I’ve kept in mind ever since then, and I think that’s what we did today. We kept it simple, to the basics, and hopefully everyone went home with a new skill today that will benefit. Focus on the process, just as much as the outcome. Sometimes, the destination you reach is not as important as the path you take to get there.

Mombasa vs. Nairobi...No Comparison...

Kenya is a predominantly rural country. In fact, (as far as I’m told) there are only three actual “cities” in Kenya – Nairobi, Mombasa, and Kisumu. This weekend, I took a trip down to Kenya’s primary and capital city Nairobi. We did briefly see Nairobi when we first landed in Kenya, but only for about a day and a half and that was mostly lost in a jet-lag induced haze.

Anyways, so Thursday night I took off for the city that it sometimes referred to as the most dangerous city in Africa, or Nairobbery. Let me tell you…I LOVE it! The cool breeze that I felt once I stepped out of the airport and drove into the city at 2000 metres above sea level was like a breath of fresh air (and the air does seem to be cleaner in Nairobi). I was staying with my two friends Zu and Jami who are doing their placement with the Nation Media Group. There is a definite vibe and energy to Nairobi that I have truly missed since leaving Toronto. Tons of well-dressed people making their ways to work. Skyscrapers, streelights, and sidewalks (so far I have only counted 4 streelights in the entire city of Mombasa, only 2 of which work at any given time, none of which are actually obeyed) The difference between Mombasa and Nairobi is like night and day. Like many other primary cities, there’s some negative feelings between the two places. People in Mombasa say that Nairobi is too fast, too rushed, and the people are rude. In Nairobi people say Mombasa is too slow. Having seen them both, I think I’m in the Nairobi camp.

Friday morning, I headed to the visa office to finally make my status legal in Kenya so it was a bit of a relief to get that out of the way. So we spent the weekend wandering the city, sampling various restaurants, and heading to various bars and even playing a game of ultimate frisbee with some expats. From Parklands, to Westland, from the Central City, to Downtown, I got a taste of city-life again. We went for breakfast, lunch and dinner, I toured the nation media building where Zu and Jami work, toured the masai market, and just wandered the streets.

Funny story, Zu took me to the Ngara clothing market just outside the city centre in one of the more sketchy areas of town. By clothing market, I mean a bunch of people who have lined up along a street with their cardboard boxes, and displays of clothing layed out on mats that can be quickly closed up should the cops arrive (of course its all illegal). So we walked, doing a little shopping. I realized just the impact that living with 2 girls to this point has had on me – as Zu looked at one shirt and asked me for my opinion, I said “It’s a nice shirt, the kind you would wear on a Friday to work with a pair of jeans.” The surprise on Zu’s face made me realize what I had just said. A simple yes or no woulda sufficed. Did I really say that?!?! (if you ever wonder whether I actually think about what I write, consider – would I actually admit saying that??)

Anyways, we continued shopping, and I was haggling with a vendor over a shirt when we heard a loud bang! Heads turned and people started to run, but for some reason we continued to haggle. Then we heard a 2nd bang, and saw a huge cloud of smoke moving towards us…tear gas. Apparently it’s a regular occurrence for Nairobi police to come by and shoot tear gas in the area to disperse the merchants, and of course any people who decide to shop there. We knew it was time to go, as the vendor yelled at me to give him the money for the shirt, Zu and I decided it was time to leave…quickly! Fate was telling me that I was not to buy that shirt I guess. As we ran away from the crowd, weaving and ducking, i have to admit i did wonder - where the hell am i?!? Good news is that we did get away in time, and we’re not affected by the tear gas at all. In the end, I am laughing at it, the only part that bugs me is the fact that i didn't get the shirt!

But that’s just the kinda city Nairobi is. Not without its problems for sure. First and foremost is security. On Friday night, even going from the restaurant where we were having dinner to the club (that was just down the street) required a cab – a distance you would be ridiculed for taking a cab for in Canada. But it is what it is. It’s unfortunate though, I really believe that based on the amount of potential the city has, if only the safety and security can be improved, Nairobi could really become world-class. I know there’s a huge side of Nairobi that I didn’t see, the slums (although we did go to Kibera on our first trip), the despair, the poverty etc. I know they’re there, but for one weekend, I got to see the kind of city Nairobi can be. In my lonelyplanet guide, under the section on Nairobi, the authors begin by asking the question: “Who’s afraid of big bad Nairobbery?”. Their answer is “Quite a few people apparently”. I like to think I’m not one of them.

Oh...So You Don't Train Snake-Charming Chimps??

I’ve been trying to think about what to write about for a few days now, and I realized that I was having trouble because I have spent majority of my time since I got back from masai mara working. So then it hit me, makes sense to talk about that. I don’t think I’ve actually talked about what I actually do here, or where I actually work? And really, (as I reminded myself in the shower this morning) isn’t that the number 1 reason I’m here? I know many of you asked me before I left what exactly I was going to be doing – I remember my mom specifically asked me at least every other day, and my responses were usually limited to “ummm…uhhh…well…its like…” and then some random words that could describe anyone who sells ice cream to someone who trains snake-charming chimps.

So, I’m working at the Community Health Department (CHD) of the Aga Khan Health Service on the campus of the Aga Khan Hospital in Mombasa. CHD is a small organization, just under 20 staff and..well..no budget! Quite a drastic change when you come from an organization with 12,000 staff and a $1.5 billion budget. I have to bring my own pens to work with me here. Like many other NGO’s we are solely dependent on grants for our funding, and unlike some other NGO’s under the Aga Khan Development Network (AKDN) we do not receive any type of funding from AKDN or the Aga Khan Foundation (AKF). While being independent of AKDN/AKF is a source of great pride, it is also comes with some risk. You see, CHD is currently wrapping up a major grant that has basically been sustaining the organization for the past 4 years. It was a grant from the Rockefeller Foundation to implement a Community Based Health Information System (CBHIS) in one of the poorest districts in Kenya – Kwale District. Basically, we want to modernize the system from paper to electronic while also providing a comparison for the health information that is collected at a higher level. CHD has done a lot, kinda like the little engine that could. CHD has been instrumental in implementing health management information systems in Coast Province, and the model was subsequently implemented in a few other provinces as well with the help of the Danish International Development Agency (CIDA…where are you???)

If I had to describe the health care system here in one word it would be ‘archaic’. But thats where CHD comes in. We have community health workers going door to door collecting health data from ~ 38,000 people in Kwale and then we analyzed the data and develop evidence based interactions. Since I have been here, we have conducted focus groups on malnutrition and breast feeding, spraying campaigns to eradicate foot fleas, and educational sessions on health and hygiene (see earlier blog posts). I have also had the opportunity to visit and meet with District Health staff (government staff) in Kwale district and other districts and listen to the challenges they face. I have had the chance to take multiple trips out to rural villages from Malindi up north to Kwale down south. Let me tell you, the challenges the health care system faces here are challenges that I never imagined could even exist! For example, we recently attempted to improve drinking water through the distribution of water guards which is basically a liquid water purifier, but locals rejected it because of mistrust (some said it tastes funny, others said the colour of the water changes, others said the colour of the water doesn’t change so what does it really do?). I guess they want to continue drinking contaminated water.

Anyways, CBHIS wraps up Sept 30th and there has been a flurry of activity to wrap it up and ensure that we meet our donor requirements. I have been spending most of time assisting in various components of the wrap up like creating communication tools, policy briefs and now on a report to present our latest data findings. The learning has been incredible and the opportunity to contribute to this has been great!

But I mentioned ‘risk’ above, and the risk is – what comes next? The simple answer is – we don’t know. We have submitted a few proposals and are crossing our fingers (or as they say ‘inshallah’) we get them (including a smaller one to CIDA written by yours truly..CIDA you better come through!). Unfortunately, we recently received word that one of our larger proposals was rejected and as such we have had to cut staff. It is very unfortunate, but such is the life of an NGO. At the end of the day, it comes down to dollars and cents, or I guess I should say shillings (no equivalent of cents here). Any ideas that I propose are met with “where can we find the funding?” and then I’m back to the drawing board to figure it out. It’s a challenge, something I’ve never had to face before, but something I’m glad I’m getting the opportunity to do and see. With luck, the biggest grant we submitted (to the European Union) on reducing mortality and morbidity for pregnant women and children under 5 (2 very vulnerable populations) will come through – we find out on October 15th. If we get it, the wheels keep turning and all is well for the foreseeable future. If we don’t….well…I’ll let you know..

A Natural Wonder

Safari. It’s a magical word. Ever since I found out I was coming to Kenya, I have dreamed about going on a safari. I spent the last three days fulfilling that dream in the wonderous Masai Mara. Named for the Maasai tribe that live there and the Mara river that divides it, infamous across the world for its beauty and its offering of animals in the wild it was an awe inspiring experience that no words or pictures can really describe.

Sunday morning, 6:30am I left home for my flight. I was flying a very small airline Mombasa Air Safari to the Mara. It was the smallest plane I’ve ever been on, not more than 20 seats and a bit of a bumpy ride, but cool nonetheless. I was sitting in the departure lounge waiting to board when a staff came in and asked the British couple I was talking with to board the plane. I mentioned that I was also on that flight but was instructed to please wait. Ok – no problem. I waited about 10 minutes, wondering how long it takes 2 people to board when I saw my plane rolling down the tarmac. WHAT?!?! I instantly jumped up and started screaming “That’s my plane! That’s my plane!” A staff rushed over and asked where I was going to – I indicated the Mara (Ngrende airstrip) and he said “no problem” just wait. Uhhh..ok? Turns out the other airline that uses that small terminal Blue Sky Aviation and my airline have an agreement to share passengers and I had been switched over to Blue Sky. Ok…but would have been nice to know that in advance and avoid the minor cardiac. But, boarded the plane and after hearing the pilot inform us that “we need to take off now, bad weather is coming” (not what you want to hear when you’re on a plane that small) we were off.

Arrived safe and sound in the mara Sunday afternoon around 11am with the kind of excitement a school child has before his/her first day of school. I was meeting 5 friends there who had come on a different flight from Nairobi. Our accomodations were deluxe, we were staying at the Fairmont Mara Safari Club in our own luxury tents. Something about a comfy bed, hot shower, evening turndown service where they put hot water bottles in your bed so that its warm when you climb in, and a morning wakeup call in which staff come to your room with your choice of tea, coffee, or hot chocolate (and biscuits) that just makes the whole experience that much more enjoyable. Turns out the Fairmont has been voted as the top Safari lodge in the Mara and number 3 in the world.

So we all arrived and rested for a bit, and at 3:30pm piled into our Land cruiser for our first of 4 game drives with our driver Odgina (or Henry). Right out of the gate, I was wide eyed and just craning my neck everywhere. Through marshes, and open fields, swamps, and bushes we drove spotting game. The list of animals we saw included gazelles, wildebeests, zebra, giraffe, hyena, numerous birds (including 2 osterich’s mating…kinda weird) and all of the big 5 – lion, rhino, elephant, buffalo, and a very rare sighting of a spotted leopard! Something about being in the wild, surrounded by animals in an open expanse that just makes you realize what a small piece you are in a larger puzzle. To see all these animals in cohabitation doing only what nature intended – survive - makes you wonder about the issues that surround our daily lives. In that period, you just live in the moment, sit back and watch, and suddenly the rest just seems oblivious.

I went on this trip hoping to catch a wonder of the world – the wildebeest migration. The annual event where close to one million wildebeest make their way down to the serengeti. Unfortunately, our guide informed us that this year, not as many animals did the migration and in fact the best sightings of it had already passed and that our time was better spent viewing game in the park (it would be a long drive down to the mara river where the best viewing spot is). My dissapointment was very short-lived. As we approached the end of first game drive, very content with what we had seen, we stumbled upon a group of lions. As we watched and snapped pictures, more lions joined. And then all at once, the lions gathered and started walking. Our guide informed us “they’re hunting”. Twende twende! (let’s go!) About a dozen lions moved out from the bush in hunting form for their next meal. It took us a few seconds to see it in the distance. Buffalo. Three buffalo were walking towards the lion pact in the distance – I was not sure if they buffalo saw the lions or not, or whether they just were not afraid of them. The lions began to approach and the buffalo kept walking towards. We held our breath wondering if we would see a kill (a very rare sighting). The buffalo were huge, and the sole fact that there were 3 of them was probably what saved them. For an hour we watched a cross between a football game and a chess match as the lions tried to outsmart the buffalo and the buffalo fought back for their lives. Henry told us that the only way for a lion to kill a buffalo would be a sneak attack from the back and that an attack from the front could be deadly for the lions because of the buffalo’s large horns. So we watched, as each side strategized, the lions tried to circle one buffalo in order to attack. One move, that I thought was particularly sneaky was when 2 lions broke away in separate directions and drew 2 of the buffalo away, the remaining 10 lions circled the buffalo, however this feisty creature continued to fight them off. In the end, the buffalo’s lived to see another day (or at least, they were alive when we left), but it was amazing to see nature like this. At one point, we saw a few lions break away and start walking in the direction of our jeep and we got a little nervous that perhaps the lions had decided to go for an easier prey…not the case Henry assured us, but we still asked him to drive back a bit. We continued watching until dark, well past our scheduled 6:30pm return time, and basically kept watching until the lions broke away and we couldn’t see anything anymore.

We returned to our lodge tired, and a little cold, but nonetheless on a huge adrenaline rush after watching that and very excited for what tommorow would hold. The next morning we woke up, and piled into our land cruiser for our morning drive. We spent the next 6 hours around the mara viewing various animals and admiring a very scenic sunrise while singing songs and even throwing in an Indian guzzle here and there. After about 3-4 hours of game viewing, we had arranged to visit a Masai village and meet members of the tribe. We were welcomed with song and dance and spent time with members of the tribe learning about their history and their way of life. I’m running out of words to describe these kinds of experiences, so I’ll just say it was really cool. As they taught us their way of dancing, we wanted to teach them our way of dancing and decided to teach the masai trip the ancient art of bhangra dancing. We left the village to sight of the children jumping up and down with arms doing the ever so popular ‘screwing of the lightbulb’. We followed up in the afternoon with close encounters with rhino’s and a return trip to the masai village to show our appreciation for hosting us in the morning with shoes for the children, and a large sack of flour. I know that gift-giving needs to be done with the utmost consideration and sensitivity and we were hoping to give something that the village could use and would benefit from and not just something that would seem like charity. I feel that when I saw the looks on the faces of the children, especially the look of one woman when we pulled out the flour, we had hopefully struck the right tune.

So we continued with game drives, and viewing animals, and just soaking in the atmosphere and learning a lot about each animal. The final game drive was bittersweet, I felt as if I had seen what I wanted to see, but was sad to see the experience end. Funny thing on the way home Tuesday, I was told to be in the lobby of the hotel by 1:15pm for my ride back to the airstrip. Around 12:50pm I came to the lobby thinking I was nice and early to check out. I was told that the pilot was waiting for me – thinking that he was in the plane at the airstrip waiting. No – the pilot was there, at the hotel! I’ve never had a pilot come and personally pick me up for a flight. A bit of a mixup in the time I was supposed to be ready by, and a bit of delay in checking out, and as we walked to the jeep, my pilot informed us that we were now running behind schedule (we had 3 more airstrips to stop at in the mara before coming to Mombasa). A quick ride to the airstrip, and as we arrived the propellers started (by the co-pilot), my pilot noted “they were just waiting for us” so basically I single-handedly held up the flight. Sweet,…you should see what I can do to a hospital network.

All in all, I can easily say I have returned from the mara feeling refreshed, renewed, reenergized and relaxed. My mindset feels different, maybe it was 3 straight days of not having to think, or 3 days of fresh air and amazing scenery in a cool climate. Whatever it was, I loved every minute of it, and am so grateful I had the opportunity to do it. I truly saw the Africa of my dreams.

The Good...

First off..i have to give HUGE ups to my fUHNatics dragonboat team on an amaaaaazing season! You guys are amazing. Paddling with you is something I missed terribly, and I can’t wait to join you guys in the boat next season. I loved reading up on your results and all the banter…Congrats on all your accomplishments….how you guys consistently broke the 2 minute barrier is beyond me, but I definitely have some training to do to catch up!

Anyways, about a month ago, as I was approaching one month, I wrote an entry in which I listed the things I miss from home. As I approach 2 months here (that was a quick month!) I thought I would talk about the things that I love here. Because its just as important – if not more so – to focus on the good here rather than whats wrong.

1) I love the windows in our shower. Taking a shower in the morning with sunlight coming through is a great way to wake up (no, they’re not transparent windows).
2) I love the picturesque moments. Walking through our neighbourhood, there are so many kids playing around and it cracks me up sometimes to see the things they do. I walked by a boy and girl bouncing a basketball, and I looked around and wondered where the hoop was. My question was answered when I saw the girl make a circle with her arms and the boy banked a shot off her face and into the makeshift net. Then they switched and the boy became the hoop…it was pretty funny.
3) The beach – Aside from the sun and the sand (and the incredibly salty water) I love just staring out into the Indian ocean, wondering if there is someone on the other side somewhere in India or Sri Lanka staring back at me.
4) Perfect Pizza - the pizza place we visit every Friday night. It’s become a ritual for us to go for pizza on Friday night, and I love the pizza they make!
5) I love the smell of the bakery that I pass by everyday on my matatu ride home. It only lasts like 5 seconds, but I’ve timed so I know exactly when to take a deep breath (although sometimes I get it wrong and end up inhaling a full breath of exhaust)
6) The learning – and there’s been a lot! To be in a totally foreign environment and learn something or realize something you never even imagined…that’s the main reason I’m here. And the amount that I’ve already learned is incredible, I think I’ve learned more than I will ever be able to contribute. I know I’ve complained about the pace, and wanting to be able to do more, but I think one thing I’ve learned more about is the idea of pace. Not only do they work at a different speed here, but they use a different speedometer altogether! So like, lets say I was a car, and I’m used to travelling at 100km/hr. Before I came, I knew I would have to slow down to like 20 km/hr. But my notion of 20km/hr is something totally different and so a good learning has been realizing what their idea of fast and slow is…but it still drives me nuts sometimes!
7) I love the people I work with. I may rant about the insurmountable problems in health care here, the complacency, etc. etc. but the people I work with are here, they are committed and they are not giving up. You can only admire that kind of drive. Plus, being a small organization, it feels like family here.
8) Debating with my supervisor. He is probably the most interesting, and knowledgeable person I’ve met here. A wealth of information, it is very fun to debate ideas and theories and the field of international development with him. Goes to show you that being physically worlds apart does not always mean that the thinking is different.
9) I love our porch swing. Set up perfectly to watch the sun set over the water as you rock back and forth (if only I could do something about those damn mosquitoes!).
10) My gym. The best medicine for anything thats ailing me and the only place i can take deep breaths in the city without causing severe lung damage

And finally…I love it when it rains. The weather here is a little odd, it’ll be sunny and hot most of the day, and then every now and then the clouds come in, the skies open up and it absolutely pours for like 20 min….and then its sunny again. I guess my favourite part is after the rain ends. The dirt is washed away, the streets are little emptier, and the air feels crisp, cool, and a little cleaner – even if only for a moment.

Bringin down the hospital...one virus at a time...

Wed afternoon I’m sitting at my desk innocently working away as a productive member of the CHD team when our IT specialist comes to me and asks “have you been sending email?” my response was “no, not recently” wondering if they have the ability to read my emails (and praying that they don’t!). Our IT person responded “well, no one in the hospital is able to send emails right now and the hospital’s IT staff think you might be causing it.”

WHAT!?!?!

She says “how do I explain this?”. I say “I’m pretty computer literate, try me”.
“there is an open portal somewhere in the hospital’s network that is exposing the entire network making it vulnerable to any viruses, the network in response has put up firewalls which is preventing everyone in the hospital from using email or the internet. The IT staff in the hospital have been tracing this portal for quite some time now, and they have traced it to someone in this department and then they specifically traced it to your IP address”.

Now, I’m not the most technical person, I’m computer literate, but not technical, so I don’t even know if that makes sense so please refrain from any “that doesn’t make sense” comments.

But I did get the point and I asked our IT person point blank “so you’re telling me that right now I am single handily disrupting the entire Aga Khan Hospital network and that no one can send email or anything because of my laptop?”

“Yes”

Well…Mission Accomplished.

Ok, so I’m not an undercover hacker, and I didn’t come here to destroy the fibre optic network, or the Aga Khan Hospital. But c’mon…how often do I get to do that?? Especially without even knowing it?!

Anyways, my instructions were to disconnect from the network, do a complete sweep of my laptop (which was clean) and then let the IT people work on..well..whatever it is they do to keep the network running. A few jokes and comments about making my laptop “Kenyan compliant”…(whatever that means) later, and I’m good to go and that portal, or whatever it was is gone.

Maybe it’s the all white casing, maybe it’s the apple logo, but I guess something about my laptop raises suspicion. But the irony here, is that although I have a mac, I’m using the Windows OS – well I’m forced to since for some reason when I load Mac’s leopard OS I can’t connect to the network (any mac users out there who know why this is happening…help!!). so its really just the casing and the apple logo..the rest is all the same. Anyways, i hope i didn't raise any suspicion, we don't have our work permits yet, so my legal status in this country is questionable right now, and the last thing i need is accusations of espionage. I'm happy to report that i'm working off a new IP address so ha! just try and find me now!

Oh and today as I arrived to work, I came to find that again, our entire hospital network was not working – it’s a regular occurrence here and can happen anytime and our IT person assured me that it had nothing to do with me. I would think not considering my laptop was still in my backpack…but I don’t have to tell you who everyone’s fingers were pointing to…

Shoulda just stayed in bed…

Reality Check

I started to write this post called “Identity: Africa” in which I was talking about recent discussions I’ve been having about how we refer to this continent. Then I went to work yesterday and I have now shelved that post. Instead I just want to tell you what I learned yesterday at work.

What is a household? At the Community Health Department (CHD) when doing statistical analyses we rarely refer to individuals and instead refer to households. But then I asked – what is the definition of a household? It turns out that the deciding factor of what household you are in is what pot you eat out of – literally - and this is not just a Kenyan concept I’ve been told, its an African concept. In rural villages, it does not matter if 10 people live in 10 different huts. If they congregate to eat the same food cooked by the same person, they constitute a household. At first, it seemed kind of odd when you are considering health outcomes to combine people simply on the basis of where they eat. I argued that the living standard, or the income of those 10 people, as well as the housing quality of those 10 people may be completely different. Not so I was rebutted. There is such a strong sense of group behaviour (which upon reflection I can say that is very true) here and a sense of what is mine is yours. Rarely in a village will you see one house standing strong while another is crumbling. Rarely will you see one person fail while another succeeds. But what happens when personal differences arise? Conflict must arise? Sure conflict arises, but even if you can’t stand the other person, even if you won’t talk to the other person, you will still eat with that person. If a situation gets to a point where 2 people can not eat together, one person will most likely end up leaving the community. How there came to be such an emphasis on the concept of food, I don’t know, and I’m told that it’s a cultural concept that maybe I just can’t understand. I guess to compare, we consider a household by where we sleep? That’s the closest I can think of.

Anyways, seems like a moot point, but I found it incredibly interesting. Over lunch with some colleagues (eating some questionable chicken that I’m hoping doesn’t come back to haunt me) we started discussing my ever-favourite topic of the benefits (or lack of depending on your view) of NGO’s in Africa and the work we do as CHD. For those of you who read my post called “Talking Sh*t” you’ll have read about how inspired I was after seeing a community so enthusiastic and empowered to make a change in their own community. How encouraging it was that they all came and wanted to make things better. Turns out, we have to pay them each 100 shillings (~$1.50) to come to our little sessions. Its an incentive. How, or why people require incentives to improve their health is beyond me. But that’s the reality.

Finally, near the end of the day, I sat in a meeting to discuss our community based health information system. We have collected an incredibly large quantity of data from households in villages across this province so that we can analyze it and develop evidence-based interventions. However, large discrepancies had been turning up in the data between what is being recorded at the community and what is being recorded at the facility. Why? Because our enumerators (data collectors) tend to make up the numbers. What?? Sure…sometimes they’re not keen, sometimes they’re complacent, sometimes the system just doesn’t work. There’s overlap, under-recording, over-recording, gaps, and pretty much every other inaccuracy you can imagine. The Ministry of Health has their own way of measuring, each district has their own way of measuring and the idea of a standardized way to measure just hasn’t come up yet I guess? But that’s the reality. Either we work with the system we have, or we sit on the sidelines.

I hope you are not interpreting this as a rant. Also, I am not trying to put down my organization. CHD is the one trying to make the change, but is being stifled in the process and I am actually developing quite a loyalty to the organization and my co-workers. So this isn’t a rant. Far from it. Rather it’s a realization, an epiphany about the system that I have to work within. But, my hope is that my awareness will enable my ability to overcome it (or at least deal with it). My only question now is…where do I begin?

A New Normal

I just wanna start off by clarifying something. I’ve received a few notes (which I appreciate) from people just making sure that I’m happy and well. After reading some of my previous blog entries, I realized that they sound a little dark and may make it sound as if my experience here has been…well..less than enjoyable. I hope that’s not the case. What I write here is my raw thoughts. I don’t edit this before I post it. Sometimes I just speak (or in this case write) my thoughts regardless of whether it makes sense or not. To be honest, I read back on some of these posts and I wonder what the heck I was thinking at the time. But that’s the beauty of a blog I figure…I’m not keeping a journal – I started to, but then quickly realized that what I was writing in my journal was exactly the same stuff I write here, and so was the frequency. So this is my journal, when I get home, I’ll print off every page (on recycled paper, double-sided and make sure to reuse the ink cartridge) and bind it into a book. But thanks to all for checkin in...

NEhoo…last wknd we decided to take a trip out to Haller park which is an animal sanctuary just outside Nyali. It was a great day and I got to see giraffes, hippos, crocs, gators, and probably the coolest – giant tortoises. It got me very excited about the prospect of that magical Kenyan experience – safari’ing! No – no set date yet, but it will happen…stay tuned. Traveling large distances in Africa is not the easiest thing to do (or cheapest). After that we hit the beach till dark and once again I saw probably my favourite sight of all - the sight of the full moon illuminating the Indian ocean as it crashes onto the shores…I never get tired of it.

The work week has been slow, but maybe its just that my blood pressure has finally returned to normal as I continue to settle down. The sights, the sounds, even the smells are becoming familiar. I know when to hold my breath, I know when/where to just look straight, and I know when to wear ear plugs (not that I carry them around). Yesterday, we had the odd cloudy day (its rarely cloudy here) which meant that it would be cooler (the heat is coming)…so I decided to take an hour over lunch and just wander the streets a bit with no particular destination. Its really amazing when you just randomly hit the pavement to see the microcosm that is not only Mombasa, but maybe Kenya, and maybe Africa (ok that’s a big generalization). First there are just tons of people who are walking around with somewhat empty looks on their faces and you wonder if they’re actually walking somewhere, or just walking. Then, there’s tons of people just sitting on the side of the street, not really doing anything, just chilling, as if they plan to sit there all day. There’s street vendors everywhere selling everything you can imagine. There’s food stalls that tempt you, but I continue walking lest I want to spend an afternoon on the toilet. Tiny narrow alleyways entice you to walk through and see what they have to offer. Music is blasting at almost every corner, and if you can’t hear the music, its probably because its being drowned out by the (sometimes musical) horns of matatus and their conductors yelling where they’re going and haggling you to get on (even you’re walking in the opposite direction they’re going)

There’s the modern mixed with the rural. The western-style business people going out to lunch mixed with the traditionally dressed women with an incredibly large quantity of goods on their head and tiny infants wrapped around their backs. Finally, there is probably the saddest sight - the sight of multiple street kids sniffing glue. They also walk around with lifeless looks on their face, except that they are unjustly young, barefooted with ripped/minimal clothing and have plastic water bottles with industrial strength glue in them stuck to their noses which they sniff all day. Its truly a heart breaking sight to see youth that are so lost…seems so unfair.

But this is Mombasa, this is my adopted home, in all its beauty and all its grime. It tingles at your senses and emotions and invites you to interact. You can see both where Africa has come from, and maybe a little bit of where its going (however that’s a whole other debate). So I think I’ll continue to wander, to walk, and explore the streets of this old industrial port town and see what else I find. Its not Toronto, its not normal, but it’s a new normal.

A Mombasa Month

Yesterday marked the one month anniversary of the day I left the comfiness of home for my Kenyan adventure. Today marks the one month anniversary of my arrival. So I’ve made it through a month here! Therefore, I thought i would take this chance to just think about what’s gone on the past month. So i’ll start off with a bit of a confession – Mombasa is not what I expected.

When I was first told I would be placed in Mombasa, and started mentioning Mombasa to others who knew of the city back in Canada, I got the impression of sleepy, airy, relaxed sea-side town where the ocean is just footsteps away, you don’t need to take out life insurance to cross the street, the air is (somewhat) clean and its peace and quiet is around every corner.

Now those of you who I actually talked to about Mombasa may either be wondering a) how the hell did he get that from what I said? Or b) you mean it isn’t? (probably more A). But I have to say, living and visiting a city are 2 completely different experiences. When I first arrived in Mombasa it was easy to see why people instantly fall in love with the place. We stayed in a gorgeous hotel on the coast of the Indian ocean, and everything seems so scenic. That first night I saw the full moon brilliantly shine over the Indian ocean I can honestly say I was hooked. However, it was a little short lived. The hotels are actually quite a distance from the island (the actual city is an island the hotels are off the island). The island is more of a congested, smelly, loud mess. Having said that though, I’m also settling in pretty well and Mombasa is not that bad – just not what I expected. We have found a nice little place that is on the island but removed from the chaos and smelliness of the city centre and is actually right on the waterfront. Every night I am able to come home and sit out on our porch swing and watch the sunset over the water (I can’t go watch the moon on account of our guard dogs who still don’t recognize me at night and come charging at full speed).

So what have I done in the past month and what have I learned? Well…for one thing, I have shaken more hands in the past month than I have in the past decade. Kenyans love to shake hands…so much so that they will go out of their way to do so, but it’s a nice gesture. I've also learned that there is no improper time to answer a cellphone. I've seen meeting chairs (in mid-sentence) and teachers (while teaching) stop to answer their phone...its a little ridiculous, oh and no one's heard of the vibrate feature..they all just ring. Kenya is also probably also one of the slowest country's I’ve ever been to - nothing moves fast here…except for the matatu’s. My work has been slow to say the least. I miss critical thinking and having my mind challenged and managing multiple tasks. I don’t mean to sound condescending, but I feel as if the pace at work is starting to make me dumber. But I’m learning to adapt – I mean, as long as I’m not wearing my bright red Toronto FC t-shirt, I can pass off as a local anyday. I swear I’m even starting to recognize some of the matatu drivers. Streets are starting to look familiar, I can navigate my way around and I’m starting to speak “a little” crude Swahili (really wanna take some lessons). OH! and the last few times I’ve taken a tuk tuk, they’ve quoted me the local price right away, no bargaining needed! So there is some good news.

Recently I took a field trip out to a district where we were going to do a health education session at a rural school (built by an NGO) which had the most interesting motto:

Struggle for Success.

Struggle for Success? Struggle? I found it very odd that a motto would indicate that you need to struggle in order to succeed. Why not “strive for success” or something? But as I thought about it, in a cynical manner I thought that it maybe that does somewhat describe whats going on in Kenya. Success is a struggle. I know I wrote a little while ago on the level of complacency that exists here, but there are those who have true passion and ambition and want to see change – I’ve met them! I am lucky to count my supervisor at work as one of these people. But it just seems like there are so many things holding them back - corruption, violence, injustice, poverty…the list goes on.

Its funny how much can change in a month. Recently I was talking to my fellow intern Sarah who mentioned that sights that would make us run for disinfectant back in Canada are just brushed aside here. At home the sight of a gecko on the wall inside my house, would probably have me a little concerned. Here, as long as he’s not trying to tell me how much i can save on car insurance its all good. I’m starting to learn to re-adjust my standards. What we would consider chaos in Canada is organized in Kenya. You just have to remember, as I’ve been told so many times “this is Africa”. So, you adapt, its what human beings do. Billions of people have been doing it for billions of years before me - at least that’s what I keep reminding myself otherwise I’m never gonna make it.

So one month down, 7 to go and i look to the next 7 months with optimisim. I am optimistic that my work will become more challenging and maybe even faster paced, I am optimistic that I will meet more Kenyans with true passion and ambition for change, I am optimistic that I will adapt.
Here’s hoping the next 7 months are full of life, laughter and learning.
The journey continues…

because it matters..

just a short note here.

as i approach my one month anniversary of being in kenya i just want to say how much i appreciate the thoughts/emails/msg's i've been getting from back home. I can't tell you how good it feels to know that people back home are reading and I hope you are enjoying reading this blog as much i am writing it. it gives you a great sense of connection and sometimes in a land where political correctness is primary about what you say, having an arena like this to express your thoughts is a saviour.

so keep em coming, i assure you i read them all and love to get them...especially on those days when home seems so far away...

Back to School...

I hate starting sentences with “In Canada…”

One initiative that my work is trying to implement is its Program for Continuous Education”. Basically, training courses for health care professionals right now come from mostly East Africa, but we hope, worldwide. So when I found out that we were offering a course this week on “Community Based Health Development” I jumped at the opportunity to grab my pen and paper and audit the course for a day to see what its like.

Well…to begin with, its just like every other training course I’ve been on. Introductions in the morning, coffee at 10, lunch at 1, and the token guy who will just keep talking and talking with no regard for time (yes I know…African time). Actually, and I mean no disrespect here at all, what surprised me was just how little we were covering! (Yes I realize that I’m talking about a course being offered by own workplace). It took us 2 hours to come to the conclusion that the household was the “structure” which influenced health the most….i mean...its an important fact..but really..2 hours!?!? We then spent some time discussing Community empowerment and how we could best empower grassroots action…finally the good stuff! It was a bit of a circular discussion, and basically the class felt that NGO’s and international donors should not provide support at the grassroots level as there are many levels of hierarchy to go through (sigh…). The talkative dude then went so far as to say “They should just give the money straight to the government and let the government decide how to spend it.” Bite my tongue.

If you’ve been reading anything about Kenya, you can’t read more than 2 sentences without seeing the word corruption…its everywhere! As much as I wanted to pipe and say “really??..like you want me to give you my tax dollars (via CIDA) to your government so they can buy themselves another Armani suit they saw?" Ok fine…unfair generalization, but I don’t think giving to only to government is the answer - at least not in the current system. But I also didn’t want to risk an international incident and possible lynching by insulting their government. Turns out though..i didn’t have to! The lady beside talkative dude…just blurted out “I’m a proud Kenyan, but our government is just too corrupt!”. Sweet! What ensued was a huge rant on government corruption and how if donors gave money directly to government, nothing would ever happen. Finally i see some passion! Props to talkative dude here, he somehow rearranged his argument to convince the class that “no..maybe donors should be giving only to government”. Ok…now I had to pipe in (either that or the teacher saw the huge smirk on my face and couldn’t resist). I tried to choose my words carefully and basically posed the question “How can we create confidence in the international community that corruption will not eat away at international aid?” (this is where I tried to refrain from the “In Canada…”). What I was hoping for was a spirited answer surrounding making governments more accountable and increasing transparency….power to the people!

Instead what I got was complacency. An answer of how to simply work with the system. “Well, if there’s so many layers of red tape and therefore many more chances for corruption, lets try to remove some of the layers…the people will still be corrupt, but there’s just less of them.” Nuts. Not what I was hoping for. I guess that was enough for one day.

Anyways, it’s a 2 week course and they’ve invited me back to attend next week so who knows…either I’ll dazzle them with my wit and intelligence, or I’ll be on the 6:00 news and home a lot sooner than I planned.

Oh, and I almost got run over by a matatu on the way home.

Health Action Day

On Saturday, the three of us decided to volunteer our time at a Health Action Day that was being put on jointly by the Madrassa Resource Centre and the Community Health Department (my workplace).

We arrived bright and early Saturday morning (and very blurry eyed due to a late Friday night) at 7am at the MRC office in downtown Mombasa ready to go. We were driving to Kalifi district which is just over an hour outside Mombasa. An incredibly bumpy ride as we got more and more rural the number of potholes and bumps totally outnumbered the amount of paved road (or what passes for roads out here).

Anyways, we arrived in a small village in Kalifi to find that there were probably about a hundred people already waiting for us. We were basically setting up a free clinic for rural villagers to come and see a doctor and get medication if need be (separate clinics fro men and women/children were setup). There was also a voluntary AIDS testing centre where people could get their HIV status…makes me wonder how many people received a death sentence…There was also a testing centre for young children to be weighed to ensure they were being nourished properly.

People from all over the area (some I was told would walk about 10km) to this clinic. They would begin by registering themselves where we took their name, age, sex and hometown (it was interesting to note that some did not even know their age). From there they were directed to the appropriate clinic. It should come as no surprise that before we knew it, the lineup stretched probably a good 4-500 metres.

I was placed in the pharmacy to help pack drugs to dispense to patients as they came with their prescriptions from the doctors (~15 doctors in total had volunteered their time). It was a bit of a rush in the beginning as the lineup outside the makeshift pharmacy continued to grow and we pack drugs as fast as we could. At one point we decided to count just how many Canadian laws we were breaking by doing what we were doing (lost count eventually) but then again – Canadian laws don’t exactly matter here.

The hours passed somewhat quickly as patients came in and out and medical advice/prescriptions were passed out. In the afternoon, I switched over to the registration desk to help register people as they came. We started seeing patients at ~9am and about 6 hours and over 1200 patients later, we decided that we had to at least stop registering patients as we realized that it was already 3pm and to see the patients that were already registered and waiting in line would take another 3 hours or so and then cleanup and debrief.

While I completely understood and agreed with closing down registration, it was incredibly disheartening to have to turn people away and times like these I’m glad I don’t understand the local language as I didn’t want to know what the people were saying when we told them we couldn’t help them. I will never forget the look on the face of the frist man we told we couldn’t register as we had to close. Some were resigned and started the long walk back home, others decided to just hang around the clinic – maybe if anything to justify their long walk there. But you could definitely see a look of anguish on some of their faces. While its comforting to know that over 1200 people were seen, I foolishly wish that we could have helped them all. But my hats off to the physicians who tirelessly and without breaks stayed all day to see and treat these people. Sometimes I wonder though, were the drugs we were prescribing really going to help? Would the illnesses these people were suffering from be cured by a few advils or some cough syrup? Part of me thinks that the real medicine was the one-to-one interaction with the doctor and that just having someone who listened was the best medicine. I’m glad I got the opportunity to see grassroots health like this in action and I hope I get the chance to do it again. As for those people who didn’t get to be seen, I hope they come back…