I switched days this week at the hospital to visit the CCC (Comprehensive Care Center) this morning. Today was the pediatric clinic so the "waiting bay" was full of young children with HIV and their parents. Every few months they come in for a checkup and to receive ARVs (antiretrovirals). All services offered including the consultation and prescriptions are free.
Alexia just interrupted me to ask what I was doing, "homework" (my common reply when working on my computer).
"You didn't finish your homework from yesterday?"
"No, I just got more today."
"Why are there no dashes?"
"So you can write nicely!"
She's learning to write in school and copies letters on the dashed pencil lines her teacher makes in her notebook.
I caught up with Mwanafunzi as we walked to the clinic. He'd gone to a rave on Saturday night and said I should come next time to "relieve some stress."
"Sounds like fun" I said hesitantly, not wanting to make any sort of commitment, "What kind of music do they play?"
"Mostly Western." (Meaning European/American, not country)
The waiting bay is essentially a covered cement porch with a long cement bench on one side and a metal-barred window on the other. They were short staffed today, meaning there was only one person checking people in and taking their weight and height, Mwanafunzi, so I was given the job of passing out people's folders with their medical history.
Files lay strewn across the table in a mix of brilliant colors. Some said "Ministry of Health--Meru District Hospital" with an official seal, but many were plain with a single patient's name and file number written along the spine in black Sharpie. All were torn and tattered on the edges.
People, mainly mothers, walked up to the window and handed me a small, folded piece of yellow paper through the metal bars. On the cover was their name and file number and the date they started their treatment. I handed their cards back and fetched their folders for them and their children (if they both had HIV) or just their children. After getting their files they were redirected around the corner and into the check-in room. Here Mwanafunzi would take their height and weight to determine their BMI (Body Mass Index). If a child's BMI was too low, they were prescribed F-75, the same formula initially given to malnourished kids in the critical room of the PEM ward.
A woman carried her toddler into the room and placed her on the scale. She cried and kicked her pink pants covered legs under a beautiful white embroidered dress. She wouldn't stay still long enough to get her weight and giving up, the mother grabbed her and hopped on the scale too.
Mwanafunzi left to get something leaving me as the only person running the check-in room. A few women came to the window to get folders then walked around without a word and set their children on the scale to be weighed. "Uhh we need to wait for the doctor." I was met with confused looks and frustration. Why wasn't I writing down their measurements? Realizing the women didn't speak English I repeated and waved my hands hoping my gestures would make more sense. Luckily the Swahili word for doctor is daktari, so they understood the gist of what I was saying and went back to sit down in the waiting bay. Another woman walked in wearing a shirt with "Hakuna Matata Kenya" emblazoned across the front and a young boy named Armstrong. The power flickered out a couple of times as I waited.
Dorcas was running a little late to pick me up so I decided to check out the Youth Center I'd seen a sign for. The external walls of the building are painted with a series of images giving tips on how to avoid rape. They included such things as not wearing provocative clothing, walking alone at night, or getting drunk. Inside I explained that I'm teaching health classes at a primary school and I wanted to see what services they offer in case anyone ever asks me for advice on something I can't help them with or don't know the answer to. They provide free services dealing with everything from unwanted pregnancy to forced marriage.
Entering Meru National Park on the way to our first food drop signs warned us "Beware Elephant Crossing". A few cattle illegally grazed along the dirt road running through the park. We drove past the town dump, essentially a large pit for burning trash, and the smell lingered in the car. I rolled down the window but the air was thick with dust. It gathered on my lips as I wiped a thin, gritty layer from the notebook on my lap. It was a hot day, one of the hottest yet and the option was to either open the window and choke on the dust or close the window and breathe the increasingly warm air. I chose to alternate between the two.
We spoke to the headmaster for a bit before handing over the 98 one kg packages of Bora Bora Nutri Mix we'd brought. In addition to bringing their own cups to eat the porridge in, each student must bring water for the porridge's preparation. The school doesn't have a reliable water source and has been borrowing water from the neighboring houses.
The headmaster gathered some kids to get in a picture with the porridge. They laughed as I talked. "They've never heard anyone talk like you before" the headmaster said. I was asked to introduce myself so they could hear me talk more, unfortunately no one understood my accent and everything had to be translated into Kiswahili.
While there we also assessed their latrines. MKMF had built a block of toilets there which the girls are using, but the boys are still using old dilapidated wooden toilets. Another project is underway to build a new teachers toilet, but digging the pit has been a slow process. When the parents are called to help out, only a few come, usually women, who have trouble digging in the rocky soil. The headmaster said it's hard to ask the parents to dig on an empty stomach. Dorcas recommended providing food to parents who come to dig in the future as a form of payment. We're looking into this as an option to get the project moving along.
We didn't see any elephants on the way back but there were a bunch of baboons along the road!