A day in the life of… the Public Health Program Coordinator (that’s me!)

Many readers have asked me what a typical “work day” is like for me here in Kenya, so I’ve put together an example of one. Admittedly, the following is a hybrid of “typical” things I work on at work, as my tasks vary from day to day. I prefer having a job where every day is a new challenge, because falling into a monotonous routine would quickly become tedious and boring. Instead, here is just one example of what I get to engage in each day:

I leave my host family’s home at 8:30am (after being woken up by a rooster around 6:30am, in time for my morning run and shower), say muuga (“hello” in Kimeru) to the security guard as I exit the security gate of Chogoria Girls Secondary Boarding School (our house is on-campus, as I live with the Deputy Principle who works long hours at the school next door). As I walk the approximately one block distance to my office, I have “regulars” I greet every day on my way to work; Kenyan culture pretty much requires you to pause and shake hands with anyone who greets you on the street. This took some getting used to, as most Americans just ignore each other as you pass on the street or nod your head in recognition that they are passing you; luckily I am the type of person who would wave and say “Hi” to just about every single person who crosses my path, so the only adjustment for me was the handshake.  I manage to only stop a few times on my way, but EVERY single person along the street stares at me unabashedly, so I get a little self-conscious. I make an effort to give everyone (especially the children) a kind smile and continue walking at a quick pace to my destination. Regardless of my efforts, this 5 min walk takes me 15 mins each morning. When I finally get to work, I then have to officially greet each staff member, with the formal handshake with each individual, of course.

I prepare for one of my weekly meetings, which are scheduled to begin at 9:15, but people don’t usually show up for until 9:45, as everyone runs on "Kenyan time” (which implies being a MINIMUM of 15mins late). On Mondays, I attend the Department Heads Meeting in the office of the founder and CEO of HopeCore (we all call him “KK”), along with the Financial Manager (Wafula) and Micro-Enterprise Program Coordinator (Sam). We go over each of our schedules with our Weekly Reports on the previous week and Weekly Action Plans for the coming week. This meeting is really informative, but always seems to end “on Kenyan time” too, so when it let’s out at around 10:45am, I hurry to get the entire Public Health Team to finish their morning tea, pack up their gear, load the jeep, go to the bathroom (there are no flush toilets at the schools), and try to leave by 11am (even though we are supposed to leave by 10:30 each time we have a mobile clinic scheduled- which is 3 days a week). I have now worked for HopeCore for a month and we have not left on time once.

The 30 min jeep ride feels just like being on that Indiana Jones ride at Disney Land, with so many potholes and steep inclines that you have to hold on to something with each hand. Boy am I glad I don’t get motion sickness! We actually have a fantastic driver, Micheni, who accomplishes incredible feats with our old hunk-of-metal jeep each day and manages to keep us all from falling out of the doors (some of which don’t close all the way). The team is very positive and there is always laughter in that jeep, which makes the stress of getting us all in the jeep melt away.

When we arrive at the school (which always has a cool name like Gianchuku or Mbogori), the team waits in the car while I go greet the Head Teacher (that’s what they call the Principle of an elementary school) with the formal handshake AND by signing their school guest book, which they get incredibly excited about (probably because very few people can make it up the steep overgrown pot-hole ridden paths just to get to the school). The Head Teacher then introduces me one-by-one to his (or her) entire staff, class by class, and then I get to introduce my team to them. Only then, can I request 2 classrooms for us to use.

Public Health Mobile Clinic TEAM!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 (L to R: Lennah, Jeff, Winjoy, Morris, me, Harriet, Charity, Jeddy, Micheni)

We use one room to provide clinical services to all children and teachers suffering from illness, calling them in class by class. The most common ailments include: intestinal worms, ringworm (on their foreheads), Malaria, Typhoid, Gastro-intestinal issues (diarrhea caused from drinking unclean water), and stomachaches.

We use the second room for health education using a PowerPoint presentation from our laptop and projector, charged by a generator we run an extension cord to. Lennah (whose job title keeps changing between “Assistant Health Program Coordinator” and “Health Educator”) does the presentation for the lower primary classes (nursery and classes 1-3) in Kimeru (because they have only just started learning Kiswahili and/or English), and then one of our 3 Peer Educators (who are nursing students looking for work experience) presents for upper primary (classes 4-8). I must say I am very proud of what powerful and engaging speakers they are! Some of the content, however, seems inappropriate for this audience… for example: when one of our Peer Educators was giving a presentation on Hygiene, the kids got uncomfortable and started whispering to each other. When he asked the class what was wrong, they told him that they couldn’t possibly follow the recommendations he was giving them (which was to wash their towels once a week and not share towels with other people) because none of them had their own towels (most large families only had one to share) and they also couldn’t wear clean underwear every day, because many of their families couldn’t even afford to buy them a single pair of underwear to begin with. That was awkward… but at least I’ve identified one way I can improve the current presentations (i.e.: providing hygiene goals that are more realistic and achievable), because the presenters are already outstanding!

After the presentations, the school provides our team with afternoon tea and sometimes a whole meal (Although a few of the 22 schools we serve are unable to afford to provide lunch at school). It is important to note at this point that while these schools clearly need the food more than we do, it would be rude and culturally unacceptable to refuse this kind gesture. In fact, accepting the school’s offering graciously is the best way you can show your appreciation and avoid hurting the pride of the teachers there, who are unable to provide the medications or show flashy PowerPoint presentations like we do. Besides, we don’t know which schools even want to provide lunch to us, because it would be rude for us to ask ahead of time and they serve us each full plates without prior warning.

After we eat, the whole team pitches in to finish seeing the remaining patients using a triage system (aka sending the serious patients directly to our licensed nurse). Then we pack up, I give the kids high-fives as they crowd around me, and I give the Head Teacher a gift of 12 soaps for students and teachers to use (hopefully every time they use the bathroom or are about to eat) and a final official handshake.

When we get back to the office, I need to pay each staff member lunch stipends (which they get regardless of whether the school provides lunch or not—mainly because HopeCore doesn’t provide medical benefits and this keeps our staff happy), transport stipends (for those who live outside of Chogoria and have to commute), salary for those who work per diem, vehicle fuel, and funds to replenish our medical supplies and pay a lab to run tests on the blood samples we’ve collected.

Then, I make coffee and work with Lennah to improve our PowerPoints and fill out the necessary paperwork for financials and input data on how many students we helped that day at our mobile clinic. I am also starting to work on writing blogs for the HopeCore website and finalizing an incoming grant from Planned Parenthood Global to add HIV and unintended pregnancy prevention to our health program.  On Tuesday nights, I also attend a grant writing class via webinar through the Segal Family Foundation.

It sounds hectic—probably because it is—but I love every minute of it! I have a lot of responsibility and a lot of say over the future of the health program, as well as a determination not to let anyone down.

My new name: Introducing... Stacy Kagwiria!

Today I received my Kimeru name (Kimeru is the local dialect in Chogoria) and "Kagwiria" (pronounced: Cah-Gwhere-Lee-Ahh) means "someone who makes people happy"! What do you think?

Originally, my peers were going to name me "Makena" which means "joyful one", but a previous Global Health Fellow and my boss' girlfriend are both already named Makena, so that one was vetoed. But now I love my new name and will share it with pride.

It is important to introduce myself with a Kimeru name in Chogoria and the surrounding Meru area because it helps people connect with me faster. 

 

 Since I am going out into different neighboring communities at least 3 times each week it is a valuable asset for me to have. Furthermore, using my Kimeru name demonstrates my respect and interest in the local culture and lifestyle. This is especially important to me because I don't want to come in with a "Team America" or "Americans know best" attitude; I think that is so short-sighted and ignorant. While I have worked hard to learn all I can about public health and behavior change theory, I know that there is always more to learn and have no pretenses about my expertise. I feel I can learn more here than I could ever possibly teach, but I will share what I can in return.

I am falling in love with Kenya the way I fell in love with Ghana last summer.  

 

The two countries are remarkably similar: both are stable nonviolent nations open to growth, and are home to the friendliest, most welcoming people I have ever met. The biggest difference, as far as I can tell, is the food. While Ghana's food staples include spicy hot soups with dough in the middle, topped off with chicken legs or antelope meat.... Kenya's food staples include a mix of maize, beans, and potatoes with beef or chicken. Ghana's fruits were a little more tropical, with mangoes and coconuts grown on nearby trees; whereas, Kenya grows mostly bananas and grows an enormous amount of chai tea. In Ghana they call white people "ubrunis", and in Kenya they call us "muzungus".

Both are fascinating African cultures that strangely make this white girl feel right at home!

Redefining "Worship"

I am still definitely jet lagged, but happy to have arrived and energized by how new and exciting everything is to me.

I went to a church service this morning with my host mother and it was like nothing I had ever seen before! The service was full of singing and dancing and "praise the lord, sweet wounded Jesus" phrases shouted out by the Baptist-like priest. At one point, music was playing and all of the congregants closed their eyes and each started chanting their own prayers, while waving their arms madly in the air and rocking back and forth. Some even jumped around; I'm surprised more of them didn't bump into each other or knock one another over. A couple of people even had tears streaming down their cheeks! It's a good thing all of their eyes were closed during this part, because I was in total shock: with my jaw dropped and eyes wide, looking around. I can't say I had a religious experience myself, but it was fascinating to watch people so overcome with emotion and love for a higher power. My favorite part was the dancing and clapping and singing --it was joyful and fun, a pure celebration of their religion-- unlike the church services I've attended in the US, which were often solemn and tiring.

I thought it was beautiful and I don't regret attending.

{I know that religion can be a touchy subject for many people and I want to go out of my way not to offend anyone. This is, however, how I can best describe my experience today at an African non-denominational Christian church service.}

Getting to know my Kenyan FAMILY

I'm still suffering from some jet lag & yesterday I was exhausted and fell asleep by 7pm... I got up for half an hour for dinner (at 9pm) and quickly went back to bed (because in recent days I've had trouble sleeping around 10pm and needed to catch my sleep window. So last night was the first time I have slept through the whole night.

The rooster crowed at 6:05am (a few minutes later than he usually does) and I've been up since then. I wanted to go running, but all of the girls attending the Chogoria Girls School next door have just returned from Midterm break and are hanging out and studying all over their school field. I am too self-conscious to go run laps around them, especially because everyone stares at a Muzungu (white person). They wouldn't do so maliciously, but enough to make me a bit uncomfortable. They are especially excited and swarming around the school reconnecting with their friends after having each gone home to visit their families for the first time in months. I think I forgot to tell you that Mamma Lucy is the Deputy Headmaster (aka: Vice Principle) of the Chogoria Girls School (a secondary school: aka high school), so I will hardly see her anymore, as she works 5am-midnight most days. She tucks the girls into bed in each dormitory and goes to wake them in the morning as well. She is extremely dedicated to her job and I can't think of anyone better to care for these girls.

I will still be receiving big home cooked meals at the home daily though, as her family hires a "house girl" (aka a cooking/cleaning maid who comes here every day). I'm not used to having a house servant, so it is a little awkward for me. Especially since the "house girls" are high-school aged girls who had to drop out of school to work and help earn money to support their family (typically to support their parents and siblings, but sometimes to support a small child or two of their own). At least, this is my understanding of it. So the "house girls" don't know very much English, as they would have learned that in school. It is difficult to communicate with them, so I just make sure to smile kindly every time I see Winnifred (the house girl hired by my host family). I wish I could get to know her and ask her about her family and life, but the language barrier is just too great to overcome.

My host father, Timothy, is a teacher at the Chogoria Boys School down the road. My Kenyan parents both work much longer hours than they are actually paid for (reminds me of my own American dad).

Their son, Tosh, is the sweetest boy you will ever meet... and the shyest. When he speaks (which is a rare occurrence) it is barely a whisper, but he has a kind disposition and clearly enjoys when I talk to him. I've learned that the way to have a conversation with him, is to ask him questions with multiple choice answers. Instead of, "what is your favorite subject in school?" which is a question he would struggle to find the words to answer, I would instead ask him, "Do you like English or Math class better?" It is still difficult to hear his responses, as they are barely an audible squeak, but he nods and smiles after he answers each of my questions.

He is most animated when I bring up Liz, the former Muzungu global health fellow, because he absolutely adores her. I hope he will be able to open up to me as he did with her. I'm working on it.

Tosh recently fell down some stairs (a few days before my arrival) and fractured his leg. He is terribly embarrassed by it and yesterday, he cried because he didn't want to go to school because everyone would see him struggling to walk with crutches. Lucy was distraught because Tosh wouldn't even take his breakfast. She did eventually get him to school, but it was a struggle all morning yesterday.

So today, I offered to wake Tosh up for Lucy. She had already prepared to bring Tosh breakfast in bed (Chai tea, bananas, and bread with butter & jam), so I brought it in and gently woke him. He wanted to go back to sleep, but was surprised and excited to see me in his room, so I was able to coax him to sit up and eat breakfast with me  :)

A pencil sharpener a day keeps Hepatitis away

Before traveling to Kenya, I'd asked some fellow Americans who had experiences in Kenya themselves, if there were any school supplies in particular that Kenyan children are lacking. The overwhelming response was pencil sharpeners and futbol (soccer) pumps. Apparently, the schools here receive large donations of pencils and futbols, but no means to utilize them. Many Kenyan children use old rusty razors to sharpen their pencils, which puts them at risk for contracting Hepatitis. 

So I asked Tosh about this issue over breakfast this morning. At first, he was reluctant to admit that pencil sharpeners are scarce, and a rare commodity here, but when I told him that I brought some to give to school children, he was unable to hold back his eagerness. He admitted that his entire school only has one or two pencil sharpeners and his class rarely sees or gets to use them. I showed him the big bag of sharpeners I brought and told him to take some. I was surprised at how modest he was, only taking two. Most 9-year-olds in America would have grabbed as many as they could of any object they wanted that was offered up to them on a silver platter.

Then, Lucy came in the room to iron Tosh's clothes and gasped when she saw the pencil sharpeners. "Where did you get those," she exclaimed. "I have been searching everywhere for a place to get sharpeners for my girls." (whenever Lucy says "my girls" see means the hundreds of students she oversees, not merely her own 2 daughters). I offered her some as well and, once again, she chose to only take a few (for her entire school), despite the fact that I would have given them every last one if they had asked. Lucy told me that I should save the rest for the other schools I visit because every school in this region is in need of them.

I must admit that I am surprised to learn how widespread this shortage is, and would personally like to bring an entire suitcase full of them back to Kenya when I visit home over Christmas. In fact, I am even going to look into ordering a large supply of pencil sharpeners from an online manufacturer.

Friends and Family: if you have any connections or suggestions, please don't hesitate to share them with me. Furthermore, if any of you feel inclined to purchase and donate pencil sharpeners for me to distribute to the schools desperately in need of them, please snail mail them to my parents' house & I will bring them to Kenya after Christmas.