Clinic Visits and a Cynical View of the Mzungu

Last week, Colin and I traveled to a clinic called Chulaimbo. It is due west of Eldoret, about 2.5 hours away. Colin and I hopped in the car at about 7:30AM and began our morning road trip, with mid-90s jams of the Fugees. Colin had asked if I was okay with the cursing in the Fugees songs...I am just glad he didn't ask to listen to my ipod on the way, because we would have had to skip about 80% of the songs. The Paul Simon Graceland cd seems to be missing from the random collection of mixed cds in the car...apparently this cd is a favorite among the research assistants and coordinators. Perhaps, the cd has found a home in a disc player at one of their homes? Oh, well...I think I can sing that entire cd from memory anyways, so we should be good to test out our vocal skills of me trying to mimic the South African tribal moans that are laced throughout each track of the album. I may have to practice so I nail the performance in front of Judy, she doesn't know what's coming! 

The drive to Chulaimbo was very beautiful. We passed a rusty sign with an outline of Africa that had words written across the Sub-Saharan portion that once said "You are at the Equator" but now the only legible letters are "Y_u ___  a_  the Equator." Thankful for my catholic school days full of hangman during indoor recess, for my ease in filling in the blanks. Once we passed the sign, the temperature increased about 10 degrees, even through the windows of the car, we began to pump up the AC. The drive actually had a well paved road, which is an anomaly here. The roads were lined with large boulders, with banana leaves and palm trees jetting from the cracks. The backdrop of the large hills or mountains (okay, compared to Indiana landscape, I would call these mountains...but I am not sure if they actually are considered mountains) reminded me of a mix between Palm Springs and Maui, with the dark red dirt and desert-ous rocks and palms. 

Once we reached the clinic, it was a short visit at the HADITHI office. Janet, the Research Assistant, is very organized and was once a clinical officer, so she knows how to fill the forms with detail. She also graciously fills in for the AMPATH general pediatric clinic's clinical officers when they are short-staffed. At this clinic, she says that each child comes to the clinic according to his or her appointment time, and that she almost has a 0% rate of children missing appointments. Apparently, in the past, the clinic staff have scolded children in the past for not showing up, thus instilling some fearful sense of responsibility in the young ones. As a field coordinator, it is comforting to know that a clinic that is physically so far from Eldoret is able to manage the daily tasks of an RA in an efficient manner and that the response rates are good for the children and caregivers. It is important to recognize the sacrifices families and children make to attend clinic for HIV and other health-related care. Many families walk for 2 hours before they make it to the clinic location, others save for weeks in order to take a matatu ride in the general direction of the clinic. Children often have to take off of school, for their day's travel to and from clinic, often lying to classmates and teachers of why they are missing school, too scared to inform others of their status. For some children who attend clinic still don't know their statuses and are therefore taking these efforts on a whim or a lie told by their parents that they have some other illness, such as TB. This is an ever present sign of the impinging effects of HIV on these people at the clinics, tired faces lingering with desperation and for some, hopefulness.  

On the way back from the clinic, I chose to drive, to give Colin a break and to let him take some photos and video of the beautiful drive. The 2.5 hour drive was extremely tiring. I did not think it would take so much out of me, but as a US-trained driver in Kenya, it is hard to cope with the multitude of distractions. You not only have to adjust to the outrageous pot holes and questionable rocky routes, but you also have to avoid hitting watoto (children) on their lunch break from school, each of them with oversized backpacks, each wearing their school uniforms, scurrying along the roadside. Each color of uniform represents a different school or school district for the public school kids. As we started to pass the rainbow of colors, each color presenting at a further distance from the clinic, Colin and I would call out "pink school!" or "blue and orange school!" It was a fun novel way to play "I spy" on a roadtrip. So, not only do you have each side of the road lined with school kids, but you also have a various array of obstacles such as a herd of cows, stubborn donkeys, goats and sheep, piki piki or motor bikes, and matatus, which notoriously drive over whatever they please, however they please! One kiddo jetted out in front of the car, to escape a tag-like game with a friend. I quickly put on the breaks and swerved, and pointed at the kid and said "WE WE," pronounced "way way" meaning "YOU!" he was scared shitless, frozen in his tracks.

The weekend was fairly uneventful. I chose to not travel anywhere, so that I could soak up some zzzz's since I developed a congestion headache over the week. I joined a gym, called Boma gym, which is evidently tied to the Red Cross, so most of my fees are supposedly tied into providing donations to the Red Cross...so they say...sooo they say. The gym, which costs approximately 70USD/month (OUTRAGEOUSLY expensive here!) has three treadmills, two ellipticals, two bicycles, a stairmaster, and some free weights. After my first day at the gym, the "trainer" (let's be honest, he wipes down the machines and probably does NOT have a degree in physio-health) approached me and asked how many minutes I had been on the elliptical. I responded "60 minutes" and he had a surprised look on his face and said "wow, you have a lot of energy." I didn't know what his response meant, since he had been watching me, the only person in the gym for the past 60 minutes, straight. So I just laughed and said "mmmyeahhh" and walked toward my escape, the girl's locker room. 

Friday night, Amy made padd thai and some "short-termers" headed up for dinner. It was a fun, relaxing dinner, full of laughs, a perfect start to the weekend. 

On Monday, I chose to go to Turbo clinic with an RA and Judy. Turbo usually has several patients on Mondays and it is helpful for us to go to help out clinics on their busy days so that we can count remaining pills in MEMS bottles and help distribute the future dosage and mark them on our forms. When we arrived at the clinic, Juliet, the RA for Turbo was busy with a patient, so we quietly sat down and started organizing our things for the day. The mother of the patient looked at me and studied me as I sat down next to Juliet and then proceeded to ask Juliet in Swahili for some fare to get back home, eyeing me as she was talking to Juliet. Juliet, ever so softly, informed me of the request, and I told her that we would oblige, this time. We do not have the funds to provide rides to patients on a normal basis, so it is up to our discretion on who we give money to and the amount of money to be given. 

The expectation of wazungu to give money to people in Kenya is quite an unusual dilemma that we face every day. Unfortunately, my view and opinions of giving money to strangers has been influenced by my mugging experience in Mlolongo, two years ago.  In some way, my mugging occurred simply because I am a mzungu (well, not in SOME way, it is exactly what the muggers had stated, so yes, it is true). According to the beliefs of the current Kenyan society, a mzungu has money, and if you ask, or simply take, you will most likely get money from said mzungu. The formation of this conceptualizations for some Kenyans could be due to the generosity of numerous mzungu-led organizations in the areas, the influence of the British colonization (and thus the ineradicable hierarchy of whites vs blacks), and also the presence of missionary groups who are there to give and provide help for some people. However, I think as my own protective mechanism, I have been completely shut off to the idea of giving to complete strangers, partially because in a way, I still feel violated for the mugging. A violation to my conceptualization of what safety is and feels like. I do not think this cycle of expecting wazungu to give money will be broken, nor do I think it necessarily should be broken, because some people actually do receive help, I just think I need a break from the expectation. I wish I could have a tattoo or a sign that says that I am exempt from the constant asking or begging, at least for a little while...I need a bit longer to heal. 

One thing that Colin and I have talked about is the "Justin Bieber Syndrome" (thank you, blogger for auto-correcting my misspelling of Bieber...how dare I do injustice to such a name by not spelling it correctly...my bad!) or the fact that if you are a mzungu, you are constantly being watched. No matter where you are, people basically stare at you...children stop in their tracks, slack-jawed in awe? or fear? (word on the street is there are rumors floating around some homes that wazungu like to come and grab you while you are sleeping and sell you to people in the US....a fear that may not be far from truth for some orphanages, but I digress). Sometimes, I wish I wasn't so observant, because the feeling of eyes on you can sometimes be creepy and is mostly just annoying as you feel like you are being talked about as you complete a simple daily task such as put your groceries in a cart. When walking to my office, I sometimes sing in my head Rockwell's classic 1984 hit "Somebody's watching me." I, of course, laugh at the fact that this immediately plays in my head, but may look to an outsider like a deranged mzungu for randomly laughing as I walk. Oh well, more reason for people to keep their distance from me. I am trying to have a sense of humor about it, but hopefully I will just get used to it.

The rest of the week should be fun. I look forward to our meeting on Friday with all of the counselors in our HADITHI office. It will be a chance for me to get an idea of how they approach counseling and discuss any issues they may have for particular cases. Since I am not able to conduct any counseling for the study participants, myself, since I am a mzungu and may have a heavier influence on the message that I am giving, this will be a good way to learn the real issues that adolescents and families deal with and a way I can impart some new ideas to the team.