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Friday, April 26, 2013

Privacy Settings?

An interesting aspect of living in Kenya is that there is very little  sensitivity to privacy in the public domain. I have often felt that Americans are over sensitive about privacy issues and a bit paranoid.  In fact, I’ve been known to complain about HIPPA, for instance, when I am told that I can no longer request info from our pediatrician about our older children’s records. Of course, at home,  the whole topic  of having identities stolen and the creepy sensation that nothing is private any longer because of the invasiveness of the internet, has complicated our feelings about the modern world and created a sense of unease for anyone over 30.  
In Kenya, The lack of concern for privacy or boundaries in certain situations, most certainly has to do with people habitually living in close quarters and many never having their own private space because basically, there is none. Or relatively little. Internet security is not a big topic of concern yet, and although security is constantly being talked about, privacy is not.  The majority of folks are not technologically connected beyond using cell phones, so you don’t hear much about stolen identities and such.  No doubt all of this will soon arrive.
The lack of privacy or boundaries in some settings takes some getting used to.  I am accustomed  by now, but on occasion, I am still taken aback by something that occurs which would a) never occur at home and/or  b) strikes me as completely unacceptable because of my own personal hang-ups about privacy or personal space, which seem closely related.  Just a small example is when you are at the ATM machine and there are others waiting. There is no hesitation on the part of people waiting to just hover, overly close to you and the machine, by our American standards, and people just leave their receipts in the machine all the time, or on the floor or in the waste can next to it. It cracks me up because they have gates around all their houses but they just leave their bank receipts for the taking.
In the last few months, I’ve had several moments which have highlighted this issue and have also kind of blown my mind. My first real experience with the whole privacy matter happened when I took the boy that we are sponsoring, Dennis, to the eye clinic at the hospital. His eyes were troubling him and because we wanted to help him do well in school, I took him to get checked. There’s a  reasonable clinic at the public hospital.  After paying a small fee at the outdoor counter, we were told to wait in a room. The “waiting room” it turned out, was also the examination room, and the consultation room. We sat on a bench with other patients, and waited while the doctors, or clinicians, did eye exams and diagnosed other patients. There were probably eight of us there at once…a couple of young mothers with babies, another woman with an older child, a couple of men, and me and Dennis. We had to wait about 20 minutes, before she called his name, but the entire time we were privy to both the exams (stand at a distance and call out the directions of the letters on the eye test) and the consultations for all the other patients. I didn’t really think much about it until  it was Dennis’ turn. His name was called to come stand on the line at the far end of the room , but as he got set to read out the letters, all heads swiveled  in his direction to watch and listen . It was almost like he was performing or in a sporting competition the way folks watched him. It was funny to me then and now, actually, and it certainly didn’t bother anyone else, but I did think to myself “yikes, no HIPPA here!”  After the exam, the doctor called him to her desk and asked him several questions in a normal voice making  no effort to keep the conversation confidential. I was standing there as well and was glancing over my shoulders  at the others in the room feeling self conscious for Dennis, but he didn’t flinch or glance around. Again, no one seemed to notice or care, so I just decided to lean into it, thinking “well, there are certainly no secrets here!”  Not a concept I’m completely comfortable with, but what can you do?
This issue of privacy and/or personal space comes up for me frequently when I am waiting in line at the bank, or at the internet/cell phone service store where the lines are guaranteed to be long. First, people cut if given the opportunity, and with no remorse. I guess I’m an easy cuttee because I am often caught unawares until it happens and then I’m like “Wha???” looking around indignantly and no one catches my eye.  This gives the expression “you snooze you lose” another meaning! I mean, I definitely don’t snooze any more. In fact, I’m all elbows and outstretched arms, leaning on whatever is next to me so someone  shorter than I  won’t sneak underneath me and take my turn!
 Being ” on cue” can be a  very intimate experience, believe me. Kenyans like to stand right on your back. I mean right on it, like they want to get on for a piggyback ride. Another favorite position is right next to you when you are doing your transaction, all eyes, watching the whole dang thing! At the Ugandan border crossing cue, I had a young man literally standing so close I’m sure he could see my pores. He was sort of waiting, I guess, but making me so uncomfortable I had to finally tell him that he was standing too close to me.  It didn’t seem to bother him. He just kept on standing there. He either didn’t understand me or was worried he might lose his spot!
My most disconcerting episode so far was right before our trip. I had to go to the bank and get dollars exchanged for Kenyan Shillings so we would have dollars to go into the parks in Tanzania. I had to go twice because we needed a lot of cash to go over the border and into the parks. The first time I went I had Liam with me and he was waiting in a chair off to the side. I had a lot of Ksh with me and I asked the teller if he had dollars. HE answered yes, took my Shillings ( 84000) and proceeded to do the transaction. I was watching through the window rather intently as I had also given him my passport. I noticed, with a start, another person,  a man, looking in another window to the side of the teller,  watching the whole transaction too! I was stunned and felt a little whoozy. I mean, I was going to walk out of the bank with $1000 cash on me. The fact that this stranger was intently watching this whole transaction just gave me the creeps. I tapped on the window and pointed to the other guy, “um, I don’t think he should be there watching you,” I said nervously. The teller just smiled a big bright Kenyan smile and said, “it’s ok” which is their pat answer for most concerns. After receiving the money, I quickly gestured to Liam and hooked my arm in his as I said, “ok we are walking quickly home; no stops. That guy just watched me take all this cash and put it in my purse.” Fortunately, no one followed us, but when I went back in I told the manager that I thought it was unsafe to have another window on the other side of the teller. “oh that is for big deposits. It’s ok” he said with a big grin.
My most recent experience with the issue of privacy again happened at the hospital and fortunately it was not my privacy that was violated but it was nonetheless disconcerting. I was spending time in the hospital, pediatrics ward, because Julius, the baby I have been monitoring and snuggling was admitted again for a lung infection. He is always there with his caretaker from the children’s home and I go down and visit and try to give her a little relief and him a little love when they are there. The Pediatrics ward, like all the wards in the Moi Teaching and Referral Hospital, an underfunded public hospital, is crowded. There  are two “mamas” and two children to a twin bed  there. Talk about no privacy!  Everyone is on top of everyone else, and they sleep, brush teeth, change clothes together , and yes, hold each others’ babies. Since it is a teaching hospital, when the docs do rounds, they always have a large gaggle of students with them. So, since Julius is an infant, I wasn’t overly concerned about his privacy, although the fact that I could go and look through his files was strange (again no HIPPA here!), but there were older children in the ward as well and we were all privy to their issues, or certainly could have been, if interested. In fact, it’s like the sharing of their stories is what kept the mamas going. Whenever I would go in, there would be several mamas sitting on two beds ( at least the original 4 and then maybe a couple more) just visiting or eating. At one point I was pretty stunned when the docs came through and were examining the adolescent that was in Julius’ bed. Apparently she had had some psychic episode which was concerning and the lead doc was examining, asking questions of the mother and the child, and all of the parents/other adults  in the ward cubicle were all ears,  me included. I was literally smashed against the wall holding Julius because of the number of students in the cubicle, but I could clearly hear the conversation between the lead doc, the assistant doc, and the patient’s mother. I was a bit uncomfortable because it  seemed like maybe it should be confidential. But again, no one else seemed concerned. In fact,  I’m pretty sure I could have gone around and asked any of them what their kid had or why he/she was there, or even the nurses, and they would have been happy to tell me.  With a bright smile and reassuring "sawa sawa" , meaning , "it's ok." 

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