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Friday, October 10, 2014

July 6th Talk at UUCCI Our lives and work in Kenya

Why we are there? AMPATH
In December of 2011 Michael and I signed a contract with IU/Kenya, which is a medical school partnership, to oversee the building of a new chronic care facility in Eldoret, Kenya.
 The public hospital in Eldoret, the Moi Teaching and Referral Hospital, has been home to the IU/Kenya partnership and the larger consortium of North American Medical Schools called AMPATH for about 30 years. In the midst of the AIDS crisis, back in the early 2000’s  IU/Kenya AMPATH shifted its focus to HIV testing and prevention and support of HIV positive patients. They built about 60 clinics out in the countryside of western Kenya, and their efforts there have made great strides in the prevention and treatment of AIDS in that part of the world. In fact, AMPATH  has now moved into a new phase where they are dealing with a lot of other medical issues, some of which are the results of AIDS. There is a growing cancer rate in Kenya, and heart disease and diabetes are bigger issues than before. A Hoosier donor, someone who has some passion for the medical work being done in Kenya, donated a lot of money and wanted to get this medical facility built. It will not only be just the second cancer care center in Kenya, it will be the only one in western Kenya and it will serve people from all over the west, plus Uganda, Tanzania, Ethiopia and Sudan. It’s a complex project because of the many doctors who have collaborated on it, including IU’s Dr.  Bob Einterz and Dr. Loehrer from Simon Cancer Center in Indianapolis. It is also complex because of the space needed for both care and research and the high end equipment which will need to be installed. There are no chemotherapy or radiology facilities in this part of the world. So, in a lot of ways, it is a whole new ball game.
We got involved with AMPATH many years ago when we were engaged in a local group here called AIDS ACTION. AIDS ACTION held events each year with the goal of educating the public about the realities of the global AIDS crisis and also to raise some funds for various organizations who were on the forefront of the battle. AMPATH is one of those groups so one year we donated money to them, Dr. Einterz came here to the UU Congregation to speak, and our relationship with them was forever solidified. Several years later Michael was asked to come to Eldoret to consult on the construction of a new facility, the Mother and Babies hospital, funded by donors at  Riley,  which is now a mainstay of the Moi Teaching and Referral Hospital, and prevents thousands of deaths by providing prenatal care and healthy deliveries  for women and post natal treatment for babies in western Kenya.
With this new contract, Michael started going over to Eldoret once a month for the first 8 months, as well as organizing  the building project from here. He is not the General Contractor, but rather, represents IU in getting the building right and also making sure that they get their money’s worth. He is also, as a green builder, very focused on the energy efficiency of the building and saving the hospital money in the long term. As a public hospital, you can imagine that their funding is not great or stable.
He made several trips that spring, and met with architects, builders, doctors, and solar providers while getting the project underway before they actually broke ground.
As a family we decided it would be both interesting and challenging to go live in Kenya for a couple of years. It has been both, no question, but there is so much more to it, that one cannot even imagine from afar,  that we have experienced and that we have learned. I am going to try to describe some of what we do but mostly focus on AMPATH and the project so that as Hoosiers, you can learn about it and also tell people about it because it is something all Hoosiers should be proud of.
As I say, as a green builder, Michael has focused a lot of his energy on the sustainability of the building, both energy wise and equipment wise. Strangely, to us, solar power is not used as often as it might be in East Africa. Mostly this has to do with the fact that people hesitate to invest money in solar energy because of the costs, earlier, but now maybe due to instability in the region. Michael has lived in Africa before, and he feels strongly that there has to be some risk taken in order to move things along. Not unlike how the folks who started and continue to push the AMPATh organization operate.
The new building, which I will show you some pictures of soon, will have a lot of features thanks to Michael Greven, which it probably wouldn’t have otherwise. Not only is there not a lot of creative thinking around buildings in Kenya, there is also not a lot of knowledge about what can be done differently. Also, of course, money is always an issue. Fortunately for us, the woman who donated the majority of the money for this new building also has an interest in energy efficiency and environmental sustainability, so she was very pleased to have someone managing the construction, who is also focused on those aspects.
Some of the sustainability features which Michael has insisted on, and really made a focus for the hospital, engineers, and architects are:
v  Solar photovoltaic generating 405.8 kw saving 14,355,000 ksh yearly
v  Solar hot water for lavatories
v  350,000 litres of captured rainwater for irrigation and flushing of toilets
v  High efficiency toilets and faucets
v  High efficiency lighting controls
v  Low to zero volatile organic compounds in paints
v  Focus on natural ventilation and lighting
v  Minimum usage of timber and no use of endangered timber
v  Tinted glass to reduce heat gain
v  Selection of finishes based on durability and sustainable maintenance
v  Locally sourced materials to the greatest extent possible and a focus on products “Made in Kenya”
There are some pamphlets available in the Fellowship Hall for those who would like to read more about the construction project. I am going to show some photographs now of the project so you can get an idea of the construction work itself, the size of the project, and how it has progressed over the last year and a half.


As we adjusted to our new lives, it became clear that there could be a million opportunities to get involved in one way or another, yet we were uncertain for awhile of how to engage. Michael had his work of course, but the pace of work is not as intense as it is here, so he has more free time than he has ever had I think, since we’ve been married. That has been nice for us, in a lot of ways, as we have time to be together, visit on things that have happened, debrief about activities and things that are befuddling to us, and support each other more. We decided, early on, that there was only so much we could do, as visitors, and a lot that we didn’t understand, so our motto became,
“Be Kind, Don’t Judge, Don’t Assume, and Be Generous.”  This has basically served us well and has enabled us to focus in on things that are important to us but also helpful to our surrounding community.

One of the mysteries that we faced upon our arrival in Eldoret was how life would be for Liam and me. Liam’s story is quite interesting because he did go to school there for a term, but he also ended up hanging out with a lot of interesting young medical students, residents, etc, who came through to do their rotations and studies. However, as you know, he did end up finishing his HS diploma online through the Indiana Virtual Schools and then felt like he really was ready to come home and be on our property here and make some money so he can “move on.” So that is what he is doing. I will go back in early September to join Michael for the final 10 months of our contract, so our life will be quite different without Liam there.

The most difficult aspect of moving away from here for me has been not having work of my own. I have had to create and recreate, over and over again, work  for myself. I have to say it has really helped me understand better what I like to do, what I can stand doing, and what is important to me. Kenya is a place that has an enormous amount of challenges, many of which you know about, just because it is a developing country in Africa. I had been in Africa as a young person, but in a very different area and country. A lot of time has passed since then, and Kenya has been through a lot in the last 30 years including the AIDS crisis, which I consider to be sort of the fundamental reason for other ongoing issues they have. As I mentioned before, AMPATH has been instrumental in minimizing the rate of AIDS in western Kenya and increasing treatment and care. It’s such an inspirational organization and filled with really amazing people. I have benefitted a lot from meeting many of them. I had not thought about exactly what I would do but I did know that I like to DO. Michael and I are alike that way, which is good. Not being a medical person, and not having a lot of background in any of the work being done at the hospital, it became clear over time that my focus would need to be on children. I have always been interested in the well- being of kids and had thought that might be where I landed, I just wasn’t sure how.

Fortunately there are some organizations already set up in Eldoret, associated with the hospital and AMPATH in which I have been able to pour some energy and time. Sally Test Pediatric Center is one of the most important things happening in Eldoret, in my opinion, and I have great respect for the people who are involved there. One of the early doctors to come to Eldoret with IU/Kenya is Dr. Joe Mamlin. Joe is an incredibly smart and committed doctor and he and his wife Sarah Ellen have now lived there consistently for 13 years. They do an amazing amount of work revolving around the hospital, the students who go to the US and Canada, and the clinics. SarahEllen has been heaven-sent for me because she also is all about children’s health and welfare and knows everyone and everything. The hardest thing for me, coming in as a new person, and not being a medical person, was finding my niche. The Sally Test Pediatric Center made this somewhat easy because there are children there all the time who need attention, care, and love.

 I say it was easy, but it was most definitely NOT Easy to start volunteering there. AS I mentioned, since I’m not a medical person, I did not used to be all that comfortable in hospital settings. This hospital is particularly not pleasant, between the unsanitized sensual experiences, and the lack of privacy for patients, and just the incredible horrifying injuries and diseases that you see children suffering from there. Not to mention the fact that abandoned babies are left at Sally Test as well. I started going regularly in September, soon after arriving. There were days when I could hardly drag myself in. Once I got there, after winding my way through the very open spaces of the hospital wards, passing lots of unpleasantness along the way, I was ok. The babies and small children who were abandoned were suffering from all sorts of neglect, abuse, and physical maladies. In fact, I had never held a badly malnourished or disabled or sick baby before. Hard to believe, but it’s true and I know now how privileged I have been. One of the important things I learned quickly, is that with a bit of love and correct health care and nourishment, these kids can survive and thrive. I held  a lot of sick babies over  the last 20 months, and although I can’t say it was always enjoyable, it has always been  worthwhile. What more could a baby or small child need than just to be held, snuggled and smiled at by a loving adult? These babies to me are the most important people that I can touch because their needs are so basic.  Having this place and these kids has been a life saver and a real distinct and solid way to use my energies and talents to their benefit. I can’t say that I  always feel like going in, because sometimes the eyes of those kids just gets to me too much, but I know that the caretakers there are very dedicated and well trained and I am grateful for their work and I do go  in to see them and lend a hand when I can. Our efforts around the community have expanded beyond the building and Sally Test at this point and we are always trying to find a balance between helping and not burning out.

The Sally Test P├Ždiatric Centre (STPC) has four primary goals:
1.    To prepare hospitalized children and their caregivers for medical procedures by explaining WHY and HOW they will take place and provide a variety of positions for comfort and other coping techniques.
2.    To be a catalyst for a positive change in attitude toward children, women, and families as important participants in medical decision-making within the local and national medical communities.
3.    To provide a safe place for children to play, grow, and develop while they are hospitalized.
4.    To give the highest quality care for abandoned infants, toddlers and all children, providing stimulation and love that ensure each child reaches his or her developmental potential while awaiting placement.

The Facts
·         Child Life Health Workers provide intense counseling, medical play and procedural preparation for 60-100 children and families daily from among 200 children on the wards or visiting clinics.
·         The Centre creates a variety of activities for between 20-30 ambulatory children daily.
·         Annually between 25 and 50 abandoned children receive loving attention.
·         Five times a week the STPC Outreach Team reaches 25-50 children and 25 parents in each of 5 rural settings.
·         Parent classes are presented twice weekly to approximately 25 parents by visiting medical students, residents, faculty and MTRH staff.
Your Support Can Provide:
·         $25 - Disposable diapers for 1 week
·         $25 - Procedural distraction toys
·         $100 - Juice and biscuits for Outreach Clinic kids for one quarter
·         $100 - 20 stuffed dolls for medical play made by Imani Workshops

There is so much need in Kenya, that when you are there long term, you have to find your path for helping people without becoming the local ATM or drowning in sadness. Michael and I have chosen to help several children who have no one and adults who have no means, and to support organizations, like children’s homes, which are working towards becoming more sustainable. We are hoping to get our IRS not for profit status any minutes so we can continue this work through the upcoming year and thereafter. Whether it be sponsoring orphans to go to school, teaching kids and adults about global warming, helping farmers learn to better use their property with fewer chemicals and more production, or planting trees, building gardens, etc, for those who are either unable to do so or need a hand, or lending a hand at the local street children drop in center, we are happy to be able to  help and we have made some headway in several projects.

There have been several opportunities that we have promoted where folks here at UUCCI  have been supportive and we do appreciate all the support. We are constantly amazed by the generosity of this congregation and it just shows that where there is a will there is a way to make a difference.

Aside from all the need, living in East Africa is both intellectually and emotionally stimulating. Yes, there is a lot or poverty. There is also a lot being pushed forward that will one day result in that country making its way forward as a more developed country, and hopefully, all of its citizens will benefit. The struggles they face are not uncommon in the developing world, or even here, for a lot of people. In fact, greed and corruption, tribalism and old rivalries do  still exist, but there are lots of good folks working hard to break barriers and help the society in general move forward. It’s a complex place and we feel strongly that there is a lot to learn and understand about its history, geography, culture and development which we are just getting a small taste of by living there these three years.

I want to touch a little bit on the adventure side of our life there because it is not all just work and helping people and facing the realities of this nation which is struggling to move forward. Kenya is situated on the equator, it has a long coast on the Indian Ocean, and Eldoret, where we live is, in the Great Rift Valley. The Great Rift Valley is an enormous geographic phenomenon, which runs from the ME all the way through East Africa. It’s quite stunning to see and quite a lovely place to live.  Eldoret is 8500 feet in elevation, so it has a nice temperate climate, where all the flowers that you purchase at your local nursery in the summertime grow wild, and there is an abundance of all kinds of vegetables and fruit all year round. The Great Rift Valley is an incredible offering in terms of natural beauty. The valley is actually several “rifts’ connected together caused by heaving of tectonic plates and volcanic eruptions thousands of years ago. The North end of the Great Rift Valley, in Kenya, is bordered by Escarpments which are quite picturesque. We have taken some wild and interesting trips through the valley and over the valley as well. They are wild, mostly because you are never sure what to expect, except that you will be surprised. Generally, the roads are not good, and often hazardous, but nonetheless, if you put your seatbelt on and try to relax and enjoy, despite the flat tires and bumpy roads, it is usually fun and always interesting. Not only have we seen people living in the countryside in ways that one never sees here, we have also seen amazingly beautiful biological diversity, whacky birds and wild animals, and we have been warmly welcomed on our path by people from all the 42 tribes of Kenya, living their lives as pastoralists, farmers, teachers and children’s home directors, as well as doctors, engineers, nurses and “mamas” selling their wares in the market, or taking care of children who have no parents. We have been lucky to make acquaintances with a large number and variety of Kenyans, which has helped us learn more and better understand just how complex this country is.
We have also had several visitors, including our adult children and some of their friends, and I guarantee you, their visit to Kenya has been a highlight of their young lives and something they are never going to forget. After 20 months, although we know we will never be insiders, or natives, we do feel comfortable and at ease and like it is our home for the time being. Since most of the what the media has to say about Africa and there is plenty of bad news coming out of Kenya I think it’s important for folks here to understand how much beauty there truly is, both in the people of Kenya but in its natural environment as well. There really is so much more to it than I can possibly express. We have a large house there and welcome visitors, so if you are ever so inclined…..As we say in Kenya, KARIBUNI! (Welcome)

Reading I: WHAT has been said about AMPATH in the World of GLOBAL HEALTH.
Nominated multiple times for the Nobel Peace Prize; featured in The Wall Street Journal, National Public Radio, BBC and other international media.

"Of all the HIV/AIDS programs that have received funding from The President's Emergency Plan for AIDS Relief (PEPFAR) none has been more effective than AMPATH.  Its focus on training Kenyans to treat Kenyans is extraordinarily enlightened in its potential for genuine sustainability."
-Randall L. Tobias, Former United States Ambassador and Founding United States Global AIDS Coordinator

"It takes money to lessen poverty, food to lessen hunger, medicines to lessen deaths from AIDS, operating suites to address obstructed labor, and so on.  But it also takes passion and, above all, vision, and that is what the leaders of this program allow to flourish and encourage in others."
-Dr. Paul Farmer, Founding Director, Partners in Health

"This Indiana-Moi partnership is a model for how to tackle the huge challenges of HIV/AIDS and poverty in general, and one of the most inspiring examples of humanitarian partnership I have ever seen."
-James Morris, Former Executive Director, United Nations World Food Programme

"AMPATH goes far beyond providing 'just' healthcare - strengthening livelihoods and also working with the local community to take away some of the shame and stigma associated with HIV/AIDS."
-George McGovern, Former U.S. Senator from South Dakota

"The people working on this program are public health heroes.  They are doing things that many people thought could never be done, and it is going to have a huge multiplier effect."
-Dr. Tim Evans, Former Director of Health Equity for the Rockefeller Foundation

Closing Words
Some sources say that the words below were written on the wall in Mother Teresa's own room.  In any case, their association with Mother Teresa and the Missionaries of Charity has made them popular worldwide, expressing as they do, the spirit in which they lived their lives. 
They seem to be based on a composition originally by Kent Keith, but much of the second half has been re-written in a more spiritual way.  Both versions are shown below.
1. The version found written on the wall in Mother Teresa's home for children in Calcutta:
              People are often unreasonable, irrational, and self-centered.  Forgive them anyway.
            If you are kind, people may accuse you of selfish, ulterior motives.  Be kind anyway.
            If you are successful, you will win some unfaithful friends and some genuine enemies.  Succeed anyway.
           If you are honest and sincere people may deceive you.  Be honest and sincere anyway.
            What you spend years creating, others could destroy overnight.  Create anyway.
            If you find serenity and happiness, some may be jealous.  Be happy anyway.
            The good you do today, will often be forgotten.  Do good anyway.
         Give the best you have, and it will never be enough.  Give your best anyway.

         In the final analysis, it is between you and your God.  It was never between you and them anyway.

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