Reflecting on children and TB

Two weeks ago, at 14 years of age, David shyly greeted me in his Kenyan community of Nyumbani, a special home that cares for orphaned children infected and affected by HIV.  It was obvious that he was in good health and was happy to have visitors as his eyes filled with loving connection with his older brother William.   William and I traveled to Nyumbani outside of Nairobi to spend the afternoon with David who had survived  tuberculosis after losing his parents to HIV.

David had endured months of TB treatment that left him feeling sick and wondering if the medicine he was taking actually was helping him to get better.  But with constant care and encouragement from his foster family and medical community, David recovered.  To see David and his brother together, arms draped over one another's shoulders, smiling and sharing looks that only brothers can give, moved me greatly as I know David is one of the lucky ones.  I have met the mothers whose children did not survive from this preventable and curable disease.  TB is one of the top ten killers of children worldwide.  We must continue to illustrate how important comprehensive TB care is for our children around the world, and follow up with action by encouraging our communities and leaders to prioritize TB prevention and treatment.  David is a testament to the loving commitment provided by his local community.  Scaling up similar efforts is critical to our children.

The Essence of TB Photovoice

I wish you all could have been in the room today as our amazing TB Photovoice Kenyan group wrote stories about the photos they took yesterday out in the community, and shared them with the group.  Each of the 3 photos they choose to share was filled with a deeper meaning that they expressed with great passion and intention.  Through today's sharing, I watched the understanding of the power of photovoice come into view.  A seemingly ordinary picture turns into a metaphor for an aspect of their life's experience.  What was a bit abstract the first day has become clear and has made the group excited about their work and the future of the project.  As we discussed the photos, they each expressed their story in such a thoughtful and meaningful way that my role as a facilitator was quite easy as it didn't take but little prompts for them to discuss the many aspects of the photo.  So glad we recorded their voices!  Although at times there was rather loud background noise as what sounded like a freight train thumped away above us!  Again, I am so happy that I arrived last week as I have learned so much about the realities and culture of Nairobi and Nakuru, as well as my ears had a chance to get use to the Kenyan accent!  My visa is for 3 months......hmmmm...wonder if they family wants to come and join me!!!

First day of training goes sawa sawa, very fine!

Habari! 

 

I conducted our first day of TB Photovoice training yesterday and today the trainees are out in the community taking photos of things that represent their community.  Tomorrow we will discuss the photos and listen to the intent of the trainee for several of the photos they took.  They then will identify themes amoung the them, then move to narrowing our focus on issues that have come to the surface regarding the interaction of the wider community and TB.  The trainees are looking to implement photovoice with a group of 15 women in Nakuru as early as next week.  I am so impressed with the insight and compassion of the trainees.  They understand the importance of truly listening to the women in the Nakuru group and are excited to hear their perspectives.  Tomorrow's session is going to bring photovoice alive as the trainees share their photos and begin to see how this process begins to take form.

 

For training purposes, we brought single use cameras from the States.  There is no problem developing the film, but this type of camera is not an option to use with the Nakuru group as this type of camera is history in Kenya!  The TB ACTION Group will brainstorm how best to provide digital cameras to the Nakuru group, since they are costly.  Options they are considering are sharing cameras, decreasing the number of participants, and I am sure other ideas will come forward in the next day or so.  Since they are not worried about this, neither am I!  I am confident it will fall into place.  Hakuna matata!

 

Since in TB Photovoice, we look to see the broader picture of TB in terms of how a persons relates to their family and community, I have found the issue of schools particularly of interest while I have been here.  The public schools here in Kenya were supposed to start yesterday.  Yet over the weekend, the teachers' union members were out on the streets protesting the fact that the schools are overcrowded.  Thus, the teachers are now on strike and are standing firm.  An inadequate number of teachers have been hired to accomodate the number of students attending school.  There seems to be overwhelming support for the teachers since it is obvious to Kenyans that effective learning can not take place for children when there are more than 100 students in class.  The teachers are demanding that 28,000 teachers need to be hired to adequately provide instruction for their students.  The biggest grievence  is the apparent last minute diversion of money  which was supposed to have been set aside for hiring teachers.  Instead it went to the military. Speaking to people in the community, they are in support of the teachers. For now, children are being kept home, with the impact already being felt in the business  and transportation community as families have decided to wait until the strike is over to purchase necessities for the school year and to transport their children to boarding schools. 

 

Training begins Tuesday but relationship building is in progress

Already it is Monday and the TBPV training begins tomorrow morning.  Since I arrived I have developed a better sense of the staff involved in the project and I am pleased with their commitment to prioritizing this process.  I am looking foward to hearing how they will apply photovoice is a practical way for their community.  For example, the single use cameras will be used for the training and there is a photoshop that can develop the film in 1 hour.  But these cameras are not common place here and so this type of camera will not be an option for the Nakuru group.  We will have a full conversation about how to best fit their needs and contain their costs.

This morning, the faciliator, Alice Opiyo, of the exisiting Nakuru womens group arrived here in Nairobi for the start of the training tomorrow.  It is obvious that she has a mannerisms which will foster a positive relationship with the women selected for this project. I am glad I am having the opportunity to spend time with the 4 staff members of the TB ACTION group prior to the training.  It is giving me a better sense of who then are, how best to conduct the training, as well as anticipate possible concerns for the practical aspects of the project.

I have limited internet access in the next couple of days as I will be in the training.

Asante sana!

Jambo from Nairobi

Ah!  To be in Africa again makes my soul sing!  I had an uneventful flight, which is always good and all of my bags arrived in one piece!  At the airport, I met my partners from the TB ACTION Group Kenya, Betty and Lynn.  They have truly taken care of me and arranged a wonderful furnished apartment for the night. Although, all I really needed was a bed after the 20 hour flight!  I awoke to familiar doves making their calls and to the sound of cars and people going off to work.  I have not been in Nairobi for 18 years and I am amazing at the concentration of people!

Yesterday, I took public transportation in a "matatu" to visit different locations around the city.  Now, Will knows that I am on edge whenever he drives but for some reason, being in the front seat of a matautu when we are nearly running someone over or hitting another vehicle every few seconds, I  found myself incredibly calm and actually quite meditative!  I guess I was just going with the rhythm of the city like everyone else! 

One of the places I visited was the Nyumbani Orphanage for children.  Nyumbani means "home" and what they have done is created a truly nurturing home for these children who otherwise would never know that that word meant.  You can see that the children are being well cared for and that many generous donors have invested in the infrastructure of the home.  The children literally scooted around me on their scooters as we walked down the side walk.  The older children will be starting school in one week and their school fees have been paid and they are ready to learn after a few months break.  Nyumbani is like a little village with kind and respectful aunties, uncles, mama and papas guiding these children.  The need is so great and not all children are fortunate enough to be placed in this home but it certainly is encouraging to see a highly efficient and loving place for these children.

The ride back from the orphanage should have taken about 20 minutes.  Instead, at rush hour it took me nearly 3 hours!  The downtown city center was filled with workers trying to catch matatus to leave the city for the night.

I am now staying with the executive director of TB ACTION Group, Lucy Chesire and I couldn't ask for a more gracious hostess.We will start our training next Tuesday and today will go over all of the logistics to make the training a success.  They are very motivated and are pleased with the materials we have compiled for next week.   

Compared to my memories of Cameroon, Nairobi is clean and there is new construction and cranes visible everywhere.  Even the pace on the street is much faster than I remember.  No slow African walking!  Everyone is hustling to go from place to place.  I saw an enormous bird yesterday in a downtown tree that was bigger than an eagle and a blue heron.  It looked like a prehistoric vulture!  Still don't know what it is!  Also, I am hearing medical emergency sirens which I never heard when I was here before. I have eated ugali for the past two meals with many different sauces and it has been delicious!  I also had like a doughnut this morning called mandazi!

Photovoice is about being in community and hearing from the community, but as a trainer I am fortunate to be able to learn about their community through friendships, food, transportation and conversations! Romel and others have reminded me not to eat anything from alleyways like I did in South Africa, but I must say, although the aftermath of eating something that my body totally rejected, the experience I had meeting the art traders and getting to see their backrooms where they assemble bracelets and accessories, and discussing TB to a group of 25 people (hearing their myths of the disease and hopefully imparting some new knowledge, was an experience I will always treasure.  The aftermath will always be remembered with humility!

Ansante sawa!

5 days and counting!

5 days until I board a flight to Nairobi, Kenya!  Ah, to be back on Africa soil!  With all of the last minute organizing (collating training materials, communicating with Lucy Chesire the Executive Director of TB ACTION Group-Kenya, childcare for Tessa and Casey, back to school supplies) I have had few moments to take in the fact that I am returning to a place that nurtures my soul and continues to call to me every week through dreams, images, and  thoughts.  I have a deep sense of gratitude to our TB Photovoice Board of Directors for their support, as well as to the TB ACTION Group-Kenya for their persistence and collaborative spirit.  And this trip truly would not be possible without the love and support of the man I met in Africa 19 years ago in Cameroon.  Will, thank you for taking care of Tessa and Casey while I am gone.  I will dream of you all every night.