Shortages are B.S.

Kiddos hangin' out.

It’s strange to feel proud of a medical program while your students are very obviously struggling with worms. It’s strange for worms to be the problem all of a sudden.

Back in 2008, when we had no budget for a medical program, de-worming was the only thing we could do. It’s free in Kenya. Our very first American volunteers created a nice partnership with the nearby Kangemi Health Centre who agreed to come to Hamomi ever three months to administer de-worming medication and Vitamin A. It was one of many creative ways to handle life’s difficulties for Hamomi’s students that year. But now there’s a shortage of de-worming medication.

The Kenyan government likes to throw around words like ‘shortage’ and ‘rationing’. Sometimes there is water or electricity rationing on certain hours of certain days which rotates around neighborhoods in Nairobi – and which conveniently doesn’t affect the more well-to-do neighborhoods. Sometimes there is a sugar shortage or a milk shortage all of a sudden and you are politely limited by management to purchasing only 1 KG of sugar or 3 packets of milk. Of all the things to be short on, sugar is the strangest to me. It’s like Washington with an apple shortage or Nebraska with a wheat shortage. Maybe it’s more legitimate than that – maybe it’s a bottleneck situation like a nurse shortage in the US while nursing becomes the most competitive school to get into. But it doesn’t feel like that. It feels like a cruel joke that jacks up prices, makes people desperate, aids the black market, pumps more money into the ports, and so on and so forth.

Nutrition is also play an important part
in health and preventive care.

So it’s difficult to feel like an actual shortage of de-worming medication and Vitamin A is connected in any way to how expediently or generously the Kenyan government is administering medication to its needy. My head jumps to an over-simplified image of a massive pile of medication in a store room, atop which a politician takes a nap after a greasy meal of nyama choma, as the medicine appreciates in value and we watch our students’ adorable little bald heads break out in spots.

And then it’s quite strange to feel proud of our medical program simultaneously. Obviously worms are a problem we need to find a new, creative way to tackle, but for the first time it feels like worms are the most dangerous thing we’re not handling.

This year’s audit has helped us implement the Medical Program in a more organized way. Last audit it was simply about launching it and figuring out what we were up against. Now it’s about that next step of knowing what needs to be done and creating a timetable around that. With the innovative ideas of Daniel Isindu, our unbelievably energetic and enthusiastic medical program director (and super hero math teacher), we have developed an annual calendar that’s bound to make this next year even more affective.

A girls' hygiene workshop in August, 2011

Yesterday, we began our quarterly medical workshops which will have many pieces. First, a nearby community organization Lea Toto who focuses on children with HIV/AIDS will come for an educational workshop, which will also offer voluntary, private counseling and testing at the end. They will come twice. First was yesterday, Saturday, May 5 to speak to all the parents and guardians and then the second will be next Saturday, May 12 to speak to the students.

Yesterday, 28 parents, guardians and neighbors attended. They were with the Lea Toto representatives and Daniel ran a clean water workshop for the students. Next Saturday, Daniel will run a similar workshop for the parents and guardians while Lea Toto is with the students.

A girls' health workshop in 2010

The next quarter’s workshop will fall in August, what we have named Hamomi Health Month. It will include workshops with Lea Toto, a hygiene outreach campaign, check-ups from the Kenya Sustainable Health Association (KESHA) for all our students and staff, check-ups offered to community members and neighbors who would like to attend (but must pay KESHA because we can’t afford all their screenings), an additional visit from another organization yet to be decided (potentially focused on eye care, oral hygiene or disease prevention), and an overall assessment of our most at risk students whose situations require extra attention and care. Daniel has his work cut out for him in preparing for our first August with Hamomi Health Month, but he is already compiling a team to join his planning committee and get prepared.

I should tell you, I’ve been working on this post for over a week, but not happy about posting it with such dismal news about the de-worming. Well, fear not, because we’ve also had some phenomenal help from American volunteer Nikki Johnson, who called me in the process of writing this to let me know a couple wonderful things. First – Kangemi Health Centre got a shipment of de-worming medication and Vitamin A and will be administering it on Monday! Second, we have needed to expand our budget to buy more toilet paper, but this cost adds up really quick. Nikki has formed a partnership with a TP company who will give us a discount of 7 shillings per roll and might throw in free delivery! We were looking at the additional cost running over $1,100 and will now be less than $750. May seem like small potatoes, but it makes this change in budget much more palatable for us. (It’s also always exciting to form partnerships within Nairobi. Hopefully these partnerships will grow and grow until we are a Nairobi organization run by fellow Nairobians.)

A washing station built and introduced to Hamomi in 2011.

This is similar to my last post in that it’s not that our services have changed much, (actually if you take the de-worming shortage into account, you could argue they’ve lessened), but we’ve moved into a level of organization that will allow us to track everything and ensure that everybody is receiving adequate care. For example, we have a huge book of Hamomi Medical Files now that allows us to look up any of our students’ information if we need to analyze how he or she is doing. It includes all their screening information (height, weight, general info), report cards and attendance, Hamomi admission form, background assessments and a monthly assessment of how ‘at risk’ their situations are based on all of the above. This is all information Raphael and Musumba have been able to rattle off about any one of our students at any time if asked informally, but it’s now been made more accessible and analyzable. Within the next year, we will be in a position to mathematically assess our progress, our needs and our shortcomings.

So, I feel good about it. Man, a  lot of these sentences have included “I feel…” opinions, but that is what we’re dealing with right now, and I feel like what we’re implementing now will lead to more posts full of facts, numbers, stats and concrete measures of progress. I feel that way at least. But you don’t need any more of that. Now it’s on us to prove it.