October 31-November 1, 2010

This has been a very interesting two days.  Yesterday morning I went to Mass.  What a moving experience.  The children choreographed much of the service; there was dancing and singing and the children did much of the reading.  There were drums accompanying the singing and dancing.  Just prior to the service I was standing outside, and a small boy came up and hugged me.  I noticed he had a Cochlear implant.  I told him I knew what it was and hoped it helped him.  He asked me how I knew and I told him I also had a device, though totally external.  I showed him my BAHA.  He was amazed.  I snapped it off and he looked at my head and looked at the processor.  He walked away and came back a few minutes later with another boy and told me he wanted me to show his friend also.  Many of these kids with HIV develop hearing problems because they get ear infections that go undetected.  They are so used to pain that they do not complain and by the time someone discovers it, damage has been done.  Many of them suffer permanent hearing loss.  Sister Julie knew all about BAHAs, but told me they are far from having the technology here.  The boys and girls that have had Cochlear implants were sponsored to go to the US and the Cochlear company donated the devices and the doctors donated their services. 

Lunch was rice and meat chunks again.  Not too imaginative!  I then met with the nurse, Phrelym who showed mne the medication system.  Not too high tech, but very practical.  They have plastic containers with dividers that go to each house containing morning and evening doses of medications for the younger children. The moms give the meds. The middle level children have the same system, but they take their own meds, supervised by the moms.  The oldest children just get the bottles of pills delivered to the house they are in and they are totally responsible for knowing what meds to take and when.  The nurse does surprise spot checks when he counts the pills left in the bottle.  That way he knows if the kids are being compliant.  Phrelym also took me over to see the respite house.  This is where children from the outside Nyumbani Village come when they are sick or when family members just can't take care of them for a week or two.  The village is an orphanage also, but not for kids infected with HIV.  In East Africa, the word orphan is used looesly.  It does not necessarily mean the kids have no parents.  It may mean that they have been rejected by their parents or that their parents just cannot take care of them.  The mom in the respite center was wonderful.  Most of the kids are malnourished and/or dehydrated.  They all looked far younger than their actual age.  Since they are sick, this is the only place I have not seen smiling faces. 

Sunday is a free day for the kids and I wandered around talking to them and taking photos and movies.  They were playing basketball, riding scooters and bikes, many still wearing their Halloween masks. 

There were some unannounced visitors today.  Some Medical Students/Interns showed up unannounced this afternoon.  In addition, some administrators from the Deaf School down the road.  I had visited that school two years ago with the GSE team.  I was talking to one man named Fred.  The conversation led to my BAHA.  He asked if I would come over and speak to their students the next day.  Protus was standing there and thought it would be a good idea for me to do that. 

Sister Julie took me into Karen, which is the town we are adjacent to, and only about a mile and a quarter away.  We went to Nakumat which is their big store with everything...similar to WalMart, food and all.  Many of the locals think it is too expensive, but by our standards, it is quite inexpensive.  I bought water and some yogurt and things to have in my room.

Dinner was rice and green grams (similar to lentils).  Certainly healthy! 

This morning, I met Phrelym after the staff morning meeting.  I helped him set up the medication containers and deliver to the houses.  We then stayed in the nursing office to see if anyone came or needed anything.  Only the preschoolers were on campus.  The older children either went off to primary school or to boarding school (high school kids).  The only people that came into the nursing office were staff members needing one thing or another.  Most medication here does not require a prescription.  It is similar to the system in Mexico.  After a while I went over to the preschool and helped the kids with some of their school work.  I then played with them at recess.  The preschool kids are 2-6.  The babies, younger than 2 are in a situation more like a daycare with a staff member.  We had ugali for lunch....an East African staple.

This afternoon I was picked up by Fred to go over to the school for the deaf. Here is an update.  I went to the school for the deaf this afternoon.  It is an adult vocational training school.  They teach woodworking, sewing, cooking, auto mechanics and hairstyling.  They gathered all their students in a big multi-purpose room and asked me to talk to them for a few minutes about my BAHA and also how proud I am to wear it and that I am not ashamed.  Many of them do not want to wear hearing aids because they thing it is a stigma.  Those that have hearing aids have all behind the ear devices.  The audiologist interpreted for me in sign language.  It kind of freaked them out that you had to have your skull drilled, but I told them it sounded worse than it was, and that there was no real pain.  They asked many questions.  Thehy wanted to know if they could die from having someone drill a hole in their head.  I explained that it did not go through to the brain.  They wanted to know if they could play sports with it.  They wanted to know if they were born with bilateral profound deafness if a BAHA would work.  I told them it would not.  I had so many people touching my head and touching my processor, I could not wait to get back and wash my hair and clean my processor!  I gave the administrator the website for Cochlear.  They of course wanted to know the cost of the procedure and the processor.  I did tell them that some facilities and doctors will give a discount for cash paying patients and that maybe Cochlear could point them in the right direction and help them out in some way.  They have no neurotolgists here and very few ENTs.  I was so glad to do this, but also sad, because it is doubtful that any of them will ever be able to get this technology.  In a way, it was unfair, but it also gives them hope that maybe someday in the future, there will be new technology for them.  Very interesting experience.

Tomorrow I am going to Mukuru in the slums with Janice, Matt and Kourtney.  One of the Rotarians is going with us and we have a driver arranged by Sudesh.  This is where one of my water projects is at the school, so I will be glad to see its completion.
More tomorrow