Thursday, December 17, 2009

Impunity and the Siamese twins

The headlines of the Daily Nation today read:
"How corrupt officials stole free primary school cash"

Several senior officers at the Ministry of Education were suspended for misappropriating 37 million shillings (370,000 euro). The money was donated by DFID (UK international Devleopment fund) for free primary education for 100, 00o children. The report states that payments were effected through 44 payment vouchers, involving 29 senior officials. The funds were embezzled through fraudulent accounting used supposedly in workshops and training. DFID has since withheld 1.2 billion for Free Primary Education untill audit queries are addressed, culprits charged and cash recovered.

Donors are pulling out due to the corruption. Thousands of innocent children will be affected and may not be able to go to school next year because of greedy officials who were employed to act in their best interests.


This is what it means in Kenya: embezzlement, corruption, lying, stealing, and openly to as if people are not accountable for breaking the law if they caught

Today, I received a referral from an OT about Siamese twins joined at the stomach, sharing a liver and other vital organs. Their parents have abandoned them, leaving them at Kenyatta National Hospital, to be cared for by the nursing team, who do their best to look after them.

Their abandonment has caused a few issues.

Firstly, the parents have not signed consent for surgery so the twins may face many years of being bedridden, rather than having an actual chance at living

Secondly, due to the lack of stimulation, the children haven't learned to speak yet.

They are 1 year 3 months and are spoken to in several different languages depending on which nurse attends to them: Kikuya, Kiswahili, and English by their Irish Speech & Language Therapist; Somali, their mother tongue by their parents who occasionally come to visit.

I met them today for the first time. They are learning to stand with the help of the dedicated Occupational Therapist. They reached for me today and one of them actually pulled a rib of my hair out from the root...painful!!

They have been abandoned because the parents live far away on the coast and don't know what to do with them. Disability is a major stigma here and brings shame on the family. I'm guessing this is part of the problem but I can't be sure as I haven't met the family. There is also the risk that one of them may die as they share vital organs. The parents may fear they will loose one or both of them.

Nevertheless, the father has given up hope and isn't involved in their care

Doctors have consulted a surgeon in China who has performed a similar surgery with success.

We are waiting to hear. Its in the hands of the therapists now to improve their quality of life

So I'm on the management team.My first case of Siamese twins with language delay
I am looking forward to seeing them again in Jan. Today, I just did a brief consultation with advice for the nursing team.

Apart from work, I'm heading to Zanzibar to begin my Christmas holidays. Not that you would know Christmas is coming. All the annoying stuff is omitted. No Christmas carols, or crazy shoppers or christmas parties. Just people awaiting time off work to be spent with their family upcountry.

No gifts or special food. Just another day off with no fuss

Thats the way I like it. This year, no fuss. Rather, sunshine, swimming, spice tours, going out to new places on a tropical island, snorkeling, not worrying about what I wear.

Flip flops and a syrong, vest top too. No makeup

Simple and easy and fun. Zero stress

Can't wait

Happy Christmas to all at home

I'll text on Christams day

Tuesday, December 8, 2009

The hospital, new apartment and Christmas plans

So I have finally moved out of the Mbagathi way apartment.. away from the constant noise of traffic and over to the peaceful grounds of Kingara Road, near Lavington. What a culture shock the move has been. I feel as though I have left Africa momentarily..

There is a pool downstairs which no one uses as the water is too cold; the house woman cleans the house twice per week and there is a TV, not that Kenyan TV is that spectacular but at least I can watch Brothers & Sisters and other gems like North & South (upper class woman from London in 19th century moved to Milton and falls for industrialist- new money so she has to compromise...all that English reserve, the slow burning romance is developing nicely..its wonderful.

Anyway besides watching DVDs, I have been very busy at the hospital. My colleague lost his father in law and as man of the house, he is expected to look after everybody else so he has taken indefinite leave, which means that instead of showing up late at 11 am for work, he doesn't come in at all. I have inherited his caseload. My door is always open. As one client walks out, another one walks in.

Sometimes, I need a translator as parents communicate only in Kiswahili. When this happens, I shout outside my door, "ANYONE HERE SPEAK ENGLISH? GREAT FOLLOW ME AND TRANSLATE FOR ME PLEASE."
and then some poor sod from the waiting room, who popped in for a hearing test, is conducting a speech and language assessment in English and Kiswahili! So much for confidentiality!

Speaking of confidentiality, there is none. People walk in and out of my room as if its their living room; to chat, wash their hands or tell me all the intimate details of the next client's medical history, in the middle of my session.

People are not big on privacy either. People stare in the window to see what I'm up to. I am slowly getting used to this but it takes a lot of patience and cultural sensitivity.

And then there is the constant searching for the file. When a client comes to see me, they pay a fee of 500 shillings to open a file. Sounds straightforward but not in K. Hospital. This process can take anything from 10 minutes to 30 minutes. Meanwhile, I'm sitting in front of the client wondering whyon earth they were referred to me as it may not be immediately obvious.

I have become a lecturer to 4 foreign audiology students..bright 20 somethings from Nigeria, Uganda, and Kenya. They seem so focused, motivated and eager to learn, unlike many students I know (I myself only focused in 4th year, dossing my way through 3 years of lectures and practicals)

So, I'm having a christmas party next weekend. Just a few mojitos and beers before heading out next Friday night. If its nice, it might even turn into a pool party (always wanted one of them).

Preparations for Christmas are beginning. Rather than shopping for a list of people, I have booked a cottage in Tiwi beach for New Years, bought a "forthy thieves" New Years Eve party ticket, a bus ticket to Dar Es Salaam and a room in Kendwa Rocks, Zanzibar...nice change from Sullivans in Gort

10 other volunteers are also coming so it should be a nice crowd. Looking forward to 3 weeks of beach time! Well thats all the news from Nairobi.

Goodbye and Goodluck

Tuesday, November 24, 2009

My brother's wedding

Ollie and Leanne got married on Sat 14th November in Cashel church, Connemara. I was glad I could make it. It only took 14 hours to get there-Nairobi to London flight, London to Dublin flight, Dublin to Galway bus and car trip deep into the wilds of Connemara.

So back in Ireland again after 3 months in the Dark Continent. Funny enough, it was Ireland that was dark. Grey growling clouds threatening rain, or sleet and then torrential rain the rest of the time. Very few people seem to carry umbrellas and of course it's unsightly to wear a bag over your head as is the fashion in Nairobi when it rains. And the pain in people's faces when it rains, their mental health taking a nosedive untill the bleakness passes, if it does. It is grim when it rains in Ireland.

Luckily, there was no rain on the day of the wedding. My mother had put a "child of Prague statue" under the hedge and prayed for weeks for sunshine. I don't believe in piseogs but it seemed to work.

People arrived from the US- my first cousins Patrick, Yvonne and aunty Rena; Ollie's friend Eamonn from the Jersey shore, many fun people from Kilimordaly, a general sprinkling of people from all over. Elaine arrived from Florence, where she is working very hard drinking red wine, eating pasta and researching law.

The church ceremony was surprisingly the funniest part of the entire event. The priest must have watched and rehearsed Father Ted because he was in fact Fr. Ted. He spoke about the holy sanctity of marraige by referring to how women and men fall in love, from experience of course, and how to have a fight before you go to bed to clear your head or wait the next day and through dishes at your partner's head if you feel like it. He spoke about how single couples walk hand in hand and then proceed to one walking in front of the other. In general, tips on how to survive a marraige.

The prayers of the faithful were executed with grace and precision, having been rehearsed twice live. I blame myself. My cousin asked me if it was time for the prayers just before the first reading which I was in charge of. I, so focused on the first reading from Tobiet, responded yes and then all five of them trapsed after me up to the altar for company. They got a clap on the way down though and were ready for the next time they were actually called to say the prayers of the faithful. Dave forgot his and read out cousin Elaine's part. She was hiding in back of the church. She said later that he made a much better job of it than she would have.

I was like the paparazzi for the day. Armed with my Rebel XT super power Cannon camera, I made sure to capture people usually with their mouths open or crossing their hands yelling "no more" or dancing at the disco. Eamonn S has some crazy moves on the dance floor. A mixture of finger pointing, floor sliding, standing on chair routine and hip girating, all with a broken collar bone. He had broken it while attempting a somersault in Sullivans (classic disco in Gort) the week before. As one man said, its dangerous at 25 but even worse at 35.

My Dad gave a moving speech, welcoming Galway hurlers to the event and of course Leanne, saying "he wouldn't have chosen better himself".

Ollie spoke about how lucky he was to have Leanne and how much our parents have done for them. My mother Agnes, who saved lives during the day and looked after five brats and Paddy as well. She deserved that bunch of flowers and much more. Ollie spoke about how Dad had written the book on how to live well and supported him through years of hurling training, blaming the referee or Joe Rabbitt if he had not played well. It was emotional and I was proud of them

By the end of the meal, jet lag kicked in, but first the Old Timers band and much later the disco. If you would like to view pictures of the disco shenanigans, view my facebook page.

Now I'm back in Nairobi. Back to the sunshine, blue skies, few shillings and the noise. Unlike the peace of Connemara, this place keeps you alert and awake even when you are supposed to be sleeping. I'm getting up at seven to the sound of horn beeping, and the constant buzz of cars and matatus.

It was worth the trip. I met great people, caught up with old friends and even managed to fit in the Ireland vs France game on Wednesday where Ireland were cheated out of the World Cup. Great company that night despite the loss. I had to leave McSorley's pub in Ranelagh just before Thiery Henry struck the ball twice with his hand. I can't believe I am writing about football in my blog. Africa is really changing me!

Monday, October 12, 2009

Your health is your wealth

I have survived my first month in Nairobi and it hasn't been easy! I got over my initial shock in the first few weeks after being robbed on a matatu. I was set up. The matatu tout dropped my fare on my lap, I scrambled to pick it up. Meanwhile the well dressed man next to me with briefcase and newspaper , was busy taking my wallet out of my bag. I knew instantly I had been robbed, and began shouting at everyone on the matatu, but no matter..another wuzungu robbed.
I am over that now, but very suspicious of all men on matatus carrying envelopes, briefcases and newspapers..

My work days are very busy. I am working in 3 departments in Kenyatta National hospital: ENT, Psychiatry and OT. Full waiting rooms await my arrival at 9pm. Some have travelled far, and all arrive at the same time and wait all morning if they have to, to be seen. Appointments with different times don't seem to work . People come in the morning, wait all morning and no one ever complains or grumbles. Some have to pay some money that they don't have, others pay 500 shillings (5 euro) which is a lot when you have a family to feed. So I decided to go to them, to Kibera slum, one of the largest slums in Africa

I was contacted by an Association to give a talk on speech and language therapy to a group of mothers with disabled children in Kibera. I met the pastor who introduced me to the group who met in a church under construction (no roof). He introduced the session with a prayer (help) and my colleague translated from Kiswahili into English. I emphasised the need for early intervention (o-5 years) and the group of parents appeared receptive. Then time for questions

My 15 year old is very violent. We keep him at home and have locked him in a cage as he is very dangerous. What can we do? It is not safe to let him out

My 5 year old was bitten by a dog yesterday. I brought her to Kenyatta hospital and have been seen home with these prescriptions. They cost 500 shillings per day but I can't afford it. She is starting to itch (rabies alert)

My 16 year old has Cerebral Palsy. She doesn't speak. She's not in school as I cant afford the school fees.

My 5 year old hasn't spoken since he got meningitis last week. They sent him home but he isn't talking now and he is very limp

Sorry if i have depressed anyone. Makes the recession at home a little easier to bear when you put it in perspective. And no one complained that day or will ever complain..maybe that's the problem, no one complains to this useless Kenyan Government

Too busy worrying about their own interests.

Kofi Annan has just left the country- flying 4 day visit to put pressure on Government for reforms. He is trying to speed up reforms including the trial of those who bear the responsibility for the violence that claimed more than 1, 000 lives early last year following disputed presidential elections

Kofi Annan said it would be dangerous to enter the next electoral cycle without reforms

"Kenyan leaders must listen to the voices of the people"

so there..just a flavour of life in Kenya

Sunday, September 13, 2009

first week

I have just settled into my apartment off the Bogathi Road near the city centre of Nairobi. I seem to have landed on my feet. My flatmate, Trixie has been in Kenya for a while and is showing me around. We get on well, with lots of things in common. Started the day with western brunch, great coffee in a mall...I know, how American. but these malls are everywhere and its the only place to get a good cup of coffee, loads of white people around, seems like home. Off then to an african dance class very unlike home. I moved parts of my body I haven't moved in years, rolling sholder movements, but dancing, arm swinging, leg tapping and all at the same time, its exhausting. Then I had to catch 3 matatos home, while carrying 3 bags...I miss my car.
Friday night was fun. Went to a Dutch girl's party, lots of African dancing and drinking Tuskers..very light and fizzy beer that everyone is proud of.
I like the buzz of Nairobi but there is a great divide between Nairobi and the rest of the country which I will discover more about in the upcoming weeks as I travel Western Kenya
starting work tomorrow as the only speech and language therapist in the country, how daunting!!

Sunday, August 23, 2009

10 days to go

I' m sitting here on the couach in Inchicore after a long week of leaving parties, birthday parties and catch ups. I'm exhausted just thinking about it. I've said farewell to friends I won't see for one year. I'm finishing work on Wednesday after 5 years...I'm at a crossroads again, anxously awaiting my departure on the 3rd Sep but sad to be leaving everyone behind for such a long time
I don't know what awaits me in Nairobi but I do know that everything will be different. I wanted a change so I'm sure I'll get one