Posted by: jeff | June 29, 2011

Tumemeliza lakini tunaanza

Well, it is over.  Only problem is, it is just beginning.

Today was a complete scramble to finish up business, get USD back in our hands, kill it for a bit dani ghetto kubwa, and make it to Nairobi.

This morning we split to town for a meeting with the Majengo Sub Chief and the Thunguma Sub Chief to finalize the fifth kiosk location and get some more Facility Usage agreements signed.  The Majengo Sub Chief was ready to see us right at 9, and introduced us to a man named Meja who worked for a church on the edge of Majengo and Nyeri Town.  He told me he had a location set, I just needed to pay it a visit and give things a GO.

After the meetings at the Office of Public Health (the Mukaro Location Chief and Sub Chiefs are in the same building), we headed up to Mt. Kenya Hospital to pay the DMOH a visit and return one of his books.  He was not in at the time, but some other members of the District Health Management Team were in, giving me the opportunity to thank them for all of their help and continued support moving forward.

On our way back into town, we ran into Edward to begin settling financial matters.  We hit the bank to withdraw some dough, then journeyed back to the Center.  Today we actually ended up spending a good amount of time with Edward, and it was great to catch up with him.

Back in Thunguma, Steve and I strolled up to the Kiosk running at the Police Post.  I must say, it was a damn good feeling walking up to a Mashavu Kiosk running without me doing anything for it.  The Ladies had been taking patients all morning, had a few chochos outside, along with some big smiles on their face.  Today seemed like the first day that they were really getting the hang of using the system and really rocking with it.

The Ladies have split up the duties of the Kiosks – 3 locations are permanently assigned to 1 person each, and the other 2 locations will be rotated.  Lillian is assigned to the Monday Thunguma Kiosk, but she is not quite up to speed with typing and website usage.  Luckily, the Champion of the CHW Kiosk Operating Team, Margaret, is more than willing to help out and put in the time to bring Lillian to a place where she can run the kiosk on her own.

After some time at the Center cleaning up our place and packing all our stuff, Steve and I split up to accomplish our afternoon tasks.  A new outlet was required in the community room at the Police Post, so Steve picked that up as he stopped by Eunice’s fruit kiosk in Gatitu to have her sign the employment contract as well as drop the Facility Usage Agreement off at the Gatitu Dispensary.  I on the other hand ran to town to convert the fat stack of Kenyan Schillings we had recently acquired into USD and meet with Meja to finalize the Nyeri Town Kiosk.

On a side note: the USD is a long and skinny bill.

It took me quite a bit to settle affairs at the bank, but all was okay as I waited to hear from Meja.  I had talked to him once around the time we were supposed to rendezvous, but he was still in a meeting.  After we waited a bit longer without being able to contact him, Edward and I headed back to the Center.

Don’t worry, on the way I grabbed one last round of Buffalo to bring back to the Center for Steve and I to feast on.

Once we had our room pretty much under wraps, Steve and I headed up to the Kiosk to say our goodbyes to our Ladies.  Today they were able to take 6 patients, and they definitely know they can keep raising that number.  It is great to see the Kenyan Schillings on the table and our Ladies making money from this service.

When it hit them that we were actually leaving, the Kiosk slowed to a halt as the tears came out.  These Ladies have been unbelievable to work with; extremely cooperative, ready to learn, and most of all, ready to do everything they can to not let us down.  It is hard to believe that 2 months ago we were first meeting these women, and now we have officially employed them to run Kiosks all over Nyeri.

The goodbye moments are always odd ones, and Margaret and Lillian were quite ripped up about it.  There was some solid hugging, and they were assured that we would be in contact quite a lot.  This is more than true, because we will now be receiving emails from them twice every day for the next year – in the morning when they open the kiosk and in the evening when they close the kiosk with the report from the day.

I was not able to meet with Meja, but Martin – the Nurse – is stepping up into the role and is in pursuit.  Things are looking promising – hopefully he will lock it down this week.

Im not really sure what to say.   It has been unbelievable to design something and then have the opportunity to implement it – I guess you can truly say we are humanitarian engineers. Before we came, we used to joke around that we were coming here to start a business.  Wildly enough, I believe we are social entrepreneurs.  On that note, if you ask any of our warafiki wakenya, they may call us pretty good Fellows.

GO on the one-year pilot has been pressed.

A rotating 5 location Mashavu Kiosk in Nyeri, a UNIDO partnered Mashavu Kiosk in Olosho-oibor.

6 Community Health Workers and 1 degreed Nurse employed, working to provide greater access to pre-primary health care for all Kenyans.

Thanks for sticking around for the ride folks – we hope you enjoyed following along with this unbelievable adventure.  Even though our time for now is finished here, Mashavu is just getting started.

We would like to thank Khanjan Mehta for providing this opportunity, as well as the Humanitarian Engineering and Social Entrepreneurship Program at the Pennsylvania State University for breeding this type of learning.

I would also like to thank my parents for having the utmost patience during my time as a Padawan Learner training to become a Jedi Knight.

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Posted by: steve | June 29, 2011

RTTZ Blogs Completed

Hey everybody, we went back and added some fresh blogs regarding our trip to Tanzania – just click the RTTZ link to the right, under ‘Coming to you from…’.  We dated them near when they would’ve been posted if they had been written live.

Posted by: steve | June 27, 2011

Karibu Kutoka

Yesterday I made my exit from Olosho-Oibor, and executed a massive shopping trip in Nairobi on my way to Nyeri.  Several supplies needed to be purchased, both for ourselves and for the CHWs.

Before hitting the Ngong-to-Nairobi bus, I stopped at the chai and chapati-selling MPESA kiosk at the bus stage.  Between my looking like Jesus, knowing Kiswahili, and the characters that the bus stagehand profession attracts, we had quite the amusing morning convo.

After hitting Nairobi, I knew I had many things to buy, but I had not yet been given a list or the pesa to do it… so I dropped off my stuff at Terminal (special thanks to those guys for keeping all of the goodies of the day safe and secure), then I did some scouting for white coats and ID badge makers.  Found some good leads, but nothing solid.  CopyCat seemed like the place to go for ID badges, but they said their store in Westlands (outskirts of Nairobi) could make much more professional IDs.

Looked like I had some more time to kill.   Naturally, I gravitated towards Mombasa Dishes.

After this staple Nairobi meal, I gave the owner a formal goodbye, as we may not have a chance to hit it up on our way out of the country.  I then shopped for myself a wee bit at the Nairobi City Market; went to search for the maasai market, the home of the knitted hats we desired.  I spent probably an hour making some nice-sized circles around Nairobi before finally being directed by several people to the correct location.  Once there, I headed specifically to the “rasta” corner to find us some fresh knitted hats.  I spent a significant amount of time deciding upon color and size, chatting with the rastas, and moving from store to store.  After much thought, I finally made my decisions.

I received the M-PESA as I was negotiating the hats, and didn’t have enough without it, so I convinced one of the rasta salesmen to follow me to an M-PESA kiosk to pay him for the goods.

With the personal business in order, and money in my pocket, it was time to hit the Mashavu shopping list.

Shopping List:

1 Backpack, 5 L surgical spirit, 1 container for surgical spirit, 1 cotton roll, 2 thermometers in Celsius, 1 weighing scale in kgs, 3 ID badges, 3 white coats, 1 notebook, 1 power adapter.

After a bit of store hopping, I found cheap white dustcoats on clearance.  Checked that one off pretty quickly.  I hit Nakumatt to quickly knock out the weighing scale, notebook, power adapter, cotton roll, and container.  Just needed a trip to the chemist for the surgical spirit/thermometers, and then had to figure out a way to get some ID badges.

Around this time, Paul from UNIDO called and wanted to meet up to chat before I headed out of the country.  We had a good walk around the block as I struck out on 5 L surgical spirit bottles at several chemists.  At this point, it was about 1 o clock, so I figured I’d have time to investigate the Westlands CopyCat, as they made exactly the badges that I needed.

Paul walked me over to the matatu stage, and before I knew it, I was in Westlands.  Paul didn’t know exactly where the CopyCat was, forcing me to ask people.

Another bout of getting lost ensued.  After walking around most of the Westlands, being given conflicting directions as to the location of CopyCat, I finally ended up in the Westlands mall.  This is mall is 4 stories, contains a food court, a movie theatre, a grocery store, and looks completely like a western mall.  It was quite an odd culture shock, but it was probably good preparation for what is to come in the next week.

Again, walked up and down the mall, after about 30 minutes found the CopyCat that I had been seeking.  Unfortunately, there was a small problem… specifically a padlock-sized problem.  They were closed, and seemed as if they had been closed for some time.  Why the other CopyCat, and even people in the mall, including the shop next door, didn’t know that, I’m not sure.

So at this point I was a little stressed, as I had gone on quite the long, walking-filled, often misdirected adventure to finally reach a closed store.  Improvisation became the name of the game.  In order to make ID’s, I ended up utilizing a cyber café and a textbook centre store… and I don’t want to mention how many times I ran up and down those stairs between the two (checking the size of the ID badges they sold, printing a sample to really check, looking for thick paper, seeing if they could print color, etc.).  Important part is that in the end, I had 3 ID badges made on stock paper (the single white piece of stock paper in the entire textbook center?) placed in convenient holders with lanyards.  What a victory.

By the time this ordeal was over, it was around 6 o’clock, and I still needed to hit a chemist with the big 5 L surgical spirit bottle.  Luckily, the chemists in Westlands are both more abundant and better stocked than in the city center, so I quickly found a place that had what I needed.

The entire day was filled with a significant bit of haggling.  At this point, questioning a price comes naturally – I even got the surgical spirit at the chemist on discount after wondering aloud whether it was cheaper down the street.  We have definitely come leaps and bounds on this front – it’ll be hard to pay the written price when we get back to the states without as much of a peep.  Khanjan always says that everything is negotiable though, so it may work just as well back home.

As I was leaving Westlands, it began pouring rain… absolute buckets.  I made it on a bus quickly, and for 10 bob (I guess ‘hakuna stage ya 10 bob’ is a Nyeri thing) got back to Nairobi.  I even managed to get off right next to Terminal.  I splurged on a taxi – after the walking I had done, the amount of stuff I had purchased, and the added water weight of my wet hair, I considered it a valid expense.

Pretty smooth ride back to Nyeri-town, and I got Wangila to pick me up at ‘the gas station formally known as caltex’.  I then finally reunited with my other African half, Jeffrey, and showed off all the stuff I had schlepped from Nairobi.  We commenced on some catching up as I was re-welcomed to my Nyeri home.

Today, Thumbi invited us to meet his family in Mweiga for a lamb slaughtering at his grandfather’s home.  We were both quite excited for the feast to come, but also had some Mashavu business to attend to.  Bright and early, we ran to Micha to get a facilities agreement signed for Mashavu to run at the PCEA Riamukurwe church.  We caught Virginia Munyiri before the service started and got our saught-after signature.  The other Mashavu business – giving our Nyeri CHWs all of the supplies necessary for independent running of kiosks, we left for after the slaughter.

We headed into town to begin our trek to Thumbi’s.  Jeff and I, on very little sleep from our chilling/working of the night before, used the matatu ride to get in a quick 30 minute nap.  We eventually got off a ways down the road from the Mweiga stage that we were used to.  Those who have been avid readers for awhile may remember that Mweiga was initially one of the proposed kiosk locations, as we had a good partnership with the Mary Immaculate Hospital there.   Things didn’t work out logistically, but we are grateful for the many cups of fantastic chai and good times we were provided by the sisters.

After getting off the matatu, we went on an hour trek through the brush to reach our destination.  We passed lots of grazing animals, great scenery, and some absolutely enormous sesil plants.  These things were like Jurassic-park style, could probably kill a person with their pointy edges, kind of plants.

We got to Thumbi’s place – after greeting his shosho, we went to find his grandfather grazing some cattle.  Thumbi temporarily took off, leaving Jeff and I to carry on Kiswahili/Kikuyu conversations with his grandpa.  For some reason, we couldn’t get on the same page, and had several communication breakdowns that ended in sijui’s and awkward laughter.  Hamna shida, we still had a good time watching over the cows with him.

At around noon, Thumbi came back with what I believe to be his uncle, and led us to the house where the slaughtering was to take place.  Not going to get too graphic on you (if you want graphic, search for our ‘Finally. We have been waiting.’ blog post), but we were quite involved and up close for the actual killing portion.   Good to even have new experiences on my last full day in Nyeri!

The slaughtering and cooking was fast-paced, as we had told Thumbi we wanted to begin heading back around 2 so we could meet the CHWs before it got too late.  We were given enormous plates of potatoes and peas, just in case the endless kondo meat wasn’t enough to fill our tumbos.  After absolutely indulging, we chai’d a bit, and then headed back on our way to Nyeri.  I don’t think I could’ve possibly been any more full than I was on the walk out of Thumbi’s place.  Talk about nimeshiba.  Just in case we wanted more, his family gave us an entire leg of meat for dinner.

Our goal of meeting the CHWs before it got too late didn’t really happen as planned, despite our quick slaughter.  We had to spend some time setting the backpack and computer up a bit more before handing it off, and ended up meeting at Lillian’s at around 7.

We headed there via Swagga with two backpacks full of goodies for our inaugural Mashavu kiosk operators.  As soon as we got there, we were handed plates of food and hot chocolate (they still call it chai, but they use chocolate mix instead of tea leaves).   Not that we were incredibly hungry, but we played our part and ate some nice-sized plates.  After dinner, we shared the goods with Margaret and Lillian, as Eunice couldn’t make it.  They went through each item, tried on the coats and ID badges, and sounded truly motivated for the task at hand.  They repeatedly spoke about, now that they had the proper supplies, all that is left is the work.  They don’t want to let us down – they appreciate how much work we’ve put into this, and know that they alone can make or break Mashavu at this point.

After the meeting, we made it back to the center via Bushman (in a car?) to begin… packing.  That’s right, putting things back into suitcases, to bring them back to the United States, which is to happen in less than 24 hours.  Still haven’t fully processed that we are at the end – even this packing just feels like we’re making another one of our near-monthly progressions through our journey (Nairobi -> Terminal -> CYEC -> Tanzania -> CYEC -> CYEC with kids at Ivory -> now).  Even the goodbye’s are followed by an insistent nitarudi!  Sijui lini, lakini nitarudi!  One more day of movement and travel, and then we’re back. Woah.

Posted by: jeff | June 25, 2011

Nimechoka kupendukia

As we close in on Sunday, our last full day in Nyeri, things are beginning to come together a bit.  There is a whole lot of shakin n bakin goin on, but the ball is rolling for sure.

Today Thumbi and I were absolute animals and covered some serious ground.  I am actually quite surprised he kept up, but with some encouragement, the occasional chai, and a couple plates of maharagwe, anything is possible.

First up however, is yesterday.

The kiosk went smoothly I must say.  In the morning after we arrived, we sent Eunice and Mohammed, a boy who lives at the Center, out on an advertising trip.  They threw posters all around Ruring’u and were able to recruit a person or two.

In the morning I called up the Majengo Sub Chief and got the good news that she had found a location for me.  I would have loved to meet with her to see the place, but she was attending the funeral for the 4 children who died in the Kangemi fire this week.  Monday morning I am meeting her to see the place and hopefully seal the deal.

Shortly after, the Chair Lady at the PCEA Riamukurwe Church in Micha gave me a call to let me know the Church Board had accepted my offer.  Talk about fantastic.  Just like that, the two locations in question were nearly set.

In the afternoon, Mohammed and I ran to town to print some more advertising and marketing material for the ladies.  I wanted to leave the Kiosk for at least a little bit to give them some time without me.  They eventually did end up giving me the ol ‘Jeff please come’.

Problems existed, but it is Kenya and the first solid day of Kiosk running on their own went pretty well.  They saw 4 people by the end of the day, which is not too high, but they are now on board with the idea that they can do 10 patients a day no problem.

Leo Asubuhi Thumbi and I set out on a wild day.  We hit the trail and passed through the valley to Kangemi from Thunguma bright and early to get a photo of Margaret for her ID badge.  The walk was a fantastic morning hike, and I think I may just throw a picture from the times below.

After Kangemi, we headed to town to grab a matatu to Nyeri to meet Eunice and Lillian.  When we sat down inside the matatu, it quickly became apparent that it was not going anywhere for a  bit.  Not having the time to wait, we headed over to the piki pikis to catch a ride.  The bargaining was highly successful; we ended up paying only 50 more total that we would have for a matatu.

Making it to Gatitu in no time at all, we rolled to Eunice’s for another picture taking session and some chai.  The time was enjoyable and we then passed on to Lillian’s.  At Lillian’s, similar activities ensued, allowing Thumbi and me to head back to the Center to finish crafting some ID badges.

The badges were nearly finished, I just had to put the photos in them and send to Steve, who was just hitting the ground in Nairobi for a day full of supply gathering.

Nikikuwa kwangu, I finished up all the contracts, agreements, and advertising posters and sent them to my email so I could retrieve them in town.  While working, Raisa continued her support from wherever in the world she is and caught a few errors in a document or two.  Nice.  Thanks again to Raisa for hanging here with me for a couple weeks – I had a killer time and she was a massive help.  An enlightened lady she is, and I would love to have her back on my team in the future.

With everything taken care of at this place, Thumbi and I split to town to print everything I needed.  It must have taken me an hour to get everything printed and photocopied, but it was eventually achieved.  I went to Steve’s photocopy gal to give her some company, as she has become quite lonely without him popping in all the time.

The first order of business with everything printed was heading to the House of Faith Church in Ruring’u to get Pastor Kamau to sign the Facility Usage Agreement – essentially declaring that we will be using the space every Friday for the next year.  I attempted to rendezvous with some other cats in charge of locations, but the best I got was a run in kesho asubuhi with the Chair Lady at Micha.  Hamna shida, that ball is rolling fine.

After all was settled, Thumbi and I eventually made it back to the Center.  Margaret and Lillian came by the Center to see the place and get some details on where they go to get paid.  I also reviewed their contracts with them and had a little signing sesh.

Sasa, Steve amefika hapa.  He has brought lots of goods from the city and the Kiosk Operator backpack is complete.  White lab coats were also located, so the Ladies will be pretty pumped about it.  The ID badges are also killer, and I have a nice new hat.

Greenhouse from last year is still kickin, however the same cannot be said regarding the first prototype of the solar dryer constructed this year. Take note of what happens after you leave.

Oh just the ol Saturday afternoon dance party in the library

Posted by: jeff | June 24, 2011

Ruring’u

Today my Ladies get to run a kiosk.  I will of course be there with them, but this is their first full day kiosk.  Yesterday they practiced a whole bunch on the site, so hopefully today they are ready to go.

I should also be finding out what is going on with the last 2 kiosks today.  Hopefully the Majengo Sub Chief has some good news for me, as well as the folks over in Micha.

Posted by: jeff | June 23, 2011

Utengeneze kuwa Jeff ingine

Man this was a crazy day, but it was a million steps forward and every single one was completely necessary to this operation.  No time to breathe yet, but I still have not figured out how to actually ‘have’ time so I guess it doesn’t matter.

Last night I again worked until I fell asleep on the computer and edited documents while sleeping in a very destructive manner.  I am not sure how this is happening, but asleep Jeff seems to be very against awake Jeff making progress.  Luckily, I did not give my alarm the chance to fail again and woke up shortly after 6.  I threw supplies in my back pack for a Mashavu Kiosk and split to Gatitu before 7.

During the evening yesterday, plans for today’s kiosk in Gatitu began to unravel – I finally got a firsthand taste of the limit of the Sub Chief’s power.  Through some way or another, communication between the Sub Chief and Dr. Kanyiri at the Gatitu Dispensary completely broke down or did not happen at all.  I am not sure, however I think there were assumptions made by everyone and that just never works.

Every Wednesday a group of people meet in the building at the back of the Gatitu Dispensary grounds, preventing us from being able to use the building Wednesday morning.  How did this never reach my ears?  I am still not sure.  Point is, this morning, no kiosk was able to happen at Gatitu and more coordination had to be accomplished for a location that I had been assured was good to go.

I made it to Gatitu pretty early and the Dispensary was not yet open, preventing me from discussing things with Dr. Kanyiri.  With nothing solved on that front, I went to Lillian’s place.  I was unsure about heading inside the compound that early, but I luckily ran into her husband outside.  Once inside, I found Lillian cutting the grass with a panda (a machete of sorts) wearing a fantastic knitted blanket on her head as a hat.  Ahh mwanmke mKenyan.  Anyways, we chatted about what had developed, and I assigned her to instruct everyone to proceed as if they were running a kiosk, fulfill their morning reporting email from the kiosk duties, and do practice consultations all day.

At 8:30 I had to be in town for the District Health Stakeholders Forum that Dr. Munyua had invited me to.  I got there on time to naturally find 2 people in the place doing some finishing set up work.  Right, I’m in Kenya.  Thinking it would be best for my morning state, I headed up to the joint right inside the government grounds for some chai and mandazi.  The morning necessities were appreciated by the body, and once I returned, things were picking up a little bit and only about 30 away from starting.

The meeting was highly useful to attend.  Representatives from all organizations involved in the health sector of Nyeri South District were in attendance.  Most of the time was spent on each organization giving a brief presentation on the work they do, who their partners are, along with the challenges they face.  There were representatives from several hospitals, the whole District Health Management Team (DHMT), FBOs, CBOs, NGOs, and research institutions.  A few groups were mainly focused on HIV/AIDS and TB, all covering what appears to be a very thorough range of angles to tackle.

As I had hoped, there was a nice amount of chai and light morning eats – arrow root, sweet potato, samosas, and fried bananas.  A couple huge cups of chai always make a man happy.

Having attended that meeting, I can now say that pre-primary healthcare is a gap that no organization is addressing in Nyeri South District; work to keep people out of hospitals.

During the meeting I had arranged for a rendezvous with Mr. Gatoga, the Gatitu CHW secretary and more importantly the apparent acting Sub Chief of Micha.  After booking it out of the Forum, I caught him on the road nearby Samrat Supermarket to lay down what I needed to confirm.  He understood, was in full support, then used my phone to call Mr. Kagunda, a village elder that is a member of the church board.

I don’t think I have ever made it to Micha from town that fast – I landed the last spot in a matatu to Skuta, nikifika I began booking it down Nairobi Rd  with a path at the bottom leading through the hills to the village.  However, I noticed a dirt road that went towards a maize field and I could see a boarding school that was in Micha on the far side.  As I cut through the corn, women kept popping up giving wild looks while I smoothed the situation by continuously shouting ‘wemwega!’

Somehow, I managed to pop out of the maize field through a barbed wire fence right next to the shopping center.  Fantastic.  After a nice series of place to place people tracking, I finally was on my way to the right lady.  Over at Riamukurwe PCEA Church, I was able to sit down with the Chair Lady of the establishment, a one Virginia Munyiri.  She was very thankful and supportive of the previous operation (nice work Penn State), and welcomed conversation about establishing a partnership moving forward.  Luckily, the pastor strolled by while we were talking, giving the opportunity for us all to sit down in his office and formally discuss matters.

I explained that we were looking to use their facilities one day a week – every Thursday.  We only require stima kidogo, some chairs, and a table, making the burden on them very little.  After my pitch, they said they would speak with the rest of the board and give me a decision tomorrow or Friday.  Now, we wait on Micha, but things are looking good.  Ideally, we would run a kiosk there tomorrow, but such is life.

With things solidly in motion, finally, with Micha, I was able to start the hike down the nice and long dirt road to Gatitu.  I will again say, I want to find a map of all this territory with the Locations and Sub Locations marked, but no success in finding one yet.

When I got to the Dispensary, I found Dr. Kanyiri in his office doing some light reading – the new proposed Constitution of Kenya.  Both of us shared the same sentiments – finally we can sit down and talk about this directly.

Communication was certainly completely broken between him and the Sub Chief, as he informed me he had no idea about any of this.  Again, assumptions people – I should have been at his place days ago, but it slipped through with the confident reassurances from the Sub Chief it was good to go.  Hakuna matata, as Dr. Kanyiri was extremely receptive.

During the Mashavu Kiosk at the Gatitu Dispensary, nearly every person we recommended to see the doctor strolled right over to Dr. Kanyiri for further treatment.  Mashavu was certainly good for his business, and he definitely agrees that we are addressing an area in the health care system that is completely overlooked.  I was tickled to hear him say that he is ready to help Mashavu grow, and that we can use the building every Tuesday for the year.

If you recall, the Githiru Kiosk was supposed to be on Tuesday.  However, when Khanjan and I were at the meeting with the DHMT, we were advised to not run a kiosk in Githiru.  Yes – it is the perfect place to run a kiosk, top to bottom.  No – there is not a clinic or police post in Githiru.  The lack of a police post really changes the game.  The ladies were concerned about going by themselves with Mashavu in a backpack to Githiru, and the DHMT agreed.  It would be fantastic to run a kiosk there, but there is no use in risking ending everything for it.  With Githiru out of the picture, Tuesday is open.

I had paid a visit to the Sub Chief of Majengo yesterday, and told her I now had Tuesday open and wanted to run a kiosk in Nyeri Town close to Majengo, or at the police post right at the edge.  The model of what is arranged at the Thunguma police post is quite fancy and something to explore.  Having the police ‘offering’ other services, such as Mashavu, may quite possibly be able to slightly improve the view of the police in the community.

The Majengo Sub Chief had been waiting for me to inquire about bringing a Mashavu Kiosk to her location, and she seemed pleased that I had finally asked her.  I had originally requested Tuesday, but since Gatitu was just moved to Tuesday, Wednesday was now open.  I gave her a ring this evening to let her know that I needed to alter my request and encourage her to look for a place that we can use every Wednesday.  Hamna shida.  She told me that she will let me know on Friday, leaving me to now wait and see what happens.  Hopefully she is excited about it and hooks us up with a good spot.  Tutaona.

Where are we at now?  Thunguma Police Post on Monday – confirmed.  Gatitu Dispensary Tuesday – confirmed.  Nyeri Town Wednesday – in the works.  Micha Riamukurwe Church – response pending.  Ruring’u House of Faith Church Friday – confirmed.

I would really like to have a definitive answer on Micha tomorrow, but it won’t be the end of the world if that does not happen.  With everything that happened at Gatitu, I think it is mandatory that there be some sort of agreement between us and the landlords (or person/body) in charge of the space.  That is on my to-do list for tonight.  The concept of every Tuesday for 52 weeks is not incredibly tough, but chances are kama kutakuwa matata I won’t be here to make things clear.

Tomorrow, since there is no kiosk on this side (Friday, folks), I will be giving the CHWS the supplies to run a kiosk at around 8:30, so they can begin fulfilling their responsibilities.  First thing when opening the kiosk – send Martin an email – ‘I am running the Nyeri kiosk and ready to take patients’.  What they really need now is repetition.  The ‘group teaching’ approach for these women definitely works and they know how to help each other.  All I need is for them to collectively solve the problems.

Kesho we will get those Ladies practicing while I run into town and get some stuff done.  Should be good….coming close to having all of this finalized.  3 out of the 5 in the bag.  Lets finalize these two and start feeling comfortable with this.

Posted by: steve | June 22, 2011

Maasai Maa-shavu

No cobras or leopards have been seen, which is good because I haven’t had the time to craft a spear… but yesterday morning I did see my first bit of good wildlife.  We had been told that giraffes frequent the area, but due to rains and misfortune, we seemed to miss the times when they are near.  After expressing my frustration to all locals, yesterday morning I finally received a flash regarding the giraffes.  I ran out of my room, and to my delight, 3 giraffes were parading through the brush, right by Agnes’s house!  One asked to be Mashavu’d, but I regretfully informed him that our tape measure was not quite long enough.

Mashavu business – Thursday, Khanjan came for a visit and planning meeting with the CHWs, the head CHW, community members, and UNIDO representatives.  We nailed down everything from the pricing scheme to the location of the kiosk, and everyone was in agreement.  We were to take the soap-making room within the UNIDO power center, as the women who were in charge weren’t utilizing it at all (they now share a room with the supply room).

The CHWs accepted the payment amount, as well as the lofty goal we had set in terms of number of patients per week.  We talked about marketing, and how it will take a few weeks to really saturate this place with Mashavu, as it hasn’t had the months of community outreach that Nyeri has enjoyed.  This was the meeting where the CHWs first heard that they were being paid, and began to understand the seriousness of what they had been selected for.  Agnes was the most vocal during the meeting, which essentially allowed all the stakeholders to agree with what I had hoped, that she would be the designated leader.

After the meeting, I lost my cohort, Rachel, due to the ever-growing condition of return-to-home-itis.  Pole sana kwa mimi.  Since then, I’ve been holding down the mzungu fort here on my own.  It’s been good times though.  Friday, we had another good day of training, as I moved a computer and some other supplies into Mashavu’s new semi-permanent home at the UNIDO kiosk.  Computers here are quite a chore, as all of them are filled with viruses so bad that they immediately destroy USB drives.  This makes loading anti-virus software quite difficult.  I was designated the role of cleaning all four UNIDO computers, as well as the one at the dispensary.  This is a task that wouldn’t be difficult if I had: endless, quick internet, a USB drive guaranteed to be virus-free, and a copy of Windows XP on cd.  Unfortunately, I had none of these, so I had to improvise.  I found a way to mostly guarantee my USB drives were clean, and decided to take a trip to Nairobi on Saturday to find an XP disc.  That way, I could completely wipe all the computers, hamna shida.  While out and about, I could also get a few other supplies for the kiosk – a dustbin was requested, as well as cotton rolls for sanitation of the thermometer.  I also needed to print some posters, and get a new natural gas canister for cooking (the few days of cooking alone with a jiko weren’t working out).

I spoke to Agnes about ways to get to Ngong, and she informed me that from 7 – 8 AM there was a matatu that left for only 70 KSH – what a steal! (Piki piki rides are 300).  She also agreed to pass out posters later that day so they could be dispersed to churches the next day.

The only rides back to Ngong were from 4-5 PM, and as I would have bags at this point, it was important that I made it back there in time.  After hitting Ngong, printing some posters, and sending them off to Agnes, I scooted towards the Nairobi bus stage.  I hadn’t eaten any sort of breakfast, so when I saw a bus round-up man with a cup of chai in his hand, I asked him to direct me to its source.  I would never have known, but a small MPESA kiosk right by the bus station was what supplied everyone around with chai and chapati.  Score!  A little Kiswahili knowledge prevented me from paying too much, as well as generated lots of laughters with my fellow chai drinkers.

After catching a bus to Nairobi, I realized that I had no idea where to go for a Windows XP disc.  I spoke with Khanjan, and decided to meet up with him first, and then take the Windows XP adventure second.  I grabbed a few things at Nakkumatt, alafu we went to Habaisha.  Habaisha is an Ethiopian restaurant right by the Terminal, and Khanjan’s designated hotspot.  We worked on generating a Nurse agreement document, as Khanjan was interviewing 2 nurses that evening.  After some conversation, I crafted the doc as Khanjan tried to check off some of the million other things on his to-do list.  Afterwards, we headed to Mombasa dishes (per my request) for some delicious maharagwe lunch.  Had a great chat about Mashavu, I-spaces, and life – one of those real conversations that he would always reference over the phone – “I’ll tell you all about it when we are sitting across from each other in Kenya”.

After chatting it up quite a bit, he decided to join me for the Windows XP adventure.  The computers I wanted to install it on already had a product key, and just needed an installation disc to swipe the hard drives, not an original fresh copy.  We searched and searched, got lost a few times, denied a man who was overcharging, and finally found a spot.   A bit of haggling (It’s great what some Tuko pamoja’s will get you in this place) got us a copy for 150 KSH.  Antivirus was too expensive, so I decided that I would burn up a Safaricom by downloading some free stuff instead of getting a cd.

At this point, it was already approaching 4 PM, and I needed to get back to Ngong if I wanted to make it on a matatu.  I rushed over to the bus stage, and managed to make it to Ngong just at 5 PM.  I did a bit of waiting/trying to find other people who were waiting, when finally a small car/van/truck came.  The back was a covered truck bed, but it couldn’t have been more than a 3 x 2 x 2 meter box.  I watched as at least 20 Kenyans fit into this small space, and along with a new friend I met, decided it wasn’t in our best interest to join.  We were told another “vehicle” would be coming anyway.

Luckily, I ran into both Simon (the UNIDO power center manager) and Joseph (the head of the CHWs) who also needed to make it to Olosho-oibor.  Hakuna matata, I knew we’d collectively find a way back.  Eventually, a pick-up truck pulled up, with a roll cage built on the back of it.  We got in it early, so were able to get some room on the benches that had been placed around the edge.  Mothers, cover your eyes… we were able to fit 21 people on the back of this thing.  I felt safe, as I couldn’t have moved even if I wanted to – I was nicely packed in with everyone else.

This ride down the mountain, at sunset, turned out to be a great first bit of community outreach.  The kidogo kidogo kimaasai I knew, plus the Kiswahili, caused quite the good time.  Lots of laughs and good times were had as we rolled down Ngong hills towards Olosho-oibor.  One of the women I met, Helen, who Simon introduced to me as his second wife (he was joking), invited me for dinner Monday night.  She also invited me for marriage, but I gave her a labda baadaye on that front.

I finally made it home, and noticed Agnes had called me several times (it was hard to get pocket access on the truck).  They were worried I had gotten lost/mugged/in some sort of jam, but I assured them I was with Joseph and Simon and all was well.

Sunday morning, I headed to church with Mercy, the nurse at the dispensary and owner of this house.  It was the same church that Simon, Helen from the truck, and Mary, the other UNIDO power center employee, go to. Simon and Mary didn’t make it, and Mercy sat on the other side of the church from me, so I had a nice time enjoying the kimaasai church service by myself.  Some people translated a few of the parts, but I was honestly happy with it being in a different language.  The singing and dancing was really nice, and took up a large portion of the service.  I even got a chance to introduce myself and plug Mashavu!

Almost immediately after church, Elizabeth came over for some typing practice.  Agnes eventually joined as well.  I wanted to have a quick pep-up meeting before the big start the next day, and talk more with Agnes about her role in this whole thing.  I showed her the CHW agreement, talked to her about the payment plan, and prepared for the big next day.  I then was invited to Agnes’s for some ugali na stew with Mercy, who was staying there while I occupied her house.  I gladly accepted.  It was a good family meal, chased some chickens about, hung out with her kids, and had a good bonding time with Agnes and Mercy.

Then Monday came.  The big day.  The truest big dog and pony show of them all.  It turned out to be a day of good progress in setting up the kiosk, but fairly uneventful in terms of turnout.  I spent the day getting the computer in that room to actually be able to have the functionality necessary for a Mashavu kiosk (access the internet and have a webcam working).  Stupid webcam/USB connector issues put me in a tizzy all day, and by the end I still didn’t have it finished.  Agnes did a few patients without the camera, and we called it a day.  Almost more importantly, we were able to do everything that needed to be done at a kiosk.  All forms were filled out, logs were completed, and consultations were properly done.  Without having a real kiosk here before, it was good for Agnes to go through all of the motions for the first time.

After day one at the kiosk, I met up with Simon and headed to Helen’s house for a great chapati and potatoes dinner.  Fantastic dinner – the first hour or two of conversation was entirely in kimaasai, which allowed me to reflect back in my head on the day’s happenings and what needed to be done.  Simon and I then got into a very productive conversation about the concept of Mashavu, how to make it happen, and ownership over the project.  I explained that although I am the big “Mashavu” presence right now, in just one week, Mashavu will be comprised solely of people here, and a room at the UNIDO kiosk.  It will truly be what they make it, as I will be and a 7 hour time difference away.  He understood the point, and I believe he intends on making sure Mashavu succeeds to the same level that the UNIDO power center has.

Yesterday was day 2.   The computer was fully functional (finally… I still am not sure what was wrong, but I’m blaming it on the USB extenders for now).  We were able to get 3 REAL patients in the morning (exciting stuff!), and Agnes did the consultations without a single glitch.  After a bit of a slow period, Khanjan arrived with Paul from UNIDO and several other interested people.

We Mashavu’d a few of them, giving Agnes some more profit for the day.  This was my ‘goodbye’ meeting with Khanjan, as he is headed towards other parts of the world today.  Next time we see him will be back on the other side, our original side, of the world.  Farewell Khanjan, Safari njema!

We’ve begun to draw curiosity with Mashavu, and had more people say they’d promise to come today.  Only one week to get this Olosho-oibor party rolling, then it’s all up to the community.

Posted by: jeff | June 20, 2011

Yes we Khanj

Ahh what a day.  After cranking away for most of the night and hardly getting any sleep, I luckily did not have to rely on my alarm (which has been failing me lately….sijui kwanini) as Raisa woke up early and got the day rolling.  We enjoyed a bit of morning here and then strolled up to the Thunguma Police Post right around the corner from the Center.

Margaret was nice and prompt, but we had to wait a little for Eunice and Lillian.  Khanjan and his tag-a-long rolled up shortly after us, and once Lillian and Eunice arrived we were able to start the much anticipated meeting to nail down all details of the kiosk.

The meeting was exactly what needed to happen.  The Ladies needed to hear Khanjan lay things down firm and give them a good talking.  It is tough for them to fully grasp the idea that this is their business to market and it is on them to sell their product.  Entrepreneurial concepts are quite foreign to them – certainly something that would have been nice to have the time to teach them.  We ran through everything, top to bottom – what they are getting paid, what they have to do to get paid, the kiosk locations, who is operating which kiosks, what they have to submit each day, how communication will work between them and the nurse, how communication will work between them and us, client number expectations, plans moving forward, yada yada lotso stoof.

After the formal meeting wrapped, we brainstormed for a while on our marketing strategies.  Khanjan gave us the good assignment of ‘Ill give you 500 schillings to use for advertising’.  It again took a bit to start getting them revved up and thinking on their own of how they can grow this.  After a bit of Raisa and I batting around thoughts to get their brains churning, the ideas finally started to trickle in.  As the exercise continued, it was great to see them start weighing costs and efficacy of various methods of outreach.

Shortly after 1 I had to book it to the Center and on to town to meet Khanjan.  Raisa hung with the Ladies to work with them on exactly how to fill out the log sheet, save it, and attach it to an email that is sent to us.  She said it was quite the challenge, and that none of them were able to get through the whole sequence on their own.  It is certainly something that will certainly have to be worked with extensively, because it is what they have to do in order for them to be paid.

I met up with Khanjan before 2 at a café in Town while he was enjoying a fat plat of githeri and pili pili kali along with his tag-a-long.  We were able to do some brief scheming and then book it over to the DMOH at Mt. Kenya for the meeting with the District Health Management Team.

I was not sure exactly how the meeting would go, or how many would be there, but it turned out to be killer.  There were about 10 members of the 15 person team, all highly attentive and ready to hear what we had to say.  Typically for this setting I would have my man Steve next to me, but Khanjan and I were able to tag team the hell out of it.  We were able to create a very good picture of Mashavu in their minds and solidly run through the data that the Kiosks have been able to collect so far.  I definitely loved the degree to which they were diving into the stats and trying to get themselves a nice understanding of the health of those areas.

After we had brought them into the loop on what Mashavu is and what it can do, they moved the conversation in the perfect direction with their questions – where exactly are we now and how do move this thing forward?

Khanjan did a fantastic job at breaking down the challenges we face and bringing them all into an understanding of what our entity has the capabilities to do.  We worked them hard on the results and community reaction we have seen thus far, and emphasized the number of people that have headed to the clinic because of Mashavu.

At this junction, I must truly put my hat off to Khanjan Mehta.  Often times, as you work with a professor and set out to accomplish things, upon the accomplishing everyone is pleased with the work and life goes on.  Khanjan on the other hand did an unbelievable job at understanding what was going on, where we had brought this too, and then immediately acting to move it the next step.  I could not have imagined that we would be jumping off a 1 year pilot right now – not at all.  We do work for him, and then he immediately turns around, takes what has been done, pairs it with the resources he has, and shows you the massive potential for growth.   Well, not only shows you, but works with you to implement the next step.  He thinks big and makes big moves.  I love it, and could not imagine working for a better man.

By the end of the meeting, Dr Munyua was telling us about the massive lack of pre-primary health care, the huge lines that result at the hospitals because of this, and the absolute necessity to begin taking action to try and keep the public healthy.  Heyyy….isnt that our pitch?  Excellent.  You know you have done your job when you have them pitching your project to you.  What does this mean?  Well, full support from the Ministry of Health.  There are a few short term items we need from them to get this really rolling in this town, as well as killer framework to being scaling this operation up even more.  They offered the services of several entities inside the Ministry and it is going to be very interesting to see how we can bring them into play.  Additionally, we got the complete go ahead to begin utilizing the MOH name and logo in our material for the kiosk and the likes.

Bottom line: the meeting threw pure joy into me to see that we have actually built this to the point where honest Ministry of Health involvement is finally a reality and a necessity agreed upon by all entities.  Baby baby!

Dr. Munyua also graced me with an official invitation to the Stakeholders Meeting on the health sector in Nyeri District on Wednesday morning.  The meeting is to bring together all entities working on health initiatives in the District so everyone can not only understand all efforts going but ensure that there is no overlap.  He told me I will have about 5 minutes to present info on what our work is, what we have accomplished so far, and where we are running with this.  It looks like I will be on my own for this one, as Raisa is leaving Nyeri tomorrow afternoon to catch a flight out of the country on Wednesday morning and my cohort Steve atakuwa Olosho-oibor.  Sijui lini atafika hapa lakini natarajia karibu!

Tonight and tomorrow I again have way too much to do trying to organize these 5 kiosks as well as work on all these side projects.  Landlords to be met with, CHWs to be trained, marketing for kiosks to initiated, kiosks to be run, metal to be cut, ground to be broken.  Boy oh boy.

Posted by: jeff | June 20, 2011

Phase I: One Year Pilot – GO

Tomorrow is the big day.  The one year pilot gets the official kick-off here in Nyeri and over in Olosho-oibor with Steve.  Oh baby.

Khanjan finally made his way into Nyeri today; something I have certainly been waiting for.  While we have been working to finalize material for the kiosks, a chat with him was absolutely mandatory to confirm all final decisions.

When he arrived, I was walking back to Thunguma from Nyeri Town.  On my way, I stopped by the Ivory to grab him as I headed to the Center.  When we got to the Center, the two of us headed to my office (the lower hills of the shamba) to catch up and discuss what has been going on.

For the formal planning, Raisa, Khanjan, this gentleman, and I headed over to Outspan.  We got exactly what we needed accomplished, and it looks like we are all set for tomorrow.

Tomorrow morning, the Thunguma Kiosk is opening at 9.  The three freshly trained CHW – Mashavu Kiosk Operators will be there, as well as Raisa, Khanjan, and me.  We will have a nice formal meeting laying down the deal with the Operators, as well as discussing a few very important things.

At 2:30 tomorrow afternoon we have a meeting with the District Health Medical Team to review all of the health data that has been collected.  We are also looking to begin formally outlining our partnership with the Ministry of Health throughout this one-year pilot, as well as what our relationship will grow to be beyond this round of work.

Its business time baby.  I think Ill release the flyer for each kiosk as each day comes….here’s to Thunguma.

And yes, I did watch Episode I tonight while doing work.

Posted by: jeff | June 18, 2011

R2 and I – we headin to Kamino

This morning I woke up, and made the executive decision to enjoy some time on the kitanda to finish The Prince and The Pauper.  I had purchased the book at an Old English Used Book Store in Amsterdam; an event that seems unbelievably distant at this time.  I have thoroughly enjoyed the read, and I feel it is highly appropriate.

Lately I have been doing the standard heavy spring allergy dealing.   As we progress into what they view as winter, there has been plenty of rain and plenty of warmth for everything to flourish and grow.  This naturally leaves Jeff with a congested nose and some tissues jammed up to prevent the drip as he throws back Benadryl that Tara brought him.

As you may have extrapolated, this last week was filled with teaching CHWs how to use a computer and the Mashavu website.  Teaching them is a very tiring activity, but it has been fun and quite productive.  The Ladies have moved along very fast, and we are now with two women that should be able to run a kiosk by themselves, and one who is going to need some more time and a partner.

Through doing this, the reality of how we are affecting lives and what goes on here is really setting in.  For such a long time, we had been working on something that would be executed, and upon conclusion all involved would go back to what they were doing.  All partners here in Nyeri and around Kenya played along fantastically, the team from Penn State enabled a very quick sizing up of the operation, and the work was highly successful.  The problem is, now that we have started doing work that is truly extending for a long period of time, and crossing into the realm of employing people, lives are truly being impacted as we mess with what is here.

In the beginning, as you play through the channels of hierarchy in this world and round up people, resources, and permission to do what you want, people are anxious to be involved.  People see us Westerners here working, wonder what we are doing, and some wonder how they can be involved with the hope that there is something on the other end.  ‘Why else would these people from the West be here if they were not going to give us something?’

The idea that we are working together to better the community can certainly be pitched, and it can be accepted that the only reward is that of what we can do for the community (and lots of chai/lunch).  Establishing your model/concept/plan/design in manner that involves the removal of yourself changes the growth and the level of involvement that everyone has.

For most of our time, we were mass producing the Jango Fett clones.  They had to mature very fast and be able to serve a clear cut purpose that was not too complicated, nor restrictive, in who could perform the tasks.  We were able to involve whoever wanted to be; grab the next willing and throw them in the fire of running Mashavu kiosks.

Now, we have found ourselves raising Boba.  The real needs a lot more training, growth that is honest, and the nurturing care that is required to produce someone who can serve as the next incarnation of you.  With this, selection has to happen – there can only be one Boba (well, for us 3).

What does selection mean?  What is the impact on the ones you selected?  What is the impact on the ones you did not?  What is the impact on the relationship between the two?

Answers: A lot.  Massive.  Gargantuan.  Apocalyptic.   Conflagration.

Through the proceedings leading us to now, it had been something weighing heavily on my mind.  I knew I could do nothing about it, I knew I could not select everyone, I knew I could not say enough to those not selected and those selected to make things okay.  All I knew was that I had to wait and see what would transpire.

At the end of this training week as we approach the start date (Monday June 20), all of these questions have been answered, and the darkness has been exposed.  The dark is dark, and there is no way I could have uncovered a stone in my mind to hint at how dark.  Animosity and broken friendships, paired with gossip, rumors and slander.  Yet at this junction we must press on, because as we live in this Babylon system, there is nothing I can do to change people and being beat down by the reality of it all helps none.  How do we prevent the Clone Troops from becoming the Imperial Stormtroopers?

I don’t have the answer to this, besides the knowledge that we must keep the Force strong in us, not succumb to hate, and have no desire for power.

I wish I could employ everyone.  That may solve all problems, it may not.  Im not sure.  Regardless, pressing forward is mandatory and work must continue.

Projects can be designed in classrooms.  Projects can be planned in offices.  Projects can only exist on the ground, and the impact they are having can only be seen once they are there.  Lives will be touched, top to bottom, and there is no way to understand the extent until you push things that far.  This can only be discovered once you operate for a large period of time under the belief that you should be doing what you are doing, you will help lives, and that you must continue.  Yes, those are all things that we have struggled with throughout, but the actions are what dictate the belief.

Even as I turn the corner after this mentality, I only have one option.  Continue.  I have 10 days left here to make a package – a package that I cannot make changes to after delivered.  No slipping can happen now, and I have to put everything into making this exist.  There was a point where we could turn back, but certainly not now.

Come Monday things are a go.  Are we ready?  Im never really ready.

Today was very large grey water planning sesh.  Wildly enough, a project that Steve, Thumbi, and I started planning months ago has turned into quite the thang.  A land planning consultant of sorts that is all about permaculture has been hired and the operation is turning serious.

The Center consumes about 900,000 Liters of water every month, about 80% of which we can capture, clean and use.  Additionally, there is a massive amount of rain water runoff that can be captured high on the property and properly utilized down the hill in the shamba.

On one side of the Girls Dormitory there are 3 outdoor wash basins and 2 bathrooms with sinks and showers.  To locally handle they grey water, we will be using swales.  Several variations exist, with one essentially being a deep hole that is filled with mulch.  Around the edges of the hole, miti ya ndizi can be planted.  Talk about fantastic news kwa wasichana wenye wanapenda ndizi.

To handle the grey water that we will channel downhill in French drains, a series of reed beds (bamboo and sugar cane) will established.  A fish pond is to then be established to the hold the water runoff from the reed beds after filtration.

This morning we started creating large to scale map of the Center.  I have not worked as a cartographer in quite some time, and it a damn good time surveying the entire property of this place.  So many nooks, so many crannies.  After creating the frame of the site on some monstro paper, we moved into an afternoon full of planning.  Thumbi is now on his second draft of the big map and it is looking fantastic.

It is going to be awesome to see this whole thing come to reality.  Implementing the grey water as well as rain water capturing is seemingly the starting point for a ton of work at the Center.  Tomorrow we go back at things and keep this puppy going.

Today is my half birthday.  This may be the first time I have ever remembered.

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