Emailed from my friend Dr. Shoup, who recently retired from his practice to go fight for children in Africa. And who, I keep forgetting to mention, was at one point both a priest and a doctor - the Catholic church told him he had to pick one or the other, and he chose medicine.
part 1
part 2
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As time goes on I more fully understand the Nyumbani organization. The first operation of the Orphanage for HIV + kids started in 1992 - but in reality it was a hospice where kids were brought to die. In 1999, Nyumbani began to get some ARVs, anti retroviral drugs which are used to treat AIDS. With the arrival of ARVs the death rate dropped dramatically from an average of three per month to a much lower level. They even had a period of 18 months without a death until Samuel (age 10) died last Sept and Mary died last Oct.
As I write no child is in the little infirmary (these kids all apparently know that going to the infirmary means the end - so it is a great problem to get a child into the infirmary just to treat his cough which is not related to his HIV status but simply to get him or her out of the cottage so the other kids are not kept awake by his coughing). All the kids here look healthy and happy and by Kenyan standards they are probably spoiled - but they would need to be a hell of a lot more spoiled to get to the standards of even the very poor in the States.
At present the are 94 kids here - ages 9 months to big man Dennis age 22. As a child Dennis was too sick to start school and did not finish first grade until he was 13. Of the 94, 63 are on ARV medication. By the way all these kids learn how to swallow tablets and capsules at age 3 - liquid meds and suspensions are too expensive.
In the US it costs roughly $20000 per year to treat an HIV patient- the vast majority of whom are on medicaid. Here at Numbani the cost of the ARVs runs between $5000 and $6000 per year per child this money comes from donations raised in US, UK, and Italy.
There are five cottages and s school house surrounding a square that is the playground. Each cottage is roughly 625 sq feet and sleeps 15 0r 16 kids. Narrow bunk beds, a table where most can sit to eat -same table for study. One big problem I see is the wide variation in ages in a couple of the cottages - the school age kids need to do their homework admidst the noise and activity of younger ones. These 625 sq feet also contained a small enclosed area where the cottage mom or "uncle" can sleep and have a little privacy.
I hope some of the pictures I have taken will better describe what is difficult for me to put into words. BUT the big thing here is that these kids are loved, fed, and cared for very well. The manager here is a 29 yr old man who is impossible to describe - he is a saint, father to all 94 kids, organizer, leader. The UK Nyumbani Newsletter reprinted an article that a journalist from England wrote about this man - believe me none of you could get through that article with dry eyes.
The second part of Nyumbani is the outreach program which consists of three widely separated clinics located in various slums in Nairobi. The staff of all three are employees of Nyumbani. One clinic, however, is supported by USAID. History is being made at that clinic tomorrow (Monday) as they will be able to start ARVs on some of their children after years of red tape trying to get these meds. Nyumbani workers and local community have spent months trying to educate the guardians, grandparents, aunts, etc on the use of these drugs. The other two clinics are fully the responsibility of Nyumbani i.e. staffing and financial. At present Nyumbani cares for somewhat over 1300 HIV+ kids in these three clinics.
I use the word clinic in a very broad sense. I have been working in Kibera, the second largest slum in all of Africa - over 1 million people live there. I have taken pictures of the clinic but thus far I have not been ableto bring my self to take any of the "homes", the filth, the poverty. I guarantee you there is nothing like it in the US. Now, for my little clinic which consists of 4 little rooms - this is better than the clinic that just has one room which acts as waiting room, exam room, and office. At Kiberia we do have a little privacy but there is no running water, no funnel, no measuring cup.
Immediately next door is a similar building that is used as a day care center for HIV+ children who are badly malnourished - I am talking about toddlers, an eight year old girl who has had several close calls with death and who will not speak much but will sit on a bench drawing all day.
Then there is my very talkative, bright, healthy looking nine year old, Brenda. Both Brenda's parents are dead and she is living with a poverty stricken aunt. She should be in school but she is from Uganda and does not have the proper papers so she cannot attend public school. She helps care for the toddlers, helps feed them, and change diapers. A neat kid. I asked her if she would like to be in school: "no,I want to be with you" Through the nurse I am trying to get her into a private school -tuition is KS 3000 per year which translates to $38.46 per year i.e. thirty eight dollars and forty six cents. Some of the volunteers here have managed to get her some books which has pleased her greatly. Am not sure what tribe she belongs to but she almost certainly speaks three languages: her native tribal language, Kiswahili (note what we Americans call Swahili should be spelt Kiswahili), and of course English. I will try to keep you up to date on Brenda.
Back to the clinic- there are at least 60 kids who should be on ARVS but only 6 are taking them through a gift from "EyeWitness" - a Belgium organization about which I know nothing. All the kids receive "routine meds from the clinic, viz Bactrim (Septra), tylenol or its equivalent, and multivits. We take care of the usual childhood stuff, colds, cough, diarrhea,earaches. I picked up one kid who has resistant Tb - for 60 straight days he requires a shot of Streptomycin problem is he has no butt- I mean his gluteus max is just about non-existent. He also is in CHF (congestive heart failure) - the nurse tells me he looks great compared to time he first arrived at clinic. He looks like he cannot survive another day to me. With help he gets up on table and waits for his shot. No tears, no emotion - he is probably to sick to cry. Thus far I have given him three shots and each time after we get him off the table he says "thank you." Something just does not seem right with that situation.
The day care is really to make sure the kids get a least one healthy meal. Brenda is there because her aunt is trying to find work. Oh, all these kids need to be dewormed about every three months. We have a sock to liquid med called "Wormkil" - the dose is one teaspoon twice a day for 3 days i.e. we should dispense 30 cc's. Problem is we depend on guardian to bring in empty bottle - the clinic has very few spare bottles and they are old medicine - ie previously used. There is no funnel - so one must have a steady hand in pouring from a gallon jug into a small bottle. Then the fun starts - how much is 30 cc's. Here I have depended upon David, the nurse to eye ball it a tell me to stop pouring. All this got to me so yesterday when I went shopping with some of the volunteers I found a small funnel but could not find anything like a measuring cup. But where there is a will, there is a way.
There is a very nice and very British restaurant within walking distance of the orphanage -it is called The Rusty Nail. It is frequented by the volunteers over the years and actually the owners are very nice. Sr. Julie, the nun from Phil, and another volunteer took me there last Mon to watch football.Julie is an avid football fan - we did not go to watch Mon Night Football - they went to see a re-run of one of the games played on Sun - every Mon there is a replay of an AFC game so poor Sister never gets to see Phila (NFC). At any rate last Mon evening there was a damn cricket game between S. Africa and Eng on the TV and the owner would not go to football game despite fact that he and his Brit fellows told us that there was no way Eng could lose since they had such a hugh lead. Nevertheless, we had to wait until Eng got the last out- it ain't like baseball; it took almost one hour before that last out before we could watch the football game -the outcome of which we already knew the final score. At any rate it had me mad.
Frid I had a brain storm so when we went back to the Rusty Nail today for lunch I go up to the Brit, explain the situation in Kibera and ask him to give me two shot glasses. He very kindly obliged and tomorrow I will take our two new measuring cups of 30 cc's apiece to Kibera!..Problem is without running water I will have to clean them in the plastic tub of water we bring from Nyumbani. I just loved 'getting back at my Brit friend' !
Mon 6:30 PM. Just back from Kibera. It has been a long tiring day. The kids I saw today were doing OK but the frustration is that there are no ARVs to treat these slum kids. What amazes me and all the other volunteers is how neatly dressed these destitute kids are - oh the dress on a little girl might be a few sizes too big but it is clean and neat. The biggest difference between Kibera and Nyumbani Orphanage is the absence of smiling, talkative, hugging kids.
I have to fight the frustration - we do the best we can with the little we have. These kids are innocent victims of the scourge that is over so much of Africa. Why , why I keep asking God; what, oh God are you asking us to do. Yes, the world wide response to the tsunami disaster is great but why cannot the West get together to help the human disaster that is killing millions in Keyna and all over Africa.
Most of you probably do not realize that almost without a doubt AIDS is another disease that the white man brought to a foreign soil. AIDs without a doubt began in Europe and has been around for thousands of years and just reached epidemic levels after the sexual revolution of the late sixties and early seventies.
I have not as yet gone to the other two outreach slum clinics but from what the other volunteers tell me they are even worse off except that the previously mentioned one that is supported by USAID has gotten ARVs which where delivered from NYumbani today. I was tempted to try to steal some for my kids at Kibera but that would only make the problem worse - you have to make sure there is a continuous supply of drugs. If you treat someone for a brief period and then stop you are inviting another mutation to a drug resistant form that only further makes treatment more difficult -HIV is the smartest virus humans ever encountered. More later.
The third big part of Nyumbani isNyumbani Village which is about three hours over very rough roads from Nairobi - if you look at a map it is about 1/2 way from Nairobi to Mobassa the big port on the Indian Ocean. Construction has begun for Phase I - by Dec 2006 all three phases will be completed and occupied by 750 orphans plus 300 adults who will act as moms and uncles.
Fr D'Agostino took me to this site on the Tuesday after I arrived. None of the cottages will have plumbing and I learned a lot from an American building/construction teacher from Bowling Green Univ in Ohio, as well as from a white native Kenyan expert in water. Multiple wells will have to be drilled, human fecal matter will be saved, methane gotten from this and then the fecal matter will be used for compost. 19 acres have already been cleared for beans, bee hives are being built, Land of Lakes (the American dairy) is supplying cattle and the expertise to establish a dairy so that this Village will eventually be self sustaining by producing not only food for itself but for others as well.
Individual Americans are great but our government stinks. Bush and his cohorts have no idea about the third world. There are serious questions here whether American Embassy interfered with absentee ballots from Americans here during the past election. I promise you I have yet to meet an American who can stand Bush. As an individual you can do just a small amount. Our government needs to be involved and stop violating treaties that we agreed to in previous administrations. Millions are dying here while $40 million is spent on parties for the inauguration - hopefully God will forgive us
