School of Medicine 4th Year, Rush Medical College
Kisumu, Sept 2015 – April 2016
I arrived in Kisumu didn’t know what to expect. It’s my first time in Kenya and first time in Africa. This trip, just like other medical trips that I’ve taken, cemented my desire to work in improving maternal and child health. As soon as I got off of Jambojet on my first day in Kisumu, Davis, one of the FACES drivers, greeted me. With a big smile on his face, he showed me the major attractions in town, and introduced me to the Lumumba clinic and the FACES office in Milimani.
From then on, my eight months in Kisumu were fast paced. I worked on the Pamoja project, which had a quantitative component and a qualitative component. The quantitative study found a high correlation between low social support and HIV-related stigma among adolescents living with HIV. The qualitative portion explored the ideal social support intervention for youth living with HIV and the impacts of migration on the HIV care and treatment of these youth. The first part on social support adapted from an adult social network microclinic, called the kanyakla. Our goal was to eventually use the kanyakla intervention against a control group to see differences in retention in care. In the second part of our qualitative study, we explored how adolescents’ migration impacted their ability to remain engaged in HIV care and adhered to ART regimens. We identified factors at multiple domains (psychological, social, environmental, cultural and economic), which presented as barriers for migratory adolescents to access care. We wanted to use the results to find interventions to improve care for migratory adolescents. During my project, I learned how to conduct interviews, lead focus groups and analyze qualitative data.
I also shadowed the other departments within FACES. I helped the reception staff with checking in patients; I learned how the clinical officers provided routine HIV care and how the pharmacists dispensed medications. I participated in the annual Sunburst camp. The organization trains adolescents 18-24 living with HIV as peer leaders, and offers various supports for youth living with HIV. In addition, I did a rotation at the Kisumu District Hospital (KDH) in the obstetrics ward. I helped the interns, the clinical officers and the midwives, and was involved in the management of high-risk obstetrics, including HIV infected pregnant women. I did vaginal deliveries, participated in morning rounds and cesarean sections.
During my time in Lumumba and the other four clinics that I worked at (Nyahera, Rabuor, Tuungane, and Pandpieri) I learned from community healthcare workers, clinical officers, researchers and patients. They all showed tremendous motivation in mobilizing the communities, and inspired me to do the same. Besides research and clinical work, I volunteered at the Tawi Initiative my friends started in the Rota village of Kisian Junction. It is a community-based organization that uses permaculture to empower the local community. We bought fruit trees, planted indigenous medicinal trees and built hippo proof fencing for the shamba.
I also ran two half marathons with my Kenyan friends. We trained daily, ran around Milimani and along Lake Victoria. We raced the Kakamega Marathon through the kakamega rainforest, one of the last fragments of jungle in western Kenya. I also had the chance to meet Mama Sarah Obama at the World AIDS Marathon in December.
From day one, I tried to adapt to the Kenyan way. I even asked everyone to call me by my Luo name “Atieno (meaning born at night).” I ate everything that was offered to me, but my favorites were the wet fried tilapia with brown ugali and green grams with chapatis. I attended all local events, baby showers, weddings and funerals. I danced to rumba and bongo music. I wore colorful kitenge dresses sewed by the local fundi and beaded sandals intricately threaded by the Maasai people. After just a week, I fell in love with the community and was able to call Kisumu my home.
Overall, I truly enjoyed my stay in Kisumu. While my research project aimed to offer support to the HIV positive youth in the region, it motivated and humbled me more in return. I was fortunate to have met great friends and benefited from excellent mentorship from Dr. Hilary Wolf, Dr. Craig Cohen, Dr. Patricia Ong’wen and Dr. Carol Camlin. FACES has positively impacted the health of many youth in Kisumu, and I am truly grateful to have been a part of it.