Goodbye Kenya

I have returned home in December and resumed work at GSK this week! You know that feeling when you wake up before your alarm usually goes off and you think: “No wait, it’s Sunday so I can sleep in… ahhhhh. Oh no, IT IS Monday!” That is how I felt only infinitely worst since I had not worked in over three weeks. Anyway…

What a great fellowship and a fun experience!

I am grateful for my IAVI and KAVI coworkers as well as my fellow GSK PULSE colleagues. This would have been a far less fun experience without Beverley, Caroline, Lisa, and Eileen to share the experiences. There are many stories I can share with friends and family, but there are many more stories that are “you had to be there.”

Goodbye Friends

Beverley, Eileen, Caroline, Lisa

Thank goodness I spent the first of the six months in London. Had I lived in the same apartment with Caroline and Beverley for at least six months then we would be considered married in the eyes of Kenya. Polygamy (for men only) is both legal and routine.

It still amazes me how five strangers could get along so well for nearly half a year. I look forward to our meet up in Boston- the middle point of our homes in the U.K., Quebec, and Texas! (no map or compass was used in my calculation, but I assume the real middle is in the Atlantic Ocean… though I also like the idea of a boat cruise).

Hell’s Gate

Mt. Longonot

Goodbye Colleagues

I wish I was able to accomplish more while working with KAVI. Of course, science never has an end point. Fortunately I am very confident I have left after enough time that the work is sustainable Kenyan scientists to continue.

I finished up my work and take off my lab coat for the last time.

“It fits!” Simon exclaims as he dons my GSK lab coat before it even settles on the rack. “You’re leaving this here, right?”

I’m not going to lie: I wish they all coordinated for my last day and wore the New York City t-shirts I got them (I suggested Boston t-shirts but they requested NYC). I should have taken more pictures since I don’t have pictures of even half my coworkers or any of the lab.

I did my absolute best. I learned a ton. I taught new skills and ways of thinking. I have a lot to bring back. I have changed.

“If you think you’re too small to have an impact, try going to bed with a mosquito in the room.” -Anita Roddick

Final Fun Times in Kenya

Below is a summary of Kenyan adventures in November and December.

Diani Beach

My KAVI coworkers took a team trip to Mombasa which is along the coast of Kenya. Because of U.S. and U.K Embassy warnings about the past issues with terrorists, GSK forbid me from joining my team.

This is like being told you have an all expense paid trip to Disneyland, but your parents forbid it because Goofy looks threatening.

So instead, my roommates and I went to the safe (but apparently not as nice), southern part of the coast. Diani Beach was a quick 40 min flight from Nairobi which made this a very easy weekend trip.

and no other tourists!

We rode camels!

“I think you killed your camel!” Said Beverley.

We all bought a Maasai dress for someone. Here we pretended to be Maasai.

Ostrich Farm

Tour of ostrich farm –> Ride ostrich –> Eat ostrich (not the same one)

Wendy and Anna

Eileen shows the strength of an ostrich egg

A bit chewy and flavorless. We agreed it was good to try, but nobody will order it again.

Animal Orphanage

We pet a lion and I was licked by a leopard.

Amazing how close we were able to get to the animals

~5 month old cheetah

Lukenya Trail Run

The current fastest marathon runners in the world are Kenyan. Wouldn’t it be fun to race alongside them!

We did not run the marathon distance, but I ran the 5k while Beverley and Lisa raced the 10k.

1st Prize: ~$40

I am the fastest 5K runner in all of Kenya.

I wish I was 22 yro

Okay, so competition was not fierce. The heat, dust, and rocky terrain made this the most difficult non-obstacle race I have run.

I was asked to take a picture with this guy. Maybe he is someone famous? I should have asked…

Famous Kenyan?

Lisa and Beverley also ran really well!

My GSK colleagues, Allison and Chris P., designed these race shirts for our team runs. I missed the Corporate Challenge 5k in July, but I was happy to run a race in the team shirt.

GLucozade Port

Thanksgiving in Nairobi

Anna and Wendy came to visit for the week which shifted the balance to four Americans in our group! Together with Eileen we were able to recreate some of our favorite Thanksgiving dishes.

It is tough to be away from family on such an important day. Fortunately Beverley, Caroline, and Lisa built up my excitement by talking about this dinner for a month which made this slightly depressing day away from family something to look forward to! It was fun to share our traditions while also explaining the origins of the holiday: something about Native Americans, Pilgrims, and small pox blankets (okay, I don’t actually remember the real story). Beverley, as a joke, had a feather headband and asked if we are supposed to sing the national anthem before we eat.

The main dish is key to the holiday, but I was not able to find turkey. When I tried to explain that a turkey is a large chicken, they brought out a large chicken. It is a small difference and chicken is similar enough.

Anna brought everything else that I could not find here: cranberries, pumpkin filling (for pie), quality cheese, and stuffing.

Caroline, Beverley, Eileen, Kevin, Lisa, Anna, (Wendy took the picture)

 To end with an American stereotype, which is fitting for typical Thanksgivings:

“I don’t stop eating when I’m full. The meal isn’t over when I’m full. It’s over when I hate myself.” -Louis C.K

An Outsider’s Perspective

AMREF Management regrets to inform you that November 30 has been canceled. We hope there is enough space to include it in next year’s calendar.

Good find Lisa Kenyon

There is a children’s clothing store nearby. How better to attract the attention of passing customers then by showing off your clothing on a hanging baby?

The security guard asked me to leave immediately after seeing the flash from Caroline’s camera.

Do you work in a stuffy and non-air conditioned office? Do you find yourself rolling up your jacket sleeves for ventilation, but then yelled at by your wife for wrinkling you suit*? This tailor shop has a solution for the everyday businessman!

*Funny side story:

Beverley and Caroline attended a meeting at their NGO, AMREF. The theme of the HR led meeting was that AMREF employees need to look more professional.

(paraphrasing from Beverley’s telling of story)

• Men: have shirts ironed by your wife or your mom.
• Women: wear your skirts below the knees. After all, men will be men.

You’re not from around here.

How to spot a tourist:

1. Camera
2. Maps
3. Bright colored vest

When you hear the whistle, find your buddy.

---

---

This could be a racist story if I was in the U.S., but I’m not so:

It was 7:15 pm when I returned home from Muay Thai class so the sun had fully set.

I was jogging up the dimly lit stairwell to my apartment by taking a couple steps at a time. As I am midway up level three I suddenly see only white teeth in the shape of a smile at the top of the stairs. I am startled and the smiling figure realizes this. “Habari (how are you?). Did I scare you?” the security guard asks.

“Yeah, your… uhh… dark features blend in with the dark stairwell.”

He laughs and I continue up past him with my heart beating very fast.

Visit to Kenya AIDS Vaccine Initiative of Kangemi

The two KAVI sites in Kenya are located in Nairobi and Kangemi.

The Nairobi site at the Kenyatta National Hospital, where I work, has an up to date lab where we receive blood donors and perform high-throughput assays. The KAVI site in Kangemi is located in the slums. Here the KAVI employees are within the area where many at risk volunteers can be found. A lot of the employees live nearby or have family that live in Kangemi so they are able to build trust within the community.

The Kangemi site does a lot of the initial screening for potential volunteers. They have kits for quick HIV, malaria, and pregnancy screening. They also host informational meetings to explain how the clinical trials work and what is expected from the donor. The doctors also administer the trail medicine. Further blood analysis is sent to the Nairobi site.

Malaria detection kit. (Picture taken by Lisa Kenyan)

I had a free day so I asked to visit the site.

KAVI in Kangemi

Kangemi, like most slums, is adjacent to middle class neighborhoods. This is because those that live in the slum might work in the adjacent town. Here there is a main road that splits the sections. Look to the left= slums; turn your head to the right= gated community.

I was introduced to the staff and everyone was eager to explain their role as well as answer my many questions. It was difficult to take pictures since there were clients here. The people in the pictures are KAVI employees.

Clinic Compound

I had some questions: (these are summaries put in my words)

Q: What are the volunteer’s top concerns?

Most people have never had blood drawn. Their fear starts with being in a doctor’s office. Then they are afraid of the needles. Finally they worry too much blood is being taken [these are multiple vials, but small quantities].

Q: Clinical trials require both HIV + and – patients. How do you get them to come in since being HIV + can make one an outcast?

Many people don’t know they are HIV + until they are tested here. [It can take weeks or years before showing something that is not a “flu like symptom.” HIV makes people ill, then they feel well again as their body boosts antigen levels].

If they already know, or we find out, then they come in the same way and around the same times as any other volunteer.

[HIV blood vials have a different colored cap. This is so I, as the lab technician, knows to be extra careful. Side note: it is practiced everywhere to treat all bodily fluids as HIV+]. Very few people in the lab knows exactly whose blood this is since patients names are replaced with an identifier number.

Q: Some trials require high-risk, but HIV- patients. How do you find sex workers and men who have sex with men since both practices are illegal?

We have built trust in the community. We have many clinical trials so past volunteers tell their friends that KAVI can be trusted.

Q: Do the clients get compensated?

It is immoral to pay people for blood donations so they get paid as a transportation reemburstment. We used to pay per km, but everyone said they lived at the farthest point to get more money. So payment is set at ~$15 USD per visit.

 

They suggested I return and go into the residential area and see how the outreach works. I really, really, want to see this first hand. However, I don’t speak Swahili well enough to understand the conversations. Also, in my opinion, a white person might make people hesitant to participate since I am not a local and could be seen as “overseeing” things.

A trip to the black… err… underground markets

I was told I have been neglecting the views of the city and culture of Nairobi. There are many nice supermarkets and malls throughout the city, but as you walk around you will find stands where you can buy… well, anything. Used, of course.

Are these your shoes? Perhaps you donated them and are now being sold between $2-10.

I showed in an earlier post how vendors sell the exact same product next to each other. I always think how would I out compete my neighbor. Selling roasted nuts? Maybe offer water and soda too. Here at this shoe shop it was immediately obvious: a fold out chair so people can sit while trying on the shoes.

Pants for only 50 KSH (~$0.50)!

Kevin: “I got maize, avocados, and bananas… was a child on our shopping list?”

Caroline: “KEVIN! That child is not for sale… I think she is the cashier!”

Child for sale?

Seeing us next to her stale, a women who was very close by tired to sell us some fruit. They are not bad or irresponsible parents, it was just a funny view.

It is very convenient to spontaneously buy produce (with an outer peel) as a snack on my way home from work.

HIV R4P

Nope, this is not a rapper’s name, it was the conference I went to in Cape Town, South Africa.

ohhhh… a woven bag and a beaded lanyard!

HIV Research For Prevention was partially sponsored by IAVI. I was invited to both help represent my site at KAVI as well as explain how IAVI and GSK partner up to assist worldwide. I met with many IAVI employees from around the world. I was also introduced to some of the leaders in the field of HIV research. Personally, I felt I did an amazing job pretending I too am an expert on HIV. “You have been studying HIV since the ‘80s? Well I was born in the ‘80s and have been studying HIV for five months. So yes, I would love to compare our findings.” This was obviously not an actual conversation and I was lucky that there was almost always at least one other person (i.e. real expert) in the conversation with me.

Cape Town

I could talk about how great the conference was (probably the best conference I have ever attended), but you really just want to see pictures of Cape Town.

Here is the extremely brief summary:

• Developing nations (mainly African countries) continue to be under equip with accurate knowledge about virus transmission and medical supplies.
• Developed countries are of course at high risk, but most have an insurance plan to cover HIV treatment. People with HIV can live a mostly unaffected life if given early treatment.

1. Which groups need to be addressed
   1. Minority groups such as sex workers, transgender, and men who have sex with men are at high risk but are underrepresented in clinical trials
   2. Advertisements for preventative measures are not directed towards these groups
2. Where should the the focus be going
   1. Further research with preventative medicines such as antivirals (remember this is a ‘research for prevention’ conference)
   2. Reduced cost to consumer to make preventative medicines a possibility for any budget
   3. Male circumcision (personal note: at birth. The Maasai perform male circumcision at age 13 *cringe* as a progression of the boy becoming a man)
   4. Female empowerment with additional birth control options such as female condoms or diaphragms with anti-HIV gel coating

The conference started on Tuesday so I arrived Saturday night.

Camps Bay

The outside temperature was perfect: averaging around 75 F, but the water is extremely cold (probably around 55 F).

Day Tour of the Peninsula

Cape of Good Hope

The Cape of Good Hope is the tip of the African peninsula. This is where the Atlantic and Indian Ocean meet.

Boat ride to ‘Seal Island’

So many seals

Boulders Beach

Plan for half a day when you visit the Kirstenbosch Botanical Gardens.

Kirstenbosch Botanical Gardens

King Protea- South Africa’s national flower

    

Table Mountain

Table Mountain

It looks like I am making a C. The person I asked to take the picture apparently had no idea what I was trying to do.

View from the top

Evening Cape Town Tour

Morning Shark Cage Dive

I did not bring my camera so I do not have any pictures  😦

It was cool to see great white sharks chomp on chum from a very close distance. The water was freezing though.

I really enjoyed Cape Town and hope to return again to explore more as well as go on wine tours. Johannesburg would also be nice to visit.

I instinctively wanted to use Swahili greetings, but then I had to remind myself that they speak Afrikaans here (and fluent English). It’s like taking to a German person but the only word you know is ‘Volkswagen’ so you shout that.

---

---

I have been taking Swahili lessons. Now I can comfortably stay greetings, tell people what I am eating (in all tenses), and negotiate prices (using only some numbers). I also know how to say soldier, which makes the rent-a-guards that patrol my apartment complex very happy when I upgrade their job role.

The language is rather simple and I wish I took lessons back in August because I suspect I would be able to hold full conversations by now. Because a lot of people in Nairobi combine Swahili and English in the same sentence, it often makes it even easier. There are some interesting parts that I now understand a lot better. Such as:

You may hear someone speaking in English say “Me I am going shopping.” (note: NOT: Me? I am going shopping). This is because the exact Swahili translation for anything about oneself is “Me I am…”

Here is one fast food chain that makes a Swahili-English pun. Kuku means chicken.

We are “kuku” about chicken!

In Swahili they don’t usually say the word “hello” (except to tourists: “Jambo”). The basic greetings start with “how are you?”

So when I say, in English, “hello” or “good morning,” Most people will respond with “I am fine.”

Then there are the words that have multiple meanings. This is common with any language, but there are some sentences where context is crucial to understanding the meaning:

The word ‘nyanya’ means both tomato and grandma. So: ‘Sisi ni kula nyanya’ means either we are eating tomatoes OR grandma. Let’s hope context clues solve that mystery quickly.

Visit to GSK Kenya and Factory Tour

Lucozade, Ribena, Panadol, and Scott’s Cod Liver Oil are fine GSK made products that Americans have never heard of (yes, the beverages are still manufactured by GSK). Other wonderful over the counter GSK products include: Tums, Aquafresh, and Breathe Right nasal strips.

How much fun would it be to tour the factory where these are made…

The GSK PULSE Team helped set up a meeting so those on PULSE assignment in Kenya could visit the office and factory located in Nairobi.

Today is a really good day in the factory!

Our PULSE colleagues in Kisumu flew down to Nairobi. I was very interested in meeting these five colleagues and trade stories. Three of them routinely post on the formal GSK blog and they are always so positive and say how everything in Kenya is amazing. Could Kisumu and Nairobi be that different?

We arrived at the GSK Kenya office at 9am and I was immediately amazed that the Kenyan employees were ready for us. They were on GSK time, not Kenya time! We even had an agenda! I was expecting the typical 30-45 minutes late start.

The tour began by getting a VIP badge. This badge gave us access to everywhere. I don’t even have access to all the rooms at my home site (only Caitlin and Patricia know the secrets within the ‘Mother’s Room’)

Product stability testing

                          

Yes, Pappar, I will bring back a pallet for you

I was really surprised how close we were able to get to the product.

After the tour we broke up into small groups to talk with potential PULSE volunteers and answer their questions. We began with an introduction of ourselves, how we have adapted, and what we have learned so far.

Quick 5 min speech explaining the slide below.

I couldn’t resist sharing a picture of autumn

In the small groups I was asked similar questions that I had grilled former volunteers: how do you deal with being away from family, scariness of being in a new country, and how to deal with language difference.

As a reminder, a PULSE applicant might have an option to work in their home country (3 months) or work abroad (6 months). Everyone I spoke to I tried to suggest they work abroad. When else could you travel and really experience another country (or two in my case: England and Kenya)?

One women was very eager to go on an abroad PULSE assignment. Her biggest fear was that living anywhere else in the world would be too expensive. I attempted to alleviate her concern by letting her know that PULSE will pay for extras that are required, but you do not have in your home country. For example, they will pay for your housing since you will still be paying for your home country housing. For me, in the U.S. we use the tap water for cooking and drinking so GSK pays for our bottled water here.

“You can drink the tap water in the U.S.?!” The potential PULSE volunteer gasped.

“Yes, it is clean,” I assured her.

“I have never drank tap water. Does it taste different?” She further inquired.

“It’s more watery then water. It’s got a water kick to it.” It is easy to pass comedian’s jokes as my own since it is very unlikely they know Jim Gaffigan (starts at time  1:15).

“So you don’t have bottled water?”

“We do, but tap water is regulated by the U.S. government.”

“You trust the government more than we do.”

---

---

The Kisumu group and my fellow Nairobi-based workers reconvened at Talisman for dinner. Talisman was voted the best restaurant in Kenya. “Oh how impressive,” you might say. “How many stars did it get?” It should surprise nobody at this point that Michelin has not granted a visit here yet. Talisman was delicious, but then again, I have been excited by all low sodium foods here.

It was great to chat with the Kisumu group and hear about their lives in the third largest Kenyan city. My take home thoughts from them is that their view of Lake Victoria looks fantastic, but I have won with Nairobi since there is far more to do nearby. Also, and more importantly, my flatmates and I get along far better and have way more fun together.