Confusion

I write this entry from the top of the hotel I am staying at in Kisumu.  There is a rooftop bar, with free wi fi internet and hip hop/music from home.  It is overlooking a park with trees and walkways similar to Central Park in New York, and Lake Victoria is not far off in the background. My heart and brain are overflowing with feelings, and I find myself longing for that bowl in Harry Potter that Dumbledoor puts his memories into - thinking that if there were less going on in there, I would be able to form some sort of clear understanding or picture of how I feel.  Since this is not the case, hold on to your seats as I take you on a few tangents that I have experienced in the past week.

I met with the director of the Doctors Without Borders office last week on Thursday.  After conducting almost 20 brief interviews with people living with HIV in Kochia, I decided a trip to Homa Bay where they are actually getting their ARVs from was necessary. I entered the meeting with many questions formed with the knowledge from past papers written, research before this trip, and the recent interviews I had had. 

All the research and knowledge I walked in with was quickly replaced. The patents on ARVs are starting to run out, which has allowed for the development of cheaper generic drugs in the past five years.  THey have been able to combine pills that were originally made by different pharmaceutical companies, bringing the 6 or 7 pill count downt to 2 that you take 12 hours apart. The huge figure of 10,000 dollars to treat a patient for one year has dropped downt to a more reasonable figure of 100.  The Kenyan government (with assistance from USAID and PEPFAR) provides ARVs for free to every person living with HIV.  I explained that many of the people I interviewed were having trouble getting the proper amount of food that is required when you take ARVs, and that sexual education in schools was non-existent.  The director responded that that was outside of what they deal with, because MSF works exclusively with hospitals and providing medical services as opposed to social. I am now on a hunt to find the social services (NGOs, CBOs, etc) that are trying to address these problems. 

The bigger issue and disease now is TB.  The director explained to me that there is much more stigma surrounding this disease, and people here think that it is only a 'poor persons's disease.'  People are not being tested for it frequently when they go to health centers, because most of the focus is on the voluntary counseling and testing of HIV. Many people who are living with HIV also have TB, but few know or are being treated for it, so this is where Doctors Without Borders have been focusing. The visit was very interesting, and opened my eyes to the difference between what is being presented in literature and what is actually happening on the ground.

I spent this past weekend in Kisumu (3rd largest city in Kenya). It has been like a mini vacation from Kochia, and I feel quite spoiled.  The gaps in income back home in the U.S. are known by everyone (or almost everyone), but I have never had the opportunity to experience how the different groups are living, being very fortunate with the upper middle class upbringing my parents have given me (thank you).  I have now experienced it in Kenya.  I spent yesterday laying by a pool in a resort that reminds me of places I've stayed with my family in Hawaii.  The drive to get here was on a bumpy dirt road, through mud houses that looked similar to where I live in Kochia.  I was unable to swallow the guilt that was lodged in my throat as I snacked on fries while looking out onto Lake Victoria.

I have met many volunteers during my stay here, and find myself wrestling with the concept of 'helping.' I have had conversations with many of you via email or phone about this, and find myself still confused.  Personally, I'm not sure how much I can do to change the disparities that exist here.  My heart is urging me to come back home, spread what I have seen to as many people as possible and work to change our country's foreign economic policies and mentalities - but this by itself is a daunting task. The pull to do something to change the inequalities here is felt by everyone that has spent longer than 2 weeks here, but the answer to how still evades me.