Goodbye Kenya

Today is my last day in Kisumu. I will be heading to Nairobi tomorrow morning and if everything goes as planned (which you cannot take for granted at all here), I will sightseeing bit around Nairobi before heading to Cairo. Even though I'm excited about the next leg of my journey, I'm definitely going to miss Kenya and hope that I'll be able to return someday. I've learned a lot during this trip and found myself thinking about things that I realize I had largely ignored while in the US (poverty, corruption, government's role in helping people). Despite many of the frustrations that I had here, Kenya is a really beautiful country and I hope that I was able to capture a bit of it in the hundreds of pictures that I took here.

I realize that being here for roughly 2 months offered a greater immersion to the country than most other short term missions (which usually last about 2 weeks), allowing me to see patients and the children on a more regular basis, follow their progress, and get to know them better. Furthermore, I feel like I was able to get a better sense of the different concerns and obstacles that come with the operation of a missions organization. In short, a more real, non-sugarcoated experience.  

To be honest, I don't really have the kind of spiritual high that one might get from leaving a retreat or something like that. But I think that's a good thing. I believe that I was able to experience God's work in a different way while in Africa and to find his presence in many not so obvious areas which I tried to translate in this blog. I was also able to see people's lives tangibly transformed by the gospel in positive ways.

It's hard to say whether or not this missions trip met my expectations prior to coming here, mostly because I wasn't really sure what to expect and had few expectations. I am extremely grateful for the people that I've met and for the friends that I've made- the team at Christ's Hope, the local volunteers, all the patients who opened their homes to us, all the children who wanted to talk to the mzungus, the staff at Maseno hospital. Again, I'm really looking forward to coming back to Kisumu, but until then I'm off to Cairo!

I'll be updating my blog (or at least trying to) while I am traveling - hence why the blog is called wanderingandrewly

The people we met and the friends we made

 Some of the men of the discpleship group, some examples of people's lives being transformed

Yoshi (left) and Lee (right). I actually randomly went up to Yoshi at Nakumatt (Kenya's rough equivalent Walmart) because I thought he might be Korean. He turned out to be a Japanese student studying public health abroad in Kenya. We exchanged information and we met up twice for dinner and just hanging out. He had met Lee, who is Malaysian but from Taiwan who is also studying Public Health, and invited her also.

Kanako (middle) is also Japanese and in the same program with Yoshi, studying public health in Kisumu. She's interested in studying the mother-child transmission of HIV. Even though we couldn't communicate with each other 100% due to their somewhat limited English, we had a lot of fun and learned a lot

George is a local volunteer (now actually full-time staff with CHI) and someone who we worked with a frequently to visit patients around the villages. He was all around a great and funny guy and someone I'd really want to see again if I were to come to Kenya.

Another George (there are many people here named George) who was our guard for about half the week. He asked me to teach him guitar. He's getting officially married to his wife in the summer.

totally random: I helped to visit a bee-keeping operation, donning a bee suit, smoking the hives, and collecting honey. This is a program that aims to provide a sustainable source of income to Kenyans through raising bees and collecting honey

The people we worked at the bee hives with. The family was incredibly grateful and gave us a huge meal after the bee-keeping excursion

A child of one of the patients we visited. It's truly tragic - her mother and father ended up dying of AIDS and she herself is HIV positive. She's already at a ridiculous disadvantage at life, before she even realizes it. Her eyes are hauntingly similar to her mother's

One of the local children who lives with one of the girls we visited regularly (the patient we visited was orphaned when both of her parents died of AIDS). She was really friendly, I think she wanted to play with the mzungu

Marieke holding the baby of one of the patients - we don't get the test results for the baby until tomorrow

Lillian, another volunteer who we worked with frequently, teaching a bible lesson at the ministry care point in Nyahera

All of these children are either half or full orphans, where one or both of their parents have died of HIV/AIDS

Really rowdy bunch of kids at Mambo Leo. Like most other African kids, they loved getting their picture taken

Children at the remand center who left a really strong impression on me during my time in Kenya. So many times I wanted to smack them but I realize that kids really learn what they see; they're not born violent or inclined to yell back to adults. I saw that the aggression of the children is really the product of a cycle of abuse and so it is important to treat them with love (which sounds corny but very true)

Children at the R.O.C.K ministries performing a skit around the negative social effects of traditional African culture. They wrote the skit themselves and came up with all the costumes! 

The younger children at the R.O.C.K waving goodbye. I'm really going to miss them

When they found out that I knew Brazilian Jiu-Jitsu, they wanted me to demonstrate

He's a patient who we were taking care of whose stay nearly coincided with our stay in Kisumu. He had been abandoned by nearly everyone in his village when he was dying before Desmond took him into the house. There he fed him, clothed him, cleaned up his vomit, cleaned him. Sadly he passed away from meningitis due to his immunocompromised state. We went to his funeral, which was packed with people, and his mother took us aside and told us: "all these people at the funeral, they all abandoned him when he was sick and now they're acting like they were there for him -- your organization, complete strangers, you were the only ones that were there for him" This left a strong impression on me, immediately reminded me of Matthew 25:34-45: 

"Then the King will say to those on his right, 'Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. 35For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.'

37"Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? 38When did we see you a stranger and invite you in, or needing clothes and clothe you? 39When did we see you sick or in prison and go to visit you?'

40"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.'

41"Then he will say to those on his left, 'Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.'

44"They also will answer, 'Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?'

45"He will reply, 'I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.'

This is another patient who Desmond took care of at the house as well. He had suffered a stroke and was unable to walk. Fortunately, he survived and is now going through rehabilitation to regain his strength

Pastor Martin and George visiting a patient in his home. This patient literally lives in a 1 room mud hut with walls that are falling apart. His previous home was burned to the ground - the only thing that he owns is a bucket

The things we ate:

I got really excited because I thought this was a Korean restaurant. Unfortunately I was wrong - Korean food doesn't exist here

I've grown to love mandazis (sort of like donuts) while in Kenya and chapati (sort of like naan, not pictured). I've grown to like a lot of Kenyan food and I'm looking forward to trying to find some good Kenyan or East African restaurants in NYC

This woman proudly displayed and paraded around the chickens that she would soon slaughter for our lunch at the health clinic

Similarly, we picked out the talapia that we wanted to eat (which was covered by swarms of flies) and then they deep fried it and served it to us. I tried to forget all the flies that had been eating it just moments before

We also had a lot of western style food. These pork chops, which we ate in a resort area off of Lake Victoria, were extremely delicious

the things we saw:

These rainbows appeared right outside our gate. The most vivd and complete rainbow that I have seen in Kenya

Masai Mara

herd of elephants walking away from the storm in Masai Mara

giraffe enjoying a meal of leaves at masai mara

I've never heard of this before. There was a rainbow around the sun

One of my favorite pictures from Masai mara

Kakamega Forest

we hiked up to the top of the largest hill to see the sunrise over kakamega forest - the only equitorial rainforest in Africa

This was a gigantic banana tree - just one of the many exotic plants in the rainforest

more pictures of the plant life in the forest

the view as the sun was rising over the forest

notice all the mist all around the forest

as daylight broke, the animals in the forest were going crazy. Even at the top of the hill, we could hear monkeys, birds, and other animals loud and clear

These boda drivers wanted me to take a picture of them

These African women wanted me to take a picture of them after they saw me taking a picture of the boda drivers

Kiboko Bay/ Lake Victoria

view of one of the numerous rainstorms that we were in during Kisumu's rainy season

view of the sun rising from Lake Victoria

Some fishing boats parked along the coast of Lake Victoria

beautiful view of the vast expanse of the lake - you can see the moon in the middle of the sky

a couple of fisherman who had risen bright and early to start their day

Nice view of the coast from the sea. If I had to imagine a visual for God speaking to me, this would be it.

Compliance

One of the remarkable things about modern medicine is how good the drugs can be if they are used correctly. All 3 of the individuals below were on their death beds with extremely low CD4 counts. One of our patients (not pictured) had a CD4 count of 2 (as a reference, an HIV patient with a CD4 count of 200 is considered immunocompromised - as in, a count of even 200 is very low). Another was found on the side of the road in a wheelbarrow. For some, their families had essentially abandoned them in the hospital to die. However, thanks to the modern medicine and the grace of God, these and other individuals were able to recover and are healthy today.

Although we do not yet have a cure for HIV, the current drugs used for treating it can be surprisingly effective. During one of my medical school interviews, the interviewer who ran an HIV clinic, said that it was exciting practicing in that field because he saw, "patients who had one foot in the grave seemingly come back to life." Despite the effectiveness of the therapies however, one of the major issues in realizing this effectiveness is the lack of compliance - oftentimes patients will not take their mediations, take wrong dosages, or take pill combinations incorrectly. And a large part of what we do when we visit the patients in their homes, is to make sure that they are taking their medications consistently and correctly - we ask them to show us their medicines, we count their pills, and we "quiz" them on which pills they take every day and how.

In spite of all of these efforts, sometimes the patients will still not comply. Sometimes I can't believe how non-compliant patients can be: there was a woman who after about 2.5 months still did not understood how to take her medicines and was getting more and more unhealthy; in another family, the mother was repeatedly getting drunk on illegal moonshine (changaa) and unable to provide the drugs correctly to her children (We eventually put the eldest son in charge of giving the medicines). In my mind, I wonder if they understand the stakes; their lives are on the line and directly correlated with their taking the medications correctly. HIV ruins lives, families, communities, and nations. Here's a graph I found on wikipedia about the plummeting life expectancy in Africa due to HIV/AIDS, erasing all the gains that had been made in past decades.

The non-compliance of the patients with respect to their physical health reminded me of my own non-compliance regarding my spiritual health. Jesus essentially gives us 2 "prescriptions":

"'Teacher, which is the greatest commandment in the Law?"' Jesus replied: 'Love the Lord your God with all your heart and with all your soul and with all your mind.' This is the first and greatest commandment. And the second is like it: 'Love your neighbor as yourself.' All the Law and the Prophets hang on these two commandments.'" - Matthew 22:36-40 (NIV)

Despite these prescriptions, how many times have I loved myself above God or treated my neighbor lesser than myself. Pretty much all the time. Just like our lives, families, and communities would be better if everyone took their medicines correctly and avoided harmful behavior that spread HIV, those same institutions would be improved if we followed those prescriptions. Just like we have dosing regimens not to constrain them but to help them, we have been given these commandments to not to restrict our freedoms but to improve our lives. But we all see that the world is not the way it should be and that we not been living the way we should be living - and this has been true since the very beginning, starting with Adam. Indeed, we don't fully realize that the stakes in failing to follow God's prescriptions are infinitely higher than failing to follow a doctor's prescriptions around drug therapies.

Theoretically, stopping the spread of HIV could be simple: avoid unprotected sex, don't use dirty needles, and for those already infected, take medications correctly so as to reduce the viral load to low enough levels where it would be unlikely to transmit the disease. Nonetheless, visiting and speaking to patients sometimes offers a glimpse of how difficult it can be to take medications correctly. For example, a patient might find themself feeling better so they might take their medicines less frequently so as to save pills and thus money; a patient might just not have the time/energy after juggling work and home duties to go to the clinics, which are often located far away and inaccessible; sometimes, even if the patients make it to the clinics, they are corrupt or unreliable and don't provide the right medicines to the patients; some patients just don't understand or have the capacity to understand (the woman who was noncompliant for 2.5 months had AIDS dementia). But I am still routinely surprised by the apparently poor decisions of some patients and will never fully understand their behavior as I have not been in their shoes.

But whereas I would not be willing to live the lives of these HIV patients - to contract the disease and to live in Kenya's slums - Jesus voluntarily became a man and became the perfect example for us. Where Adam had failed to be compliant, Jesus was perfect, living the life we should have lived and died the death we should have died. But beyond that, through this obedience and death, we have been saved from ourself.

"Therefore, just as sin entered the world through one man, and death through sin, and in this way death came to all men, because all sinned— for before the law was given, sin was in the world. But sin is not taken into account when there is no law. Nevertheless, death reigned from the time of Adam to the time of Moses, even over those who did not sin by breaking a command, as did Adam, who was a pattern of the one to come.



But the gift is not like the trespass. For if the many died by the trespass of the one man, how much more did God's grace and the gift that came by the grace of the one man, Jesus Christ, overflow to the many! Again, the gift of God is not like the result of the one man's sin: The judgment followed one sin and brought condemnation, but the gift followed many trespasses and brought justification. For if, by the trespass of the one man, death reigned through that one man, how much more will those who receive God's abundant provision of grace and of the gift of righteousness reign in life through the one man, Jesus Christ.


Consequently, just as the result of one trespass was condemnation for all men, so also the result of one act of righteousness was justification that brings life for all men. For just as through the disobedience of the one man the many were made sinners, so also through the obedience of the one man the many will be made righteous.

The law was added so that the trespass might increase. But where sin increased, grace increased all the more, so that, just as sin reigned in death, so also grace might reign through righteousness to bring eternal life through Jesus Christ our Lord" - Romans 5:12-20 (NIV)

The doctor at the hospital I stayed at last week said that the war against HIV as it is currently dealt with now is a hopeless cause - people's behavior is especially difficult to change, especially given different aspects of the culture here (ie: aversion to using condoms, polygamy, wife inheritance). We can keep trying to treat and prevent new infections using traditional methods but we're just putting out fires and not containing the spread - the disease could only be eradicated on a large scale if a vaccine is invented.

If we are non-compliant to the "prescriptions" granted to us by God, then to me, the cross is like the "vaccine" which preempts the inevitability of our non-compliance, addresses our intrinsic inclination to sin, and eradicates death once and for all. In light of the frustrations that our team, doctors, mothers, children, communities and nations face every with dealing with the HIV problem and non-compliance, the new covenant in Jeremiah made so much more sense to me. The compliance issue with HIV offered the backdrop by which I might be offered a glimpse of God's frustration and heartbreaking disappointment at the Israelite peoples' failure to uphold the earlier covenants.

"The time is coming," declares the LORD,

"when I will make a new covenant
with the house of Israel
and with the house of Judah.

It will not be like the covenant
I made with their forefathers
when I took them by the hand
to lead them out of Egypt
because they broke my covenant,
though I was a husband to them,"
declares the LORD.

"This is the covenant I will make with the house of Israel
after that time," declares the LORD.
"I will put my law in their minds
and write it on their hearts.
I will be their God,
and they will be my people.

No longer will a man teach his neighbor,
or a man his brother, saying, 'Know the LORD,'
because they will all know me,
from the least of them to the greatest,"
declares the LORD.
"For I will forgive their wickedness
and will remember their sins no more." - Jeremiah 31:31-34

Mzungu!

"Mzungu! Mzungu! How are you? I'm fine!" - If you're a foreigner and walking through a town in Africa, you're pretty much guaranteed to hear this. Most often the culprits are little children who all somehow seem to know the phrase "How are you? I'm fine." (Note that they don't actually wait for you to ask them how they are, they just immediately answer that they're fine) Oftentimes they'll chant it together in unison (which is actually sort of cute) and you'll hear it coming from unknown directions and hidden pockets like an ambush - behind a fence, underneath a bush, a child being washed by their mother. On one occasion, I saw a little baby using up some of its precious first words trying to say "moo zoogoo..how ah yoo" It's sort of cute and endearing at first - it almost makes you feel like a celebrity, being recognized and called out anywhere and everywhere you go - but after a few weeks, as with the paparazzi, they can definitely start getting annoying. Looking back at my own childhood, I think the closest thing i could think about to this behavior is how we always used try to get a truck to honk its horn everytime we saw one pass us by on the highway. Sometimes the truck drivers ignored us but It was exciting to get any kind of response.

Random school kids out for lunch saying hi. (I don't know what's wrong with the kid on the bottom left)

 Children playing in the schoolyard in a different part of town excited to see the "Mzungu"

children from one of the slums, Nyallenda

They love it when you take their picture and show it to them

Random kids yelling out "Mzungu" while we walk down the streets

As an Asian, I also get called Chinese all the time. Oftentimes, I'll be walking down the street and a street vendor or piki driver will yell out "Chinese" or Ching chong. When I bought new sunglasses at the local mall, the lady wrote "Mr. Chinese" on my receipt. Being Asian does have its perks though - since Asians are not that common here, much of their impression of us comes from movies, most of which happen to be Kung Fu flicks. On one occasion, our local volunteer started laughing while we were walking down the street, explaining to us that he heard one of the African men telling another, "you better watch out for those guys over there, they can knock your teeth out with one blow!"

Needless to say, as a foreigner and as an Asian, I stand out a lot. And unfortunately, one of the most annoying things about this is the idea, held by many of the locals, that foreigners are just made out of money. As foreigners, we oftentimes pay more for everything, sometimes significantly more because prices are usually not printed - transportation, food, and merchandise. To be sure, it is probably true that I do have access to more money than many locals (although I would also like to point out that considering how much debt I will incur due to medical school, my income will be significantly more negative than theirs for the next few years) but it is not a good feeling at all to know you're getting ripped off and paying more than an African for the exact same things, especially when you're here to try to help the country.

However, those locals who try to rip me off obviously don't see it that way: the mzungu who is able to pay more should pay more. There's a feeling of entitlement to my money and a sense of justice in taking it (in a very Robin Hood-esque mentality I suppose). Sometimes locals will see a mzungu coming and simply go up to them, stick their hand out, and demand money: "give me five shillings." One time, a local was helping out a mzungu set up a Kenyan neighbor's bee-hive project, seemingly out of the goodness of their heart - helping to build and take care of the hives - but then at the end of the day said, "all I ask for in return is a brand new cell-phone."

I'd like to think that this line of thinking is unique to Kenya but it's pretty common all around the world. For example, it reminded me of how low and middle class Americans generally don't even think twice about taxing the upper class at higher rates - it's only fair that they should pay more right? I don't know what it's like to be in the uppermost tax bracket but they're probably not too thrilled about paying a higher percentage of their income. In general, I think that when we see that someone has a lot more than us, it's easy to feel a sense of injustice and that perhaps they owe us something.

The truth is that as a Christian, I should be trying to help the poor because that's what I'm called to do, more so than anything else. Unfortunately, it's not always clear how it is that we should help the poor. Oftentimes, helping the poor in a meaningful way is pretty hard and confusing. Surely we can't just go around handing out money or gifts to anyone who looks like they need it. There would be chaos and it would also potentially create a harmful cycle of dependence where the recipients would not learn to help themselves and also feel justified in their sense of entitlement to the giver's goods. Unfortunately, I think a lot of the missions and aid work in the past did exactly that - giving out money, food, supplies rather haphazardly to the needy, creating a cycle of dependence and a growing sense of inadequacy in a nation's ability to help itself. Sometimes giving someone what they want, or rather, what think they need, is precisely what will hurt them the most.     

If we are indeed inclined to expect something from someone that has more than us, how much more do we expect from God? We all know and have personally felt angry at God for not making us richer, not making us more beautiful or talened, taking away a loved one, striking us with some kind of disease, etc. We might even bargain with Him: "ok, for all the good things I have done today - I went to church, helped an old lady across the street, donated a lot of money - all I ask for is a brand new cell phone." We ask for, or maybe even demand in prayer that he gives us what we think we need, perhaps not realizing that those things might be precisely what will hurt us the most. I guess we can find solace in knowing that although we might not know how to help the poor because at times it is difficult and confusing, God knows how to help the poor (in this case the poor would be all of us). And furthermore, He has already given us something that was more costly to Him and of greater value to us than we will ever know.