Cultural and lifestyle differences compared to life in America are everywhere here, and I hardly noticed them anymore. You mean we really don’t shake hands every time we see someone in America?! I just don’t believe that these days. Bucket bathing doesn’t feel weird anymore and living in this community feels like home for the most part. Life doesn’t feel so different. But sometimes the differences slap you right in the face. These are some examples of those cases.
For our technical students, the following was suggested as a rule the breaking of which would classify as a “gross infraction”: Premarital sexual relationships are not allowed.
Say what?!
Now, at first, I thought this was referring to a case with teachers or staff and the students which seemed alright (if an odd use of terminology). When that proved incorrect, my next assumption was that the clause referred to sexual relationships on the school compound. Wrong again. In fact, it referred to a rule against any student engaging in se at any point in their life while they are a student (all premarital sex anyway).
This is such a gross violation of privacy and human rights it horrified me. It’s true that sex at an early age can lead to unwanted consequences (illness, pregnancy, dropping out of school… etc) but it is NOT within the realm of school teachers or school officials to know what their students do with their personal lives. At the very least, they have no right to know. The way to tackle the issue of unwanted consequences of sexual relationships is to teach life skills, counsel students on good decision making, and make sure they get good sex education all with the aim of equipping students with the tools and knowledge to be able to make informed decisions. That should be the role of the school. So says the American.
When we brought up our concerns, my colleague and I discovered that this is a common rule for all secondary schools in Kenya, especially boarding schools. I shared my points and said that I, personally, feel uncomfortable with the rule, but since I can’t know what is appropriate in the Kenyan context the issue should be raised again at another meeting where some other Kenyans can weigh in on the issue. It was eventually decided that there was no need for such a rule, as we are teaching life skills and most of these students are having kids already, but also because we don’t have to follow exactly what the schools do. Rafiki has its own standards and values it needs to uphold and we have to do what is right for the organization. It was really such a strange conversation. On the one hand, my mind was completely blown by the idea of this rule – coming as I do from a place that holds such high value in personal space and privacy. But, looking at it from the Kenyan contex, where it is a village that is responsible for raising a child and parents/adults know best, the rule makes a certain amount of sense (or at least you can see where it comes from). I stand by everything I argued and my opinion holds, but sometimes I have to step back and realize that it is an entirely different culture I’m living in and I have to make sure I’m being culturally sensitive. And that is sometimes a really difficult thing to do.
Also, an experience a couple weeks ago has been a great demonstration of the failures of the public health and medical systems in Kenya. An OVC in our program at Rafiki was bit by a dog so the mama took him to a clinic. The clinic was able to give anti-tetanus but anti-rabies was quoted at 6,000ksh (about $60) and the mama couldn’t afford it. She came to us for help so we began looking into ways of helping her. The problem is that we don’t have 6,000Ksh lying around either. We contacted a friend of a colleague who works at the hospital and he offered to get us all 6 doses for 1,000Ksh under the table. He would basically just steal the vaccines and give them to us. A tempting offer, but we don’t want to buy into the corruption which only serves to keep Kenya in its current, debilitated state.
We kept looking into other options and eventually found a partner organization who would be willing to reimburse us if we arranged for the OVC to get the vaccine. Sweet, problem solved! But not so fast… we called the hospital with this information only to find out that the last doses in stock had been sent to another health facility. In order to get the vaccine to the OVC we would need to travel to Kisumu and purchase the anti-rabies from a chemist. So the next day, I traveled to Kisumu and bought the 6 doses (the complete regimen) for 7,800Ksh and brought it back to the district hospital. Since anti-rabies needs to be kept in cold chain and I had no way for transporting it like that, the chemist put some ice packs into the bag and I rushed as fast as I could (not fast considering Kenyan transportation). It took me about 2.5 hours to get to the hospital. Upon arrival I discovered that the chemist had packed the anti-rabies in a solid block in the middle and the ice only on the bottom so the ice was not as effective as it could have been. But the anti-rabies went straight in the freezer at the hospital labeled for our OVC. By the time he arrived with his mama for the shots it was day 7 post-bite. Anti-rabies is supposed to be started at day 1 or 2 post-bite or efficacy is drastically reduced.
We did everything we could, as fast as we could, and the kid still could have died. At day 7 post-bite with no symptoms he probably didn’t get infected anyway. What could have helped this situation? Any number of very simple things – or things that we, in the developed world take for granted every day:
a. Supply chain for anti-rabies to prevent stock outs in the district hospital – though even then, the cost of anti-rabies makes it prohibitively expensive for anyone in the community we work in
b. Cheaper medicines for the community
c. Anti-rabies vaccines for animals in the community – I’ve heard of programs in other areas of Kenya where children get a 50Ksh (50 cents) stipend to bring their dogs to school for the shots
It breaks my heart the number of simple, preventable things that can take a child’s life here. One of our close partners in the Ministry of Health just lost his 10 month old daughter to an upper respiratory tract infection because the right anit-biotics weren’t given in a timely manner. No one should ever have to know that kind of grief.
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