The (Bright) Future of Healthcare in Kenya

Our entire program in Kenya is built on a partnership between Indiana University School of Medicine and Moi University School of Medicine. On the educational side of this partnership, we train up physicians in both Kenya and North America who are prepared to tackle global health challenges.

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One lovely tradition in the training of Kenya’s next generation of physicians is a ceremony in which all of the medical students are given their first stethoscope before they begin their clinical rotations. A long-time faculty member at Indiana University, Dr. Anginieta Biegel, provided this thoughtful gift to the students and endowed a program to sustain this gift after her death in 2008.

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This ceremony is organized by the wonderful Tal and Betsy Bosin.  Tal is a retired IU professor who teaches pharmacology to the Moi medical students every year, just as he did at IU for many years. Together, he and Betsy also manage the scholarship program that enables Kenyan students from poor backgrounds to be able to become doctors. If you want to change the face of healthcare in Kenya, give poor, brilliant kids the opportunity to become doctors.  Amazing.

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This Stethoscope Ceremony is a special milestone for the medical students. Each one has their name read aloud, they receive their stethoscope from a clinical faculty member, they are congratulated by Dean of the Moi University School of Medicine and the Principal of the College of Health Sciences, and then they recite together their medical vows. The students beamed with pride after being given their stethoscopes, with the hope that each “would care for those we do not know.”

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Seeing the bright and beautiful faces of Kenya’s next generation of doctors is such a delight. My heart fills with joy to see all the hope and promise for this country’s health care system in the faces of these wonderful students.

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Fighting

“But we refuse to believe that the bank of justice is bankrupt… Now is the time to make justice a reality for all of God’s children.”

Dr. Martin Luther King, Jr., March on Washington, August 28, 1963

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Right now, over 3 million children in the world are infected with HIV. Ninety percent of them live in sub-Saharan Africa. In these places where kids with HIV live, in places like Kenya, our 2- and 3-year-olds have to take these medicines that you see below twice a day, every day to stay alive.

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(In case you didn’t count them, that’s 9 pills or pieces of pills. Every day. For a toddler.)

Today, my fight for justice included the opportunity to talk in depth with the CEO of a big company that makes drugs about what we need most for little kids with HIV. He gave me the chance to give him my wishlist and my priorities for versions of these medicines that would work better for our little ones with HIV and for their families. I was more than happy to do so.

That was my part in the fight today to make justice a reality for all of God’s children.

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Dinah’s House

I went on a quest with my team to find Dinah’s house. Dinah’s oldest two children have not showed up in the HIV clinic for the last 2 months, and one of them was quite sick the last time we saw him. Our clinic outreach team had not been able to locate them and Dinah did not seem to have a working phone number, but my team had made some contacts in the neighborhood and thought we could find them.

Dinah cares for 11 children – 7 biological children and 4 orphaned nieces and nephews. We know that she is often overwhelmed with this burden, and my wonderful team and I could not help but worry about the family.

After some driving adventures over dirt non-roads and lots of asking for directions, we managed to find Dinah’s house, one room in a long row building made of mud with a tin roof.  In this one-room home, there is not room for all 12 of them to sleep on the floor of the single room, so some of them sleep at the neighbor’s.

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The needs at Dinah’s house are stark – she asks whether we could help with food, with shoes for the children so they will not be kicked out of school for having improper attire, and maybe for assistance in renting a second room.

Dinah’s nephews and nieces ended up with her after their parents died two years ago. The eldest, a 16-year-old girl, told a terrible story with tears in her eyes. After her parents died, she had tried to look after her siblings, but then members of the local community had burned down the house in which they lived because “they didn’t want the HIV in the house to spread.” The girl speaks sadly, wistfully, about the school uniforms that they lost in the fire. They have struggled to remain in school ever since.

The good news at Dinah’s house was that everyone was still alive, even the two who have HIV and have been quite sick. One of the boys continues to be quite sick, though, and I worried that he needed to start treatment for TB. All of the children are malnourished, and it is clear there is not enough food to go around. We arranged for transportation for them to come to the clinic for the x-rays and medicines that I want to make sure they have.  We can keep them alive with these medicines, though clearly this family needs much, much more.

Dinah’s house reminds me of where I am, of what it means to live in one of the world’s poorest places.  When you go to Dinah’s house, you cannot escape from what it means that ONE BILLION people still live in extreme poverty, surviving on less than $1.25 per day. At Dinah’s house, you cannot ignore what it looks like to live in a country with 1 million orphans, where it often seems like an entire generation of parents has been wiped out. You see Dinah and these 11 children fighting against all odds to keep everyone healthy and fed and in school, and it seems like they are too-often losing. It is ugly and sad and painful.

And yet.

Better to look. Better to let your heart break. Better to be aware.

When you are aware of what HIV still means for our world, you can become part of the larger, global community coming together around these families and helping them to carry on.  When your heart breaks, you draw close to the hearts of others. When you look, you know how to fight.

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December’s Top Five

Clearly, I have been a deficient blogger in December. So on this the last day of December and the last day of the year, I will do a quick recap of the top five highlights from December in the world of Doctor V.

ONE: World AIDS Day

We launched The Pocket Square Project initiative to provide support services for my Kenyan children living with HIV with the first-ever World AIDS Day INDY event at one of my favorite establishments in Indianapolis, The Libertine Liquor Bar. You can see all the photos here, but everything about the event felt like a fabulous birthday party to celebrate more years of life for my kids. We launched our website, debuted a video describing the project, and sold lots and lots of great pocket squares to a crowd interested in fashion, philanthropy, and global health.

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Photo credit: preppyguidetolife.com

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TWO: Youth Initiatives in Action

With support from The Pocket Square Project, we have been able to start offering support groups for HIV-infected youth at several of the clinics that never had these groups before. Even though I wasn’t present in Kenya, the kids and clinic staff kept me updated in real time with pictures and thankful emails about the group activities. These times for interaction and education with others who understand what they are going through offer the kids a lifeline for growing up positively with HIV.

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My favorite thing on WhatsApp – when my adolescents in Kenya send me photos of their events as they are taking place!

Even more fun was seeing some of our older youth living with HIV take leadership roles in organizing some of these activities. For World AIDS Day, our youth organized a soccer tournament for teams of 10-14 year-olds. They hosted a community outreach event with education on HIV and entertainment like dance troupe performances to facilitate HIV testing and awareness. They came together to run a youth activity day that featured educational sessions, a talent show, soccer match, and goat roast for over 100 HIV-infected kids. I love seeing these kids have the chance not only to grow up, but to shine. It makes my mama/doctor heart so proud.

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THREE: Italy

I had the privilege of spending my birthday week in one of my very favorite places in the world – Italy. Nothing could make my heart happier than wandering around Rome and Florence, soaking in the beauty of the cities, and eating, eating, eating. Such fun. This gorgeous place.

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FOUR: New Projects

New ideas are my favorite things and this month has been full of launch of new projects. The Pocket Square Project seems to have endless potential to grow. I love how my friends came together to launch this initiative to connect people around how fashion can unite local and global communities. I am also launching several other new projects. With my filmmaker collaborator, Thomas Lewis, we received a grant to create new films in Kenya that will focus on HIV-related stigma. We hope these films might generate empathy that breaks down the intense stigma and isolation surrounding those with HIV. I am also launching a research project that looks at children’s adherence to HIV medicines in Southern Africa, East Africa, and Asia (yes – LOTS of travel ahead!). Plus, we are closing out the final minutes of this year with a grant submission to explore how the HIV virus in children becomes resistant to our medicines and what we can do about this. Plenty of new adventures for work.

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FIVE: Embraced by Dear Ones

Throughout this month, I have been embraced and loved by friends and family in big and small ways. For this, I will be endlessly grateful. In the first holidays after divorce, I cannot tell you how much it means when people make an extra effort to get your new address, to reach out with calls, to send texts on days they know will be difficult, to let you know that you are not alone. I have been well and truly loved, and that will be a bright memory for this transitional December of 2014.

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Birthday dancing with my dear Elizabeth. With candy canes!

My darling nephews bring me nothing but joy with their love and dearness.

My darling nephews bring me nothing but joy with their love and dearness.

As an example, my dear cousin sent me this unexpected gift that makes me smile every time I look at it. These earrings were made by my cousin’s grandmother through marriage, a remarkable woman who she describes as “one of the nuttiest, naughtiest women I know.” She was once kicked out of the Kremlin! This woman, an artist, traveled the world by herself just because she wanted to. I loved this sweet and thoughtful gift filled with love and pointing to an exciting future ahead.

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And so we walk together into the close of December and the new adventure of 2015! My favorite Mary Oliver for this new year ahead:

I want to think again of dangerous and noble things.

I want to be light and frolicsome.

I want to be improbable beautiful and afraid of nothing,

as though I had wings.

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World AIDS Day: Faith

I am day late on my World AIDS Day posting for the best of reasons – we were too busy launching the first-ever #worldAIDSdayINDY event last night.

A great crowd came out to The Libertine to commemorate World AIDS Day and to help us launch The Pocket Square Project initiative. I am overflowing with gratitude for how communities here in Indy came together to connect around fashion and global health. More on that later, hopefully with photos!

I still need to tell a special story here, though, for World AIDS Day. (Even a day late.)

On every December 1, the day that we celebrate World AIDS Day, I remember a little girl named Faith.  I met Faith the very first time I went to Kenya, which was exactly 10 years ago.

December 1 was Faith’s birthday. I wish that Faith was alive today to turn 14. Faith’s birthday should be celebrated. There is a gap in my heart every World AIDS Day when I think of Faith. There is a gap where a girl should be celebrating her birthday.

Faith was the first child under my care who died from HIV. I took this photo of Faith and her mother on the day that I met them in Kenya on the wards of the hospital.

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Faith was 4-years old, and she only weighed 4 kilograms – about 9 pounds. I had never seen a 4-year-old child like Faith before that day, a 4-year-old who weighed less than some newborn babies.

Four-year-olds are not supposed to look like Faith looked. The HIV virus had stolen all of Faith’s energy as it destroyed her body’s immune system. The HIV virus was stealing away Faith. She was beautiful, but broken.

Faith’s mother had worked very, very hard to get her daughter to the referral hospital. You can see in the photo how happy and hopeful her mother looks. She is pleased she managed to get her daughter to this hospital.

Faith died two days after she was admitted to the hospital. Our medicines, our fluids, our nutritional support were all too little, too late. We could not save her. I could not save her. I remember her last breath. Faith taught me my first real lesson in how HIV steals children’s lives.

After Faith died, her mother kept thanking me for this photo that I had taken of Faith. She did not have any other pictures of her daughter, and she was grateful to have this one.

I felt terrible when she thanked me. I felt like I failed because I could not keep Faith alive. What was a photo in the face of the loss of a 4-year-old daughter?

I wished that I could change Faith’s story. I still wish that. I wish Faith was alive to turn 14 on this December 1, on this World AIDS Day. I wish we all could know Faith today. I wish we were celebrating Faith’s 14th birthday today in a different way.

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We have lost so many Faiths. 210,000 children died from HIV last year. 210,000 stories we will never know. 210,000 birthdays that will not be celebrated this year.

When I took care of Faith in 2004, I did not realize that my life’s work would become trying to change the stories of children living with HIV in the world’s poor places. I did not know I would one day be caring for over 15,000 Kenyan children just like Faith through the AMPATH program. I did not know that I would spend every day trying change the stories of children with HIV around the world into stories of health and hope.

3.4 million of the world’s children are living with HIV on this December 1, 2014. I love it that we gathered in Indianapolis for World AIDS Day to try to change the story for children like Faith. That is the entire goal of The Pocket Square Project.

I want more birthdays for more children.

We could have kept Faith alive if she had been able to enroll in one of our HIV clinics and start the medicines for HIV before she got so sick. We could have given her many more birthdays. On this December 1st, let’s keep committing ourselves to more and more birthdays for children like Faith.

 

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