This school visit choked me up a bit

Posted on October 11, 2022 by johnageddes

Last week while visiting a school in Nyanza Province with Dan, I experienced a particularly touching moment.

Two schools, Nyangulu Secondary School the adjacent primary school, also called Nyangulu are in a valley (Nyangulu apparently means “a place of valleys”) that’s down a very bumpy road that gets partly washed out by the rain. It rivals a bumper-car ride at the fair to get there. The schools are virtually on the equator.

The secondary school looked orderly and well managed. We were there to bring greetings on behalf of the CanAssist Trustees and donors and to officially turn over a new 10,000 litre water tank that was already full to the brim because of the late afternoon rains we have received in the past week. While I had been visiting the district for the previous week, the mornings were often bright and sunny and hot and then, at about four, thunder rolled in the distance and brought a brief but torrential downpour. Then the skies cleared in about an hour.

Video: Typical short afternoon cloudburst in Nyanza Province.

The Nyangulu secondary school has about 700 students who all met outside during their morning break to receive our greetings. One of the girls thanked CanAssist for their contributions to the school. She requested that CanAssist help next with some kitchen improvements. After the assembly, Dan and I strolled over to see where three cooks work to provide two meals a day for the 700 pupils. It was a tiny smokey shack with a couple of huge pots and a lean-to beside it with another open fire. It was unimaginable that they could provide food daily from this environment for all of these kids.

Video: Can you imagine preparing lunch did several hundred high school students in this “kitchen”?

Then we walked next door to the primary school where another water tank had just been installed. Once again we were greeted by staff and students and I went from classroom to classroom to say hello. In once class they sang for me.

Video: Grade 5 at Nyangulu Elementary School welcome me with a song,

As we were about to leave, we were directed to a group of very young students under a tree by the primary classes who wanted to greet me with a couple of poems.

One of the poems was about being a Good Samaritan and thanking CanAssist for the contributions made to the school.

Video: Outside under a tree, a grade three class recited a poem they had practiced about CanAssist being a Good Samaritan to them.

“A Good Samaritan becomes a good neighbor. A neighbour is anyone in need. We were in need of hand-washing containers, latrines, storybooks, balls for play and fresh water to drink. CanAssist was there for us. You provided all these. You are our Good Samaritan, a wonderful partner. God bless you and thank you.”

I found this very touching. I told them that I remembered a stained glass window depiction of the Good Samaritan in New St James Church in London, Ontario beside the pew where my family usually sat when I was a their age. I probably spent a lot of time looking up at that colorful window and daydreaming during the sermon.

**This stained-glass window is like the one I remember from my childhood.**

I realized as I heard these kids and thought about this childhood memory of the Good Samaritan window that the message of that parable must have had an influence on me in choosing both my vocation as a physician and the development work that I have done over the years. I reflected on what a privilege it has been for me to be able to work with communities in East Africa, to meet so many friends there and to have unique interactions with them. My life has been incredibly enriched by these experiences. Hearing the children recite this little poem triggered a surprisingly emotional response in me as and will be a moment that I will long remember.

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My tree at Kona Baridi

Posted on October 8, 2022 by johnageddes

I have visited my friends, Liz and Stephen Moiko and thief family several times over the past 18 years. They live on a farm-like property near Kiserian, Kenya, about 45 minutes southwest of Nairobi.

On every visit (and when I have traveled with friends to Kenya) I always take time to hike up the hill to visit a tree that hangs out over the edge of the Rift Valley.

**A visit to my favourite tree in January 2012. Two weeks later, Liz had Charles who is now 10 years old. Time flies. But somehow this spot remains constant.**

The valley below is often lush and green but this time it is dry and brown. There is always peace and quiet there with a refreshing breeze and maybe the tinkle of goat bells in the distance. It is one of my favourite places on earth.

Video: Some moments with my tree near Kona Baridi in 2022.
It never disappoints.

Once again I hiked up to my tree and soaked up the ambiance, reflecting and remembering. And taking the same photo I have taken for years of the tree arched out over the valley like in a group of seven painting.

Video: Finding my tree on Google Earth. A half hour hike from the Moiko homestead.

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Malaria, HIV and COVID. What’s changing with health in Kenya?

Posted on October 1, 2022 by johnageddes

Kenyans are used to dealing with illnesses that threaten their well-being.

Malaria is ever-present. I figure that malaria poses a much greater threat to me as a visitor than COVID as I visit Kenya and I take daily prophylaxis to protect me. Malaria can cause fever, malaise, muscle aches, headache and sometime death. Better medical management choices, rapid tests for malaria, and recent introduction of immunization for infants will soon reduce the prevalence and morbidity in Kenya (and other tropical countries) from malaria.

Africans have also been living with HIV for over 20 years now. Although HIV/AIDS was devastating a few years back it has become manageable with education and effective management. New cases of HIV are now much less common.

Preexposure Prophylaxis (PREP) and Postexposure Prophlaxis (PEP) are now available and medical management of AIDS has come down to one pill a day and an every six month checkup at a local health facility instead of 10 pills daily on a regimented schedule and monthly visits to a special clinic that is not close to home. A test and treat model whereby newly diagnosed cases are immediately put on antiretrovirals rather than waiting until their health indicators are deteriorating has reduced morbidity has made a huge difference.

When I traveled here in 2004 the prevalence of HIV was over 40% in one of the communities I frequently visited. Today I am told that new cases are much, much less common and most of the patients with HIV are long-standing and receiving effective ongoing care. In 2004, Kenyan life expectancy was 48 compared to Canada’s 81. Today it averages 68.

What about COVID? The recent COVID pandemic has disrupted the Kenyan economy and health as it has around the world.

During tHe height of the pandemic last year Kenyan Public Health authorities instituted a strict lockdown. Schools and most businesses were closed for over a year. There was a curfew imposed from 7pm to 6 am for over three months with the penalty for breaking the curfew being arrest. Hand washing and masks were required, along with frequent temperature checks before entering indoor establishments or stores. Gatherings for funerals or weddings were restricted. Masks were required in all public transportation including matatus (the ever present taxi vans often stuffed to the brim with 14 passengers) Vaccination was delayed but gradually became available (AstraZeneca) in mid to late 2021. Pfizer boosters have recently become available but, as in Canada, calling it a booster rather than a third scheduled shot to complete protection is making it seem optional to many and uptake is less.

**Dan rolls up his sleeve to get his Pfizer “booster”.**

There has been no easy way to determine how many were infected. My friends tell me that older folks were dying of short catastrophic illnesses but there was no way to know if it was COVID because testing was not readily available.

Businesses and individuals who worked in the hospitality/tourism sector suffered financially. Small street vendors were limited in how they could sell their wares or foods. There was no financial social assistance. It was a struggle.

Now, in September 2022, things look like they are returning to normal. Some people tell me that they think they probably had COVID as they had the common symptoms but no one really knows for sure. I have seen no one wearing a mask in the week that I have been living in this rural community. When I arrived there were a few masks in the airport and on the plane. This was requested but not required. No one talks about COVID unless I question them.

**Higher income countries have an older demographic. Look at the map of Old Age Dependency ratio, the darker areas having an older demographic**.

Western countries, Have an older demographic and have more diseases associated with aging like heart disease and diabetes and cancer. More people in these countries will require intensive management of COVID or even die from it because of the increased vulnerability caused by advanced age or co-morbidities. These cases do exist in Kenya, too, but they are difficult to diagnose because of lack of testing and little management that patients could access (ventilation or even oxygen therapy) unless they are well-off and live in a larger urban centre.

World death statistics from COVID show much lower death rates per 100,000 population for Kenya (in blue along the bottom) than the western world. Is this because the deaths are just not being identified or because the lower average age means less severe illness, or both?

So Kenyans have a couple of things going for them in terms of COVID. The much younger population are not as likely to become severely ill and if they acquire COVID at school or in the community they will develop natural immunity that might be boosted with recurring mild infections. They also have a warm climate here and folks spend most of their time outdoors. Weddings and funerals and other gatherings are mainly outdoors and homes have open doors and windows much of the time to improve ventilation. Vaccination is now available to them as well. The challenge now is how to encourage them to get it . The poorer uptake of the “booster” is mainly due to thinking it is optional rather than the resistance seen in North America by folks who think it is impacting their “freedom”.

(Video) Socializing after church outdoors. Some get a COVID booster under a tree while others remain inside to sing some more.

What’s next? There has recently been a small outbreak of Ebola in Uganda and another suspected case in Kenya. The border between Kenya and Uganda has been closed. Hopefully, this will be contained as in the past. We have seen how HIV and COVID can insidiously invade a community.the fear is always that Ebola will become more difficult to manage as well.

**To end on a cheery note, here is the hibiscus I have been looking at this afternoon beside the porch at Dan’s house as I write this post.**

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S.P. Geddes School in Osiri Village, Kenya

Posted on September 27, 2022 by johnageddes

In 2011 I met Meshack Andiwo who lived in a small Kenyan village near the Luanda K’Otieno ferry that takes passengers and cars across Homa Bay to Mbita Point. He told me that small children in his community were struggling when they went to Primary School because they didn’t have the basics of English and arithmetic. They were too young to walk the distance to the nearest Primary School. Once the were old enough to walk the distance to school they were behind many of their peers and they became discouraged and lagged behind. He wanted them to have some early childhood education so they would not struggle or be discouraged and quit when they were old enough to walk to school.

I told my late Dad who was about 92 at the time,about this challenge and he offered some financial support through the CanAssist African Relied Trust to start to build a school for the community and it began with one small tin classroom and a latrine. And so it began.

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* video Come, come, come. Come to SP Geddes School for a better foundation. A young child will grow and grow and later become a doctor/teacher.

I visited the school today. There are several buildings now, a kitchen, clean new latrine, a fenced playground and a small office. There are currently about 50 kids at the school from preschool age to grade 4. They are learning the basics and being fed a breakfast of porridge and a lunch of beans or rice and vegetables, sometimes their only nutrition in a community that struggles with food security.

*Video* How wonderful is this welcome?

When we formed the CanAssist African Relief Trust in 2008, we determined that it’s mandate would be to provide sustainable tangible infrastructure and not programming or management costs (like teachers’ salaries or feeding programmes. This is for two reasons. One is that it would commit for a longer term and limit the number of communities that CanAssist donors could help. It also would foster reliance on outside help and May might foster dependency rather than encourage financial planning and self sufficiency. The latrines, classrooms, water catchment, text books, solar panels, fencing etc are tangible gifts to give the building blocks for running a school or clinic or community sanitation programme. Responsibility for managing and funding the programming is up to the recipient.

**Feeding these kids two meals a day is an important motivator to have them attend the school and ensures that they get some sustenance.**

.Food supplies for the fifty kids at SP Geddes school cost about $15-$20 per day. Parents pay a small fee to cover the cost of the food but by the end of the week, they sometimes run out and Meshack and Caroline have to dip into their own means to support this. I plan to send a bit of money every so often to help them with this expense. If you want to help a bit with this, let me know as even a couple of dollars a week would be of great value to sustain these beautiful kids.

* video Children at the SP Geddes School washing their hands before lunch.
In addition to early academic education they are taught other life skills.

Caroline and Meshack’s grandson was named “SP” in recognition of my Dad’s generosity and the school was named the SP Geddes School. I met SP as an infant several years ago and what a treat it was to see him again today. He is now 9 years old.

**Reuniting with young SP, named after my Dad.**

Meshack and Caroline take good care of the children at SP Geddes School

Visit to a rural Kenyan Elementary School

Posted on September 27, 2022 by johnageddes

This morning, Dan and I dropped in to the Ramula Primary School, a rural public school that has about 700 pupils from grade 1 to 8. Although I am no longer a Trustee with the CanAssist African Relief Trust, the CanAssist board asked me to look in on a few project partners while I am here in Kenya.

The purpose of Dan’s visit to the school this morning was to sign an MOU with the head teacher of the school to confirm the building of an 8 stall pit latrine for the boys. Last year CanAssist built a girls latrine at the school and also supplied some much needed desks.

**Dan Otieno, CsnAssist’s African Field Representative signing an MOU for a new boys latrine with the Head Teacher, chairman of the school board and chairman of the PTA of Ramula Primary School.**

You would not believe the state of the current boys latrines. They are old and in very poor condition (I won’t disgust you with photos.) I watched as three or four boys opened doors looking for a stall that was useable. Toilets that are collapsing and I’m poor repair are not uncommon in Kenyan elementary schools. Although these schools are publicly run, there seems to be no money for many basic needs, like text books and sanitation. CanAssist has helped several schools in East Africa over the years to help with water collection, sanitation and other infrastructure.

**Girls’ latrine** **built last year at the Ramula Primary School.**

CanAssist does not work on a cookie-cutter mold. Every project is different and tailored to the needs expressed by the school or hospital or community. This morning a young woman in grade 8 asked if they could have a couple of cupboards for books – essentially asking for book shelves. I told her that I would pass on this request to the CanAssist trustees. And one of the teachers who teaches language and English asked if they could get some storybooks in English and Swahili to help with reading and literacy.

For the past few years the Ontario Teacher’s federation has generously funded purchase of requested books for two or three schools annually through CanAssist. Dan usually asks the teachers what they need and the books specific to their needs are purchased from local booksellers. I am sure that when this funding comes through later this year he will be asking this teacher for his recommendations. (Thanks OTF for your ongoing support.)

We were received warmly. The students, the teaching staff, the Chairman of the school’s Board, and the head of the Parent-Teachers Association all expressed appreciation for the gifts that Canadian donors make to the school through CanAssist.