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My “luck fern” would’ve loved this, if my neighbor’s children hadn’t eaten it.
Guess it wasn’t so lucky after all.


The first word that comes to mind when I think of my close-of-service conference isn’t “bittersweet” or “informative” or even “drinky” (a staff member volunteered to pick up our happy hour tab for the first evening, no doubt to his perpetual regret.) Instead, that word is “wet.” When I left for the conference, we were two months into the rainy season. It should’ve rained more-or-less every day, at least for a while. To that point, it had rained exactly seven times.

Seven.

By contrast, in western Kenya, they have experienced hundred-year floods, including one only two weeks before that had killed seven domestic tourists hiking the gulches of the impossibly beautiful Hell’s Gate National Park. The journey to Naivasha, our rendezvous point, took roughly three days, all told – much of which I spent with my face pressed against the glass of the matatu, my features smushed, as I stared in undignified amazement.

You see, the world I had left behind was one of simmering anxiety: delicate corn shoots, hastily planted after the second downpour, were withering to nothing and dying in neat rows. Livestock with ribs like xylophone boards dug through trash heaps looking for vegetable scraps. Meat was cheap, but milk scarce and expensive; when you can’t keep your animals alive, it pays to cut your losses and slaughter them. But here, there was water in chaotic abundance. At one point, we rounded a bend and came to a place where the overflow had risen over the road. As the driver hesitated, debating if he should try to cross it or find an alternate route, I couldn’t shake the image in my head of women in one particularly hard-hit village near mine rushing from their homes and kneeling in mud puddles to scoop the precious water into storage containers with tiny teacups. I had taken shelter with my bike under the thatch awning of a grain kiosk. They hadn’t even waited for the rain to stop.


Eh. Yeah. Looks plenty safe. Full speed ahead, captain!

I’m sure I was thoroughly annoying as I frolicked nymph-like through the drizzle while all my more waterlogged sane colleagues grumbled to each other and scrambled for slickers. My roommate, a Pacific Northwester who should’ve been more able to cope, told me on our first day: “For God’s sake, if you’re that excited, take it with you. Take the rain. ALL OF IT.”

Apparently, I did. Because my first night back in my own bed, I woke deep in the night to that familiar pouring-pebbles sound of sudden, heavy rain on a tin roof. For reasons I can’t begin to understand, my first reaction was laughter, bubbling out of my diaphragm like cool water from a long-dry spring. I giggled myself back to sleep.

Finally.

Finally.

The rainy season is here in earnest.

Now, the choking dust and oppressive heat of the other 9 months of the year have been briefly replaced by damp days and chilly nights – which please me greatly, of course, as well as the farmers who rely on them for their lives and livelihoods. For most of my coworkers, the first patters of rain on the tin roof of the clinic were met with gleeful grins and high-fives all around — and the official “START” button on the 26-hour countdown clock until they’re complaining bitterly about the cold. Everything is temporarily back to normal; everything is as it ought to be.


Neighborhood shopkeeper, Yuda, checking on the status of his water catchment device (black basin, lower right) but refusing to come out and say “Hi.”

I keep telling them they don’t understand cold until they’ve had to pour boiling water from a teakettle onto their car doors so the locks will open, but they just laugh at me and sweetly inform me I’m full of it. IF ONLY THEY KNEW.

As for me? I’ll be over here celebrating with my chic-kabisa village threads, combining a traditional seasonal textile with a hot new “American dress style” (read: I printed a picture off the internet and gave it to the dress fundi.)

Not pictured: The front has pleats and a kind of A-line shape. It’s actually really cute. And I have some matching hammered-metal earrings that are sort of raindrop-ish? I’m going to miss being viewed as a trend-setter for my revolutionary “things that sort of match” and “last year’s Target catalog” collections. But my yoga pants in America have missed me desperately, I have no doubt.

I love the rainy season. I’m trying not to think of it as “my last rainy season,” even if I’m out of here in 50-something days. I hope I’ll be back. Someday.

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Pregnant women and new mothers, at my clinic for the ante- and post-natal vaccine program, listen attentively to a public health officer explaining waterborne disease prevention.


Motherhood: is there a state of being so near-universally revered, so infused with a sense of power? True, it involves a lot of blood, screaming, indignity, and poo, but it’s kind of a neat magic trick to be able to transform two indistinct blobs of protein into a new person. (I mean, it doesn’t require any particular talent, it’s sort of automatic, but still.) By choice, it’s not something I anticipate being a part of my career-and-travel-centric life plan, but I recognize that for most people it is. My more fecund friends are already reaching – or have reached – the stage of life wherein it’s a practicality to be considered, and to them I say this: I will dote on your spawn. I am happy to be Cool Aunt Megan, who will take them to the zoo and teach them to count in Swahili and let them eat ice cream before bed, under the express condition that I can dump them back on you at the end of the day. (Best of all worlds, right?)

In this respect, my friends and coworkers view me as an entertaining oddity. Women who are educated and have jobs tend to delay marriage and child rearing, at least for a little while. A handful of them are around my age, and two of them are also unmarried. Both want children, and one while one says she’ll be happy to stop at three, the other confessed she wants at least five. At my clinic, everyone is either actively pregnant, or old enough that their children are grown and no longer need them. To hear me talk about my personal ambivalence towards marriage (if the right guy comes along, certainly, but not for its own sake) and disinclination towards being a mom (I’m going to be in school for another DECADE, who needs that expense?) must be as curious as watching me turn up my nose at someone offering me an ndoo full of cash. As the Coast shifts away from its bucolic, village-driven social structure towards one of commutes and semi-urbanization, motherhood is no longer a woman’s sole calling; however, it certainly remains her highest one.

For virtually all Kenyan woman for whom it’s biologically possible, motherhood is something of an inevitability. Region, tribe, education, and distribution of wealth account for variations in the when and how many, but overall, it’s rare to find a woman who doesn’t expect to have a large family. You cannot discuss the female experience in Kenya without paying due to these expectations. The raison d’être of this entry is to discuss what it means, how it works, and how I fit into the picture in my little corner of Kenya. (Per always, sweeping generalizations will do us little good.) Of course, motherhood doesn’t end with birth, but to limit the scope of this entry, I’m focusing on the sticky bits.

Several studies put the overall average age of sexual debut in Kenya as between 12 and 13. From my experiences in the educational system, I find this unsurprising; an emphasis on fear-based abstinence-only education and general sense of shame around discussing the topic of realistic sexual expression results (with disheartening frequency) in girls as young as fourth grade having to drop out due to pregnancy. According to the headmaster at one of the schools where I work, only about 1 in 5 students in the district will score well enough on the national exams to continue school after eighth grade, and most of those are boys. “For all the girls who remain,” he inquired matter-of-factly, “what are they to do? There are not enough jobs as house girls [domestic servants] and selling vegetables to go around. They may as well be married and do their duties.” It keeps them safe from becoming prostitutes, he argues. (I’ve blogged before about early marriage, so click here.) Nonetheless, motherhood often comes early.

In cities like Nairobi and Mombasa, hospital births are increasingly common. But in more rural areas, even those like my village that are within walking distance of a “town” (in the sense that you can find it on some maps), the overwhelming majority of women give birth at home, under the care of traditional birth attendants, or TBAs, who have served as midwives among the Swahili and Mijikenda communities for countless generations.

Which is … problematic.

Let’s start here: there’s no right or wrong way to become a mother. Too often, the culture wars surrounding childbirth (especially in America) are content to shame women instead of empower them – do you want a waterbirth? Natural birth? Birdsongs playing on your iPod in the delivery room? YOU’RE A DIRTY HIPPIE. Want an epidural? Feel comforted by the bleep-bloop of hospital machines? Considering a c-section? YOU’RE BASICALLY MURDERING YOUR BABY WITH YOUR OVER-MEDICALIZATION OF A NATURAL PROCESS. Neither of you deserve a baby! How dare you make different choices than someone else made!

And God help us all if you have an opinion about breastfeeding.

Nonetheless, I can’t deny that I personally have been influenced by a number of sources – reviews of medical literature, talking to American friends about their childbearing experiences, reading blogs by doula-types – into feeling that American-style childbirth *is* too often over-medicalized. Consider for example that the rate of c-sections in the US (which is, we forget, major abdominal surgery) is over 30%, more than twice the World Health Organization findings that they’re only recommended in 15% of births. Ultimately, we’ve made a multi-million dollar business out of convincing women they’re weaker, dumber, and more easily frightened than they really are.

But that’s America. This is Kenya. For many women, the risks are very, very different. Birth is indeed a natural process, and Kenyan women are stronger than most other women I’ve met, but we must be as careful how we view it in light of available medical assistance. Health facilities aren’t perfect; many are under-funded and understaffed. Others charge unreasonable fees (officially or not) or have less-than-stellar practices regarding infection prevention. But overall, they represent a better option. It can be a fine line to walk, between unnecessary medicalization and necessary aid.

When I go to outreaches or talk with women’s groups, part of my job is to convince them to give birth in a hospital. Bring on the doctors and the drugs! The more, the better! I feel vaguely traitorous in saying this, but many women shouldn’t be giving birth at home, alone or attended by a traditional midwife. American midwives and doulas have to undergo at least SOME – and often a great deal of – intensive training before they can hang out their shingle. TBAs learn in the traditional apprenticing way, following an older woman on her rounds until they can run the show themselves. They learn a LOT about women, culture, bodies, and spirituality. But as often as not, there are dangerous gaps in their knowledge. Commonly, they have relatively little information on how to prevent or stop internal hemorrhage, are limited in their ability to assess maternal risk, rarely mention testing for HIV or STIs, and are fuzzy on up-to-date nutritional guidelines for infants and lactating women. (If I had a dollar for every time I heard someone say you can stop a crying newborn by giving it sugary black tea, or make a woman’s milk come in by drinking intoxicating palm wine … oi.)

Furthermore, in Kenya, the situation can turn dire very quickly. Many districts have only one ambulance (if they have one at all), available by special order and at great cost. The maternal mortality ratio in Kenya is 441 in 100,000. In the United States, it’s 13 out of 100,000; still not great, but certainly better. There are inevitably differences among regions and socio-economic groups, owing to the availability and affordability of healthcare, but it remains that overall, if you’re giving birth in America, it’s a lot less likely to kill you.

I know a woman, smart and savvy, who decided to rely on her TBA for all her antenatal care. She’s of relatively advanced age, which should have set off alarm bells, but this was her seventh child and she felt she could handle it. Ordinarily, she could: as Abed in Community tells us, when it comes to childbirth, “The bus pretty much drives itself.” But her TBA had no way of knowing a) that she was pregnant with twins and b) they were positioned incorrectly. She spent three days in labor before her husband put his foot down and called for help, from which point it took them about 40 minutes on the back of a motorcycle and three hours on a public bus to get to a hospital that could help her. An emergency c-section yielded two stillbirths, and a woman who spent months in recovery before she could leave her home.

This is the way of too many births: they go fine, until they don’t. I have a hundred stories like this, each a little more heart-wrenching than the last.

I’ve already written about family planning/birth control, and the accessibility issues thererin. Proper access to birth control and the ability to plan one’s family is a MAJOR step in protecting maternal and child health (unintended pregnancy accounts for one-fifth of maternal deaths every year.) But even outside of that, there is hope. I am lucky to work in a facility that is, generally, respectful of mothers’ experiences and doesn’t automatically view TBAs as The Enemy. I personally work to educate people about their life options, both from the grassroots level of empowering students to make smart decisions to planning and delivering lectures at our deep-rural outreach clinics. I spend more time out in the community than any of the other people in my clinic, which gives me unparalleled access to rural villages. During the course of other work, I talk to pregnant women about “protecting their blessings” (getting proper pre-natal care) and get the contact information for their preferred local TBAs.

I can pass this information along to the antenatal care specialist in our clinic, who runs training sessions for interested TBAs. These midwives are invited four times a year to learn about basic topics like assessing maternal health (checking for the pulse, figuring out how the baby is positioned) along with salient regional issues (prevention of mother-to-child HIV transmission, the need to sleep under a mosquito net while pregnant/nursing to prevent particularly deadly forms of malaria.) I’ve only been able to attend one of these sessions personally – I’m more a “fixer” for them than an actual facilitator – but they end with the midwives registering for our “on-call sheet.” This is a service my clinic offers to help bring them into the fold and give them a respectful role, while still being able to provide medical assistance to their clients.

I’ve never been pregnant in Africa. I’ve never given birth by lantern light. But I’ve been present at innumerable antenatal check-ups, spoken with young mothers, laughed with them, listened to their fears and aspirations. I’m generally familiar with their wants and needs. Most women feel more comfortable when connected with their culture during the process of birth – and understandably so. As we saw with beliefs surrounding witchcraft, incorporating meaningful tradition while trying to work around the less compatible-with-health aspects is a necessary challenge. Striking a balance between faith and fact is a delicate art. Each is a fulfilling component of the health portrait. Without acknowledging culture, you will accomplish essentially nothing, and possibly do more harm than good to the long-term mission of your organization.

The TBAs here aren’t in it for money or glory; they genuinely care about women, and genuinely want them to have safe, healthy births. They are strong, compassionate people worthy of admiration. Once they’re able to overcome certain myths and cultural obstacles, most of them are happy to become part of the “birth team.” That way, mothers get the best of all worlds. A laboring patient who arrives at our facility will receive a doctor’s care in (relatively) sanitary conditions from someone who can help her prevent infection and connect her to a district hospital if things go terribly awry. If she wants, she can bring her TBA with her, or ask us to call one from our on-call registry. The TBA can guide her through the traditions of birth and pain management with the spiritual support she craves, but not at the expense of accessibility to medical care, IF the need arises.

There’s nothing intrinsically wrong about the decision to start childbearing at 18, or to have five kids, or to not space them well. It’s certainly not ideal, and is often the result of a lack of information or options to the contrary (to say nothing of larger societal issues surrounding the role of women). Most women, once given the knowledge and options, make – or try to make – different choices with regard to things like birth spacing or limiting numbers. But regardless of WHAT they choose, if it’s a choice they make for themselves, and it’s not to the express detriment of the broader community (example: not vaccinating)? Fine. Risks can be managed. I have exactly zero interest in trying to seize local women’s maternal autonomy and tell them they ONLY MUST have 2.4 children at the proper intervals. Tell them they MUST breastfeed or not, MUST co-sleep or not, MUST have a hospital birth or not. I don’t want that kind of responsibility. Those aren’t my judgment calls to make.

At the end of the day, it’s all about education. TBAs must be better informed about what they can and can’t handle, as well as about basic preventative healthcare both before and after the child is born. Mothers need to be about the best health and parenting practices available, in the hope that they will take them to heart. Behavior change must be supported in the long-term. There are serious conversations to be had about sustainable populations, yes, but it’s just part of the total information package, right? No one can make those decisions *for* the woman herself. Knowledge and agency are the key ingredients. I grow sick hearing about women killed or rendered infertile by unhygienic births without a skilled attendant. I grieve with the Sunday school teacher who tells me she’s lost three nursery students in the past year to measles, an easily vaccine-preventable childhood illness. I celebrate with grandmothers who live in a state of perpetual bliss as they watch their half-dozen children raise strong, healthy herds of grandchildren to honor and assist them in their old age. For families to have wanted, loved, healthy children is a beautiful thing. (Even if I could do without them myself.)

I’m off to my close-of-service workshop – more on that later – so not a whole lot of time to blog. Time enough for a little levity, perhaps. I know this isn’t Kenyan music per se, or really at all. But there are TWENTY-EIGHT(!!!) future Peace Corps Kenya trainees out there. Some of them are reading this blog RIGHT NOW, perhaps checking out my FAQ or the packing list I posted. They are in for a lifetime of beautiful, awe-inspiring experiences they will never forget. But there’s more to it than that, and rather than let them be shocked, I’m using this morning’s post to illuminate some of those realities. Take them with a grain of salt. This song is dedicated to the trainees coming, the volunteers serving, and the half-dozen people I know who are currently considering a PC application. Stay strong. It’s worth it. ♥

When I moved to this village two years ago, I had fairly reliable electricity, by developing-world standards. Not enough to handle multiple large appliances (even if I could afford when, which I can’t) but enough to keep my laptop charged and my little box fan running. It could with 75% certainty be expected to be one 5 days a week – Tuesday and Thursday exempted, for purposes of “routine maintenance” or “rationing,” depending on who you asked (and when in the election cycle.) Those days, it would be off for 12 or 14 hours, returning just in time for bed. It would also be off virtually anytime it was raining outside, but this is our third year of drought; that’s less often than you’d think.

In the past few months, the situation has changed rather dramatically. It goes off virtually every day. It could be gone for 30 minutes, or two hours, or two days. Sometimes it only goes off in particular buildings, which a handful of area landlords contribute to witchcraft and are thus hesitant to investigate or correct. Without my little fan, my tin-and-cinderblock house – as with all houses that aren’t traditional makuti, or palm thatch – is suffocatingly hot, to the point where staying inside too long feels like an invitation to faint. (Could there be anything more embarrassing than a grown woman swooning? I haven’t, for the record. Yet.) But safety is found in the confines of the mosquito net, with incense and citronella coils burning to repel the most persistent individuals. The occasional spits of rain we’ve experience have been more than enough to jumpstart the lifecycles of countless malaria-carrying Anapheles.

Point being: increasingly often, this is a portrait of my evening.

On the plus side, I’m getting a lot of reading done.

Before you perv out, I’m wrapped in a kikoi, or lightweight cotton cloth used as a garment by both men and women. IT’S CULTURE, Y’ALL.


This is the snake that lives in my ceiling.


At night, he likes to hunt the rats and birds that also live in my ceiling.


My friend and I named him Sammy.


I somehow suspect that, when I return to the US, my life will be a little less like a National Geographic feature. But whether this is a blessing or a curse remains to be seen.


(Sammy says “Jambo, y’all.”)


Even at 5’10”, I have to stand on my tippy-toes to reach the tops of most Kenyan chalkboards.


I can barely round the corner before the first one notices me – so swift, she surely must have caught my scent. I can think of no other explanation. In seconds, the horde closes in and descends on me like zombies on a minority character in an exploitative 70s horror movie, always the first to die. Dozens of them crush against me as more come running, their tiny bare feet pounding across the sand as they sprint. Each is shrieking that familiar war cry, “GOOD MORNING MADAM HOW ARE YOU,” in a shrill voice. Each is reaching out to shake my hand or grasp at my skirts. A half-dozen leap past the others and try to snatch the bag from my shoulder – a navy canvas tote with “Democratic National Convention 2008” emblazoned across a patriotic graphic, the carrier I use for field work. For a Kenyan nursery school child, there is no greater victory, no higher honor than to carry the teacher’s books. As I swat them away and try to drag myself out of the scrum towards the safety of the staff room, a single thought, unbidden and unpredicted, ricochets through my brain:

God, I’m going to miss this.


Not pictured: The 30 or so kids crowding themselves behind me chanting “TAKE THE PICTURE!” in Swahili.


I am done teaching anything in a formal school setting. I officially stepped down after administering one final exam in “Life Skills” class. By design, I am ending my affiliations well before I complete my service: my goal all along has been to train co-facilitators to teach about health and related topics, so I will pass the curriculum 100% into their hands while remaining to help them tweak it or offer them any information on topics they feel they’re not strong enough on. It’s a sedate sort of symmetry: the first three months at site we are instructed not to launch into projects, but rather handle our “community integration” tasks and develop a strong working understanding of the culture. Our last three months, we are to reverse this process. We start re-familiarizing ourselves with what life will be like when we leave our posts, make preparations to ease back into America, and observe our completed projects to see how well they can stand on their own. If we’ve done our jobs correctly, it’s like a magic trick: the table cloth is yanked from beneath the tower of Waterford crystal stemware, yet it all remains standing. If it’s *not* done correctly … well. You’ve seen what happens when that trick is performed inexpertly, right? Same basic result. A moment of truth.

So what does this mean in more practical terms? It means that my afternoons will be a little less hectic, now that the need to dart all over the district to a different school each day is gone. It means that I will have more time to linger at the clinic, doing whatever my coworkers need done. Finish up odds and ends. Attend to a few projects I’ve been putting off, like rounding out our “meet the staff” exhibit or pulling together some teaching materials on the topic of raising meat rabbits for FUN AND PROFIT nutritional support in immune-compromised or food-insecure households. But that’s less now, too. Insha’allah, the good folks around me have learned well the lessons I’ve tried to teach them these past two years.

From now to the middle of July, the days will pass slowly. With many of my direct responsibilities removed, I can’t see it happening any other way. Nor would I (necessarily) want it to. For all my whinging about the heat, the dust, the noise, the screamy children, and the centipede monsters … waning days are meant for savouring.


Start the countdown: 99 days.

I guess we’re going to roll with this feature, if only for a little while. I’m crazy busy finishing some things up, so it’ll keep you entertained while I work on blog content that’s more … contenty.

Anyway.

This is a song about getting stuck in traffic. No, seriously. It’s completely charming, and very salient because AAAAAUGH. I had to come into Nairobi this week for a workshop, and as much as I have a secret love affair with this city, THE TRAFFIC. I learned to drive in Washington, DC. Home of the Beltway. Home of some of the worst jams in the US. And I think Nairobi traffic is the most mind-blowingly awful in the world.

Please enjoy.

I could write about the community reception, about the gratitude, about how far word of mouth has carried the project. About how the latest phase of the quest involves health clinics getting on board to hand out copies of the illustrated Swahili-language instructions to their young female patients. About how I spotted a group of schoolgirls sewing some extras under a tree during their lunch hour.

But instead, I think the smile says it all.


[Original Post Here]

Today, March 8, is International Women’s Day. Click here to learn more.

———–

The average woman in Kenya has about five kids. In my community, as with many others, children are the greatest wealth one can acquire, the answer to the most fervent prayers, the greatest source of pride. Six is often touted as the ideal. Nonetheless, between such factors as a maternal mortality ratio of about 1 in 38 and staggeringly high unemployment, it’s important for people to have the ability to evaluate their ability to support XYZ number of children and plan their families accordingly.

So while the birth control wars in the US continue to rage more than a century after feminist pioneer Margaret Sanger watched a patient die from septicemia following the termination of a desperately untenable pregnancy, it’s often viewed as slightly less of an issue in Kenya. At least, less of a public one. This is due in part to the fact that such topics are often seen as unseemly for mixed company, and in larger part because while most politicians continue to believe in large families, factors such as the staggering impact of the poverty cycle and extraordinary rise in HIV infections has caused many to become vocal proponents of “family planning.” (Always “family planning,” and never “birth control” – we wouldn’t want to give people the wrong idea, would we? If you’re not married, keep your hands – and all other parts – to yourself.) In theory, all government clinics are required to stock an adequate supply of both hormonal and barrier-method forms of family planning, for distribution at their reasonable discretion. (What this means is, of course, open to interpretation.) Some even go above and beyond, offering quarterly clinics sponsored by international NGOs like the Marie Stopes Foundation, which offer more involved methods from IUDs and Implanon to tubal ligation and vasectomies.

The most common method is far and away the quarterly injection (“Depo”): one doctor’s visit gives you three months of protection, and your husband never has to know. (There are a heartwrenching number of women for which this is a very important factor.) Condoms are available quite cheaply – ten shillings each, or free at HIV testing centres. The Pill, while the most popular choice in the United States, isn’t as widely used (easy to forget, must be taken at the same time each day, some women don’t like swallowing them, etc.) However, unlike in the US, where a doctor’s prescription is required, it’s available over-the-counter at most pharmacies – much like emergency contraception “Plan B” back in the States.

Best of all, even if you can’t make it to a government clinic to get it for free, it’s only 30 shillings for a month’s supply, or about 36 cents US$. In America, even with insurance, the same drug could easily cost you $50 or more per month. (Just for funsies, here’s a calculator to help you figure out how much birth control will cost you over your child-bearing years.) Like several of my fellow lady-PCVs, I confess it’s a constant struggle against temptation to buy it by the cargo container-load, ship it back to America, and drive around in a convertible flinging handfuls of it into the crowd like Mardi Gras beads. WOMEN OF THE WORLD, UNITE! We have nothing to lose but our co-pays. All reputable pharmacies (or “chemists,” as we call them here, borrowing the Britishism) should carry it – or so my colleagues at the clinic told me. “Just walk in and ask. You will have no difficulties.” Coming from women, and medical professionals, I had no reason to doubt them.

But nothing is ever that easy, is it?

I was in Mombasa recently for an appointment and, while wandering around Old Town eating a frozen juice packet (an “icy-icy”), I found myself remembering that conversation with my colleagues. At present, the Peace Corps medical office supplies me with all the medications I could need, free of charge. It’s not an issue. But when I finish, my plan is to be traveling/studying for a month or two before rushing home to begin my graduate school adventures, so it would probably be advisable to stock up on a few necessary items while I’m someplace where I know how to find chemists and can speak/read the language. Mombasa has more/better chemists than my village, and I’m not there often, so why not take care of it that day? I had a few hours to kill before I had to catch a matatu home, so I found myself ducking into the nearest pharmacy.

It was dimly lit, with most of the space taken up by dusty glass cases filled with lung tonics and fever tablets. Unlike familiar neighborhood pharmacies in America, where you serve yourself then present your items at a cashier, in Kenyan shops you tell the pharmacist what you’re looking for and they fetch it for you. I approached the lone person behind the counter, a middle-aged man reading a rugby report. ”Excuse me sir,” I began in polite Swahili, ”Do you sell [birth control pill brand/name]?”

He cocked his head and blinked for a few seconds before disappearing into the back of the store. A few moments later, he re-emerged and handed me an unfamiliar box. I squinted at it. The outside of the box was in German, but the inside instructions revealed that it was medication for some kind of gynecological health problem. We were dealing with the right general body region, but not quite there.

”No,” I said quietly, handing it back to him. I re-iterated the name, then described the packaging. He gazed at me narrowly. “Family planning tablets?” He switched to English. “The Pill?”

“Yes,” I said. ”That exactly. Do you stock it?”

He stared at me for a long moment, his gaze cool. “No.” His tone was low and unwelcoming. He picked up his newsletter and went back to reading, his brow furrowed. I was dismissed.

I stepped back out into the bright sunlight of the street and paused to adjust my scarf. Well, that was odd, I thought to myself. There was another chemist a few streets down. This time, there were several people working – I made a beeline directly to the woman on staff and repeated my inquiry. She thought for a moment, then offered a sad shake of her head and directed me to yet another chemist some distance away. There, I was told they would sometimes stock it, but were currently out. They couldn’t tell me when they might have it again.

I visited half a dozen pharmacies, most of which gave me some variation on that same answer: we don’t have it, we don’t know when/if we’ll ever have it, try someone else. The day was witheringly hot in the way that only blazing, cloudless days near the end of the dry season can be, and I was growing tired. Finally, I found someone I couldn’t imagine not having it: a large chain pharmacy, sharing a plaza with one of Kenya’s handful of large chain box stores. (They haven’t caught on here the way they have in America – at least, not yet.) Inside was all cool white tile and polished mirrors. Two women sat behind a case of sports injury treatments, giggling and joking. I shuffled up, placed my hands on the edge of the counter, and wearily repeated my inquiry.

One woman – let’s call her A – whipped her head around to face me and gave me a sharp look. “Are you married?” She stared me down, as if to say, I’ll know if you’re lying.

“I’m not.” I wasn’t wearing any rings and was too tired to care anyway.

A turned to her colleague, who we’ll call B, and said in rapid Swahili, ”You sell it to her.” She then folded her arms across her chest and stared pointedly down into the case.

B was nothing but polite and obliging. She walked over to a large, colorful dispensing box on a high shelf and drew out a pack. Next to the box was a poster extolling the virtues of the Pill – ”Family planning for modern women” it informed me in looping, fuchsia script. “Actually, can I have two? So I can save myself a trip back here?” B nodded and pulled out a second packet, while A drew in a sharp, gasping snort. Her stool scraped loudly across the tile as she rose and stomped into the back room. B didn’t respond to this, merely rang me up at the cash register with a smile. As she carefully wrapped the packets in brown paper, birthday-gift style, we made casual small talk about the weather, the recent holidays, and the unique necklace she had worn that day. She waved as I walked out.

To say the sum total of my experiences are due solely to misogyny or scathing moral judgments would no doubt be an unfair misattribution. In all likelihood, at least some small part of the difficulty owes to the fact that The Pill isn’t quite as common a method here as it is in the States, as I mentioned earlier. (One woman pharmacist, after informing me they didn’t have it, gently offered to give me the Depo shot for the same price if I could offer proof I wasn’t already pregnant.) But in at least two of those cases, we have demonstrable proof that birth control access WAS a touchy issue, for any number of reasons, contrary both to what I had been told and to the popular awareness of Kenya’s government-subsidized population control plans. Moral perceptions were certainly a factor, even if it was one I was ultimately able to overcome.

If pharmacist B hadn’t been there, what would I have done then? If I were a Kenyan woman who didn’t have the time to run to 7 different pharmacies, how would this story have ended? If I were married, and had only enough time to slip into one while my husband was off haggling for goods in the markets? What if I were a young woman, even a student, already shaky in my resolve, nervous about judgment, frightened of being shamed? Would my courage have lasted long enough to get to the seventh pharmacy? Or would the unspoken rebuke of the first chemist been enough to shatter my determination?

I don’t mean to imply that Kenyan women or African women or young women in general are delicate little flowers who can’t shoulder a bit of adversity. Far from it. And God knows I’ve spoken to American college students who could barely overcome their own issues to walk down the hall to their RA’s door and snatch a couple of condoms from the “FREE USE” basket. There are plenty of women, even here in Sub-Saharan Africa, who are brave and outspoken on the issue, from whom their peers can draw inner strength. But convenience and ease of access MUST be taken into account, for all the scenarios I’ve outlined, and more. As long as a disconnect exists between the recognition of the need for means women can use to prevent unplanned pregnancy (to say nothing of preventing disease) and the ability of women to obtain those means, for WHATEVER reason, we have a problem. A big one.

Yesterday, I took this story back to my coworker who had originally assured me I’d have no trouble. Her response was minimalist. She pursed her lips and shrugged, then, after a beat, added “Karibu Kenya, dadangu.” Welcome to Kenya, dear. She then mentioned off-handedly that numerous government health clinics had been having shortages of the Depo shot, too, and most who claimed to stock the elusive female condom had never even seen them. Who was the blame? Almost definitely the government, she said. They tend to promise more than they have any intention of delivering, especially in election years. (In this, Kenya is certainly not alone.)

The relationship this nation has with the issue of birth control family planning is probably no less complex than in many other countries – the conflict of necessity and access, the economics spending to save or tightening our belts, the perpetual tug-of-war between those who view it as private tool and those who view it as a public governmental thumbs-up to extra-marital non-procreative uber-immorality. (Although I’d like to point out, in the immortal words of human rights journalist and author Nicholas Kristof, birth control access is no more a cause of sex than carrying an umbrella causes rain.) To translate it into current generational slang, if Kenya and birth control had a facebook relationship status, it would be: it’s complicated.

Birth control access is a human rights issue. Anywhere. Everywhere. For one, it’s used to address any number of legitimate medical concerns, from controlling Polycystic Ovarian Syndrome and protecting fertility to increasing quality of life among women who experience severe menstrual symptoms. 58% of American women who are on the pill use it for reasons other than to prevent pregnancy. More than that, it’s a vital tool for allowing women to make appropriate social and financial choices – if and when to have children, and how many to have. It’s the single most important factor in preventing abortions, and regardless of where you fall on the political spectrum, we can all agree that bringing this number down is a good thing.

In Kenya, the right of a woman to say NO is still a controversial topic – sexual assault is a hidden epidemic, often not taken seriously by authority figures and average citizens alike. (I will never forget the feeling of white-hot rage pooling behind my eyes when, at a seminar addressing gender-based violence, one participant – a late-middle-aged man – cavalierly interrupted the female presenter to glibly inform us all that woman can no more accuse her husband of rape than a fruit vendor could accuse a man of being a thief for eating a mango he’s already paid for. It’s a ridiculous idea, and Not How We Do Things Here.) However, the discussion of sexual agency is not complete without also acknowledging a woman’s right to say YES. Yes to planning her family according to what she can support physically, emotionally, and financially. Yes to enjoying the company of and giving reciprocal pleasure to her husband. Yes, even, to saying, “Sexual expression is part of the human experience, and *I* will decide when and with whom it is right for me to participate – not the politicians, not powerful church lobbies, not the judicial system. Me.”

Sigh. It seems like only yesterday when I found myself standing on my front porch, jetlagged and hungover from Spring Break in Las Vegas, staring at the FedEx envelope half-assedly crammed beneath my welcome mat which contained the letter that would change my life forever: my Invitation to Serve. Among the many struggles of the coming months, one of the most pressing would be, “What it heaven’s name do I pack for TWO YEARS IN THE WILDERNESS?” Before you panic, remember: you’ll have opportunities to visit major cities at various points in your service, where you will be more than welcome to stock up on supplies. Most of these will have a Nakumatt, which is what Wal-Mart wishes it could be, but can never achieve that level of awesomeness. (I’m still particularly fond of how the Nakumatt in Nairobi sells heart-shaped waterbeds with built-in iPod speakers in not one but *two* different colors. Always spoilt for choice.)

To help ease your anxiety a bit, I’m lending this space to a bit of guestbloggery by my dear friends Lorenzo and Louis. They’re both accomplished bloggers in their own right, so I suggest you check them out after you finish here. In the meantime, read this! And if you have any questions, I would be more than happy to answer them either in the comments or by e-mail (mhumphreys10[at]gmail[dot]com). Karibuni Kenya, y’all 🙂

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Lorenzo and Louis bloggery ACTIVATE!

It was just a little under two years ago that I received a letter in the mail saying, “Hey, you wanna go to Kenya for 2 years or what?” Excitement ensued followed quickly by the sentiment “Well, what am I supposed to bring?” So I made wagers with fate on what to pack, did my best to predict what I would and wouldn’t need, and have spent a good part of my time here learning from my limitations in foresight. It’s been about two years now and according to my calculations a new group of would be volunteers is about to receive their invitation letter in the next few months, and my hope is that a few of them will stumble across this blog post. Now for those of you future volunteers who are reading this, I’m sure there are all kinds of evidence-based guidelines and scientific formulas devised to help a person pack for two years of Peace Corps service, but here’s a couple of pointers from myself and another volunteer living where you’re about to go. For everyone else, I’m not saying you can’t read on, but if you have anything else you’d rather be doing I won’t be offended if you choose to devote your time elsewhere.

Bring It:
Pens – You never truly appreciate what you have until it’s gone and its replacement leaves your hands, clothes, and underwear in a sticky, inky mess. (Megan’s note: Enzo darling, I think you’re using the pen wrong.) The average life span of a local pen here is approximately 30 days before the self-destruct mechanism is triggered and the writing device shatters mid-stroke, inexplicably releases its entire bolus of ink, or simply stops writing for no reason whatsoever. It seems simple enough, but treat yourself to an enjoyable writing experience for the next 2 years by tossing a few extra pens in your bag and don’t give them away.

Computer – Unless you have a really good reason for being adamantly opposed to bringing anything electronic you should go ahead and just bring a laptop. In addition to giving you the ability to send emails in a timely fashion it will serve as a useful tool giving you more versatility in the work you perform. Netbooks are great for their portability and low power consumption. Most volunteers have reasonable access to electricity and for those who don’t a solar setup capable of charging a computer is more affordable and readily available here than you might think. A good sized external hard drive (think in the terabyte range as these things can fill up quick) for pictures, music, and other files is recommended as you should back up EVERYTHING. While you can a find decent selection of gadgets, devices, and technological what-nots here in Kenya you’re going to pay a premium for such luxuries so you’re best off bringing anything plug-inable from home.

Games – We recommend Bananagrams. (Megan’s note: I strenuously second this recommendation. Also, travel Scrabble.)

Musical Instruments – Studies have shown that you are used to playing a musical instrument back home you are guaranteed to miss it within a month of arriving without it if you are foolish enough to leave it behind. Additionally, music is a great way to charm your way into the heart of anyone you meet here. There is a limited availability of quality instruments so you are best off bringing something from the US (ideally second hand if losing your instrument would be like losing a
body part). Don’t forget strings, reeds, picks, harmonica wax, or any of the other necessary accessories.

Funny Shaped Sports Equipment – Frisbees, footballs, baseballs, gloves, speedos, (Megan’s note: Golden speedos y/y?), pucks, hockey sticks, badminton gear, and lawn croquet sets. If you have an interest in any sport other than rugby, volley ball, or soccer (ahem…proper football) and you are interested in sharing that interest with the community you’re living in for the next 2 years then you had better plan ahead unless you’re prepared to do some serious improvising.

Maybe:
Toothpaste – Along with the worldwide distribution of refined sugar came the worldwide dissemination of most dental hygiene products. So unless you have a special loyalty to a brand like Tom’s of Maine don’t waste the space packing a two year supply of anything other than waxed floss. (Megan’s Note: Waxed floss is overrated. Learn to love the normal stuff. That – along with most other OTC medical items – are available for free from the PCMO.)

Deodorant, Shampoo, Petroleum Jelly, Pomade, etc. – You’re not
spending the next 2 years in an underwater research facility cut off from any sort of supply line. Follow the toothpaste rule: Unless you have some special brand loyalty save yourself the time and trouble and just go to the store when you get here.

Red Cross Wind-Up Flashlight – Guaranteed to be one of the most useful items you own until the wind-up handle snaps off in your hand with no warning (seems to happen for most volunteers around month 6) rendering the thing useless. If you’re going to bring one of these handy devices consider throwing a tiny screwdriver in your bag as well so you can strip it for parts when the time comes.

Batteries/Things That Use Batteries – Aside from being heavy,
available in nearly every village in the country (you’ll feel pretty fooling walking through the battery aisle in Kenya after carrying 20 pounds of Duracells through customs), and prone to ooze acid into all the places you really don’t want acid, there are exactly 0 environmentally friendly ways to dispose of old batteries here. If you’re planning on bringing a head lamp or something battery operated the best course of action would probably be to pack some rechargeable batteries (not those cute, underperforming USB chargable batteries) and a wall charger. (Megan’s Note: Headlamp is a MUST. So consider rechargable batteries.)

Wall Socket Adapters – US price: $20, Kenya Price: $1-2. Plan accordingly.

Quirky Cookware – Most culinary instruments from whisks and mashers to non-stick skillets and stainless steel pressure cookers are available, but for those who need to flip their pancakes “just the right way” might consider bringing your own. If you are in love with your spatula, or have a very specific potato peeler, I might recommend bringing it.

Don’t Bother:
Solio – Light weight and light duty, this is probably a useful device if you’re backpacking through the Amazon, but not so much here. The amount of babysitting and repositioning required to get a decent charge out of this ting during the non-rainy season alone make it somewhat unpractical, while leaving the device unattended during the rainy season is a sure way to drown your investment. Chances are you’ll be somewhere within reasonable proximity to power and in the outside chance that you aren’t, you’d be better off using the money you would have spent on this thing to purchase something cheaper, weather proof, and more versatile here in Kenya.

Water Purification Anything – Let’s face it, aside from the days spent between bathing and the sometime redundant menus this isn’t a camping trip. There are plenty of fast, cheap, and effective water purification methods available here in country that make more sense than bringing something from overseas. As cool and lightsaberesque as other water purification methods may be, you’ll probably only be wasting money and space by bringing them.

Clothes – Anything white. The purpose of doing laundry here, at least for a busy volunteer isn’t so much to get things clean as to get them “less dirty”. (And smelly! – M). Get a head start on tough stains by not bringing anything lighter than “smokestack gray” or the Crayola color “ashtray”. Also bear in mind that the days of loin clothes and banana leaves are over. Thanks to well off do-gooders elsewhere you’ll be able to get top-quality name brand stuff that you couldn’t afford back home for rock bottom prices in the second hand markets here, so don’t bother packing like you’ll never see clothes again (unless of course you’re a big and tall size and don’t want to tempt fate). Also, for people who go through underpants like a college athlete through a buffet you might bring a little extra of a comfortable style. It’s not that you can’t find bras and knickers here, but 2 years can be a long time to deal with an awkward fit in those sensitive places.

(Megan’s Note: LADIES!! BRING MORE UNDERTHINGS THAN YOU THINK YOU’LL NEED!! The ones you have are more delicate than you realize, and village life is to your privy-clothes what fire is to dry kindling, or Fred Phelps is to civil political discourse. Panties are less of a problem, but good luck finding a non-warped, well-fitting bra outside of a fancy lingerie store in Nairobi – and there, you’ll pay quite dearly for it. There are few things more demoralizing than getting stabbed viciously in the underboob for months because you just brought a sparse few of your favorites from Target. Sorry to get graphic there, but this is really important. Ok? Ok.)

Lesson of the Day:
The big thing to remember is not to bring too much. Aside from a few essentials which may be hard to come by here you can get everything you need and more for a reasonable price while supporting local merchants and all that stuff. So relax and look forward to it, the P word is nothing to be afraid of.

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[UPDATE]


A little more advice by another volunteer, left in the comments. And while we’re talking about clothes – when they say “knee length,” they mean it needs to COVER your knees. You definitely don’t need to (nor should you) redefine your sense of style, but you may have to modest it up a bit, depending on what kind of organization you end up with.

“I wanted to expand on the clothes. You should bring less clothes, more shoes. Size 9.5 women’s is hard to find! Also, you’ll probably want to wear the same style of clothes you wore in the U.S., so there’s no need to buy a new wardrobe from REI. Just a few additions should be fine.”
– PCV Liz, Western Kenya

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The opinions expressed on this blog do not represent those of the Peace Corps, the United States government, or any other organization. The author is solely responsible for all content on this blog.
Yours truly
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