The more people I talk to, the more complex is the tale about how the culture of FGM pervades and persists in the Transmara area of Kenya. One facet of this story that intrigues and disgusts is the fact that some health professionals, and specifically nurses, are now going underground to perform these illegal procedures.

This week I went to Elinore,* a high ranking nurse at the district hospital, to try to unearth information about the health concerns related to FGM in this district, and to ask her about the role of health professionals in the battle against FGM.

Elinore has spent 20 years in the nursing profession, working at two separate institutions in Kilgoris. With a mother who was a nurse and a father who was a public health officer, it was a natural choice for her. Because her parents were progressive and educated, she herself was not expected to undergo the cut, but as a Maasai from a village near Kilgoris called Oloiborsoito, she has still seen the range of Maasai girls’ experiences with pregnancy, circumcision, early marriage, and birth complications. Her 20 years in the health profession span a time period during which it would seem that FGM has been shed as a cultural practice more rapidly than ever, yet simultaneously shoved underground due to the fact that it became illegal in 2003.

Elinore explains nurses who inflict FGM

So, what does she think is the role of the health professional in preventing and reducing the impact of this negative cultural practice?

Elinore says that often she and the other nurses try to dispel the myths about sexuality and the benefits of FGM. “Sometimes,” she says, “when you work in health, you have to take an extra step.” Many parents, and “especially men” still believe that the clitoris, because it is a sexual organ, is what makes a girl “loose.” Because it is a woman’s sexual organ, it is somehow inherently dirty. When a young girl comes into the care of Elinore and her colleagues, they often try to bring up FGM in conversation. Especially when a girl proclaims her desire to be cut, they take the liberty of dispelling such myths, and informing girls about the health risks involved. This is a choice that the nurses make on their own – there is no sort of government program or directive to its health employees to take this measure, and some people might even think of it as invasive on the part of a health care professional.

When asked if this is something her employer, the government, or the hospital promotes, she says no. But because health professionals have more knowledge, she says, sometimes you have to go beyond your normal responsibilities. What is the role of the health professional? To offer safe cuts? To keep quiet? No, says Elinore. The role is simply to tell as many people as possible about “the disadvantages of FGM.”

Yet like I said, one of the most disturbing things about the changing landscape of female genital cutting here in the Transmara is that health professionals are increasingly implicated in the cut’s persistence.

This is partly a sinister byproduct of health campaigns that have sensitized people to the risks of HIV and other infectious diseases, so “people feared the traditional way with HIV.” These are legitimate concerns, as people used to use one knife for a whole cohort of girls. They wouldn’t use gloves, and if they were to have a pair, the wouldn’t change them between girls. Several people have the vague idea that FGM poses some kind of health risk, and thus they have the instinct to seek out someone who can ostensibly perform a safer version of the cut. I spoke to a mother yesterday, however, who despite going on about the importance of now having a “doctor” perform the cut, couldn’t pinpoint any specific health issue about which she is concerned. But it is this fear that makes it profitable to be a nurse who is willing to cut off a few extra genitals on the side.

Elinore is a very high ranking nurse, and is deeply conflicted about the prospect of one of her staff participating in this sort of thing. Yet she sighs, smiles and says that she feels lucky she has never heard of one of their staff participating in this sort of thing. One wonders if this is indeed true or if the administration is perhaps not interested in finding out and having to deal with such a problem. She thinks the nurses who do that sort of thing come from Kisii, a city located an hour an a half north of Kilgoris.

The health professionals performing the cut range from subordinate staff to nurses in retirement, and performing the cut can serve as a large source of supplementary income (perhaps earning you an additional 20,000 Kenya shillings ($250.00) or more during the December “cutting season”). Sure, more salary might curb this behavior on the part of employed health professionals, but even that isn’t much of a solution. Firstly, that wouldn’t address the issue of retired nurses. Secondly, there is always someone else around the corner who is willing to do the cut for extra income, and in lieu of a health professional, families who want to cut their daughters will most likely be willing to settle for just about anyone else.

After speaking to Elinore in her office, I stopped by the Medical Superintendant to ask permission to have a peek at the wards, and we headed over to the maternity wards.

During delivery and even in the maternity wards of the best hospital, the cut can obstruct a birth, and inflict even further pain. More on this next time…

Wards at the Kilgoris District Hospital

*Elinore specifically requested that I refrain from identifying her by name, because she was concerned about speaking on record as a hospital employee. For this reason I also excluded her face in the photo.

Enkakenya Centre for Excellence pupil Mary spontaneously hugs the new HP computers as they are being unloaded

Today an unusual sight rolled into Enoosaen as truckload of computers donated by HP arrived at the doorstep of the town’s two girls’ schools. Today we unloaded 16 computers at the Enkakenya Centre for Excellence and 16 computers at the neighboring Enoosaen Girls’ Secondary School. And there are even more slated for a what will likely soon be a community center run by the Kakenya’s Dream organization. Over the next week, a computer engineer will be helping us set up the schools’ computer labs. All we have to do is prepare the space, the electricity source, and some tables on which to enshrine our new toys.

Everyone gathered to watch the computers arrive

I am in awe – HP has thought of everything. There are extra printer cartridges and even backup battery UPS (uninterrupted power source) devices so that the fluctuating power sources we will rely on won’t hurt the computers and won’t leave the students with sudden shutdowns and unsaved work. An individual from HP actually donated the indispensable Microsoft Office software. The most thrilling thing for me is that HP also had the wherewithal to send an engineer to do the initial wiring and set up, and I’m not left bumbling around in a pile of wires as I had at one point expected to be. Somebody over there knows how to make a user-friendly donation.

At first confused by the computers...

Then reaching out to touch them...

Gradually the excitement sets free!

Pure joy at the arrival of the HP computers. It just melts my heart to see how excited these girls are!

The Kenyan Ministry of Education is giving ICT capacity ever increasing importance, but is completely unable to supply its schools with sufficient computers. This past year, for example, the government’s decision to make the KCPE (eighth grade primary school leaving exam) registration electronic caused utter mayhem and great strife for primary schools across the country that are almost never supplied with even one computer. Beyond this, computer courses are offered (yet not mandatory) in the government secondary school curriculum, but children at schools without computers are severely handicapped in both the job market and the college application process by not having access to computer classes. This is just one more reason that parents who can afford it will send their children to private schools which are far more likely to have technological tools at their disposal, and why those children get into the best national high schools and universities.

Enoosaen Girls Secondary receiving the computers. The deputy head teacher is pretty excited herself.

The Enoosaen Boys’ Secondary School has had a computer lab for years, reinforcing the inequality in the local educational system that girls face. These labs will help close that gap and send a message to the community that girls do, in fact, deserve the best, and that HP and Kakenya and her American organization recognize this. Furthermore, during holidays, the girls’ secondary school is planning to open the lab to community members to learn computer skills at a small fee, which will both generate income for maintenance of the computer lab and extend the opportunity for ICT skills and internet connectivity to the rest of the community.

An Enoosaen Girls' Secondary pupil helps unload

All of these factors dovetail beautifully to make sharing the gift of the computers with the girls secondary school align perfectly Kakenya’s overall interest in girls empowerment and community development.

The headteacher of the secondary school is just glowing after receiving the computers. She says you only see computers this nice in the bank here in these parts of Kenya. “We may have been the last school to get computers, but we are going to have the best lab in the district,” she is saying.

Likewise, ours will be the first government primary school in the Transmara West District to have computers, and one of only 2 primary schools in the district to have computers at all (although the other private school doesn’t have nearly as many).

Enoosaen Girls' Secondary pupil proudly brandishes one of the new HP monitors as she helps unload.

I have seen room for improvement in the curriculum here at the EnKakenya Centre for Excellence, and I will of course mention some of these issues on this blog because it is important to recognize problems in order to find solutions. I do, however, want to make clear that I deeply admire what the teachers do here and the amount of time commitment (6 am and 8 pm prep sessions!) and dedication required of these teachers.

To showcase of some of the inspired teaching here in the EnKakenya Centre for Excellence, here are some photos of a day on which Madam Margaret took her standard 6 science class on an impromptu “field trip” to the some nearby flora. On my way to observe her class, I found Margaret dashing into the teachers’ office holding a bunch of flowers. “How lovely”, I said about what I thought was a spontaneously arranged bouquet. To this she replied, “These are my teaching tools!” She was insistent that the girls should be capitalizing on the education their local environment had to offer. What a beautiful day to learn about cross fertilization of male and female pawpaw trees.

In the classroom - Madam Margaret at the Kakenya Centre for Excellence

In the classroom - Kakenya Centre for Excellence

In the classroom - Kakenya Centre for Excellence

In the classroom - Kakenya Centre for Excellence

On a related note, I’ll leave you with last week’s installation of “Never In America”: In a standard 4 science class I attended (in a temporary classroom beside the food storage room), the teacher was lecturing about light. “What does light do?” she asks. That’s right – it keeps away the pests. “What pests?” she asks. That’s right, the cockroaches and rats. “When do they come out?” she asks. At night to steal ugali, they answer. That’s right…. except that at that moment this class was interrupted by a rat. I guess the best education is specific to the learning environment!

Greetings from Enoosaen! I arrived here more than a month ago and I think I have finally gotten my bearings. That has entailed the ongoing process of learning a lot about how things work around here, and how they don’t – the more common subject matter from blogs about brief stints in Africa. From here on out, the two will intermingle in my reflections here on this blog. For now, I’m drafting this post on my wrinkled pages to savor precious battery on my computer, and I’m moving on to how to make things work for me.

This is an interesting subject because, actually, it seems, some things do work better for me because I am a muzungu (“European,” or white-ish person). Since I’ve arrived, certain things that had been inexplicably on hold for a long time (i.e. since Kakenya herself was last here) have started to “get a move on” at the school. I have been told on a number of occasions that this may have something to do with the fact that people see that an “American has come” so they’re anticipating that I want things to happen “the American way.” I’m trying not to take offence to this and instead taking it to mean “in a timely, organized, and accountable fashion.” Somehow, however, I doubt that this eagerness and momentum will hold for my entire tenure here.

So, what is my life like here?

I wake, sweep my room (so much mud gets in here!), make my bed under its glamorous mosquito net (embedded with a few dead many-legged visitors), try to find a bucket in which I can heat some water to take to the outhouse for a bucket bath, study a little swahili, and walk to school. It is about a 30 minute walk from here on Mama Kakenya’s farmstead (Mama Kakenya, of course, is Kakenya’s mama). There is almost always something unexpected waiting for me at the other end of this walk; today it was that the person I was meeting hadn’t prepared a thing for our meeting and instead had me sit with him for an hour while he wrote me the required document, and quite often it is something a bit more urgent. But I love my walk, because despite the constant onslaught of “Muzungu! Muzungu!” cheers from the masses of toddlers along the road, the morning brings the most wonderfully cool breezes along the main road to town.

Once I get to school, or whichever meeting I am headed to, I am tackling a wide variety of tasks, from evaluating the performance of programs at school to organizing a camp to photo and film documentation and production of advocacy materials about the school and community to overseeing construction of the new dormitory.

Also, I live in a veritable zoo. I do have quite a sanctuary of a bedroom, with its mosquito net, two windows, solitude, and privacy. Alas, in addition to the many livestock animals who stare at me as I open the door to the bucket bathing room in the outhouse, the following is a list of sightings in my room: hornets nests, a variety of spiders, a spider and biting ants in my pants on the first night (discovered while in bed), lizards, mice, a kitten that accidentally got locked in my room all day (chasing the mice), “safari ants”, weird juicy larger than a caterpillar thing, cockroaches, and the occasional lost goat or curious hen. Let’s keep in mind that these are only sightings and there is no electricity at night so it is difficult to know what else I am sharing my space with…although recently there has been something with large powerful sounding wing flutters outside my mosquito net that I am quite sure is a bat – updates to come. At least it is lambing season, so that’s cute.

How to account for my weeks of absence? A lot of work, very little power to charge my computer, internet connection problems, and the newly arrived rainy season which only compounds each of those things. My plans to go charge or buy internet credit apparently mean nothing to the rain and the impassibly muddy roads when the rain arrives. Unfortunately I don’t really have the capacity to upload photos easily, the so more of those will come when I get a better connection. Tomorrow I will go into more detail about some of the things we have accomplished over the past few weeks.

I have now finally taken a couple of days off and, to be honest, it has been great to completely check out for the first time since being here. With my sanity in jeopardy from having been too all-consumed with the goings-on at the Centre (and sometimes the general inability to get anything done here), I’ve discovered that I can go to to Kilgoris to have some peace and quiet and solitude. Aside from being the nearest town on the map, Kilgoris is also the nearest place to buy real chocolate, to buy a newspaper, and to have a drink as a woman.

As this photo demonstrates, IT capacity is a little behind in this region…

IT capacity in the region is extremely limited. It took me 12% of my computer battery just to upload this photo!