Asante Sana, Nairobi

By Rachel Bach, 2nd year MDP student

At front desk of Population Council with Frank

My three-month field placement was an educational and enlightening journey. As it comes to an end I am able to reflect on my experience and the lessons I learned.

I spent the first three weeks of my placement in Ghana as I was initially going to be working on a project there. However, unforeseen circumstances meant that project did not go ahead. Arrangements were made for me to relocate to Kenya where I, as mentioned in my previous post, “interned” at the Population Council with a group of MPH students from UCLA.

I had the opportunity to learn firsthand about the role of large global health research organizations in improving policies and programs. I worked closely with Population Council research associates and fellow interns to conduct a research project and complete a draft report for potential publication. I was also able to accompany field workers to the field as they conducted interviews in remote areas on the Kenyan coast. That experience really completed my time in Kenya. I was able to experience the challenges that go into gathering data of that kind firsthand and witnessed the geographical and transportation barriers that people face when attempting to access health services. 

My time at the Population Council provided me with the opportunity to learn more about the role of research in identifying neglected health and development problems and improving well-being and health of current and future generations. My main project was focused on the barriers that women face when attempting to access care for obstetric fistula. The Population Council has a partnership with Fistula Care Plus at Engender Health. They will use the systemative review that I produced over the next year as they design and implement future intervention projects. I really appreciate that the Population Council’s work does not end with conducting research; they strive to ensure that their findings are translated into concrete improvements in policies and programs.

Doing a summary presentation on my time in Kenya for the office

Furthermore, I learned invaluable life lessons through living and working in Nairobi. I learned about a new local culture (while eating delicious foods). I developed new daily routines, made wonderful friends, and saw some amazing sights. There were certainly some challenges. Levels of risk varied as some areas of Kenya are currently facing threats from terrorism that has hurt the local tourism industry and meant I always had to be cognizant of personal security. However, it was definitely interesting hearing local opinions on the travel advisories and comparing daily life in Nairobi to what is portrayed in the media. Kenya is facing a difficult situation, but it is not important to not let media sensationalism overshadow local vibrancy and beauty.

All in all, I had a wonderful experience that I will carry with me as my time in the MDP comes to an end. I want to say asante sana (thank you very much) to my mentors and peers at the Population Council—especially Ben, Timothy, James, Zoe, Amy, Ian, Melissa, and Nicholas—and to the various friends I met along the way. I am going to miss Nairobi and look forward to coming back one day!

Amy Westerman (UCLA intern), Zoe Baker (UCLA intern) & myself with a team of Population Council fieldworkers

Kenya help me think of a good title for my blog post?

By Rachel Bach, 2nd year MDP student

Rachel (L) with other interns

Hello! I am completing my second, and final, MDP Field Placement in Nairobi, Kenya this summer at the Population Council (www.popcouncil.org/research/kenya). The Population Council is an international, nonprofit, non-governmental organization that conducts research to address critical health and development issues in more than 50 countries. The Population Council mentors ‘interns’ every summer and this summer I am one of the six international interns completing Reproductive Health projects.

My Project:

My project aims to understand the barriers affecting women’s access to fistula repair in order to inform the design of possible interventions. Obstetric fistula is a maternal health morbidity that persists in the developing world despite its near eradication from the developed world decades ago. Prolonged pressure from obstructed labor damages the tissue between the vagina and bladder and/or rectum leaving her incontinent, trickling urine and/or feces through the vagina. More than 75% of women with obstetric fistula have endured labour that lasted three or more days and unattended obstructed labour may up to seven days.  In most cases, the baby does not survive.

Although obstetric fistula is caused by obstructed labor, it is a condition rooted in poverty, as it predominantly affects marginalized women who lack access to high quality obstetric care.  In settings lacking proper care, fistula can lead to lifelong ostracism, isolation, stigma, and shame.

It is estimated that between 2 and 4 million women and girls currently live with fistula worldwide, with at least 50,000 to 100,000 new cases every year. Fistula is both preventable and treatable, and in recent years various initiatives, campaigns, and programmes have been established to both prevent and repair fistula. However, women experience delays in seeking repair due to a number of factors beginning with a lack of awareness that repair is possible, and if aware, then lacking resources to seek care, and if resources are available, then receiving adequate and appropriate repair by skilled surgical team at a properly equipped facility.

Barriers to health care are a human rights concern and an important challenge of sustainable development. It has been said, “women with fistula are a living indicator of a failed maternal health system”. Strategies and interventions to prevent and repair fistula need to be an integral part of the global- and country-level post-2015 sustainable development agenda. It is an honour to be involved with this project!

Nairobi:

Nairobi National Park

Rachel and a friendly giraffe!

Living in Nairobi has been a lot of fun. I am sharing an apartment with fellow MDP student, Margaret. I brave my way out into the hustle and bustle every morning to take the matatu to work. There are numerous things to see and do on the weekends. Our taxi driver told me that three months is not long enough in Kenya; that I could be here for six months and still see a new thing everyday! He is correct!

In close, I am going to copy an idea I saw on another blog—a Q & A!

SOMETHING I WISH I BROUGHT FROM HOME?

I hate to say it, but my iPhone. Not only do I just miss it but also I realized after that with the right plan I could have used it as a personal hotspot to get wi-fi on my laptop!

WHAT WAKES ME UP ASIDE FROM MY ALARM CLOCK?

There is a pesky mosquito that hides in my room. It buzzes by my ear but I can’t seem to kill it. Even if I get up and turn on the light, it flies up too high for me to reach and disappears. I hate that mosquito.

GUILTY PLEASURE?

Lattes! At home I am a tea drinker, but the coffee is delicious here and I have apparently starting drinking lattes… regularly—don’t even need sugar!

SCARY MOMENT?

I was almost run over by a boda boda (motorcycle taxi). I was crossing the street… it seemed safe because the cars were actually all stopped, but then the boda boda came out from behind a truck, along the shoulder right as I was about to step out!

WHAT HAPPENED AFTERWARD?

A lady took pity on me and walked me most of the way home. Every time we crossed a street after that she would hold on to my arm and usher me across. Oh but I must confess, I have since taken a boda boda to work—so much faster than the matatu!

BEST THING YOU ARE GOING TO BRING BACK HOME?

Memories! Oh and also… jewelry...

EPIPHANY?

I have had a learner’s license for 11 years. Driving has always made me anxious. However, after being here and see the driving… the driving at home seems a lot calmer. I am also becoming quite the bold pedestrian. Just the other day as I was maneuvering my way through 4 lanes of traffic I thought to myself, if I can do this I’m sure I can drive at home!

TWEET OF ADVICE?

Way back at our MDP orientation in Fisher River, Joe Stern gave us my favourite piece of advice that has certainly proven true—to always approach our development work with humility, optimism, and respect.

More updates at: http://rachyluu.tumblr.com