Laurel and Associates, Ltd. – Madison, WI

Nairobi, Kenya

Nairobi, Kenya

On December 3, 2014, Posted by , In Travelogue, By , , With Comments Off on Nairobi, Kenya

Hello. I realize that I haven’t told you much about my experience with the Kenyan culture. Here is a hodgepodge of observations:

  • We travel less busy roads, moving through lush rainforest foliage and brilliant flowering trees with scarlet or yellow or orange blossoms cascading down from great heights. These are clearly the good neighborhoods, because the houses are large and well landscaped, and many have orange tile roofs.
  • There are speed bumps everywhere, to slow traffic where cars come out of estates or the state house, etc.
  • The round abouts are even wilder than I’ve experienced in Nigeria or in Jordan. James, my lovely driver, moves the car like he is threading a needle. He will move into what looks like no space at all, turn quickly, weave through traffic that is going every which way- while coordinating his fleet of taxi drivers over his cell phone! He seems to know how to get me where I need to go, despite enormous amounts of traffic.
  • The cars that I’ve seen look either new or pretty well cared for. James drives a Toyota wagon that is very comfortable and well equipped. I even noticed that he has air conditioning capability, although he hasn’t turned it on. Driving with the windows down really does provide a nice cooling breeze.
  • The Kenyans are very serious about security. Yesterday, when I first went to the SHOPS (Strengthening Health Outcomes through the Private Sector), I had to show and leave my passport with a security desk of three people. We were met by someone posted at the elevator and escorted to the office.
  • There are security checkpoints with gates and guards with special rods to check cars for explosives almost everywhere you look.
  • Labor must be very cheap, because a large number of staff is employed: 2-4 guards standing in front of a building all day; 3-5 porters and security personnel stationed at the front of the hotel.
  • In the hotel, they have men in dark suits stationed on every floor near the elevators. They are very pleasant. I can’t imagine standing around all day!
    Both yesterday, leaving the training site and today, going to the training site, I joined other people in elevator cars that had no lighting! Talk about freaky.
  • As I’ve observed in Nigeria and Zambia, people of all ages walk everywhere- in native clothing, American dress, suits, high heels, casual wear. They also carry loads (bags, a stool, who knows what else) on top of their heads.
  • James took me to an exchange where I could convert some of my cash to Kenyan shillings. There was quite a line and then I noticed the sign declaring rates. If I had $100 or $50 bills, I could get 84%. If I had 20s (which is what I have) the rate was 72. Since I knew that the hotel rate was 83 without any discrimination about the denominations I would cash in, I just got back in the car and took care of the transfer at the hotel.
  • James really looks out for me. When he realized that I had no phone, he got me one! (It’s from the SHOPS office, so Mbogo probably should have arranged for me to have it when I first arrived. It is already programmed with everyone’s numbers. I just need airtime, which James will obtain for me. This will make life much easier for me.
  • James also reported that there were three Masai markets scheduled this week. One was today and the others were on Saturday and Sunday. Since he is taking me to the Nakuru game park on Saturday, I didn’t want to impose on his time with his wife and two little ones (2 and 4) on Sunday. However, I was very tired and not really in a shopping mood. Luckily, he preferred that we go on Sunday because there will be no traffic and travel will be much easier. Problem solved.
  • The folks who come to the training are warm and engaging. Yesterday, I complimented a woman on her native dress and she asked me if she should make one for me. I said “Yes,” thinking that she was just teasing me. However, I really think she may do it!

Today was a much more comfortable training day. First of all, I didn’t need to rush around. Rachel, who works at the training site, opened windows on three sides of the room, which gave us a very nice breeze for most of the day.

I brought soap, only to find that Rachel had brought some as well. I teased her that now we need a towel- and I fully expect that she will bring one in tomorrow.

Austin, bless his heart, reprinted the training materials so that the page numbers were easy to see. He also gave me the email addresses of the participants in yesterday and today’s classes, so I could send them promised photos of flip chart work, etc.

I discovered that there was actually a ceiling fan right above me, so I turned it on. Then it wobbled and groaned so much that I quickly turned it off again!

The class has migrated to the right of the classroom, because more tiles have buckled on the left. However, I fully expect that, by the end of this week, we will all be standing flush with the right hand wall, because more tiles buckle every day.

Austin told me that his training group will be moving in January. I sure hope that the floors last that long! And that they find a building with elevators that stay lit!

There are already a number of people who have attended both classes and are incredibly perceptive and articulate. I’m learning a huge amount from them, some of which is pretty demoralizing. In a conversation about the need to have documentation of follow up for patients, they told me that the watchmen at some clinics tell potential patients that the clinic has no power or the x-ray machine is bad, etc. and refer them to another place (that pays the watchmen kickbacks). Yikes!

Interestingly enough, while I was waiting to convert my cash, I overheard an employee call another with an urgent message: someone needed to check into the mini bar payments because one room was charged 15,000 KS when the people who stayed in the room never opened the bar.

A different example, this time of the participant’s wisdom. Paul Ogoo said that he wouldn’t be able to attend the session on Friday that focuses on business growth. So he wanted to let me know that the training program should also focus on the much more difficult and complex issue of business reduction. What staff do you let go, how do you redistribute the work, etc? I told him that we were interested in seeing businesses grow not die, but I would definitely forward that recommendation.

Today’s session focused on how to manage medical records. Most of the organizations represented (small medical practices and hospitals) do very little in the way of auditing records for completeness and do almost nothing in the way of auditing the medical records for quality. They do not have written policies or procedures to ensure consistent and confidential handling of records.

As a matter of fact, Melvin, who is a trainer with his own business and very bright, mentioned that staff often take patient files so they can scam and bill them directly!

The class began with 6 people and ended up with 18. At the end of the session, they brought up the fact that next Thursday is a national holiday. So I tried to decide which two modules could be covered the same day. Then, after class, Austin informed me that the government also declared Friday as a national holiday.

At my look of (I don’t know, regret, frustration, exhaustion, simple disbelief?) he quickly said that the training days were scheduled and whoever wanted to come should come. He saw no reason not to continue with the scheduled training. So, that is what I’ll do.

Tomorrow, Mbogo has scheduled for me to meet with representatives from a college that might be interested in providing this training. He set the meeting for 2:30. My class ends at 1 and it takes me until 1:30 to shut down, repack and/or hide materials. It also takes about 30 minutes or more to get to the meeting site.

I wrote back to Mbogo that I will be happy to have the meeting, but he needs to provide me with fruit or something because my last meal would have been at 6:30 a.m. He replied that he’ll try to set up the meeting as a lunch meeting. Wise man. He must realize that it isn’t a good idea for me to be both tired and hungry!

Fondly,

Mom/Debby

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