Winter Wonderland

Usually I am a rather conservative person when it comes to weather. Though I think that snow is pretty awesome, I don't remember being fearless driving in it since I was in graduate school and living in Boston. I had Ravishing Ruby The Truckstop Child at the time, a beautiful red Subaru, who could traverse nasty Boston Slush, Blizzards on Interstates or in town, and take crazy night trips with friends when you literally couldn't see anything in front of you. Ruby was a good girl, and I miss her. When our first Christmas at our cabin in Boone in 1998 was marked with a wild snow/ice/snow/ice storm and we spun around backwards with the Suburban filled with dad, Katrina, Allison, Julia, two golden retrievers and a cat, I knew that I didn't want to drive in this weather again if possible.

So here I am, nearly 61, and my youthful husband greets me this morning with a hearty, "Well, last night's storm was crappy, let's see if we can get to Boone." I was not enthusiastic for an hour or so, but then joined in the delight. Sadly, we don't have a Suburban anymore, nor do I think I can ride in the Subaru for 4 hours, but, we hopped in the Toyota (without kitty) and made the trek. All was well until we hit Wilkesboro where plowing seemed to have bogged down. Still, the roads were pretty clear until we started up the road that leads to our house. And when we came through Mr. Brooks house, I was definitely worried. This was a good worry as we only drove past the first side road and were stuck. Fortunately for us, Brooks' son was plowing, and after he drove past us, we were able to manage to slide our way up as far as the switchback.


So here we are with a beautiful afternoon, evening, and walk around the neighborhood. WNCW is playing beautiful bluegrass Christmas music, and there is the possibility of 4 more inches of snow tonight. If we get snowed in???? Oh well as far as I am concerned. Kitty has plenty of food, water, and warm blankets all around her, so we will be just fine in the "hills of Caroline".

Uganda's Proposed New Laws

http://www.newsobserver.com/news/nation_world/story/231756.html

I promise that Purina Chow was not recruiting my children. They did want him to come to their birthday party, but mostly they just love him. They think about how he shaped their growing up lives by being fun, honest, and helpful and loving them back. What a wonderful experience for them. They won't forget it.

Brutal anti-gay laws proposed in Uganda

I really don’t want to write more horrified sad blogs, but it seems that the world just won’t cooperate. This morning, in the middle of a terrific thunderstorm (snow in 10 days?) I read that Uganda is proposing passing laws that could actually impose the death penalty for persons who were homosexual, and that the backing for these laws is coming from Christian Conservatives. Families who support their children can be beaten, evicted, and fired from their jobs. (Of course the gays and lesbians who are “out” automatically are evicted and fired presumably before being put to death.

As it turns out, this isn’t the only country where automatically gays and lesbians are presumed to be “recruiting children”, as if that would actually happen. Africa might seem to be a leader in this propaganda against gays and lesbians, but when you look deeper, you see colonialism alive and well and “Christianity” seems to be at the root. This type of Christianity which justifies murder just seems like a foreign concept. Would Jesus justify murder under any circumstances? I cannot imagine it. And I feel like years and years of working with gay men and lesbians, and trying to help them “come out of the closet” so that they can FEEL normal and not ashamed is swirling ever more quickly down the drain.

As for AIDS prevention and treatment, this attitude towards homosexuality simply squashes prevention efforts as they speak only towards one population. Just trying to include prevention work for men who have sex with men in an environment where this act could confer death, is impossible.

Our world is a scary place, and the agenda of the conservative Christian leaders only makes it scarier.

What would Jesus do?

World AIDS Day Dec 1 2009

Today is World AIDS Day 2009. Again. I will be busy handing out ribbons, and trying to help KIWAKKUKI by selling their beaded ribbons. I didn't think I would still be doing this, but I also thought that there would be a cure. When my friend Jeffrey and I met in Boston, I knew for some reason that this little Welsh man would have a profound impact on my life. I didn't know exactly why, I was a social work student at BU, and he was a chef and owner of two very successful restaurants Casa Mexico and 9 Knox Street, and also a lover of Gilbert and Sullivan.

Since I loved Gilbert and Sullivan as well, I just thought that we would run into one another from time to time while we performed, he as the patter baritone and I as one of the faithful chorus. But, it didn't turn out that way. A group of us, Johnny (Bloodie), Patty, Sam, Terry, Norman and me, pretty much spent most of our free time with Jeffrey, and gladly cooked, cleaned and were entertained by this amazingly charismatic man. In turn, he showed up for graduate school stuff, including my graduation. We were sort of the "bad seed" when it came to the Gilbert and Sullivan Players of various schools in Boston, as we never took anything seriously, especially ourselves, and that made some of the directors pretty mad at us. But, it didn't last, as we were the first to have the rush of joy when the shows went up and the lights. Jeffrey used to say..."What lights, where?" and look in wonderment around us. He used to do terrible things like drop his false teeth at us as we were trying to sing a patter chorus part, or whisper some hysterical joke in our ear as we were to be weeping on stage. But it was all in good fun.

Jeffrey was cast as Pish Tush in The Mikado, which was to play at The World's Fair in Knoxville Tennessee. What fun. I had two children, and we all planned to drive to see him. But, on opening night, he collapsed on stage. Patty had said that he seemed out of breath when she visited him during rehearsals and that he was very thin. But, no one seemed to know what was wrong. He was so sick that night that he needed oxygen back stage, and was immediately flown out of Knoxville to New York. 1982, GRID.

Jeffrey shouldn't have survived the bout of PCP, but like everything he wasn't supposed to do, he did survive. Probably his life wouldn't have ended so horribly if he had died. The next weeks and months were awful. His friends rallied around and helped to take care of him. No one knew what to do to make him better, and all the treatments he received just made things worse. Sometimes he and I would throw up together--I with morning sickness and he just because he was sick.

Finally, Jeffrey was taken out of the hospital, AMA, and flown back to his beloved England, where his mother and aunties could care for him and he could get Brompton's Cocktail, a wonderful mix of everything pain killing. He recognized his family, and lived a few weeks with his loving family before finally dying.

In one of the dramatic throw-ups, I had promised that..."Until there is a cure", I would keep trying to help others the way that Jeffrey had helped me. Never did I think that it would take so long. Jeffrey was only 39 when he died. He was an amazing man, the Very Model of a Modern Major General.

The voices who cannot speak

What about the voices who cannot speak?

I made one of those terrible internet mistakes yesterday by inviting my entire e-mail contact list, most of whom I do not know, to my personal facebook page. That was a pretty bad error since I was just trying to invite our community advisory board to our relatively new “cause” facebook page. We are having a town hall meeting tonight, and I wanted to get the word out there-yet again.

As I am reaping the repercussions of this error, I pondered the people that I know who would never receive this invitation, nor be able to answer, either positively or in the rage that a few people have. These are the people with whom I really interact. They are the orphans of KIWAKKUKI who are hoping that someone will sponsor them for school next year, the parents of the orphans who hope that someone will sponsor their child (one parent has died) for school because they have no income and cannot pay for school and also for food. They are the HIV-positive adults who try desperately to be hired by employers who are themselves struggling and cannot imagine shouldering the cost of medication for their employees that they know are wonderful, but have a regular medication bill that far outweighs what other employees have. They are the smiling faces of the hopeful who have been damaged so greatly. They are the faces of those who simply cannot divulge this secret…this terrible secret inside because to do it would risk everything that they have built, everything that they count on. Affording internet? Doubtful. They can’t even afford to get an internet virus, yet, they got the costliest virus of all, HIV.

I used to think that everyone should come to the place where they were open about their HIV. I used to listen and help people move move towards disclosure. I marveled at my dear friends who had disclosed their status and had made it through that disclosure intact. But, I have also met people who were beaten, thrown out of their house with nothing but the clothes on their backs, torn from their children, and found that their families weren’t quite as loving as they thought. So- what do you do? As a teen, do you listen to the horrible things that other teens say about people living with HIV? And then disclose that you too are HIV-infected? As a mother, do you disclose your status and then find that the school and other children and their parents have found out and are treating your child badly? As a professional, do you walk around with that silence all around you? I don’t know. Sometimes, I feel I don’t know much anymore.

As my friend Jacquie says, “One day we will look back on this disease and say-boy was that a hard time, I’m so glad it is over.” I hope it happens in my life-time.

The Long Awaited Visit

Ok, I have to back this blog up. Too much work has stressed my life to the limit. Not that I am complaining. But the most fun of October was when daugther Michelle, s-i-l Lexton and darling 7 month old Lyriella came to visit. I definitely know that I couldn't have raised a 7 month old myself at my advanced age. What possesses the 50+ year old women to have a baby? I guess they have nannies. Anyway, how did I forget that Christina crawled her way to freedom at 5 months and laughed when we couldn't find her, what possessed Kate to decide that she would never sleep again after her English Spaniel Ralph died and the sensitive mother told her that Ralph went to sleep. Oh well, as grandmother, the fun began as Lyriella decided her strategy. Move, look, try to decline sleep, persuade Grandpa John that she really needs all Mac products, meet and greet Great Uncles and Aunts (the vote from Lyriella seems to be that they are interesting, unusual, and she would like to see them more, and definitely want the Aunts to be a big part of her life. All in all it was a great week, and Grandma cannot figure out where it went.... I have put away the bed, found the leftover incredibly cute dresses and T-shirts, looked at the funny teeth pictures and thought.....I want my children and grandchildren HERE. But alas, that is there decision. And I will live with that!
Freedom...or fake coals, or the nasty sheepskin

It is very possible that Great Uncle Rick has something wonderful. It might need to be eaten, or at at the least given. These Great's. They are pretty wonderful.!

Great Aunt Kay knows how to deal with her babies. And Grandma is sad that she didn't have the camera for Great Aunt Anne who is equally adept. what was she thinking!

Aunt Julia had many attributes, but apparently the laces were the best. Lyriella adapted to all her family like she had been in North Cacki lacki for ever.

Grandpa John reminds Lyriella that he actually has nice things, not just the laptop, iphone and pager, and she has decided that she wants the Pakistani Wall Hanging...Oh, ok. But we have to die first. One thing at a time.



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Fiona Terry-Breathing New Life Into this Ngirilover

I love the mountains! A weekend with Fiona Terry and her two adorable children. John, Leaves, Pat and Quail, good whiskey, fire in the fireplace... what more do you need?

Make sure that the wood is ready for the fireplace!

Fiona is loving her kids!
So....what is it about this woman and her kids. Fiona is a visiting faculty member to the Kenan School of Ethics and Duke Global Health Center. She is an amazing woman, and she has given me a breath of new life. She has worked with Doctors without Borders (MSF) the International Committee for the Red Cross, and others, and has done so in refugee camps, in terrifying war situations, and in places that most of us would say a big NO! But there she is, literally on fire with her desire to slowly give us (in our working group) a new way of thinking. Ponder carefully what you are doing in a placement abroad, ponder carefully if you are hurting or helping, ponder carefully what the best way to work with refugees and internally displaced persons and provide them with safety...not to make life worse for them and to put yourself in such harm's way that you cause a mess. These are new ways of thinking and they make sense. Think in other words, in a different way and then act on it. WOW. For an old lady like me, this is challenging. Especially for an Irish old lady like me. Then, to top it off. She is so much fun. She is delightful, funny, charming and maybe a little sarcastic. But, she has the neatest kids, lovely, polite, creative, and actually pretty nice to each other. The natural fit for the weekend was to have our dear friends Pat and Quail over. What a terrific time. I just wish I were 29+ and could sign up for all the possibilities that are right in front of all of us for foreign service...and this time in the right ways. On the other hand, maybe we were guided by instinct and haven't done so bad after all!

John Bartlett

I don't often toot my husband's horn for him. But, I must say that he is constantly amazing to me. He has a way with words that make people stop and listen. He also has a way of listening that makes people believe that he has all the time in the world, just for them. His patients often comment on this, and his colleagues come to him for inspiration, advice, and sometimes just for the opportunity to vent to a person who will absolutely cherish their confidential problems and issues. When he watches others give speeches that he doesn't agree with, or pronouncements that are just plain wrong, he never confronts the person public because that would violate the rules of decorum that constitute the core of the way in which he was raised. There are exceptions to this, but only in the case of the Boston Red Sox have I actually heard them voiced out loud.

Indeed, rarely have I heard him talk about people behind their back, and since we are bedfellows, I would be the one to know. In stark contrast to me, the Irish hot-head, John is always willing to give the "other guy" the benefit of the doubt.

Well, John gave a marvelous presentation about the work in Tanzania on Tuesday for a new University Consortium in Global Health First Annual Meeting at the NIH campuses. It was an honor to begin with, and John as usual measured up to the task. What he managed to say in 10 minutes encompassed much of the work that he and his colleagues Nathan Thielman, John Crump and Professor Shao had dreamed about those many years ago. Here is the article.

http://sciencespeaks.wordpress.com/

And, the Red Sox did scrape another win out last night!

Last Days in Moshi Town

The trip to Moshi was much too short. We were both running all day and night. We didn't have enough time to get the work that we wanted to get done, and there were so many difficulties. As you go and come, it is easy to forget the electricity problems, the water problems, the food problems, the job problems. We certainly were faced with all of these problems (in spades) on this short trip. There had been neither short nor long rains this year and food prices had increased by at least 1/4. Jobs lost, Donor sources drying up.

We did have the time to bring our new med student and our between undergrad and grad school student to KIWAKKUKI. They will be doing some work there later in the year, and as you can see in the first picture, there was the usual joyous dancing and singing to welcome them. These singing folks always put on the best welcome belying the difficulties that they face immediately after morning meeting. At least 15 minutes of the day are easy! I think that as they toured the building and saw what each worker was doing, they were stunned with the amount of work, and the way that seemingly all of these departments overlap and come together, blending their speciality in with the specialities of the other departments.

I had the opportunity to visit quite a few students I knew and to meet others. The stories are just astounding. My favorite visit was to Jacinta's school in Kirua because she is such a success story right now Lubda (Hopefully).

Jacinta is standing just like a teenager. How cute. And she loved the fleece and the socks especially. Here is a picture with the headmaster and following it, a picture with her KIWKAKUKI monitor Verynice Monyo.

Remember that this headmaster took Jacinta into his home so that she would have role models in parents, and that his chldren would have role model in someone who had undergone so much trauma in her life. This young woman appeared in the KIWAKKUKI office almost 1 year ago exactly, in tears. She had run away a great distance from Mawanza (Lake Region) to escape being sold to an old man in marriage. All she wanted was a chance to finish school. Her parents had both died of HIV. She had not been tested but at that point couldn't even contemplate it. I worried about the motivation of the headmaster, but on three separate private conversations, she firmly states that he is wonderful, like a real father.

Verynice Monyo is in charge of keeping records for over 1,000 children and nearly as many donors. This is a real job!

At the same school however are two children who are also supported by a different donor. There is no money left for new uniforms, extra clothes, extra food etc., unlike what Jacinta has because of what Marilyn and Phil are doing for her. What do you do about this inequity. Because the children are funded by a large donor source, they don't pay for "social support". But who will? The community? The community cannot pay for their own food this year and line up for vouchers for Maize (Corn). How can they buy new sweaters for these two children whose parents are both dead. Neither child smiled. They probably know that Jacinta gets special treatment, but not them. It is an ethical delimna. Here they are.
We met after this visit and decided that all donors are going to be asked to allow set asides for children who do not have any social support. Even 10,000 Tsh/week would particularly help the girls. So new policies are slowly slowly being put in place after some time. What is the point after all in going to school if you are just going to be tortured for being ragged, hungry and cold. Some of the chldren overcome it. Here is one.

This boy arrived to KIWAKKUKI in tears. His parents are dead, he lives alone and has no one but a few neighbors who give him some food now and then. He was very thin and anxious about coming. After Verynice talked to him, he calmed down a bit as she told him that he would be sponsored for School by Verynice. She asked him about other things, and at this point, the Mawenzi clinic is paying some. But his whole class is going to Lake Manyara, one of the national safari parks next week and he has no money to pay.....Oh well, I didn't really need that extra kanga...right? We found a pair of tennis shoes that fit, and he was crying for joy.

Judith has been featured before, but she is another survivor. Her father ran away to Tanga with another woman when he found that his wife was positive (he refused testing). Judith had boils all over her body from the time she was a baby. After starting ART, they improved and she is now doing physically well. Kathy and Don picked her up and she is really thriving, although she shared her HIV status with her school and now the whole school discriminates against her. The backfire of disclosing her status, has caused her to want to move to a new school where no one would know about her, but that isn't possible. KIWAKKUKI decided to send out the Life & Living and Education Teams to the school to do a teaching regarding HIV education. They have "sensitized" the teachers, but obviously that didn't sink in. Despite that, Judith is doing well in school and very grateful for the supplies we brought and the extra money for her doctor's visits.

You would think that all the matatas would be over, but just that last afternoon as we were crying over trying to get this darn grant loaded on line (while the electricity repeatedly went off and on) we found that the housekeeper of KIWAKKUKI (Eli) on the far left (with Chrissy and Melkizedik) had some horrible thing in his stomach that would require surgery. Since he barely makes enough to eat and support his wife and 2 children (barely) there was no money for the surgery, and he said that he would die. Once again, you think....for about 30 seconds-that extra wood carving?...Eli? Oh well, no contest. He is the sweetest guy. Just ask Chrissy. So that was that. Send precious thoughts for this young man as he has the surgery in a pretty scary hospital.
Saying goodbye to Mr. Shah the senior, his manager, Omari, Cipe, Simon, Shafiq, the electricians across the street, Sana Zetu, Ladik Kanji and his workers, turned me into a blubbering fool, but I managed to get home just to start over again with Rose and Pauli.
So now I ponder working on a plan for these lovely folks who have the mountain of dreams each morning and each night shining upon them.

See you again next time Terrie Nikoli and Greg!

MOSHI TOWN September 2009

Our 3^rd day in Moshi began with a clinical conference entitled Ethical Considerations. Despite that the presenter had not used powerpoint in the past, (the words ran into the layout, the fonts changed so drastically that they ran off the page, and none of the speakers had given presentations before and therefore practically whispered in the microphone) the discussion was actually quite lively and spurred several MD’s to recommend that one of the next presentations had to be for a discussion of proper end of life decision making.

I was quite sure that it was going to be an awful presentation, and if it had not been for the material…wow.
Anyone who has been to Tanzania understands the difficult issues that people are faced with. The first case was regarding a woman who had undergone a c-section and had low blood pressure but was getting post-op meds when another patient next to her had a spontaneous delivery. The nurse gave the meds to a student to give the c-section to help emergently with the birth. (of course it was at night and she and the student were alone.) When she returned to the c-section patient, she had stopped breathing because the injection of pain medicine had gone in too fast.

Fortunately, she was able to revive her and all was well. The second was more difficult with a 13 year old arriving from Tanga with her mother. She had been unconscious for some time with eyes open but not seeing (not fixed and dialated). She was breathing but stopped, and was sent to ICU placed on respirator where she remained unchanged for a week. One night the MD came in and said, she is brain dead, take her off vent. The nurse was very uncomfortable but did as requested. So, it was a very lively conversation about how to determine brain death. Way Crazy!

So, for the first 3 nights we have had no internet and it has been quite frustrating, but now at last we are here with it again like a miracle. I moved around the house to take a few pictures.

We also hashed 12 hours after arriving. Somehow we had enough energy for that and really looked forward to seeing all our friends. The hash was at Sara and Simon’s land in Mweka (near the Kilimanjaro National Park) and beautiful. We had a crowd of mostly young Scandanavians (beautiful girls) and a few of the regulars.

What a great time. The weather is quite cool in the evenings and mornings, but it has been very dry. No long or short rains for the last year and everyone is suffering.

The next day wasn’t so easy. Little sleep, and tossing and turning. Our house is now in the hands of a lovely medical student from Stanford. Very smart! And she is enjoying her stay so far. She is a very positive person which counts for a lot.

Downtown Moshi looks the same, with some building and some tearing down. I already had all my hair cut off because it only costs $5. Pretty good I would say.

Well that is about all from me for now. This will be a quick trip and we are already figuring that it will be over before we know it!

Senator Ted Kennedy "Teddie"

I am 60 years old; yet, I can still remember the crazy 70's when I was a young adult, a new community social worker, full of passion and belief in change. I had friends who worked for Ted Kennedy, and they all spoke about working 15-16 hours/day, simply because they believed in his causes and him as a person. They all reported that he wanted every detail of the research and his mind for these details and sources was impeccable.

I worked for elderly persons in the Boston community. When Senator Kennedy came to town, thousands of elderly people were bussed to Boston to speak to Senator Kennedy about their concerns and needs. The hundreds of buses that clogged Beacon Hill were a testament to this man's charisma and following.

When I took my bus load of "elderly" to the building, I was able to watch these proceedings. Senator Kennedy would stand in the front with a microphone while people asked him questions. He answered each question respectfully. Periodically, he would ask, "Do you trust me? If you do not, then I will quit this job, because without your trust, I am nothing." These amazing people stood cheering, clapping and weeping.

Despite the fact that his brothers had both been killed, he stood in front of this huge crowd all alone. It was amazing.

Teddie, rest in peace, and hopefully enough of us still believe in your causes. Thank you for the many Kennedy Bills that have made the lives of millions better. What will we do without your tremendous dedication.

More Creatures Bridge and Sunset in Mountains

This has been a summer of creatures in the mountains. Of course, the hummingbirds are the most important, but the other uninvited guests have certainly been ever present....the snakes, the bat, the birds clogging the vents! Now some new ones, whatever they are, they seem to eat fruit.

gross green bug eating a tomato

gross orange bug eating grapes

Beautiful Monarch Butterfly

The project that consumed some of us, was to sweeten the Beech Builders up in order to persuade them build a little bridge to make access to Sara & David and Judy & Gail's house easier. Well there it is, and very cute at that! Complete with little hand written signs, it graces a little tiny creek that supports the water supply. At the end of the day, the beauty of the sunsets make the mountains one of the most special places in the world!

Completed Bridge Bridge under construction

Hmmmm Russell Dog sunset

And what sunsets we have here in the mountains!