Volunteer Handbook

Food Water VISA Transport Safety Internet Telephone Money Accommodations ITINERARY Contacts

Welcome

You are about to embark on the journey of a lifetime! Please take a few moments to read through this document. It could dramatically change your experience in rural Africa, deepen your work, and help keep you safe.

More questions? Please direct them to Tiba’s Operations Manager: [email protected].

Tiba Foundation • [email protected] • ww.tibafoundation.org • 415.488.5461

At a Glance

Travel Visa You will need to go online to http://evisa.go.ke/evisa.html and apply for a single entry Visa before you leave for your trip. You will print the eVisa form and bring it with you to present to the immigration officer at the port of entry. You will need to provide an itinerary and info on your hotel bookings, which you can obtain from Matibabu staff. All the steps for applying for the eVisa are clearly spelled out on the Kenyan Embassy’s website, but please let us know if you have any questions or concerns.

Reason for Entry:

Doctors and non-medical volunteers – please list “Tourist” as reason for entry

Nurses – please select “Other” and type “Volunteer Nursing” as reason for entry. Please note that a tourist visa will not be accepted for Kenyan nursing licensure.

Addresses:

Matibabu Foundation Hospital Odiado Ukwala Rd., Tel: +254 728 068496

Camunya Hotel P.O Box 446 - 40606 Ugunja Tel: +254 710 387594 [email protected]

Please contact Tiba and/or Matibabu Foundation if you need additional addresses.

You will also need to make sure that your passport is valid for 6 months after your return from Kenya, and that you have at least one blank page in your passport.

Smart Traveler Enrollment Program: We also highly recommend that our volunteers sign up for the US Embassy's “Smart Traveler Enrollment Program” (https://step.state.gov/step/). This will allow you to receive important information regarding safety conditions, as well as help the US Embassy, family and/or friends contact you in an emergency. It’s not a requirement but will add an additional layer of security for you.

Health Visit a travel clinic at least one month in advance of your trip to get your immunizations updated. Use a malaria prophylaxis. Wear repellent. Sleep under a bed net. The hotels where we put our volunteers always have mosquito nets provided, but should you want to bring your own, it should fit a double bed.

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Money ATMs: Withdraw money from ATM machines in all major cities in Kenya. Cash: There is an exchange bureau at the Nairobi airport, or you can use any number of a “Forex” exchange bureaus in town. Bring new $100 bills. Bills printed before 2000 will be refused or penalized in the exchange rate.

Mobile Phones Matibabu will provide you with a local phone and sim card; you will need to buy airtime/minutes for use. The Matibabu liaison office will help you with this. NOTE: These phones will only allow you to make phone calls. There is no text capability on these phones.

Internet Most hotels offer Internet service. You will need to buy a USB (plug in) modem when you get to town. The Matibabu liaison office will help you with this.

Food & Water Don’t ever eat anything that has not been cooked, boiled, or peeled. Drink bottled water with an intact seal.

Transport In Nairobi and/or , you will be met by Matibabu staff. See the itinerary provided prior to your travel for other details regarding drivers and transport.

For domestic in-country flights, please be advised that a fee will be charged by the airline for extra bags.

Your itinerary You will receive an itinerary from Matibabu staff at least two weeks prior to travel. You may communicate directly with Matibabu about logistics on the ground.

Critical Contacts at Matibabu Foundation in Kenya Dan Ogola, Executive Director +254 728 069 526 Dr. Fred Okango, Deputy Executive Director +254 791 389 064 Dr. Morgan Ndaga, Medical Director +254 721 476 864 Tony Okola, Finance Director +254 780 508 067 Winifred Nthambi (aka Esther), HR & Admin Manager +254 724 914 098 James Abuti, College Principal +254 701 443 231 Aaga Mitoko, Projects Manager +254 727 996 297 Julius Otieno, Finance Manager +254 721 819 587 Judy Sang, Nursing office in charge (Matron) +254 724 351 089 Berryl Dolla, HR & Admin Officer +254 721 801 860

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Section 1 - Kenya A productive, healthy and deeply satisfying volunteer experience can depend upon a really basic understanding of a few simple things.

The …

Approved Tiba volunteers will be working in Luoland. http://en.wikipedia.org/wiki/Luo_people_of_ Kenya_and_Tanzania

People here tend to be gregarious, industrious, and recently, increasingly hopeful. They’re also really friendly— especially if you smile easily, and learn just a few words of the Dholuo language.

The land…

…geography, and weather. You will be working near Lake Victoria in —not too far from the border with Uganda. This is the Great Lakes region of East Africa. The other area designations can be a little confusing. The main thing to know is that Matibabu serves . Surgeries take place in Siaya District Hospital. The outpatient clinics are in the towns of Ukwala and Nzoia, in Ugenya District—again, part of Siaya County.

You’re on the equator, so it’s warm and humid year round. There are two rainy seasons, during which sudden showers occur mainly in the afternoon and at night. Most of the roads are unpaved, so you’re either on mud, or dust.

The land is low, rolling, and green. It was once heavily forested. This is a contrast to the high savannahs most people envision when they think of Kenya. It’s extremely rural. Every ten to twenty miles is a market town, generally along the two tarmac roads in the county. In between are homesteads, spread across the land. Very little land is unexploited.

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Food is…

…basic. The staple is ugali, a white cornmeal paste. It’s generally accompanied by greens, cabbage, or potatoes. People with money add chicken, beef, or fish.

Many of your hosts grew up with restricted diets and still get by on what we might consider very little food. They often skip lunch, for instance. Don’t forget to eat. We aren’t used to the restricted calories!

Because things can get very busy, we recommend that you bring nutrition bars from home and carry a few with you at all times.

Clean, bottled water is available everywhere, at any little shop. You’ll find that your hosts are extremely attentive, but in the end, we’re responsible for our own well-being, so maintain awareness of your supplies.

Food at the hotels we recommend is healthy and nourishing. Good…is up to your taste. You should also know that not everything on the menu is always available.

Your Health

Inoculations: Get medical advice and update your inoculations at least one month in advance.

Food and water: The simple rule is: if it’s not boiled, cooked, bottled, canned, jarred, or peeled, don’t put it in your mouth.

That means: • No raw vegetables or fruits unless they are peeled. • No tap water and no ice.

Accommodations in Rural Kenya

Surgical teams will stay in a very nice, small hotel in Namasagali, outside Siaya town, and commute over dirt roads to Siaya District Hospital.

If you’re working at the outpatient clinic in Ukwala town, you’ll probably stay at the Camunya Hotel, about 10 km away in the market town of Ugunja. The Camunya Hotel is modest and clean and the people are nice.

Camunya Hotel, Ukwala, Kenya

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Accommodations in Nairobi and Kisumu

Nairobi is full of hotels of every description at about half the price of an equivalent hotel in the U.S. Kisumu has several decent hotels in the vicinity. Matibabu Foundation will help you choose.

Security in the Rural

Your person: With regard to personal crime, Siaya is actuarially safe for visitors. None of our volunteers has ever had a problem. Nonetheless, always bear in mind that you are in a place where most people have almost nothing of material value, and very little cash. Foreigners who have the capacity to travel to Africa are, by definition, immensely wealthy.

Your valuables: A wise person once told us that if you provide a temptation among very poor people, any theft you suffer is your own fault. A bit harsh, but there’s a point. • Do not ever leave laptops or other valuables in your rural hotel room. • You are safe carrying your laptop with you. • You may also feel completely safe leaving valuables with your Matibabu colleagues. They would never let anything happen to you or your things.

Security in the Cities

Your person: Nairobi is a high crime city. Kisumu is a bit tough after dark. Don’t live in fear, but do not take unnecessary risks. Go out with other people. Do not go out at night. You’ll meet lots of friendly people, but do be aware of the hustle—if someone asks you to help push a car or do anything that seems a bit out of the ordinary, politely decline and walk away.

As of September 2016, we no longer allow volunteers to spend any time in Central Nairobi or Central Kisumu.

Your valuables: Your valuables are valuable to you, but could be life changing to a poor person. Behave accordingly. Don’t carry bulky camera gear around the cities. Don’t carry your laptop on foot any more than you have to. Don’t carry your passport—carry a copy. Leave your laptop and passport and camera gear in the room safe, if available, or better yet in the hotel safe. Do not leave laptops, passports, or other valuables in your room unless it’s in a safe. Don’t create a temptation!

Money

The context for your security is obviously poverty, wealth, and temptation. It helps to think this through in order to understand how to approach your journey into East Africa. If you are raising children in impoverished circumstances, your family is on the edge of disaster even in good times. One bad harvest, one short drought, one family illness, can deplete your tiny reserves. Disaster doesn’t mean breadlines here, because there are no breadlines. Disaster means no school fees, no food, no future. Even a slight setback can mean that your child might die, not at some distant date, but next month, next week.

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Even people with resources here—houses, bicycles, food—understand how thin are the margins of comfort and survival. It’s our responsibility to be aware of this, and respond accordingly.

On some level, we will be seen as sources of money. That’s neither good nor bad, it is merely so. Be careful about how you carry and display your wealth.

• Get lots of small bills before you leave Nairobi or Kisumu • Be discreet generally • Do the best you can

Giving Money or Gifts in the Field

If you visit ill people in their homes, you will likely be moved to provide a few dollars to arrange transport to a clinic or hospital, or give a toy to a young child. You may want to pay for something more substantial, like a surgery or a bicycle.

Please do not give money, toys, trinkets or other gifts to a Community Health Worker or a community member—withhold judgment and remember the issues of survival and temptation.

Instead, make the donation officially through the Matibabu Foundation in Ukwala. Go to the Finance and Administration office behind the clinic and find the hardworking finance manager, Athing Otieno. He will help you fill out the necessary form and accept the cash. The donation will be used to good effect.

The Danger of the Implied Promise

If you don’t have a lot of experience working in the developing world, you may find this section a bit opaque, but it’s probably the most important thing we can tell you here. As we keep saying, a lot of the people you will be working with live on the edge of disaster nearly every day. An extra U.S. dollar can mean the difference between a child living or dying. That is no exaggeration.

Daily, you will encounter problems that are beyond your specialty or expertise, but that can be solved with a few dollars. You will constantly ask yourself if the problem should be attacked systematically, or whether you can help this family, this child, with a few dollars for transport to the hospital, or an inexpensive wheelchair. You will make the best decision you can and hope that your efforts do good in a place we do not fully understand.

But this you must never do: make a promise you cannot keep, especially an implied promise. You must be clear about what you can and cannot do or give. If you do not intend to do something, you must say explicitly that you will not do it. Otherwise it may be hoped for and expected.

If you are reading this and are feeling skeptical, we will ask you to trust us. This happens all the time and is a massive issue. Making a promise you cannot keep leaves behind pain and difficulty. Please be aware of this while you’re representing Tiba and working for Matibabu.

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Three Phrases to Make Your Visit Better

We highly encourage you to learn three phrases in the Dholuo language. More is better, obviously, but even this minimal effort will give respect to the local people, and return appreciation, joy, and connection to you. http://economics.ozier.com/language/dholuo.html

• Hello (How are you?) = Amosi (“ahmohsee”) • Goodbye = Oriti (“OdeetEE” - slight stress on the last syllable) • Thank you = Ero Kamano (“KamanO” - slight stress on the last syllable)

What to Bring

• Light, quick-dry, moisture-wicking clothing, socks and underwear (scrubs are great and have multiple functions) • Sturdy shoes, closed-toe sandals • Nightwear, light robe • Lightweight rain gear and/or umbrella • Small flashlight or headlamp for reading at night and/or finding your way around when there is no electricity • Insect repellent (mosquitos laugh at anything else) - Ultrathon is our favorite mosquito repellent as it lasts, and is sweat-resistant • Essential toiletries (ensure sufficient quantities for the trip) • Hand sanitizer (lots of it) • Hand wipes, supply of tissues, toilet paper (rural toilet facilities are very basic) • Personal medical/first aid kit • Sufficient supply of all personal medications, including meds you MIGHT need – keep in hand luggage • Sufficient sunscreen for length of stay, SPF sunhat, bandana • Energy bars, nuts, dried fruit snacks (many meals will feature white rice, potatoes, white bread, corn meal) • Batteries for your camera, etc. • Adaptors for plugs and converter for voltage – East African current is 240 volts • Sense of humor, patience and flexibility!

You will NOT need:

• Dress-up clothes, short shorts, revealing clothing of any kind, especially at work (exception: if going on Safari, something to wear for dinner time and swimsuit) • Large suitcase, expensive personal effects, jewelry or other valuables

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Women - Clothing

In Nairobi For meetings: Nairobi is a cosmopolitan city where people tend to dress professionally. Women’s work attire ranges from very conservative skirt/pant suits to form fitting separates for younger women. A simple and elegant outfit of black trousers/ skirt with a button down blouse and subtle jewelry will be appropriate for most occasions. Nice pumps or dressy work sandals are the best options for footwear.

For casual/tourist activities: jeans and nice tops for casual dinners, weekend meetings, and visiting tourist sites. Best options for footwear are comfortable shoes/sandals that are good for walking, but don’t look like gym shoes. A light jacket is good to have for the chilly evenings.

In Ukwala For the Clinic: All Matibabu employees dress in professional attire or lab uniforms. Nicer khakis/casual skirts and light button down blouses or dressier t-shirts are good options. Avoid white clothing as red dust and/or mud eventually coats everything. Footwear: comfortable shoes/sandals that are good for walking, but don’t look like gym shoes.

In the Field Protection from the sun and bugs/mud/brush is critical in the field. Long pants and lightweight, long sleeve, collared shirts are the best options. Wide brim hats and closed toe walking shoes are essential. Loose clothing keeps you cool. Carry a scarf or handkerchief to deal with sweat. Avoid the safari look; comfortable and covered is the best choice.

General • Flip flops are good at the end of the day. • Athleta, Patagonia, and Prana are good brands for travel clothing that avoid looking too safari. • Packing light is easier. Laundry is available in Nairobi and usually at the Hotel Camunya if you ask your maid or the front desk.

Men - Clothing

• In Nairobi: professional men wear coats and ties. You don’t have to strap on the necktie, but reasonably professional attire is an excellent idea. • In the rural: collars denote respect for the people you’re visiting. They also keep your neck from getting sunburned. • Shoes: nice for Nairobi, stout for the rural. • In general: something in between a suit and safari gear.

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A Few Miscellaneous Thoughts

The hotels where we put our volunteers always have mosquito nets provided. However, should you want to bring your own, it should fit a double-sized bed.

When you let down your mosquito net at night, make sure you get it tightly fitted over the bed and keep it that way as much as possible if you climb in and out. Mosquitoes outside the net: no worries. Mosquitoes inside the net, not so nice.

Enjoy your work; enjoy our wonderful partners at Matibabu; drink in as much of Africa as you can!

And Finally…Smile Early and Often Lab tech Clement Odongo Kide Smile first. Don’t wait for your hosts. You’ll be amazed at what happens. At home, this might be misinterpreted. Not here. Soon you’ll be smiling not because someone suggested it, but from the bottom of your heart. This can be a hard place, but you are about to work with some of the warmest, smartest, most appreciative human beings on earth. It’s the privilege of a lifetime!

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Section 2 – For Physicians and Surgeons

Teaching First

First and foremost, you are here not merely to treat, but also to teach. Treat 50 patients and go home, and they will get sick again. Teach a talented local practitioner to better care for their people, and you will leave behind a lifetime legacy.

To Bring

• Medical handbooks for your specialty • Stethoscope • Flashlight • Otoscope-ophthalmoscope (if you have one) • Box of latex gloves • TB masks

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