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One of the Mountain Kingdom’s beautiful sunsets |
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Fellows’ Flyer |
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October 2008 |
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News and views for and by Princeton in Africa Fellows |
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In this Issue: |
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Happy Birthday |
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October 26 Hahna Fridirici
October 27 Katie Fiorella and Mike Scharff |
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We’re Recruiting !
Know someone who’d be a great PiAf Fellow? As we recruit candidates for the 2009-2010 fellowship year, we need your help to find fantastic applicants! Please tell your Princeton friends—graduating seniors in the Class of 2009 and young alumni—about PiAf and encourage them to apply!
Prospective candidates should visit our Applicants page for more information. |
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2008 Annual Benefit
Our annual benefit is right around the corner! Please join us for this special evening, which will include dinner, live and silent auctions, the opportunity to hear from Princeton in Africa alumni, and the presentation of Princeton in Africa awards to Ambassadors Frank G. Wisner ‘61 and Robert B. Oakley ‘52.
October 16, 2008 6:30 PM New York City
To purchase tickets:
· Call 609.258.7215 · Click here · Email cpersen@princeton.edu |
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October 9 Michael Broache
October 12 Florence Cheung
October 15 Tom McKay |
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Update from PiAf alumna Catherine Casey, who recently completed a year working towards sustainable health care in Kenya |
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Reflections from summer intern |
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100% Alumni Campaign
We are on the home stretch of our 100% Alumni Donation Campaign, which aims to raise $5,000 from PiAf’s corps of alumni. This amount will help sponsor an additional Fellow for next year, and 100% participation in this endeavor would send a strong message to outside donors that PiAf alumni are collectively committed to supporting PiAf and the life-changing opportunities it provides.
Thanks to those of you who have already made contributions toward our goals. If you haven’t made your gift yet, please Donate Now! Any amount would be appreciated. Donations must be received by October 10th in order to be counted in our 100% Alumni Campaign.
We appreciate your continuing support of Princeton in Africa— and your help in reaching our goals!
Louise Lamphere Beryl (PiAf ‘04-‘05), Erin Ferenchick (PiAf ‘00-‘01), and Emily Harris (PiAf ‘06-’07) PiAf Alumni Fundraising Committee |
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Molweni from Cape Town! Upon returning to Cape Town last night from a long weekend away, I found myself talking about “getting home.” Indeed, after three months, Cape Town is feeling more and more like home, albeit a very exciting and often unpredictable place to call home!
I am one of two Princeton in Africa Fellows working with mothers2mothers in Cape Town, South Africa. mothers2mothers (m2m) is a South African-based NGO with an innovative model of care designed to help reduce the transmission of HIV from HIV-infected pregnant women to their babies. m2m trains and employs HIV-infected mothers as peer educators to support HIV-infected pregnant women through the prevention of mother-to-child transmission (PMTCT) process. m2m works alongside government-run clinics and hospitals to ensure that all HIV-infected pregnant women can talk to someone who understands exactly what it feels like to be HIV-infected and pregnant and who can take the time to answer the questions for which nurses have no time.
m2m has grown dramatically over the past couple of years from a few dozen sites around Cape Town to three hundred sites in seven sub-Saharan African countries, and it is exciting to be a part of all that goes on here. I work on Curriculum Development (with former PiAf Fellow Aliya Sanders ’07 who has stayed for another year with m2m) to help develop materials to explain the basics of PMTCT in words and pictures that are easy to understand, and to adapt our curriculum for each new country to which m2m expands. I also keep busy by helping out around the office however I can, from report writing and data analysis to tutoring a co-worker’s 10-year-old son in reading. The best part of being at m2m has been the chance to get know many of the women in our offices who first encountered m2m as clients and have since come back to work for a program that changed their lives. These women humble me with their tenacious love of life and their indomitable joy each and every day.
Outside the office, Cape Town has so much to offer. I’ve had many unforgettable experiences here from the intense—seeing Robben Island where Nelson Mandela and other political prisoners endured decades of imprisonment under apartheid—to the comic—having a baboon jump through our car window into our backseat while we were driving to the Cape of Good Hope. Life is full of adventure here, from learning to drive on the left side of the road to mastering South African English. [“Now” literally means “in a little while.” An “oak” is a guy, as in “he’s a good oak.” The trunk of a car is the “boot,” and traffic lights are “robots.”] When the weather is nice, there are beautiful hikes on the mountains surrounding the city. Every week, armed with a stack of Dr. Seuss books, I join a group of University of Cape Town students in going into a prison for boys awaiting trial. As I try to teach them to sound out words in The Cat in the Hat, they teach me about growing up in townships, dropping in and out of school, and living in jail. I’m convinced that I’m the one who has learned the most.
Some people argue that Cape Town is “not really” Africa, and they have a point. Cape Town does offer drinkable tap water, great medical care (if you can pay), well-stocked grocery stores, and even an enormous suburban mall, but these comforts serve to highlight the incredible wealth disparities. I drive past a Ferrari dealership on my way to work each morning, yet tens, even hundreds, of thousands in Cape Town alone live in one-room scrap metal structures without running water. Living amidst these contrasts makes Cape Town a microcosm of a world in which we live. There is so much affluence in small, isolated pockets, but too many people lack basic necessities. Cape Town always provides lots of food for thought, even as I remain unsure how best to digest all that I’m seeing.
I had thought that my first year out of school might involve more “doing” that “learning,” but whether I’m working alongside HIV-infected women at m2m or tutoring young prisoners, I am discovering that I have everything to learn. After three months, I am certain that I have only begun to explore Cape Town, and I’m excited to see what the rest of my Princeton in Africa fellowship will hold. |
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Elizabeth in front of Cape Town’s City Bowl |
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by Elizabeth Jemison, ‘08-’09 Fellow at mothers2mothers in South Africa |
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Notes from the Field |
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Children playing in one of the townships Elizabeth visited |
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Elizabeth (right) with fellow PiAf Fellow Carolina Danspeckgruber |
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by Stuart Malcolm, ‘08-’09 Fellow at Bristol-Myers Squibb/Baylor Pediatric AIDS Initiative in Lesotho |
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Just seconds after landing at Moshoeshoe International Airport in Lesotho (that cute little country inside of South Africa), I was told by the driver from the Baylor College of Medicine Children’s Clinical Centre of Excellence (the HIV clinic that I am working with this year) that work was to start immediately, and that I should be prepared: The King and Queen of Lesotho would be present at the events taking place that afternoon at the Baylor Clinic in Maseru. First day in Africa, and royalty was to be present! I guess I lucked out.
After being whisked from the airport, down the dusty and rugged hills of Lesotho, I was literally hurled into the clinic and I jumped into the day’s events. That day was one of the clinic’s Teen Clubs, a youth outreach program (which I now help to run) that brings in kids for a day once a month and discusses issues surrounding HIV. All the members of Teen Club are HIV-positive, and the club is meant to be not only a place where kids can be kids, but also where they can learn to deal with HIV and where they can get some sort of support. Surprisingly, what I found most interesting about the day was not the King and Queen, but the attitude of these HIV-positive kids. Simply put, they were amazing: fun, supportive, and laughing the whole time. And they looked healthy, nothing like what you might imagine “a poor HIV child” of Africa would be.
The activities came to an end, and to close the day, Kathy, my boss and clinic director, had organized an essay contest for the kids. The essay topic, “What I Want to Be When I Grow Up,” drew responses ranging from doctors to CEOs to professional football players. “You are the future of Lesotho,” Kathy cried to the audience of a hundred kids, reminding them that despite their HIV-positive status, life was not over. You see, as long as children stay on their HIV drugs (termed Anti-retroviral Treatment or “ART” for short), their HIV status is not a death sentence, but a manageable part of their lives. Not long ago these kids were near death, and now I see them playing, laughing, and acting like children.
Flash forward a couple of hours, and Kathy is driving me home after a tiring but fun first day. As we creep closer to my place, she spots a large mansion on the side of the hill. “See that house over there?” she asks. It was something that would rival any eating club at Princeton. “The owner of the place is the owner of the largest funeral home in the country. The last couple of years have been very profitable.”
She was, of course, referring to the HIV infection rate (which is higher than 30%) in the country and the number of people dying from AIDS. I was astounded; just hours earlier I had seen a hundred HIV-positive kids playing and having fun, and now I’m being shown the facts: hundreds of people are dying every day from AIDS. This, dear readers, is the power of stigma and what an incapacity or unwillingness to take HIV drugs does to a country. And yet this disease is treatable, and these astronomical death rates do not have to be the outcome of Africa. This is what the NGO that I’m working for is trying to change.
I tell this tale of my first day in Africa as an introduction of what I have experienced thus far. Things are different here, things are often backward, things are tough. But things are changing and people are helping and I’m glad to say that what I am witnessing is uplifting and that I’m learning every day to help.
What I do as a PiAf Fellow here in Lesotho is an assortment of tasks that always keeps me on my toes. I’m the Community Outreach Coordinator for the Baylor Clinic. I link the HIV clinic with other partnering NGOs in order to maximize the amount of patients and the quality of care we deliver. I organize recruitment for an HIV camp for children who have problems with adherence and need reminding that there’s more to life than the HIV they must live with. And what takes up most of my time is organizing children’s HIV testing events, which draw in children from the numerous districts of Lesotho to identify their HIV status and, if necessary, refer them to appropriate clinics.
As far as travel is concerned, I have mostly stuck to the hills of Lesotho. I took at trip to Semonkong, the “Place of Smoke,” which is known for its 200m abseil, the largest in the world. The trip to Semonkong, up to the highlands of the country, was beautiful, a rugged plateau spotted with pink peach trees, with roads navigable by professionals only. The abseil, which entails strapping into a harness and scaling down the cliff adjacent to a waterfall, was beautiful, with crystal clear waters, a picture-perfect blue sky, and tropical plants clinging to the edge of the cliff as I clung to the cliff myself. My one excursion outside of the country thus far was to Bloemfontein in South Africa, which was a reverse culture shock from my adoptive country (the city both had a McDonald’s and white people!). I’m looking forward to the many trips within Lesotho that my job requires. Lesotho is nothing like I imagined it would be: it’s cold (to my fellow PiAf Fellows: I sleep with three duvets and a sweatshirt!), rows of mountain shacks on the dry, rocky hills rattle when the local BMWs pass by, and EVERYONE has a cell phone.
With that I leave you. Lesotho has been wonderful, if not completely different and oftentimes confusing and frustrating. But I know this year will be a mix of highs and lows, as I learn as much as I can about Africa, HIV, and life.
If anyone is nearby, I always have room for visitors so come if you can. The Mountain Kingdom is beautiful!
Sala Hantle! |
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Stuart in Semonkong, in front of the waterfall he abseiled down |
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Stuart climbing down the waterfall (he’s the yellow dot on the left!) |
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The Baylor Clinic where Stuart works |
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Notes from the Field |
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2002-2003 PiAf Fellow Catherine spent the past year as an Acumen Fund Fellow in Nairobi, Kenya. Acumen Fund is a non-profit global venture fund that uses entrepreneurial approaches to solve the global problems of poverty. Acumen’s investments focus on delivering affordable, critical goods and services—like health, water, housing and energy—through market-oriented approaches. Through the Acumen Fund, Catherine worked with the CEO of the Sustainable Healthcare Foundation (SHF), a franchise network of 65 clinics owned and operated by Kenyan nurses. Her work centered on helping SHF franchises reach profitability and preparing the network to scale to 250 clinics in five years.
In the middle of the Kibera slum in Nairobi, Kenya—surrounded by narrow trash-filled dirt roads and makeshift homes with rusted tin roofs—is a bright green and white clinic owned and operated by SHF nurse franchisee Dorah Nyanjah. In a community where one million people live in extreme poverty in an area the size of Central Park, Dorah has successfully built a small business providing low-cost essential health care and medicines. She treats over 100 low-income patients a day with the same dignity and respect that they would get in the most expensive private hospitals in the city.
“People here are poor, but they still deserve to get quality health care, at an affordable price,” Dorah asserts. “They know if they come to me and pay then I’m accountable for their health. If they go for free services, no one is accountable.”
Despite several free health care options nearby, Dorah’s customers choose to pay a small fee (averaging under $1) for services in her clinic. Customers cite personalized service, short wait times, and consistent access to quality drugs as the main reasons for their willingness to pay. In just two years, Dorah has built one of the most lucrative franchises in the SHF network, with more than $10,000 in profits last year.
Dorah’s success has not come easily: she keeps her clinic open 14 hours a day for seven days a week, and faces competition from free options and “quacks” selling counterfeit drugs. She treats a complex mix of diarrheal diseases, respiratory tract infections, malaria, tuberculosis, and complications of HIV/AIDS. “It’s difficult, because you might treat one thing but you don’t know what’s happening in peoples’ lives. So you treat them for something, but then they go back to a place where they lack proper ventilation and nutrition and children are playing in sewers and it becomes a cycle.”
Furthermore, many of Dorah’s customers can’t always afford to pay. Kibera has high rates of unemployment and informal employment, and Dorah must balance a desire to serve the community with a need to manage her business’ bottom line. She maintains an informal credit scheme where she occasionally provides drugs and care on credit. In her wooden desk drawer is a small black notebook with frayed edges; in it, all outstanding payments are carefully noted in red pen.
This balance of mission-driven goals to increase access to health care with business goals is what makes the SHF model powerful and unique. Dorah and other franchisees invest their own capital to start their clinics and purchase all of their own drugs from SHF, raising the accountability, commitment, and sustainability of their work.
The power of this model was most evident following the disputed December 27 election in Kenya, when Dorah’s clinic was surrounded by some of the worst violence in the country. Many NGOs pulled out of Kibera, and most government health facilities were closed. Dorah kept her clinic open throughout the riots—spending four days and nights sleeping in her consultation room because it was unsafe to walk in and out of the slum. And in return, her customers showed the same loyalty—when looters came to attack her clinic, they gathered outside to defend her.
Dorah remained in Kibera during the post-election violence out of commitment to the community, but also because of her financial investment. “If I walk away, I lose everything,” Dorah describes. In Kibera, where counterfeit drugs, unlicensed providers, and overcrowded facilities are the norm, this accountability and commitment offers a valuable option for low-income customers.
SHF is just one Acumen investment that aims to use market-based solutions to poverty. Acumen believes in treating the poor as active customers, rather than passive recipients of charity. My work with SHF taught me a great deal about the potential as well as challenges of running businesses that provide critical goods and services to the poor.
I relied on my Princeton in Africa experience throughout this year in Kenya—for the skills that I built through my work in northern Uganda, as well as the network and community of PiAf Fellows throughout the world. As I progress in my own career, I see even more clearly how unique the PiAf experience is; it continues to serve as the foundation for my professional decisions and my commitment to work in international development. |
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Catherine (center) with SHF’s staff |
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by Catherine Casey ‘02 |
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Alum Update |
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Mary, a SHF nurse franchisee in Embu region, talks with Catherine |
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Philomena, a SHF nurse franchisee in Makuyu, poses with Catherine outside her clinic |
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Credence, a SHF nurse franchisee in Embu region, talks with Catherine |
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Jessica found hippos at this waterfall |
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The banda where Jessica stayed |
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Jessica takes in the landscape from a hilltop |
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by Jessica Inocencio ‘05, Summer Intern at Mpala Research Centre in Kenya |
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The Mpala Research Center (MRC) is located on approximately 50,000 acres of land in Laikipia, Kenya. Private and community ranches border the MRC at every boundary. Though there are no fences to inhibit the migration of wildlife on the conservancy, certain neighbors have chosen to mark their properties with electric barbed wire. Still, even with fences surrounding parts of Mpala, you never feel enclosed. Space is endless.
Time is also continuous. “African time,” as it is sometimes jokingly called, has its ups and downs. Most Westerners must immediately focus on weaning themselves from the grip of watches. Once you arrive at Mpala or any other African country, severe withdrawals typically take the following forms: anxiety, needing to know what time to be ready for this or that, and frustration. Local Africans will smile politely, sometimes amusingly, at you because in their minds needing to know the time for everything is a sign of worrying. Though in a Westerner’s mind, it is simply time management.
Even if you have toned it down a bit, your concern demonstrates that time is the top priority in life. I know I entertained several local Kenyans by constantly requesting the times we should meet to start a project. I usually received a reply that I should calm down. Then I would laugh because I had assumed such a simple question could be answered without any problems. It was just a matter of picking a time and sticking with it. After a few days, however, “African time” eventually relaxes you. It is the ultimate dose of tranquility you could ever receive. Finally there is no rush and that is okay.
What should one do with endless space and time? At Mpala life is quiet and simple, but it is not boring. Researchers from the U.S., Kenya, and England have chosen to conduct their independent work at the MRC because it is an inspirational and breathtakingly beautiful location. The center offers quintessential security, friendly staff, and freedom of exploration. On any given day, you can spot a cheetah stalking the airstrip, baboons chasing superb starlings, or a herd of elephants crossing the road. Every outing is a safari.
As the summer filmmaker at Mpala, I tagged along with Dan Rubenstein, an EEB professor at Princeton University, and his students involved in the Ewaso Water Project, one of the many ongoing endeavors taking place at Mpala. This project took me throughout the dry and barren community ranches to the east and the lush habitats spread across the Mpala Conservancy. I used the time to practice the art of filmmaking, and for the rest of the year, I will be editing the footage I shot to fully capture the nature of the Ewaso Water Project.
Before living at Mpala, my understanding of nature was oversimplified; nature was merely the generic lump sum of beauty and space. After living at the MRC for a month, however, my perception of nature changed drastically. With the time I graciously inherited, instead of just taking up space, which every living person does, I finally created a relationship with my surroundings. I wanted to know more and this required patiently observing what was always in front of me. Learning the intricate details of the land and wildlife ultimately strengthened my weak vision. I watched impressive shadows creep over the hills until they startled and absorbed neighboring clouds. The lighting steadily stalked the sky and transformed the land each time it moved. The canopied landscape would morph instantly from a cascade of illumination to a dim ball of dark green bushes. In the distance, you might occasionally see the long neck of a giraffe browsing the top of an acacia tree. At Mpala, I spent hours a day searching the landscape. This was my favorite thing to view. |
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Summer Sojourn |
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Tel: 609.258.7215 Fax: 609.964.1818 piaf@princeton.edu |
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Mailing address: Post Office Box 226, Princeton, NJ 08542 Street address: 194 Nassau Street, Suite 219, Princeton, NJ 08542 |
