We were reminded today that to say most international residents of Nairobi have epidurals is unfair. Which made us realize how little we really shared about the hospital system of Nairobi. This gets confusing, but I’ll do my best. First – there really is no set price for hospitals. Public hospitals are subsidized so much more standard in price (I think, that is the impression I got), but private hospitals set a fee based on the level of service. So to be in a private room in a hospital (for example Aga Kahn where we visited) is significantly more expensive than to be in aRead More →

We began our last morning by visiting a local baby fair to see what is available for Nairobi families. We met one of the women from our training at the fair, she had already booked the booth and was advertising herself as a doula (and childbirth educator from her Lamaze training last year). We then stopped at a local book store to see what pregnancy and childbirth books were available to the women of Nairobi. Nearly everything we found was out of the UK. We took note of a few titles and will offer suggestions for suitable substitutes for the DONA reading list if necessary.Read More →

We learned about Nairobi epidurals today. We laid one of the women on the floor and taped long strings of toilet paper to her to represent all the different things the mother must negotiate during labor. The epidural is still very new and so is met with skepticism from locals. Women are afraid to use one because they do not know about the side effects. They think it may make them go blind, or worse. So women avoid them. But at only about US$25, women are starting to take notice. Almost every international resident uses one at birth. Families share the fear of epidural, andRead More →

Today’s doula training focused on the problem of difficult births.  In the United States, doulas in training often think they have little to do if the mother has an epidural or if she is planning a cesarean surgery. The women in the Nairobi training began with the same belief. We took them through a few exercises to recognize the needs of the mother in those situations and watched as they changed their personal definition of a doula. We asked each of them to share a story of a difficult birth. An hour later the women were amazed at how their most difficult experiences were notRead More →

For those who want to see the photos of our Nairobi Training, follow these links: For day one: Day One Photos For day two: Day Two Photos For day three: Day Three Photos They are hosted at Google’s Picasa, so you need a gmail account to log in and then you can see them all.  Enjoy!  Read More →

When we were training in Nayngezi, we were very isolated from the rest of the world. No phone, no internet and very few people who even spoke our language. But Nayngezi was a rural area, Nairobi is a major metropolitan melting pot with residents and visitors from around the world. In our retreat center we have met: A Sudanese woman who came for vacation and relaxation. An Indian man living in the USA who had just spent a month in Sudan to be at the birth of a new nation. A South African pastor in Nairobi to preach. A family from Belgium helping to trainRead More →

Kenyan women and American women approach meal times quite differently. To the point the cook at the retreat center has asked me why I don’t like the food. Don’t like the food!  But I eat everything, including the ongali.  For those who listened to our stories from DRC, you may remember our first tastes of fufu. Fufu is a paste made from cassava flour and boiled water. We tried, we couldn’t eat it. Ongali is the Kenyan version made with cornmeal.  As an American, I will say it is much more palatable. It is similar to polenta or grits.  The problem is that American womenRead More →

Tammy and I have just had the most fun with rebozos since we introduced comfort measures to the women in the DRC. The Kenyan doulas breathed a collective sigh of amazement when they saw the first rebozo technique performed. I have to agree. Rebozos are amazing.  A simple and versatile tool to help meet many needs in labor. We were not sure how much experience they would have with comfort measures. Most of the women are midwives by training, and we were concerned most of what we taught would be repeat information for them. But in reality it is not repeat information. They know howRead More →

One of the women in the doula training works at a regional AIDS treatment center. I have recently accepted that I need to devote more of my education time to AIDS, and since I have spent the last month reading The Band Played On for my public health school orientation, I was delighted to talk to her. We compared treatment strategies for the women and children and were relieved to discover our protocols are the same. I should not have been surprised, much of the AIDS research leads to changes in treatment internationally and although I have not looked it up, I’ll bet the standardsRead More →

Yesterday, I ended the blog with a cliché I have grown to hate. In contrast to that statement, the women in this doula training do not live in a different world from me. As difficult as it may be to accept, we live on the same rock with the same finite resources.  It was simply the luck of genetics that I was born in the USA and they were born in Kenya. I dislike that phrase because it pacifies people about situations they find uncomfortable. And it is uncomfortable to be aware of the differences.  66% of the women in Kenya lack access to basicRead More →