Cultural Observations From Nakuru

(For more amateur anthropological observations, go here.)

Several weeks ago, as aforementioned in the story of an all-too-wild automotive experience, I spent a week in the town of Nakuru, at a conference on managing HIV medications. I was able to learn quite a bit, and now can start doing more and more HIV work here at Tenwek. (This, by the way, is not in the average skill set for an American family medicine doc.) I also got to spend a week in Kenya's 3rd largest city, and see their famous lake, complete with more flamingos than you would probably ever think would hang out together in any one place.

In addition to all of this, this was my first opportunity to attend a distinctly Kenyan conference. Some things were quite similar: Powerpoint slides. Lecturers answering cell phones during their talks after asking the audience to power their phones down. Meeting new people from new places. However, I'll remark on a couple of things that I've definitely never encountered in American conferences.

1. The Appreciations. The word "appreciate" is used by Kenyans in a slightly different manner than in the US. "I really want to appreciate you" to a Kenyan means "I really appreciate you". To an American, it might mean "I really want to appreciate you, but I just can't seem to muster the sentiment." At any rate, each lecture at the conference ended with a certain formality: Lecture concludes. Everyone sits in silence while the lecturer collects their materials and prepares to depart. Just as they are ready to physically leave, a (seemingly) random audience member asks them to remain "so that we can appreciate them."

In the states, you would have a sporadic round of applause. Here, "a professional speaker deserves a professional applause", as I was told. So, we all stand, and some impromptu leader tells us all what we will do for our appreciation. The options seem to be (1) a single loud clap all together, (2) a series of claps in some rhythmic pattern, or (3, the weirdest one) an imaginary gathering of overhead flowers and an imaginary presentation of them to the speaker.

2. The Energizer. Apparently, the night before we got to the conference, various offices were assigned for the week. One of these is someone to direct the Energizers, cheekily (I guess) referred to as "The Minister of Energy". Therefore, if we are sitting through the sixth hour of lecture in a bit of a slump between lunch and afternoon tea, the speaker would ask us if we needed an Energizer. This is the American equivalent of asking if you need to get up and stretch your legs. Here, the Minister of Energy directs us to stand and undergo some brief exercise, which included singing (with hand motions) "Head, Shoulders, Knees, and Toes" and dancing around the room singing a song about fire.

3. The Fill-in-the-Blank. This is a bit hard to describe. As a didactic method, any teacher (in the US, as well) will leave their sentence incomplete with a slight upswing in their intonation, which we know means "you fill in the blank with the correct answer to show me that you're listening." So, the US teacher might say "And this little fort on the river went on to become the current capital of Tennessee, which we all know as... (upswing in tone here)" and we all say "Nashville".

Kenyan teachers seem to add two peculiarities to this method. First, they do this often. Like at least every 2 minutes. Second, they do this at (what seems to me) non-intuitive moments. They might say "And because we live in a resource-limited setting it is important that we..." We what? We ensure patients are compliant with the meds? We focus on treatments that really work? We put an extra teaspoon of sugar in our chai? How would I know? The result is that most audience members can't answer the questions, or if a brave individual tries, they may blurt out something that is very different from what the lecturer subsequently says.

In the end, I think it's more of a way to keep you alert than an expectation that you'll provide an answer. Nevertheless, it was fascinating that pretty much every lecturer did the same thing.