The Road to Kilimanjaro

I am writing this from Moshi, Tanzania, a small town at the base of Mt. Kilimanjaro. Well – let’s be honest:  I’m lying in a twin bed, encased in mosquito netting, reeking of DEET, being meticulously watched by two rather odd looking Daddy Long Legs who are currently holding court on the ceiling.   

There’s a daily shuttle that runs from Nairobi to Moshi via Arusha.   We were (barely) on the shuttle by 8am, and on our way by 8:30.    The ride was advertised as a six-hour journey (insert Gilligan’s Island theme song HERE), but that time estimation clearly doesn’t take into account potholes or roadwork.   Let’s put it this way – we arrived in Moshi shortly after 5pm.   It was a long day.

You know that moment when you get on a bus – or a plane – and it looks for a few minutes like…just maybe…no one will sit next to you?   You get that unbelievably righteous “Thank God…I deserve this” feeling.   And as soon as you get it, someone sits down!    That’s what happened at 8:25.   A very pleasant-looking but also very large Muslim woman with a beautiful head covering sat down next to me.    It was fine…until I inhaled.

WOW.

My nostrils went on an instant strike.

The smell was terrible.  

How could this beautifully dressed woman have such a stench?

Part of me wants to spend a year going door to door in Nairobi, dropping deodorant on peoples’ doorstops. 

I turned my head to face toward the window, hoping to avoid any airflow from her direction.   It worked a bit, but I couldn’t sit like that for a six hour drive!   Talk about a neck cramp!

Dami saved me 20 minutes later.   We stopped and a hotel for an additional passenger, and she immediately asked the smelly woman to trade seats with her.  I am forever in Dami’s debt for instantly putting my nose back in business. 

The rest of the ride was thankfully relatively stink-free.

With the exception of the distressing moment when I realized there was no bathroom on the bus, the first two hours of the drive were relatively uneventful.  

Looking out the bus window, I felt remarkably like I was driving through the middle of Nevada.   Well…Nevada with the possibility of seeing giraffes and zebras.   

The ground was dry and dusty, and tufts of small brush littered the ground.  

But the birds!   I’m not much of a bird person, but every bird I saw looked like it had just flown straight out of an imaginative child’s coloring book.     

They’d perch on the flat-topped acacia trees that would appear every so often. 

As we drove, the acacia trees became more and more frequent – to the point that the view looked like God had reached down in a moment of frustration with a giant machete and cut off the tops of all the trees with one quick swing.  

Why this visual popped into my head I’m not really sure, but as I was thinking it the shuttle lurched.   We’d hit a giant pothole.  

It was about this time that the roads really started deteriorating.   Every few miles, we’re run into a giant cement pipe lying in the middle of the road next to a hand-painted sign reading “DIVERSION.”   The sign was invariably tilted, as any good sign should be, at a 45-degree angle.  

Well put.

The road would end, and we were relegated to using a side dirt road for up to many miles at a time.   If the whole thing wasn’t so entertaining and the scenery so fantastic, I’m sure I would have been ill.

After about the third hour, we started seeing Maasai.   

Intellectually, I know that the Maasai exist and that some still live in tribal conditions, but I guess I didn’t really believe it until I saw it.   As we drove, we started seeing tall, spindly-looking men with shaved heads wandering along the side of the road, following herds of goats, cows and donkeys.    

On their feet were straps attached to what looked like pieces of tire from a golf cart.  

They walked with a slight bent, and most had silver dollar-sized holes in their earlobes.   They were wrapped in brilliantly colored sarongs, and had equally colorful scarves wrapped around their shoulders.  

Each man carried a bamboo walking stick – sometimes tucked behind one arm, sometimes carried behind theirs backs as though they were hanging from it.   The sticks came in handy – if a goat stepped away from the group, the stick would wave in the air until the goat stepped back in line, looking as guilty as a goat can. 

What was amazing was how far from anything we would see them.   These men were miles from anything, and I can only wonder how many miles they cover in a day.

Not all that much closer to the village “centers,” we started seeing some Maasai women.   They walked along the side of the road, too, but usually in pairs (as all women prefer to do).   Large baskets or buckets sat perfectly balanced atop each of their heads.    Most of these women also kept their heads shaved, and nearly all the women had so many ear piercings, so much jewelry and beading hanging many inches from every bit of their ears, it made western women with two or three ear piercings seem ridiculous.  

I snapped so many pictures out my window that I think I drove the rest of the bus crazy.     

By 1pm we reached the Tanzania border.   Getting out of Kenya was no big deal, but once we drove through, quite literally, the big steel gate that marked the entrance to Tanzania, things got weird.

At the immigration office, we got in line at the Visa Application counter.    An angry looking man sat behind the glass who would bark every so often at his colleagues.  

Dami presented her Nigerian passport, and was told that the fee for an entry visa was $50.    $50?  

All the guidebooks said that the visa would cost between $20 and $40.

Emily and I felt badly for Dami – sometimes presenting a Nigerian passport can be problematic and cost extra.

Then Emily and I went to the desk.   The angry man told us the fee would be $100 per person.   WHAT???

Oh – and it had to be in cash, using only US Dollars, and the Dollars had to have been issued no earlier than 2004. 

WHAT?????

“No,” we said, “we only want a single entry visa.”

“No – you get a multiple entry visa.   $100.   US Cash only.” 

The immigration office wouldn’t even take the local currency!

I could feel my blood beginning to boil.

The cost was probably really about $20, and the additional $80 was likely just the requisite tax on being American.   This is a tax that I’ve come to expect, and the tax rate varies by day and depending on the person overseeing the transaction.

I hate feeling powerless, and yet I really had none.

Thank God I had a stash of US currency with me.   I’m not sure what would have happened if I’d shown up with only local currency. 

We handed over $200.   What we got in return were our passports back, and a regular stamp on our passports.   The $100 bought us some chicken scratch next to the passport stamp that said something about it being good for one year.

By the time I left the immigration office I was so angry I could hardly see straight.   But there was nothing to be done, and I had to force myself to let it go.   In the scheme of a large trip like this, $100 is nothing.

Hey – at least they let us into the country. 

We still trudged back to the bus looking and feeling rather defeated.

The terrain changed significantly once we crossed the border.   The scenery became much more lush, much more mountainous.   We continued seeing Maasai all the way to Arusha, and on occasion were able to glimpse their living quarters – small stone or mud huts. 

I was expecting somewhat expecting Arusha to be a booming metropolis.   I feel like I hear enough about it that it would at least have a couple large buildings.

I was very wrong.

When we first pulled into Arusha, I thought we were driving through a slightly larger village than usual.   The main road was paved, but everything else in sight was dirt, and there were dilapidated shops built from old pieces of aluminum siding along the road.   Ads for Kilimanjaro and Seregeti Lager were hand painted on everyone building, and palm trees were everywhere.   I almost felt like I was driving through Central America. 

It was Dami who first saw a sign indicating that we had arrived in Arusha.  

I was shocked by how underdeveloped things were in the city.   People were everywhere, though, and they were a mix of women with baskets on their heads, men in Maasai sarongs, muslims, and people wearing T-Shirts and jeans. 

We stopped briefly in Arusha to drop some passengers, and then continued on to Moshi, a smaller town located at the base of Mt. Kilimanjaro. 

It was cloudy, but 15 minutes outside of Arusha I realized that the large dark cloud in front of us – that seemed to take up the full horizon – wasn’t a cloud at all.   It was Mt. Kilimanjaro looming over us.

It was a weird feeling – it’s something I’ve wanted to see for years  - and to suddenly know that it was right in front of me, to FEEL it in front of me and yet not be able to see it – shook me a bit.

Kilimanjaro rises nearly 20,000 feet in the air, and it has a more authoritative and commanding presence than any mountain I’ve visited.   

I kept hoping that the clouds would clear so I could get a good view, but I was short on luck.   I could only see the bottom, but even the bottom revealed its enormity. 

We arrived in Moshi shortly after 5.   It’s a small, run-down town, the center of which is marked by a 20-foot Clocktower that prominently displays the words “Coca-Cola” on each of four clock faces.

We checked into the Kilimanjaro Crane Hotel – it was $55 for a room with three twin beds, mosquito nets, and a continental breakfast.    We were exhausted, but not so exhausted that we couldn’t go for dinner at one of the local recommended restaurants.    We dined at “El Rancho,” which, naturally, serves exclusively Indian food.

Riiight.

And now we’re off to sleep.    The goal is to get up at 5:45 to see the sunrise over the mountain.   Hopefully we’ll be able to see it!  

$32.00

It’s good to know that morning rush hour traffic is universal.  

8am marked the start of a University of Nairobi Medical School class called “Complications of Type II Diabetes,” but the professor didn’t show up.   She was stuck in traffic.  An announcement was made that class would instead be held at 11am, and no one seemed terribly fazed by the schedule change. 

With our sudden free hour, we went up to Ward 8B – the Adult Internal Medicine ward – where Mercy is currently doing a rotation.   Dr. Clara, the Intern on duty, quickly took us around the ward and debriefed us on each admitted patient.   There was some pretty gross stuff, I have to say, but we all managed.

We stayed for full rounds, and one thing in particular sticks out in my mind.   One of the many patients we saw was in end-stage renal failure.   
The resident leading the rounds explained that the woman couldn’t afford the dialysis she needs to stay alive.   I asked how much dialysis cost, and the answer was approximately 3000 Kenyan Shillings (KSh) three days a month.   

That’s about $32.00.
I had about twice that amount in my pocket at that very moment.

IN MY POCKET.

The realization made me cringe.
Of course, even if I paid for the dialysis on the spot the same problem would arise next month.  What’s more – that wouldn’t be fair to the other patients, who no doubt have equally important needs.   So handing over what was in my pocket felt wrong and almost demeaning to all of them.  

The woman is dying.   

The doctors are just managing her pain for now, but clearly not very well because silent tears streamed down her face the entire time I was there.
To make things worse, her family has stopped coming to see her.   They apparently know that she’s dying and that there’s no hope, so they’ve abandoned her for all intents and purposes.
Good God.
I found the whole thing very difficult.   Of course – who cares if its hard for me – imagine how hard it is for the patients, and the people who deal with this and suffer from it every day.

Meanwhile, today we had to register our phone and internet SIM cards.   Kenya has this crazy new policy in place where, when you buy a SIM card (one is necessary to use each cell phone and each Internet modem), you have to register it within 7 days or it is automatically shut off.  “Registration” involves going to an authorized dealer – like a Verizon or AT&T store – presenting a photocopy of a drivers license or a passport, and filling out some paperwork.   Of course – this process isn’t posted anywhere.   You’re supposed to “just know.” 

Its one of those things where you show up to Register and they say “oh by the way – we need your passport.”   And when you present your passport, they say “oh – but actually we will only take a photocopy of your passport.”   “Do you have a copy machine?”  “No.”   Riiiiight.
All of us had to register both of our SIM cards by COB today, or they’d be shut off.

The other thing I wanted to do today is get a TB vaccination.   TB Vaccinations are standard issue in Africa for babies born in hospitals, and most Africans have little round scars on their forearms to prove it.   As over-vaccinated as we are in America, for some reason the TB vaccination is left off the list in the offices of American pediatricians. 

Given that we’re spending our days interacting with numerous patients hacking and coughing TB germs, I really want that vaccine.

I had asked for the vaccine at the hospital, but was told that anyone over 5 years old could only get the vaccine at City Hall.

City Hall?

Emily and I took a cab downtown, and found the “Innoculation Office” at City Hall where supposedly you could get vaccinations.   
I asked about the TB vaccine, and the guy behind bulletproof glass looked at me and said, “you’re supposed to get that when you’re a baby.”
“I know,” I replied, “but they don’t do that in America.  That’s why I’m here.  I want it.”
“We don’t have that.”
“But the people at the hospital told me you did!”
“No.   Have you tried the other hospital?”
“No.”

D’OH!
There is no such thing as a simple process in Africa.   NONE.
So I still don’t have my vaccine.

From there we registered our phones, which was a whole other NOT-simple process, and then we had a beer at a downtown trattoria.   The local beer here is called “Tusker,” and the logo involves a large elephant.   It’s not bad!

I picked up a newspaper – everyone here is buzzing about the upcoming election on Wednesday.  Today’s headline reads “Green vs Red is Obama’s New Headache.”

Kenyans are convinced that the Obama Administration is funding one side of the major election debate.   Who knows.

Tomorrow we take an 8am shuttle to Arusha, Tanzania!   The ride will take about 6-7 hours, but I can’t wait.    It should be a gorgeous drive.   Our hope is to see both Mt. Kilimanjaro and Oldevai Gorge over the weekend, as neither is terribly far from Arusha.  

Wow.

I GOT TO HELP DELIVER A BABY TODAY!!!!!!
AHHHHHHHHHHHHHHHHHHHHHHHHH!!!

It was so amazing.   
I almost started crying.

What a feeling.
It was a C-Section, which amazingly I didn’t find gross in the slightest.   We lifted the baby girl out – she was only at 32 weeks - and I think I had my jaw on the floor.
I’ve never been so in awe in my life.
She started crying within 30 seconds, and for some reason they let me determine the APGAR score (as the doctor put it – “we don’t have litigation here, so you may as well go for it.” ) They handed me a stethoscope and taught me how check the little thing’s heart and lungs.

I’m on such a high.
The craziest thing – we didn’t have any lights in the operating room or the adjacent rooms.   And yet it was the first time that I could actually see why people DO this – come down here to the Third World and work in situations with virtually nothing. You can still make it work as long as you’re resourceful, and doing so successfully feels AMAZING.  

Untitled

First day at Kenyatta National Hospital. The smell is sour and distinct. The building is a dull gray and the lights are dim. The patients are desperate. The day was spent in the pediatrics department that consists of four separate wards. Mercy has suggested we spend most of our time here because it is the most organized of all the departments. That is, as organized as could be while maintaining nearly double the capacity of beds and operating completely on a system of paper records and steno pads.

And then there's Isaac. Isaac is one of about 25 children housed in the pediatric oncology ward where we spent some time entertaining. He is about 4 years old and hops around on his remaining leg. I spoon fed him some saucy mystery meat and rice and then he fell asleep in my lap. He stood out in the room because of an unusually kind smile but the reality is that each child shares a similar story. Heartbreaking.

Day two brought a little more comfort but no fewer challenges. I spent the morning in ward rounds in another pediatric unit including the acute cases. The overcrowding was no less than Mercy had described. The mothers are living in the hospital right along side the children. In one case, there were two adjacent beds that housed mothers-to-be, in addition to their already severely ill children. And I literally mean “housed”. These families are living here. The cart comes along in the morning with some sort of slop and a piece of bread. And it is carefully rationed. It's too bad the little girl in the hallway barfed all of hers up because she won't be getting more. And then there was the puke trail that made it's way into each of the units because nobody even noticed that the little girl lost her breakfast. I should have been disgusted but I laughed really hard. I hope that's not insensitive. Coping, I guess.

Dami and I were together for the day and in hindsight, thank goodness. We were standing in the back of a group of students while a festering IV port had to be removed. The child was screaming and writhing, making the process much worse as the needle tore through his skin. I looked at Dami and she was clearly upset but said she'd be fine. I was doing pretty well, just shivering a bit because they keep all of the windows open. I suppose the alternative is to have TB floating around in confined areas. At least now it floats around, then floats out the window. I hope I don't get caught in the crossfire. Anyway, I was cold and I looked to Dami and sweat was beading down her face. She left the room and I later found her in the staff room. A short pep talk was all she needed and we were back at it.

The afternoon was spent in the lecture hall with the medical students for “grand rounds”. That includes a presentation about work related stress (ha. Really? You're telling them now?) and a lecture on a case of tumor lysis sydrome. Thanks to a biology class and a minimal histology/pathology background, it made a surprising amount of sense.

And now I'm exhausted. Since I arrived in Nairobi and as of today, I hadn't spoken to my mother. We connected for only a few seconds before my cell phone time ran out. Shoot. Most know by now that she was diagnosed with breast cancer just weeks ago. She goes in for surgery the day after tomorrow and I think about her constantly. I would brave all the TB, malaria, and meningitis in Kenyatta to make sure she's ok. Miss you mom.

Hospital Smell + BO = Wow

First day at the hospital today and I think my brain might explode.  

The morning began at 8am.   Decked out in white lab coats (and admittedly feeling rather pleased with ourselves), we made our way up the stairs to the fourth floor to the pediatric ward (the elevators are apparently a little sketchy).   There, we met Mary and Margaret, the two nurses who serve as Pediatric Department Heads.    Mary sat behind a large wooden desk in a room that was clearly once an exam room.   A rotary phone sat in front of her where I would have expected a computer to sit.    Margaret sat across from her flipping through steno notebook.  Handwritten in the notebook was a list of patients currently on the ward, and what was scheduled for the day.
Mary and Margaret welcomed us to Kenyatta, and told us a bit about the pediatric unit.   
The unit was built to accommodate 60 patients.   Yet, at the moment, they have 93 admitted children.   Many of the admitted childrens’ mothers are also living on the ward, as they can’t afford a local hotel.   So there are approximately 180 people living in a ward built for 60.    How do they deal with this?   They have, in many cases, two children to a bed.
What’s more, there is a policy in place at Kenyatta Hospital that doesn’t allow patients to be discharged until all hospital bills have been paid.   Naturally, being a public hospital in Nairobi, many patients have no money to pay the bills.   Amazingly, the hospital’s solution is to keep the owing patients at the hospital.   Apparently there are women living at Kenyatta, admitted during childbirth and unable to pay the bill, whose children are now 2 and 3 years old.   Imagine that – having a baby at a hospital, not paying the bill, and being forced to stay for years.  
Some of these mothers, so desperate to leave, will try to escape by literally jumping off the second and third story window ledges with their babies.  
Other mothers – even mothers who are able to pay their bills – strategically choose not to, aware that their children will be forced to stay at the hospital.   Their strategy is to keep the children at the hospital until they fall ill again.   It’s quite a cycle – one that keeps the children fed and house, and keeps the mother unburdened by the child.
The tragedies, inefficiencies and costs associated with this boggle my mind.

Mary and Margaret took us to spend the day in Pediatric Oncology, but we managed to get a tour of the full pediatric ward on the way.    At pediatric emergency, the line was out the door with people waiting to have a minute at a window marked “Pay Here.”    The pharmacy next door was the size of my closet in Alexandria, and yet when I looked in it only one wall contained shelves of medication.   It struck me that the amount of medication was roughly what you might find in the medicine cupboard of the average Washington DC hypochondriac.   

We then toured the pediatric outpatient unit, where, at one point, the power went out.   The outage seemed to phase no one but us.

Finally we landed at Pediatric Oncology.  The room was about the size of a New York City loft, and steel frame beds straight out of the 1940’s lined the walls – each about three feet apart.   The mattresses were no more than three inches thick, and were covered with plastic and a thin sheet.  A few children were in their beds, and a few doctors huddled in the back of the room.   The rest of the children were gathered in a small room off to the side – in what appeared to be the playroom.   The playroom contained no toys, 22 children, about 15 child-sized chairs, two lunch tables, and a pile of the small mattresses stacked to the ceiling.   
Since no one appeared to be running the unit, and our arrival was unacknowledged, we took it upon ourselves to go play with the children.   They greeted us with excitement, though most of them spoke only Swahili.   Two were not only blind – they appeared to not have eyes at all.   Another clearly suffered from gigantism, and another only had one leg.   All, we assumed, also had a form of cancer.   
The children were entirely unmonitored for the first thirty minutes we were there.    We were shocked by the lack of structure and supervision.   Shortly before noon, a woman in an apron, who spoke only Swahili, appeared with a large tray and a stack of metal plates.   On the tray was a large pan filled with rice, and another large pan that was filled with what looked like beef stew.   Next to the pans was a plastic bag filled with foul smelling cream.  
Each child was given a ladle full of rice, a ladle full of stew, and some cream.   Nothing was provided to drink.
The woman motioned for us to help feed the children.   We did.

We stayed another thirty minutes and left for lunch.  
It was at this point that we realized that not once all morning had we seen anyone wash their hands.   Having just left the children, we all desperately wanted to give our hands a good deep clean.   We found the nearest bathroom, but there was no soap.  
Distressed, we used some hand sanitizer Dami had in her purse.   We were grateful she had thought to bring it along to the hospital.   Tomorrow we will all carry some in our pockets.

The afternoon was spent sitting in on a pathology class with the crew of third year medical students from the University of Nairobi.   The lecture was 2 hours long, and taught by a Kenyan version of Ben Stein.  

I could go on and on – about how different, how shocking, how sad the conditions at East Africa’s largest and most well-known hospital are – but I’m still trying to process it all in my own mind.  
Tomorrow we go back to Pediatrics, and will map out with Mary and Margaret how we can make the best use of our time at Kenyatta.  
I’m actually very much looking forward to it.  

Pillows Are Lifesavers

I have a pillow!
Thank God for the grocery store that sells pillows.   I've never been so excited to purchase a pillow in my life.   I slept, and life now looks much better.

I have coffee, corn flakes (with milk from a bag), and we're off to our first day at Kenyatta Hospital.

Little Critters

I'm sitting up at 3:27am because I'm worried that the large quantities of blood and vomit that they warned us about at the hospital will seep into the shoes that I brought. That and there is a big crack under the door of my bedroom leading to the balcony where I fear the cockroaches are getting in and are going to crawl all over me. We put the piece of foam from under the hot dog mattress on the floor and it's SO much more comfortable but now I'm worried about the roaches. Then my mind started to wander about the skeeters that have been buzzing around my ears for the last hour. The girls have talked about the countless malaria cases they see at Kenyatta although this is not an endemic area. So who's to say I won't get malaria? The doctor said not to take my pills yet.

So I got out of bed to at least do some writing while I freak out and the first thing I see in the kitchen is....wait for it....yup....a cockroach. I nabbed it with a dishtowel and decided to forego the midnight snack. On my way out of the kitchen, another little bastard was greeting me right in the doorway to the living room. I'm not sure what my deal is. I was so ecstatic to sleep on a flat bed and sleep through the night and here I am with my eyes bugging out of my head. Geez, I really need to toughen up. Alright, must sleep. Oh yeah, and PS. Mom don't worry. I'm sure I'll be fine.

Mzungu (that means white person)

So I was snarling again last night. I told someone that I could fix the broken hinge on the door. Hmm. Despite not sleeping much at night, I am feeling fairly well adjusted. This morning Mercy had some Kenyan french toast for us made with salt, paprika, and curry. Delicious.

As SB had noted, the water rationing stopped sometime yesterday which meant showers for all. Yay!!! It was really a shame that the electricity coincidentally went kaput and that means no hot water. Mid-lather I was convinced the water was running out again but later found out that I had knocked the main hose off the shower head. Brilliant. I refuse to be the white girl whining about shampoo stuck in her hair so I toweled off and went about my day. All afternoon I was wishing I could complain about the clumps of shampoo stuck in my hair.

We went to the city center today to check out the Masai Market. We rode the City Hoppa bus for 20 shillings and poor SB was stuck next to the most pungent underarms I have ever encountered. Almost impressive, actually. The market was jam packed with beaded jewelery, sandals made from leather and recycled tires, canvas paintings, ivory-esque carvings, and various other traditional Masai gifts gone mass produced. It was a square city block congested with vendors and beggers shouting “sista sista”. Mercy and Sarah were there and insisted they bargain for us. Otherwise, we get the “Mzungu” prices.

The afternoon came to a close with a late lunch at a cafe at the city center. We fell in love with some Kenyan coffee and the most intense fresh juices I have ever tasted. I kept playing in my mind the part in Willy Wonka where they lick the wallpaper and “raspberries taste like raspberries and shnozberries taste like shnozberries”. The fruit ACTUALLY tastes like the fruit. Imagine that.

We returned home on another City Hoppa which cost 40 shillings to go the same distance but the reverse. Not sure why. The trip was much less smelly but I realized mid-ride that I was making eye contact for much too long with a handsome young Kenyan and he bee-lined it for the seat next to me. Mercy stepped in and snatched the seat. She's the best. She didn't let me go without a bit of ridicule, though. I suppose I deserved it. Tomorrow we're going to church so maybe that will make up for it.

Cold Showers Are Refreshing!

The water is back on!  
The only problem is...now the electricity is now out.
So we can take showers for the first time in two and a half days, but the water is freezing cold.  
Unfazed and undeterred, we took cold showers.
Anything for clean hair.
The water started to go when Emily was in the shower, and we heard a few squeals from the bathroom - NO!!  I"M STILL SOAPY!!
But she managed.
We're clean.
And now we're headed to the Masai Market in downtown Nairobi.

Furahiday

That's Friday night in Swahili.

Don’t ask me how the question “have you ever eaten goat meat?” ever came up in conversation, but somehow it did yesterday. Emily and I looked at eat other, and admitted that while we were familiar with the SMELL of goat, and really like goat cheese in general….we had not had goat meat.

Mercy was horrified, and decided that we would have goat meat ugali for dinner tonight. Hmmm….

Ugali is a classic Kenyan dish. It’s starchy – very porridge-like – and made from flour, water, cornmeal, and a little bit of milk. To be honest, it kind of looks and feels like white play-doh when it’s fully ready to eat.

It was wonderful! We complimented the delicious meal with our inaugural Kenyan beers – Tusker out of a can.

Learning about Kenyan Food with Mercy

Goat Meat Cooking



Emily Cooking!

Serving Dinner

Ugali and Goat Meat!

Divits...and Other Things that Don't Go with Beds

This is amazing.

When we got to our room last night (Emily and I are sharing one – AND a double bed), everything looked great, except for the fact that the mattress looked oddly like a lower case letter “v.”
We both looked at it sideways, thinking maybe if we looked at it from just the right angle everything would be okay.
Not so much.

There were two pillows: one that went with the bed and one we got from Mercy’s roommate, Angie. Emily had Angie’s, and I had the one that went with the bed.
Within seconds, however, I discovered that this was not exactly a pillow. It was a pillowCASE that involved two separate things inside that LOOKED like pillows, but were actually square rocks trying to disguise themselves as pillows. OMG.
I tried to sleep on them anyway. I was boiling hot.

Two hours later – probably around 1:30am, the sounds of wild dogs barking and children screaming (the walls here are very thin) - woke us up.
I hear Emily say, “this is AMAZING.” We both started laughing, because we were BOTH stuck in the bottom of the bed divit.
It was at this point that I tried to move my head, and found that my neck was locked in place due to sleeping on rocks. LOL! Good thing I had an airplane pillow in my backpack. I pulled it out and tried to sleep on that. I couldn’t go back to sleep for about two hours, and every muscle in my body hurt from the weird mattress. Plus – mosquitoes were humming and landing regularly on my face. Somehow I didn’t get bitten, but Emily did.
Around 5am the loud Call to Prayer came over the loudspeaker from the mosque next door. That prompted more dog barking and baby screaming, and more realization that we were stuck in a bed divit.
Wow.
I popped some advil.
Back to sleep. Now I was freezing.
More mosquito humming.
More face slapping.

It was about this point that Emily started having a conversation with herself in her sleep. She was clearly pissed, it sounded like she was literally snarling at someone or something. Hilarious.
At 7:30, Mercy popped her head into the room and announced that she was heading off to school.
We woke up for a few minutes, I realized that I didn’t think I could move if I tried...and yet somehow we went back to sleep.

At 12:30 we woke up SHOCKED that it was that late. I couldn’t move.
More Advil.

We both got a good laugh about the bed and pillow situation, and Emily snarling in her sleep, and decided that we both wanted showers. That proved to be a problem, because there was no running water in the place. They ration their water, so water is always limited, but for some reason we don’t have any today. Ach!

Since there was no water, and really no food, once Mercy came back from school at about 1:30 we went grocery shopping. We each put in 5000 KSH (maybe $50) for food for the next two weeks, and got a bunch of staples. The grocery store was like Giant on crack. You could buy everything plus clothes, furniture, paint, stationary....you name it. One stop shopping.

We were hoping the water would be back on when we got here, but it isn’t. Oh well. Maybe tomorrow!

Best Bumper Sticker Ever, And other Pics from Today

Dami, Sarabeth, Emily & Mercy in front of Mercy's Flat, where we're staying

Apparently this truck is carrying Clean Water

Best Bumper Sticker Ever - Seen at the Grocery Store in Nairobi

My New Trousers and Other News

I just woke up. I can't believe it's 12:30 in the PM!!!!!!!! Sarabeth and I are sleeping on what I like to call the hot dog bun. See picture. SB asked what side of the bed I wanted but I don't think it mattered. We woke up at about 1am to the sounds of two dogs having a heated conversation and a disaproving baby waling at the same time. It sounded like the five of us were all IN the hot dog bun together. I finally fell back asleep but ended up waking myself up not long after with what Sarabeth called “snarling”. I was having a dream that my pointer finger had a flesh eating virus but that the handsome doctor was going to take care of it by sticking a needle in it and then groping me. AAHhhhhh! I have heard that my anti-malarias will give me vivid dreams. It's funny...I'm not taking them yet.
Sarabeth claims that her pillow is not a pillow and that we'll be needing to fix that today. I am feeling surprisingly perky today and very happy that our stomachs are adjusting well to the new meals of liver and rice. I am feeling a little anxious about the clothes I have chosen for the hospital so I need to buy some new “trousers”. I'm not sure why I packed to look like the chiquita banana woman. That is not going to work.

several hours later...

We went to Nakumatt, the grocery store/flip flop store/trouser store/electronics store. It was like the Kenyan version of a Michigander Meijer. Fantastic. We bought food for the week to include the staples. You know...cereal, milk, fruit, sandwich supplies, and of course more liver and some goat meat. Oh yeah, and I bought some pants. They are perfect and I will wear them everyday. They cost around $6 US.
I am in need of a shower at the moment. In Nairobi they ration the water mid-week between Tuesday and Thursday so beginning Wednesday morning, we didn't have enough for a shower. I'm not really worried though because I always smell like roses.
SB and I had a very interesting conversation this afternoon with Mercy regarding the medical community in Nairobi and more generally in Kenya. She said that for 38 million Kenyans, there are only about 6,000 trained doctors and after most leave the country or work in private hospitals, there are only about 1,500 doctors serving the public. The hospitals are painfully understaffed and one physician could easily be called in to take care of a “casualty” or emergency where 100 patients arrive at the same time. ONE DOCTOR!!! Mercy is a bright, youthful, 21 year old and she hides much of her witness to the trauma. She told a story of a young woman that needed blood so badly that Mercy herself was the donor. From that moment on she decided she must keep herself more guarded and emotionally further from her patients. Continuing in the same fashion would wash her out and she wouldn't last. She has told us to be prepared for what we will see. This could (and I think will be) the most difficult and enlightening experience of our lives.

Unbelievable

Mercy gave us an amazing factoid today:

There are 38 Million people living in Kenya today, but there are only 6000 doctors.
50% of those doctors leave Kenya to pursue a medical career elsewhere.
Of the 3000 doctors left, 30-40% choose to work in private practice or in private hospitals, which means they are not treating the public.
That is just over 1500 doctors to treat 38 million Kenyans.
Amazing.

And...the average doctor that treats the general public earns approximately $1000/month before taxes.

Late Night Chemists

I woke in the hotel after far less sleep than I needed. I ventured down to the gym to squeeze in a run before setting out on our first full day in Nairobi. I stepped on the treadmill and felt like I was flying! It wasn't long before I realized I was running in kilometers per hour instead of miles and was actually creeping along at a snail's pace. I somehow managed 10k, (yes America, that's about 6mi) before I was sufficiently wiped out.
I hadn't eaten dinner the night before so I was excited for breakfast but in a typical SB and Emily fashion, we missed it. Muffins and cappuccino instead. Dami and Mercy came to get us around noon with our cab driver that will be our semi-permanent driver for the duration of our stay. He waited for us at every stop while we purchased cell phones, SIM cards, internet service, and attempted to track down the elusive AMEX location for Dami to exchange her traveler's checks.
Along the way, we discovered some incredible marketing tools. Signs that read, “Late Night Chemists” and “Rehabilitated Public Restroom” and “Doctor Specializing in 7 diseases and Relationship Problems” were reminders that we were a long way from home. We grabbed some lunch at a local food court area where the choices were ranging from Indian and Swahili to American “Lip licking” fried chicken. All of the food was a hit with the exception of Dami's shawarma. Take-away fried rice made up for it.
To get home we opted for a public bus. Mercy did the negotiating and made sure we weren't the sardines in the way way back of a crowded mess. Instead, we hopped into a van that barely slowed down long enough to let us on. In fact, it started driving away while I had one foot in and one foot on the ground. Somehow I wasn't at all alarmed but could only smile.
We arrived back at Mercy's apartment where we had the rest of the evening to unpack and unwind. The place is perfect. Three bedrooms that Mercy shares with a housemate named Angie, another medical student. We are so lucky! We will begin at the hospital on Monday and extend our stay in Nairobi to about two weeks. There is an election coming up on August 4th and our hosts have expressed concern for our safety if we traveled to the rural area sooner. By the sounds of it, we will have more than enough to keep us busy at the hospital here. As for now, I have been struggling to keep my eyelids open all afternoon so it's time to snooze!

NewsFlash

Alert! It looks like we'll be spending at least an additional week in Nairobi. While we had planned to head out to the Vihiga District on July 31, our hosts have suggested that we delay the trip a bit. Apparently there is an upcoming election in the District that will decide a quite controversial issue (whether to adopt a new constitution). Since the last time such a controversial election was held in Kenya some violence broke out, we are going to stay in Nairobi until all the dust settles. Once the election is over, we'll head out there as planned.

We've Settled Into Our Place!

Emily and I missed breakfast, of course, so all we could get for food was a rather nondescript muffin and a cappuccino at the Hilton’s Café American. We sat there nibbling, wishing we had more food, and reading the International Herald Tribune.

Dami and Mercy (our hostess here in Nairobi) arrived to pick us up at noon. We loaded our bags into the back of the cab, and then decided to take the time (since we were downtown) to get some Kenyan money and see if we couldn’t find SIM cards for our cell phones and Internet aircards.

I wasn’t sure what to expect in Nairobi, but I have to say that the most refreshing thing is the skyline. There are only a couple skyscrapers, the highest of which is maybe 35 stories. Nairobi may be a bustling metropolis of four million people, but the downtown still retains a comfortable charm, or quaintness. Here, the stampede of human feet holds precedent over cars. McDonalds is non-existent, but Wimpy Burger is everywhere. Nairobi’s main drag, four-lane Kenyatta Avenue, snakes through the city and connects the outlying areas – from slums to rich estates.
 Dotting the way are palm trees, lush green plants, and suicidal buses called matatus — fast rides distinguishable by their splashy paint-on names such as Ice Cube, Manchester United, and Player Hater.

At about 2, the cab brought us “home,” which for the next two weeks will be Mercy’s apartment. She has a wonderful three bedroom flat about a half a mile from the hospital we’ll be volunteering at. It’s a great place! Just what we need and she’s an amazing hostess. She is only 21 – a 3^rd year medical student – and while she absolutely looks 21 she carries herself with such sophistication she could easily be much older. We’re so very lucky to be staying with her!

Mercy took us to a nearby mall, which was great because we were all starving and they had really good food. Emily and I both had Indian and loved it.
It’s funny – being here is such culture shock that it’s almost overwhelming. I almost feel as though my brain is short-circuiting, or maybe just completely shutting down. I know this is only temporary, but it is still a weird feeling. I suppose it’s healthy.

We took a matutu back to the apartment. This is one of those suicidal buses that involves what looks like an old VW Vanagon covered in all sorts of bumper stickers. In addition to a driver, there’s a full-time guy who keeps track of when people want to get in/out. It’s so funny – he opens the sliding door LONG before the van stops. It’s quite the adventure. For 20 KSH, you can pretty much go anywhere you need to go.

When we got out, we had a little walk back to the apt. On the way we were suddenly presented with the overwhelming smell of marijuana. Emily and I looked at each other and started laughing. Dami looked confused. “What??” We explained and she said “oh – I thought that was just car smoke.” That’s the new name for pot: car smoke.

Jambo!!

I arrived at Reagan National only 35 minutes late in a total tizzy after spending an unnecessary amount of time at the Apple store fixing my iPhone that I wouldn't be using for the next six weeks. What a poor display of time management. I met Dami at ticketing and we checked our bags. I looked like mountain woman with my backpack and duffle bag while she had a pile of coordinated proper black bags. I suddenly felt totally ill-equipped. I suppose no matter how much I had packed I was going to feel that way. I was on my way to Africa.

Our flight from DC to Newark, New Jersey was on what Dami called the “chug chug” plane with “turbines”, in other words, a prop plane. It was a bumpy ride but we made it. From there, our flight was delayed nearly three hours. Good thing there was ice cream and internets.

We made it to Paris with barely enough time to navigate the secret passageway that led to the shuttle, that led to a terminal with more security. Because we were boarding Kenya Airways, we had to get new boarding passes and check through security again. Our flight was scheduled to leave in 10 minutes. A bright, young, adorable, efficient, knowledgeable, french super-agent scooped us up and took care of us. (yes, I would have accepted his marriage proposal) He flew through ticketing, yelled “Allez, Allez, Allez!” and ran us right around security, through the terminal, and right through our gate. If it weren't for him, we would have been a day late to Nairobi. Two young men on the same flight had different agents and ended up missing the plane. Very sad.

For the third flight in a row, I planted my head on the tray table and fell asleep. Pretty much slept the entire way, save the hour and a half I watched Alice in Wonderland. Oh, how I love Tim Burton's brain! We finally reached Nairobi after a total travel time of about 23 hours. Anne (our coordinator), her husband David, and Mercy (our host) were waiting for us. Hugs all around! They are extremely warm and kind and I can tell that I have gotten incredibly lucky to have the chance to know them. They brought me to the Hilton to really rough it with Sarabeth, while Dami stayed with Mercy to meet with her pastor. Sarabeth and I ventured down to the hotel bar for some much needed debrief and a night cap. Whew! Africa at last!

Planes, Trains & Small Automobiles: Sarabeth Arrives in Nairobi

Never tell the Blue Van Shuttle your actual flight departure time.
Never.
I used to know this, but apparently I forgot.
My Ethiopian Airlines flight was scheduled to leave Dulles at 10:05am Tuesday morning. But the powers that be at BlueVan.com seemed to think I could be picked up no later than 5:50am. FIVE FIFTY?
I should have defiantly said the flight was at 4pm or something.
The fact that being so early drives me absolutely nuts is admittedly ridiculous, but whatever. It does.
So I sat at the airport for three and a half hours.

I could tell it was going to be a good flight from the moment our plane pulled into the gate. Why? Because the two pilots had placed newspapers in the cockpit windows to keep from baking in the sun. Newspapers!
Now there’s a business idea: cockpit window shades.

The flight to Addis Ababa was advertised as direct, but this wasn’t entirely true. “Direct” actually meant “via Rome because we’re going to need more fuel.”
This was fine, except that we weren’t allowed to get off the plane in Rome. It was eight and a half hours to Rome, two on the ground at the Rome airport, then another five to Addis Ababa.

For the record, I really like saying “Addis Ababa.”

We arrived in Addis at 8am local time. As we were pulling into the gate, I found myself feeling rather scared. I had that complete internal freak-out I sometimes get when I travel. It's a feeling of intense fear, intense stress, intense newness. I'm familiar with it, but it always catches me off guard. I sat on the plane getting ready to make my way into the Addis airport thinking "Sarabeth, what the hell is wrong with you? What is this intense itch you have to do crazy things and repeatedly put yourself in uncomfortably situations? This probably isn't even safe...you're by yourself...you have no idea what you're in store for... WHAT IS THE DEAL??"
And then I gulp and just keep going.
I have to say, I really wonder if that itch will ever go away. It's bad.

Addis was a whole other world.
You can tell a lot about a country by its main airport. In Addis, the ceilings were relatively low, there was no décor...the shops were haphazardly lined up as though the architect basically just sneezed and this was what came flying out.

There was an inordinate amount of general BO, too, which isn't a good sign. People everywhere really need to start using deodorant.
I finally figured out where I needed to be in the airport, made it through security after a rather weird pat down (my bracelet proved too much for the scanner), and found one of the last seats at the gate.

It was right about this time the power in the airport went out, which doesn't instill confidence. It was all I could do to pull out my book and start reading. My cell phone was getting no service, so I couldn't text or call my mainstays. Amazing what grounding the ability to communicate at will gives me. When I saw that I couldn't - I thought I was going to freak out again.

But suddenly this well dressed African man - about my age – appeared beside me.
He pulled out his clearly American iPhone and starting talking on it! I was instantly mad, since I wanted to be talking and texting, too. I couldn't keep my mouth shut, and very crankily said, "how in the world do YOU have service?" He explained that he had a Kenyan number, and so it would work for him. But that led to a longer conversation, and he turned out to be a really cool guy! What’s more - he lives on Seminary Road in Alexandria – approximately four miles from me. Now what are the odds of meeting someone who lives 4 miles from you in Addis Ababa?
He works for Al Jazeera and we know a couple common people. Amazing. I hung out with him for about 2.5 hours (my flight was delayed due to fog and rain), and now we're friends.

Two hours later I landed in Nairobi.
Being the high maintenance person that I am, I had refused to send my passport away in advance to secure a Kenyan Visa. I don’t like being without it. I assumed (and had read) that I would easily be able to purchase a visa at the airport, but sitting on the plane I suddenly felt ill. What if I couldn’t get a visa and was sent home? Another freak out.
It passed.

I got off the plane and found myself in a beautiful airport! Everyone there was so kind and helpful, and I made it through the visa line quickly. No problem whatsoever. For $25 they were willing to let me in and let me stay for awhile.

Down at baggage claim, I quickly found my big backpack, but my large suitcase was nowhere to be found. I have a God-awful fluorescent pink luggage tag on the bag that screams in bold print “This is My Bag,” so I couldn’t imagine it would be missing. Yet…I didn’t see it.
Finally a concerned-looking airline attendant came over and asked if I had a lost bag. At this point I was so tired that a missing bag seemed like no big deal, and I just nodded. We talked for a bit, and then he had me talk to another guy. This went on for about 20-30 minutes, when my bag nonchalantly rolled around the belt.
Thrilled, I said “Hey! My Bag! Yay!”
The two men exchanged glances and then burst out laughing.
“That bag has been rolling around the belt for the last half hour, miss.”
Great.
Apparently I was more tired than I thought. ☺

Within 10 minutes I was in a taxi heading for Nairobi. The cab driver pointed out four giraffes grazing less than a mile from the airport. I almost died! Giraffes at the airport!
Minutes later, out of the corner of my eye I saw something large flying over head. For absolutely no good reason, my first thought was “oh wow! A pterodactyl!”
Um. Right.
My next thought was “stupid! They’ve been extinct for years.” Then – “it looks like a flying deer.”
Clearly my brain wasn’t working.
I finally asked the driver about it, and he looked surprised. “You don’t have those?”
NO!!
He explained that they were giant storks – apparently quite common.
Too bad they weren’t flying deer. I would have been incredibly excited about that.
He pointed out a tree nearby that was apparently the giant storks’ known hangout. It was the funniest looking site I’ve seen. Giant storks COVERED this poor little tree. It looked like something out of a Dr. Suess book.

Traffic was bad, so the driver and I had time to make friends. He ended up taking me to a local mall and hooked me up with a cheap little cell phone. It was amazing!
I lucked out.

From there he dropped me off at the Hilton. Getting into the Hilton was quite the feat, however. An armed guard inspects every car that is let into the parking area – using a metal detector and a mirror that lets them see under the car.

The wonderful people at Hilton upgraded me, and I settled into my 12th floor room that overlooked the city.

Emily and Dami arrived at 10:45pm. Dami stayed with some friends that night and Emily stayed with me at the Hilton. Within 15 minutes we were at the bar in the hotel with glasses of red wine.

Cheers to being in Africa!
We made it!