An African Music Video

From Zanzibar to the Motor City

I left the island on a 3pm flight yesterday afternoon with an airline called Fly540. The plane sat maybe twenty people which meant no complimentary soda and no spirits for purchase. In fact, that meant no flight attendant or even an announcement as to where we were going. I felt a bit relieved to know that we were at least flying north. SB and I were under the impression that we would have a stop in Dar es Salaam and another in Arusha but an hour and a half later we landed in Nairobi without stops. We were very pleased.

After a quick stop at the market for a few last travel necessities like more tea to add to the 2,000 bags I already have, I was back at the airport to make the haul back to the States. It looks like I'm going to make it! I survived two eight hour flights with a sickling blowing her nose every four minutes, a woman that spilled diet coke all over me while I was sleeping, two obnoxious French gum chewers, an old man that played with his dentures, and another oldie that sucked the spit through his teeth like there was something caught in there. He only let up to take a nap.

When we landed in Brussels I went to use the restroom and stood marveling at the stall. I couldn't believe how clean it was. And the hand dryer was some Dyson dry-razor contraption that I used multiple times because it was fun. I even dried my toothbrush with it. But now I'm in scenic Newark watching the lemmings strolling in and out of Hudson News. I tried to buy a tea at Starbucks but I somehow had trouble. It went like this...

Emily: "Could I have one tea bag...in a medium cup...umm....with some water, too...yeah, that's what I want. Black tea."
Barista: "So you're saying you want a grande tea?"
Emily: "Oh, I guess if that's what you call it. Then yes."

Then I went to pour the milk and sugar in but decided on splenda. No, sugar. No, splenda. And what about the milk? I wonder where the cow is...I wonder how long ago that cow was milked...Oh dear, this is exhausting. I better pull it together. Quick. Next I'll go to Detroit for some good mid-western mullet mania, mustaches, and mustangs. Yeehaw. Plus I'll get some much needed family time. Goodbye East Africa. Hello Motor City.

Dolphins and Unicorns

You know you've been traveling a while when the conversation turns to Darrin no. 1 vs Darrin no. 2 from Bewitched. Of course it's Dick York! The three of us withstood the madness of Mombasa relatively unscathed. The downtown experience was less pleasant than I had expected with it's narrow streets creating a vortex of hot sweat and mostly men. Two of them apparently deemed us stalk-worthy and followed us through town until we ditched them inside the budget supermarket. I think that's the only thing we were safe from in there. Even the Weetabix seemed questionable. We stayed downtown only long enough to buy some overpriced trinkets and get the story on the hospitals in the area. There is one public hospital and three private, but mostly the better doctors gather 4 or 5 doctor buddies and start a clinic.

We woke on the third day in Mombasa excited for our flight to Zanzibar. Because the oh-so-friendly border patrol in Tanzania blessed us with a handwritten scribble of a $100 multiple entry visa on our last trip, we thought we should take advantage and head south again. We flew a small local African airline that brought us right onto the island. The Zanzibar airport is actually similar to a Yooper airport. (in other words, small) Only it's in Tanzania. They barely glanced at our passports and we were off. We took a ripoff of a taxi to Mnakwerkewe, or something like that, and waited for a bus. We quickly became impatient around yet again more sweaty men and hopped in another taxi that took us to heaven. I mean...our hotel.

Karamba is on the southern tip of the island where supposedly dolphins are a thing. Remember that, dolphins. Our room is a bungalow type structure with a grass roof and a brilliant view of the ocean. The romance abounds but SB and I usually throw the flower petals on the floor and laugh. I feel a bit spoiled having come from parts of Kenya where my dessert would buy a hospital visit but the decompression is much needed. The silence was actually startling.

I would say we lasted about sixteen minutes before making lifelong friends with a British newlywed couple down the way that suggested a dip in the ocean with some dolphins. Yes. My only frame of reference is still Flipper and posters of Sea World, but yes. We will swim with dolphins. And 6am? Perfect. Dave, our new favorite Englishmen preemptively announces he's vile in the morning but I conveniently keep my secret tucked far far away. (That would be my motion sickness.)

We climbed through a jungle of sea urchins to get to our boat that looked more like a dinghy abandoned by a 17th century pirate ship. We had been told it's best to leave at 6am before the crowds of other boats join in but we quickly realized that it was only because our boat was was 20 minutes slower than the others. The motion sickness set in almost immediately and I was a proper shade of green. The only comfort was in knowing that Anna, the sweet bride, was feeling just the same, and ended up wretching over her side of the boat. And for what? No dolphins. Our Tanzanian tour guides, James and some other dude in his underwear, attempted to navigate while whistling for what we deemed unicorns, without success. We came to the conclusion they were actually in search of the mating rituals of unicorns and dragons. Three hours of misery passed and we finally found ourselves in front of the hotel and decided we must at least give a snorkel a try.

After unknowingly being stung by jellyfish for 20 minutes, the boat sounded like an acceptable option to carry me home, until I was back on board. My stomach flopped twice and I hurled myself back in the water. I decided to take the jellyfish over the dry heaves. And so the journey ended with one that barfed, several swimmers stung by jellyfish, no dolphins, and two that swam home. A success! Vacation sure is going well.

The other side of the Karamba experience is a feeling of absolute calm. I woke the next morning and grabbed my yoga mat to practice a few sun salutations and some quiet time in the wake of a sunrise and an ocean breeze, all alone. The most stressful part of the day is deciding what to have for our next meal. Again, I am left feeling guilt of incredible magnitude having just walked away from people faced with the worst imaginable medical and financial hardship. That's been a struggle.

Two nights disappeared and it was time for checkout. That's where the dream ended and reality began. They don't take credit cards. We scraped together every penny we had in cash and came out with $2 to spare. Sigh. We were safe. Until I found that they don't take dollar bills from before 2006, and that ruled out a quarter of the money we had. WHAT? I've never heard of such a thing. In the end, we traded some old “dodgy” dollars with our friends the Brits and made it out alive. We headed for a new hotel closer to Stone Town and the airport and tomorrow is a spice tour. Cloves, curry, and anise. Yum.

Special Price for You....

Greetings from Mombasa!

I really like saying “Mombasa.”

Mombasa.

Mom-BASA

MOM-BA-sa

Mom-Ba-Saaaaaaaa.

Okay, so spending time in Mombasa is sort of like planning a relaxing beach vacation in Mexico and then spending all of your time in an extra dirty, run-down and mostly Muslim version of Tijuana.    The best beaches and resorts are a distance from the city. 

We found a nice hotel in Bamburi Beach, which is about a 25 minute tuk-tuk (a motorized bike with a carriage attached to the back) ride north of the city.    The Kahama hotel is set one layer back from the three key exceptions:

1. Our room has three beds but only two blankets and the staff seems unwilling to see this as a problem;
2. Every three hours a paralyzing smell of sewage wafts through the room, and
3. There is a late-night bar/restaurant attached to the hotel that blares music so loudly until after midnight that I tend to confuse the pulsing bass with my heartbeat.

Other than all of that, we’ve found a good place.   There’s a quick path to the beach, and we have a beautiful salt-water pool. 

We’ve been getting up at 6am to walk on the beach (Emily runs, and Dami and I walk) and enjoy the sunrise over the Indian Ocean.   It really is beautiful.   If you get there before 8, you beat all the vendors, whose primary sales tactics involve obscene harassment.   You can’t walk 5 feet without a salesman shoving something in your face, following you and relentlessly asking questions or trying to convince you to go for a ride in a glass-bottom boat.  It’s too bad, because the level of harassment – particularly towards white people – precludes any remote opportunity to enjoy an otherwise beautiful beach. 

We’ve learned to be off the beach by 8 and to spend the day by the hotel pool, which is wonderfully relaxing. 

We’ve also learned to appreciate the value of paying a little more for a hotel on the beach – that offers lounge chairs on private property and security guards paid to keep the vendors away.    When we head to Zanzibar tomorrow we’ll pay the few extra dollars to secure that privacy.

Today, our last full day in Mombasa, will be spent lounging by the salt-water pool here at the hotel.   Being here, really allowing myself to relax, makes me realize just how deeply tired I am.   

Safari Pics!

Sunrise over the Mara

Wow.

Love the Zebras

Hungry Hippos

Domestic Squabble over a Wildebeest

Cheetahs looking at their recent kill

Elephants!

Lazy Lioness




Lilac-Breasted Roller

Maasai Mara

We arrived back in Nairobi on Monday after a not-so-easy ride on the Easy Coach. It took about 8 hours on some pretty rough roads and ended with some steamy mid-afternoon traffic in the city. We called our resident taxi man, John, and he scooped us up and brought us home. We snuck in a few hours of sleep that night before our Safari mini-bus picked us up in the morning.

Makau is a man about 36 years old that owns the Wilderness Zones safari company that I was referred to by an American man on a bus in Tanzania. The man has been traveling to Kenya every year for 25 years and said that Makau runs the best ship around. I couldn't agree more. Makau was there to pick us up and introduce us to our guide, Jeff, and we set out for Maasai Mara. The drive took about 6 hours as it carried us right through the Rift Valley and into the game reserve.

Our accomodations were tents and I expected more bucket showers with cold water and most likely pit latrines. Man, was I wrong. They were tents, but the permanent kind, with HOT running water, and lights, and real toilets! We were ecstatic. We ate a traditional Kenyan lunch with rice, some ground meat that tasted like goulash, and kale. Yum. That afternoon was our first game drive. Within minutes we were staring down an extremely endangered black rhino, some giraffes, a couple of lions, and a whole mess of wildebeasts. Without actually knowing or planning it, we just happen to be in Kenya during the great migration so the Mara looks like a sea of wildebeasts. We finished up our drive just as the sun was setting over the Serengeti which as one could imagine inspired a few oohs and aahs. And then we slept.

5:30am rolled around and we woke to set out for another drive. Within hours we had seen the big five. The rhino, elephant, lion, leopard, and buffalo. We presented Jeff with a new title, the Sargent, or Sarge for short. We definitely got lucky with this one. He would maneuver our little bus through rivers and up the sides of mountains to get us the best views. I couldn't have wished for anything more. Except maybe more time. I did manage to sneak in a few minutes at the clinic in the park, though. They treat travelers but mostly Maasai from the villages around the outskirts of the reserve. They have only one nurse on duty at a time, no doctors, and the woman said they are in great need of more help. It was surprisingly tidy and spacious but maybe only in comparison to some of the devastation I've seen over the last few weeks.

Our three days came and went much too fast and suddenly we were back in Nairobi. Icky. But the day didn't end there. Sarabeth and I had just enough time to repack our bags and catch an overnight bus to Mombasa. We got in about 5am and grabbed a tuk tuk to take us to Bamburi Beach. So here I sit at 6am in the lobby of a hotel near the shores of the Indian Ocean. I'm looking forward to relaxing but at the moment the mosquitos are gnawing at my neck and I'm starting to lose my composure so here ends this post. Tea time!

Farewell Vihiga

Our time in Kisienya has come to a close. We're out of water and the solar powered light bulb is out of juice so maybe it's good timing. The week has been so uplifting that I'm ready to venture out into the world of organic chemistry and all things scientific with a rejuvenated outlook. If I could bottle up the Mugofwa family energy and shower everyone I meet with it, the world would be a near perfect place. For now, it's back to Nairobi then off on Safari. Watch out wildebeasts, here we come.

The Source of the Nile & Hungry Hungry Hippos

Driving from the village of Kisienya to the town of Kisumu makes you feel a bit like a Joad – straight out of Steinbeck’s Grapes of Wrath.   We piled into the old Nissan van a bit before nine, ready for our big “outing” to the city.   The term “city” is a relative one, but if Rand McNally and National Geographic deem it map-worthy, then I suppose do too.

The roads are terrible.  

Let me rephrase that:  REALLY REALLY AWFUL.

Riding in a van over these roads is, I think, probably much like the experience of being a passenger in a toy Tonka truck being guided by a three year old through a pile of unbalanced rocks.

It’s bad.

Despite all the bouncing and jolting (and my head being thrown against the side of the van every five minutes), we did cross the equator!   It was remarkably anticlimactic, but I did get some pictures and take the time to wonder which way a toilet would flush if it was placed EXACTLY on the equator line.   Clockwise or counter-clockwise?  

These are the things I think about.  

It’s sad.

Just past the equator, as we started coming down out of the mountains (very “Deliverance,” I know), we had a spectacular view of the source of the Nile, Lake Victoria herself.   

We made it to Kisumu without any vomiting or skull fractures, which was fairly amazing.   Emily and I both gave ourselves a pat of the back for that.

Shortly after, we stopped at the Kisumu Museum, where I refused to enter the “Snake Park,” but gladly observed giant tortoises and crocodiles.  

After a quick stop at Nakumatt, the grocery store in Kenya where all the fashionable lizards hang out, we headed to Impala Park – a reserve right on the banks of the Lake and a perfect spot for picnicking.     We were a little horrified when the entry fee was $15 US Dollars for Americans, and $2 for Kenyans, but again – we’ve learned to expect a heavy tax for being American.  

We sat by the lake and picked at our lunch, when suddenly we heard loud snorting.   It took a few minutes, but we finally figured out that about 20-30 feet from us, in the tall grass at the edge of the lake, was a hippopotamus.   We couldn’t seen him, but he was most certainly there.   Normally that would be a little unnerving, but at this point in the trip almost nothing surprises us.  We went on picking at our lunch. 

Impalas wandered around much like deer do in the US, half wanting our food but half wanting to keep to themselves.   Monkeys bounced around not far away, and came running when a guy in a uniform appear with food.  

After about an hour of wandering around the park (part of it was set up like a zoo – something I didn’t expect to see in Africa!)  we climbed aboard a small powerboat for an hour-long boat tour of Lake Victoria.    Within five minutes, two hippo heads appeared at the surface about 25 feet from the boat.   WHOA!  

Call me ignorant, but I really didn’t know that Lake Victoria had hippos.    I snapped pictures and just generally sat there with my mouth hanging open.  

Beyond the Hippos, the scenery was beautiful.   Mountains line the horizon on one side, and the lake extends on the other side as far as the eye can see – well into Uganda and Tanzania.   Somewhere far in the distance, Victoria Falls probably roared.   Someday I’d like to see that.   For today, I settled for just dipping my big toe into the source of the Nile.

Lyanaginga

I turned the corner for the last mile of my run and the children were waiting for me. Judith and David were on their way to school and this time David, the four year old, had a messenger bag. I knew he would never make it with his bare feet and the bag so I scooped it up, tucked it under my arm, and we were on our way. We were flying down the hill much faster than the day before picking up other children along the way. We even picked up a little girl named Emily. I am the only person that runs here, black or white, so there's been a lot of buzz in the neighborhood. They call me “the athletess”.

At the clinic, I have learned more than I could have imagined. Evans, the clinical officer in charge was amazing and became somewhat of a mentor. We continued to give quinine (antimalaria) injections and antibiotic injections each day. I also got to attempt an IV placement for a young child with severe malaria. The vein moved around like a little worm in the boy's hand and it didn't help that the needle had been bent in the package. Evans said the warped needle would have to do and ended up using his arm for the site. I can't believe we're practicing these procedures on these poor children that are already in so much pain but many of them don't even shed a tear.

I think the toughest part of this week for me has been the HIV testing. On day one, I saw a man with lesions on his arm undergo PITC, or Provider Initiated Testing and Consulting. The results came back negative. I have never seen such a smile. The next case was a young woman of 34 but looked about 42. She complained of a rash on her legs so again PITC was administered. She was not as lucky as the old man before her. Positive. I sat directly across the table from her while she became emotionless. No questions, not a word, and definitely no tears. I still can't believe they let me in the room. There were more infected patients at the week progressed but each one was just as difficult to watch.

There is, however, a large effort in the community to educate and break down misconceptions about the virus. We had the opportunity to speak to the community health director for the district that runs many initiatives including in-home information sessions on child bearing, hygiene, HIV, etc. Evans reminded us that HIV is not a death sentence but everyone should be tested, often, to get the necessary treatment to live a healthy life. So I stepped up and took an HIV test. Just like the patients, the doc pricked my finger, placed the drop on the test strip and added a bit of buffer. I sat watching and within minutes I got my negative results. That's always a good feeling. I can now officially say I'm HIV free, worm free (they dewormed me, even though I am SURE I wouldn't have such things to begin with), and amoeba free. Ahhh.

The School Assembly

We had amazing rainstorms last night.   Our tin roof made the pattering of the rain sound pretty dramatic, and I woke up in the middle of the night wanting to go outside and run around in it.
Probably not a great idea, so I stayed in bed.
It was still raining this morning, which made the 5 km commute to school and the clinic rather interesting.   The dirt road gets very muddy and slippery, so most people seemed to take their time getting their mornings started.    We definitely weren’t going to be taking our usual motorbike ride, that was for sure.

After a lazy breakfast, the matatu showed up to collect us at 9 – this is one of those “suicide vans” that serve as small public busses and make Nairobi traffic a nightmare.  Here in Kisienya, though, they aren’t terribly common.  We climbed in, carrying our dead laptops, phones and cameras to be charged at the school (one of the few places with some limited electricity).  

The drive in was rather uneventful, but when we pulled into the Light & Salt Academy, we were greeted with an amazing sight.   The entire student body (maybe 150 students?) were standing in two lines outside the front gate, creating a path for us to enter.   Each child waved bougainvillea, and they sang as we crawled out of the matatu.
At first I wondered what they were all doing, but it became quite clear that this whole ado was to honor our visit to the school.   It was a most spectacular sight.   Most of the children were in tattered uniforms and ill-sized shoes.   Victoria, our hostess and the school’s headmistress, had told us that many of the children are orphans – parents here die regularly from AIDS, etc.   Apparently the school has already lost six parents this year alone.
They don’t have textbooks, pencils or paper, all the soccer balls are flat (a seemingly more serious problem than the lack of texts as far as the kids are concerned), and some don’t even show up at times for lack of adequate food.   Yet these children greeted us with huge smiles on their faces.

Singing, they followed us through the gate into the school grounds, and we all crammed into the small and muddy area in front of two of the classrooms.   Each class sang us song or did some sort of performance for us – it was amazing.   Then a woman with an African drum appeared and everyone started singing and dancing.   I’ve never seen a school assembly like it!

After a few songs, Victoria appeared with two bags full of school supplies we had brought with us from the Dollar Store in Seven Corners.  It turns out that these were a bigger deal than we ever thought possible.   Almost embarrassingly so, really.    Apparently at the end of the last school year, the teachers and administration had wanted to celebrate the top students in each class – the ones who had shown the most improvement and one ones who had received the top marks.  Even giving them a pencil would have been a big deal and motivated the children to continue to work hard.   But they literally didn’t have anything to give – not even pencils.   They told the children that they would receive something to celebrate their achievement in the Fall (and Victoria has spent the last two months worrying about what she could come up with to fulfill that promise).   Apparently our dumb little bag of supplies was exactly what she’d be hoping and praying for – and more.  
I don't even know what to say to that.
She called the names of the top three children in each class, and had the three of us present them each with pencils, pens, rulers, etc.    You should have seen the elation of these kids’ faces.   I really couldn’t believe it.
Half the time I honestly don’t even pick UP my pencils/pens when I drop them.   I chew them up and lose them regularly.  It’s embarrassing.

The whole thing lasted over an hour, and we were all so overwhelmed we didn’t know what to do.
I think it might have been the most amazing morning I've had in a long time.

And then we went to the clinic and saw patients.   

And now we’re home....exhausted once again. 

Polepole Pikipiki (slow down, motorbike!)

At 5:30am I was scheduled to meet Mbacka for a run. The family was a little hesitant to let me run alone so instead I would have my own Kenyan tour guide. I was ready by 5:25 but Mbacka, being African, he runs on African time. We missed each other so I nervously left on my own but had the run of a lifetime. It was market day so the villagers were hustling with morning chores and students were on their way to school. I could hear whispers coming through the trees from children saying “Mzungu! Mzungu!” and welcoming words of “Jambo” and “Habari” from everyone I passed. Two boys about the age of 8 or 9 decided we should race. I chased them down the path as I yelled “polepole!” which is Kiswahili for slow down. Old grampas and shopkeepers were cheering me on as we flew down the hill. I loved every second of it.

The morning continued with our trip to the clinic at Lyanaginga. Day number two. We arrived nice and early with our little lab coats on to get our hands dirty. We had no idea how dirty they would get. First on the agenda was a circumcision. Ouch. The “clinical officer” or the equivalent of a physician's assistant in the States is in charge of the entire clinic and would perform the procedure. He explained that he should normally have countless other pieces of equipment but that he would just have to make it work with what he had. We somehow managed the observation free of any major meltdowns and found out that the brother was next. They were about 8 and 7 years old, respectively.

After that he said that we needed to give the boys their tetanus shots and asked who was going to administer them. Me and Sarabeth. EEK! Turns out it's actually pretty easy. Straight shot right in the deltoid. No tears. Success. Then we moved to Quinine injections intramuscularly for antimalaria. Yup. The glutes. We saw a lot of bums. And I have learned the importance of safety with sharps. BEFORE I had injected, and before I filled the syringe, I pricked myself. I was pretty nervous which is why I fumbled but everything was fine. I recovered nicely and improved with practice.

The day continued with a delivery. With SB as the midwife, Dami, me, and only Evans (the clinical officer) in the room, our adrenaline ran high for the next hour. That would make only ONE trained professional. There was no electricity, no water, no blankets on the table, no towels, nothing to wrap the baby in....I could go on and on, but Rhoda successfully delivered a baby girl into Sarabeth's arms (see SB's post for more details!). We couldn't determine the weight because the scale didn't work and she didn't pick a name yet but Brenda thinks she might name her Sarah or Emily or Dami in our honor. Kenyans do that, she said.

I have now simplified the day into a few short paragraphs but it was a milestone for all of us. It reinforced the beauty and complexity of medicine and more importantly gave us the confidence to know that we are all capable of becoming successful physicians. It was overwhelming, emotional, and motivating all at the same time.

What about the pikipiki? That's local slang for a motorcycle. We've been riding them often since our arrival but today's commute home was an unusual one. With three to the bike to include the crazy man behind the wheel, we were a little too much to handle. I'm really glad I was wearing a skirt, too. I think we popped the rear tire and barely made it home. Poor pikipiki.

Amazing What You Can Do When You Don't Fear a Lawsuit

This is a new one:  We started today with two circumcisions.  

Never thought those words would come out of my mouth, but that’s what happened. 

Two motorcycles picked us up at the house around 8:30, and we piled on three to a bike.    About 8km of dirt roads later, we were at the village clinic and Evans, the Clinical Officer in Charge (similar to a PA) was waiting for us.  

It was day two for us at the clinic, so the basic orientation process was already completed.     Two wide-eyed boys wearing shorts and flip flops, one eight and one six, sat with their father outside the “injection room.”  

I’ll spare you the details, but the eldest bravely went first.   When it was all over, he still hadn’t shed a tear.   What a brave kid!   He gave a smile to his little brother a look only a older sibling can give – that “I did it and didn’t cry – now it’s YOUR turn” stare.    The younger boy was just as brave.  

Evans had Emily and I give the boys their requisite tetanus shots.   It was the first injection I’ve ever given. 

Evans then taught us how to give other kinds of injections, and we spent the next two hours giving patients injections of quinine (for malaria) and antibiotics for various infections.   

Meanwhile, a four year old in the next room went into febrile convulsions.   We learned how to handle those, talked about possible causes, and waited for the convulsions to subside.   

Shortly after 2:30pm a woman who had been in labor since 9am that morning was due for another exam.   We were told we could observe the delivery, and I was quite excited.    In the delivery room, there was a basic green hospital bed that had no sheets, pillows or blankets.   The room had a light socket but no light bulb.   An orange bucket sat under the bed, and an IV rack sat beside it – still holding the previous patient’s IV bag.   On the other side of the room was an old crib – lined with a piece of torn packing foam.     An old baby scale sat in the corner under a heat lamp that didn’t work.   Nothing in the room required electricity.    There were no towels, no nurses, nothing. 

The woman came in alone, and looked confused as to what three Americans were doing there.   We smiled at her, and she didn’t seem to mind our presence.    She climbed up onto the bare mattress and lay down.   Evans checked her out (she was dilated to 8cm) then looked at us and asked who was going to “be the midwife,” and Emily and Dami both pointed at me.  

Evans didn’t say too much too her, and he didn’t really react when her contractions began to get severe.   He told me to put on a pair of gloves, and the delivery began.   He stood by to offer guidance and direction, but I was amazed by how much het let me handle it.    The only time her really stepped in was when we realized that the umbilical cord was wrapped around the baby’s neck.   Evans jumped into action, unwound the cord, and then stepped back.   When the baby came out, she landed in my arms.   It was a beautiful baby girl.  

We had nothing to wrap her in, so I held her for a moment and waited for her to cry.   She did.   A nurse came in with a large scarf, and I wrapped her in that.   The nurse smiled at me and told me to “finish the job.”    I cleaned her up a bit, and patted her back until she coughed.   A friend of the mother’s appeared in the room with another piece of fabric, and I handed the baby girl to her. 

I’m still so overwhelmed I hardly know what to say.  

I absolutely loved it.  

Despite no electricity, light only from the room’s window, no sheets or towels or blankets…it worked.   

The room was a mess, and I looked a mess, but it was wonderful.  

What a way to end a “work” day.   I’m exhausted and emotionally drained but I can’t wait to go back to the clinic tomorrow for more!   Strange, I know.

Now’s it’s just after 9pm and I could fall asleep.   

It’s a clear night, and on our way back to the house we’re staying in, we saw the most spectacular night sky we’ve seen since we’ve been here.

I didn’t recognize a thing, and it felt wonderful.  

Goodbye Yellow Brick Road

Okay, so admittedly there aren’t that many yellow bricks in Nairobi, and I doubt there are many horny-backed toads in the mountains of Kenya, but I don’t particularly care.

We left the bustle and lights of Nairobi yesterday morning, and now call a tiny mountain village called Kisienya home.  Kisienya sits high up in the mountains of Western Kenya, very close to Uganda, and, at times, within eyesight of Lake Victoria.

It’s a beautiful little village, and there is much I’d love to share about it, but the number one thing worth mentioning is this:  there’s no electricity.   

Well… let me qualify that.  

There is some solar electricity, at least enough that a few lights can be turned on after dark if energy is conserved properly during the day, but there are no electrical outlets.    At the moment I’m running on computer battery power, so our posts for the next week or so will be spotty.  

The bus ride to Kisienya was much better than the one to Arusha.   This bus, at least, had shocks, and looked more like a greyhound bus than an old airport hotel shuttle.  

We drove for six hours, past herds of bored-looking zebras, and hundreds if not thousands of cows, donkeys and goats.  The drive involved the largest road through the Great Rift Valley.   It’s spectacularly beautiful, and I found myself feeling a healthy sense of insignificance looking out the window at the very land on which humankind first stood upright.     

The Rift Valley is filled with tea plantations, and scattered through the fields of tea are women hunched over, picking tea leaves with remarkable speed and dexterity.   On their backs are large bags of picked tea leaves, and slung around many of their fronts are babies.   Imagine working like that.

We passed numerous little towns, many of which consisted of a few homes made from bamboo sticks, mud and old pieces of fabric.    In on instance, I saw what was once a stone structure the size of the average Starbucks store.   The structure looked like it had been mostly demolished:  it had no roof, no doors, and only holes in the walls to serve as windows.   Yet nearly 50-75 people stood inside, singing.  

It took a moment to realize that a church service was taking place.

Due to not much more than blind luck, we managed to find our stop – a town called Majengo.    It was there that we met Brenda Mugofwa, our hostess for the duration of our stay.   Brenda is a friend of Mercy’s, and while she was raised not far from Kisienya she studied and lived in the States for nearly ten years.     

Brenda helped us collect our bags from the underside of the bus, and then drove us to her family’s home (our home during our stay).    We passed many mud huts on the way to her house, and wondered if our week would be spent in similar conditions.   When we arrived at her family’s home, however, we were pleasantly surprised.   The Mugofwas have a wonderful home – a farm, really – and one of the nicest in the area.   

Brenda’s mother, Victoria, one of the kindest and loving women I’ve ever met, ran out to greet us.    We were welcomed into her home with amazing warmth and kindness.  

Victoria and her husband, Michael, told us later that evening about how they came to live in this house.   In the early 90’s they had 25 acres in a neighboring village, but in the middle of the night after a controversial election, members of another tribe, angry with the election results, came to the property and burned everything they had.   The entire family – Victoria, Michael and their seven children – managed to escape with only the clothes on their backs.   They hid behind bushes until the violence subsided, and then made their way to what became a sort of refugee camp.  They lived in that camp until they could rebuild.    And rebuild they did!   They built a new home – a better home, and were very proud of it.   But then, about 9-10 years ago, an angry mob appeared and burned their home again.    Left with nothing a second time, the Mugofwas still managed to rebuild.   And today we are so thankful to be staying in what they built.    Their seven children have grown, but the Mugofwas have taken in children from the area that needed homes.   There are currently four children between the ages of about 12 and 18 living here, and the Mugofwas love them like their own children.   

Victoria and Michael run a grade school 5 km from their home – a school they started themselves called “Light and Salt,” and other time is spent managing their farm.   They own several cows, many chickens, goats, turkeys and geese, and they even have banana trees growing in the back.  

At the end of each day, the family gathers in the living room (by candlelight) to sit, talk, pray, sing, read from the bible, and give thanks for all they have.

What a wonderful way to end a day.  

As far as I’m concerned, it’s much better than watching television.   

Mzungu Braids

My Own Production of "Hair."

Despite the fact that I'm convinced that white people look utterly ridiculous in braids, I'm getting my hair braided tonight by two Kenyan women who only speak Swahili.   They're coming to the flat, since it will apparently take an inordinate amount of time.

This should be interesting.

Take your American to Work Day

Woke with anticipation to spend the day with Agnes. The plan was that she would “take us around” but we had no idea what that would entail. She was supposed to pick us up at 8am but she arrived at 9am. I'm not sure that Kenyans even have a word for punctuality but we didn't complain as it gave us more time for coffee talk.

We got in the car to find we were driving to Thika. It is a city of about 600,000 located about an hour and a half outside of Nairobi. Because I was unaware of the traveling involved, I didn't pack my motion sickness medicine. I always thought that somewhere on the road to adulthood I would grow out of getting car sick but once again, today proved disappointing. Agnes had dusted herself twelve too many times with her eau de poison and along with stop-and-go traffic, I was stuck in the backseat with a window that didn't work. Agnes was in complete control of all the windows and she kept closing them all. I was convinced I was dying a slow death by suffocation slash nausea. Thank goodness for SB. Agnes would close the window. SB would open it. That continued for about an hour.

We stopped at the Super Micro Venture on the way that Agnes explained as a “self-help group”. What she really meant was that there were a group of people buying and selling land in smaller parcels to raise money for healthcare, education, gender equality, and upward mobility in the community. So really it's more like selves helping others. The organization is only a year old and already they have made huge strides. Most of the contributors are teachers that commit themselves part-time. We got to meet the CEO, Vice Chairman, Accountant, and several other members of the board. Very inspiring. And on the way out we had our first experience with pit latrines. I would rather not have another one but somehow I don't think that's going to be possible.

Next stop, the district hospital in Thika. The hospital provides free healthcare for those that can't afford it and services many patients from the neighboring slum, Kiandutu. The area has been a focal point for Agnes and her work with gender-based violence education due to the extreme levels of poverty. Industry is prominent and wages are low and often forces large families to live in dangerously close quarters. Del Monte actually has a huge plant that employs a significant portion of the population at minimum wage. The results are skyrocketing cases of sexual assault and positive HIV patients. The hospital has their hands full.

Despite the growing demand the hospital faces, it was surprisingly tidy and well managed. We were welcomed by the Chief Nurse in charge of all 240 nurses at the hospital. We spoke to Rosalind about her greatest challenges and ways we can help. She was bright, articulate, and highly receptive to our questions. I was pleased to hear that she dreams of coming to the U.S. for her masters in public health. She would be brilliant. I felt like we accomplished more in a half hour meeting than we have in days.

The last meeting of the day was with Edith, a counselor in the Comprehensive Care Center. It is an outdoor setting with bungalow-like rooms labeled Counselor 1, 2, etc. above the door. Patients come to the CCC for consultation and physical exams after falling victim to rape, assault, and exposure to HIV. Part of her talk with us was to familiarize us with their standards, the legality, and procedural steps to treating patients. And part of the discussion centered around some recent cases.

There was one specific case I won't soon forget. The victim had been admitted two days ago and was still being treated for her injuries. Here's the warning label...the rest of the story is painful. She is just 8 years old and was settling down to say goodnight while her family was hosting her uncle in their home. The uncle was the older brother to the father so naturally, the father told the uncle to sleep in the child's bed (I'm still perplexed by this but reminded of the cultural differences). The next morning, the uncle left early for harvest at Del Monte while the father found his poor daughter raped and immobile. It's been two days and she is still having trouble walking. The father immediately brought her to the CCC and is taking necessary action against his brother but his child will never be the same. Edith spoke without a quiver and reminded us the importance of empathizing with the patient but never to sympathize. Thika is so lucky to have such a woman. She is an angel.

Despite the jolting reality and shock value, we were all thankful to have seen an organization that is facing such challenges yet turning out positive results. In all the years Edith has been counseling, she has only had ONE case that has come back as a second-time victim. Women and children have been educated on what defines gender-based violence and where the center is located. They are willingly coming forward by the hundreds and in some cases, if the patient can't get to the facility, armed hospital representatives will enter the slums to get the victims out. The progress is amazing.

What a day. We're officially exhausted. Must rest now for our new adventure in the village.

Kenya says "yes"

It's officially been two weeks since our arrival in Kenya. And today is my mother's birthday. And today is election day. A holiday! As of about 9pm the results were showing an overwhelming response for the “yes” by 2 to 1. Such results would be unfathomable in any election in the States but this appears to be no surprise to any Kenyan. In fact, while chatting Kenyan politics over lunch, Mercy openly admits that she didn't renew her voter's card because “the government will do what it wants to do”. So it looks pretty safe to say that Kenya will have a new constitution. Another interesting tidbit was that polling locations are using fingerprint scans for identification. I had flashbacks of a recent polling experience in west Los Angeles where blue-haired ladies were fumbling with stacks of stapled lists and couldn't find my name. I think there might be something wrong there.

Today also marks the road to better health for this stubborn tourist. Just like we're told NOT to do, I went and drank the tap water right from day one. And ate everything my Kenyan counterparts were eating. And I've been hanging out with those super healthy folks in what should be the infectious diseases ward (if there were such a thing) of one of the most overcrowded hospitals in the world. And I was still in denial that I could have caught something.

But yesterday I experienced the healthcare system in Africa from a different perspective. I was the patient. Apparently I spoke too soon on Monday thinking I was feeling better but the next morning I was in rough shape. We called our go-to-girl, Ann, for a recommendation for a doctor and the only one who could see me right away was the pediatrician that takes care of her 7 and 10 year olds. So I swallowed my pride and marched up the little step ladder to the miniature exam table and let him look in my ears. I especially liked the pooh bear wall paper. It really put me at ease.

A few minutes and several uncomfortable questions about my marital status later, I had enough antibiotics and amoeba eating drugs in my paws to kill anything on our block. Yippeee!! I promised the doctor no more tap water, and I will try to cut down on my cravings for liver and intestines.

The Polls Are Closed!

27,000 polls opened at 6am this morning, and apparently a significant percentage of Kenya's 12.5 Million registered voters turned out to cast their votes.    Some Kenyans walked more than three hours each way to the nearest polling station in order to be sure their vote was included.   Lines were long, security was tight, and each voter left the polling station with a splash of indelible ink on their left hand to avoid double-voting.

After a peaceful day of voting, the polls closed at 6pm.   The local news channel is monitoring the results, and currently the tally sits at 66% Yes, 34% No, with only 1/3 of the polling stations tallied.

The election coverage involves no colorful, interactive maps or charts, and no "Situation Room."
That said, the coverage is being branded "Decision 2010."

Some things must just be universal. 

We're anxious to see where the final tally lands tomorrow.

If you're interested, the BBC has a good article on the election:
http://www.bbc.co.uk/news/world-africa-10856761

Meanwhile, it's Wednesday night and our running water ration for Tuesday, Wednesday, and Thursday has run out.
Awesome.

Agnes

I love that election day here is a national holiday.   There’s no school...no work...no open grocery stores...
just children playing outside and people waiting in lines at the 27,000 polling stations around the country.

We spent the afternoon having lunch at Angie’s mother’s house.   Angie is one of the medical students we’re staying with here in Nairobi, and when her mother, Agnes, dropped by the apartment last week she insisted that we all come to her home for lunch before leaving the city.   Today turned out to be the day.

We arrived at Agnes’ house at about 1:30, and were greeted with open arms, glasses of passion fruit juice, and a spread of food so massive I wondered if a dozen other people were expected.
They weren’t.
Agnes, a jovial woman with kind eyes, exudes a sense of caring and empathy.   When you meet her, you get the sense that you’re in the presence of a truly good and gentle human being.  She smiles widely and often - a smile that reveals thick laugh lines and defined cheekbones.  She offers hugs to anyone and everyone, and yet has a weathered face that clearly has seen much.  I found myself really wanting to hear about her experiences, her life.    And I got to!

She proudly cast her vote at dawn, and then spent the rest of the morning preparing a delicious traditional Kikuyu meal for us (her family comes from the Kikuyu Tribe in Kenya).

Over lunch we heard stories about the time Mercy’s mother found a leopard lazing on her living room carpet, and the time Agnes found monkeys righteously sitting in her dining room eating her fruit.
Both incidents occurred in the middle of Nairobi, and quite honestly I can’t fathom experiencing either one.

But then we heard more about what Agnes does for a living.   She’s a practicing psychologist in Nairobi, focusing mainly on relationship counseling and people with addictions.   But that’s only part of her livelihood.   She also has a contract with the United Nations – working for Kenya’s National Commission on Gender and Development.   Her focus is on trying to stop violence against women and children.   No small task in Kenya, she leads teams around the country that spend weeks, sometimes months at a time raising awareness in villages that violence against women and children is wrong and should be discussed.   Apparently rape, other sexual abuses and physical beatings are not uncommon in parts of Kenya.  The subject is taboo, and therefore not discussed or reported.   Agnes has spent the last few years taking action – creating specific gender-based violence and domestic violence desks at local police stations, coordinating rallies and discussion groups, and generally educating both men and women about the realities of such abuses and the corresponding long term repercussions.   Think of the difference this woman is making!

She described other issues women in Kenya face, too.   Issues such as the fact that many girls in Kenya are forced to miss school one week per month.   Why?  Because they have nothing to use as sanitary protection when they get their periods.   Another project Agnes has been working on is to get these girls the items they need, so they can keep up with their studies, not be mocked or abused, and grow into confident young women.

With every story my eyes grew wider and wider, until 100% of my energy was being devoted to NOT bursting into tears on the spot.   Some of the things we’ve seen here are so terrible, so hard, and yet just when I feel defeated I meet people like Agnes who are doing such good, meaningful work, making a significant difference in the lives of many.   I sat there feeling foolish – what am I doing that means anything or that makes any sort of difference?   My basic pre-med classes, many of which I detest and yet worry endlessly about, and my job that, let’s face it, is really about making or keeping other people an overabundance of money - both seem embarrassingly indulgent.   I suddenly felt the urge to drop everything, stay here and go to work with Agnes.    Maybe not the most practical idea I’ve ever had, but I’m not exactly known for having practical ideas.
And then, again, I thought I might cry.
I hate crying.

Our taxi home showed up at that moment.   We told Agnes that we really wanted to find a way to help her and her efforts in some way.  
I’m not sure yet what that will look like, but we’ll find a way. 

Kenya Referendum 2010

Tomorrow marks an important day here in Kenya: the day Kenyans will vote in a referendum on a new national constitution.  

You might remember reading about the Kenyan election back in 2007, when a similar issue was put to a vote.   Disputed election results then led to deadly clashes through the country – clashes that only ended with a promise of another election.  That promised election is set to take place tomorrow. 

At the polls, Kenyan voters will be required to respond to the question:  "Do you approve the proposed new Constitution?”

Based on what I've read, the campaigns for the referendum involve two camps: the “Yes” camp led by the Kenyan President Mwai Kibaki and Prime Minister Raila Odinga and the “No” camp led by former President Moi and the Church.

Opinions here in Nairobi (and presumably throughout the country) are strong, and yet oddly enough no two people I’ve spoken with have offered the same definition of what a “Yes” versus “No” vote really means.  

Confusion abounds.  

Not once since we’ve been here has the newspaper clearly outlined the key differences between the two sides, either. 

In the United States, on the day before and day of any major election, we expect to see a clear outline of each side of whatever issue is at hand.    However, the front page of today’s Daily Nation (their tagline is, of course, The Truth), only reads “It’s all Systems Go For the Referendum.”  

Subsequent articles brag about the 63,000 police officers will be deployed tomorrow to guard election materials and voters, while others clearly outline what each voter must bring to the polls in order to cast a vote.    Nowhere could I find a clear explanation of what a “yes” or “no” vote would mean.

I’ve done a bit of research, and from what I understand, if a “yes” vote carries the day, it will mean an entirely new constitution for Kenya.   Much of the proposed constitution draft is agreeable to the masses – it decentralizes power, and offers fairer laws to land owners.   But two major pieces of the proposed draft appear to be contentious: one provides a loophole that could allow for legal abortions, and another retains a Kadhi court system in Kenya.     The “No” camp is vehemently opposed to both pieces.

Opinion articles claim that the Obama Administration is backing the “Yes” camp, and that the President and Prime Ministers are only in favor of the new constitution so they can leave a legacy.     Yet opinion polls show that nearly 60% of voters intend to vote “yes.”   Now, many claim that such opinion polls are corrupt, rigged, or just plain lies.   I’ve no idea what is true,  but the tension around here is palpable.  

Tomorrow has been declared a national holiday, and most businesses (including all supermarkets) even shut down early today.   People have been encouraged to stock up on food, water, and cell phone credit just in case any problems arise as a result of the election.    We took the advice.   

We now have more water, food, and Internet airtime than we could possibly want. 

Advertisements encouraging a peaceful election line the streets and fill radio airtime.   Our fingers our crossed that things will go smoothly.    We’ll stay safe inside at home behind locked gates and doors, but I’m looking forward to seeing how things unfold.  

Photos from Tanzania

Maasai Children in Northern Tanzania

Maasai Men - Northern Tanzania

How in the world?

Under NO circumstances should there be any Hooting.

A Maasai hut in Southern Kenya

Maasai Children near Arusha

Arusha Market

Wow.

Arusha: Wimps Need Not Apply

I’ll be honest, I left Moshi feeling rather defeated. 

I wanted so badly to see Mt. Kilimanjaro, but it just wasn’t meant to be. 

We could have tooled around Moshi for the day, or even driven up to Kilimanjaro National Park.   But, it seemed silly to pay $60 per person in park entrance fees if seeing anything wasn’t really a possibility. 

We didn’t.   We hopped the 11am shuttle to Arusha.  

I left thinking I would be back – I just don’t know when.

But I will.

In Arusha, we stayed with a friend of Dami’s family.   Lola, a Nigerian, and one of the funniest women I’ve met since I arrived in Africa, has more attitude than Wanda Sykes and more strong opinions than Nancy Grace.   I loved her.

Though she vehemently (and vocally) hates Arusha, she has been there for eight years, working as a French-English Interpreter for the International Criminal Tribunal for Rwanda.    While I think her job sounds fascinating, it’s clearly just a job to her.  Frustrated with it, she’s looking to transfer elsewhere through the United Nations – possibly to Afghanistan or Sudan.    Imagine how much she must hate Arusha to want to transfer to either one of those places! 

As she says, its not safe, the people aren't very nice, and the medical care is frighteningly poor.  

Her home, meanwhile, was beautiful, and located in very nice part of the city.   All of her neighbors are affiliated with the Tribunal, and the UN provides each employee with two 24-hour security guards, a gate to the driveway, and two 24-hour policemen who patrol the area.   Her house is outfitted with three emergency panic buttons, located in all the high traffic areas.   Lola feels so safe in her house that she sometimes doesn’t even bother to lock her door.    The UN, she said, takes very good care of its people.

She graciously let us spend the night, and took us this morning to the 8am shuttle for Nairobi.  

We boarded the shuttle, and found that we had been assigned the three seats that sat right on top of the back wheels.   While sitting in the seat with the giant hump in the floor was fun on the elementary school bus, it isn’t now that I’m 5’10’. 

Great.

I sat with my knees to my chest for a little over three hours, and then thankfully was able to move when another passenger got off the bus.   

Despite the fact that I my legs were cramping, the bus hit a pothole every .5 seconds, and it was generally really cold, I enjoyed the ride.   I saw more ostriches, impalas, and even about 10-15 baboons!   It was great.   I love the scenery here - it changes faster than the weather does in Washington DC. 

After 7.5 hours on a shaking, jerking, jostling and bouncing bus, we’re back in Nairobi.   

I still feel a little numb. 

But we’re back, and though we’re exhausted, we’re happy to be “home.”  

Kenyan Border Patrolling

The first night was spent at the Kilimanjaro Crane hotel and I actually got to sleep on a BED! It was incredible. I still wore ear plugs because there was a wedding going on in what sounded like our bathroom but other than that, I slept like a rock. We woke at dawn to see the sunrise over “Kili” but the powers that be decided it should look like Gorillas in the Mist instead. No snows of Kilimanjaro for these girls.

We hopped on the 11:30 shuttle back up to Arusha where we were greeted by Dami's family friends that were kind enough to let us crash their Sunday afternoon plans. “Auntie” Lola's son Olumide picked us up from the bus stop sounding like he had been hit by the very shuttle we came in on. Turns out he hadn't gotten to sleep until 6am the night before. I guess I was wrong in assuming Arusha didn't have much of a night life. NB: Auntie is a term of endearment in Nigeria for a woman older than you with whom you are acquainted. It was a nice evening spent relaxing with some tea watching silly Nigerian talk shows such as “Ladies Love Gisting” and the movie Clue.

Olu graciously gave us his bed for the night that he had freshly Febreezed upon our arrival. We woke up nice and early and caught the 8am shuttle back to Nairobi. The ride felt bumpier than the way down but there were quite a few open seats so overall it wasn't too bad. The stop at the border was probably the worst part. The line for arrivals on the Kenyan side was a mile long and there was only one gentleman at the window. By the time I finally got to the front of the line, he told me he would not give my passport back until I “told my friends to reform the line”. By that he meant, tell everyone in line from all over the world what to do. I did it, because I didn't have much of a choice but SB commented later how great it was that suddenly I was a part of the Kenyan border patrol.

And now we are back in Nairobi. I'm feeling quite comfortable now in our little neighborhood where at least things are a bit familiar. Oh yes, and I was convinced that I had picked up some sort of parasite in my tummy because I haven't been able to eat much since Wednesday. That was coincidentally the day I ate intestines that were wrinkled on one side with funny black bumps on the other. What was I thinking? Well, actually...I only ate one bite. So it couldn't be the intestines. But it could have been any number of other questionable meat dishes I've eaten over the past week. The point is I'm feeling pretty good right now. Whew.

And speaking of feeling good...my mom is doing great!!! I spoke to her after her surgery and all is well. Thanks for all your thoughts and prayers!

Isn't it Ironic?

We travelled all the way to Tanzania to see Mt. Kilimanjaro, and it was too cloudy to see it.

I'm sure Toto was right, that Kilimanjaro was "rising like Olympus above the Serengeti,"  but I couldn't tell. 

I guess I’ll just have to come back.  

:)