Sunday, May 20th - drive with Mom to Trumbull, then switch to Dad's car, then arrive at JFK for a 10pm flight. Board plane. Attempt to sleep. Fail. Attempt again. Minor success. Monday, May 21st - Arrive in London with Virgin Atlantic eye mask around my neck to meet up with Sheneka, Christine, and Chris to amble through customs and regroup for a 1 day London extravaganza before our 10pm departure to Nairobi.
London tour includes: the TUBE! yes!!, Big Ben, walking along the Thames to find a pub (thanks to tour guide Renae, Sheneka's friend who met up with us) and fill up on fish and chips, cheese sandwiches, Guinness (me), Pimms (Chris), and cider (everyone else), a Prince Philip sighting by Buckingham Palace, Westminster Abbey and climbing on lions in a famous square that starts with T that I can't remember the name of (follow up edit: Trafalgar), photos in a urine-reaking authentic red phone booth, and finally Hamleys Toy Store to leave us all with big smiles after our inner kids were let out for a few minutes.
Tube ride back to the airport...and Nairobi here we come!
Tuesday, May 22nd - AMREF welcome, tours and lectures about the Flying Doctors, Schisto, and cultural information. Memories vague due to jet lag-induced narcolepsy the entire day. Good first tastes of ugali, chapati and some other Kenyan foods. Check in at the Comfort Hotel and settling in with roomie Angela for some much needed rest under our mosquito net draped beds.
Wednesday, May 23rd - Some yoga in my room and a breakfast of cereal, toast, and tea, and we set out for KEMRI, which is kind of like the NIH of Nairobi. In our still fresh and clean white coats (they would be very orange-brown by the end!), our group toured the labs and learned about the main areas of research happening there. I loved seeing the malaria labs and found it very interesting to hear about the traditional medicines and plants that they are utilizing to manufacture chemotherapy options. We even got to see many of the plants and products they have concocted. The view of a rotavirus sample with the Scanning Electron Microscope was interesting as well as the discussion about the impact of Hepatitis in the country. Overall, I enjoyed seeing the commitment to research of diseases important in the region and comparing the facilities and approaches to my experience at Children's and in Doctor Zeichner's lab.
KEMRI was followed up with lunch and more lectures at AMREF and then a delicious dinner at Carnivore Restaurant, which is inexplicable. Think of the Animal Kingdom in Disney World, times 10, and REAL. There are more types of meat than you could ever imagine being roasted on a huge spicket when you walk in, and the waiters never stop coming by your dish with huge metal spears to offer you a taste of something new - ostrich, crocodile, and ox balls are the most memorable. Definitely check it out if you are ever there. Even vegetarians can eat til their hearts' content.
http://www.tamarind.co.ke/carnivore
Thursday, May 24th - Woke up very excited to finally get to do a morning run in Nairobi with the proper prep: security guard's instructions on where to go and the (voluntary?!) company of Bilal and Sharon. It felt so good to move my legs before the sun came up, and it was fun to see some locals out running too. Next it was giraffe time, and we took the big bus to the Giraffe Center. It was so nice! I don't know what I expected, but I was really impressed by the place. We all got to feed them (some people form their own mouths...awesome), and then we had a little lesson about the different types of giraffes, the history of the place, and the life of a giraffe. Plus, we passed around a huge giraffe tibia, which was clearly a highlight. It was massive in case you are wondering! The names of the giraffes there are: Kelly, Lynne, Helen, Abraham, and Ed. Angela and I decided that Ed was the special one, for obvious reasons. After the giraffes and a slight bus-waiting delay (the usual 30 minute minimum!), we went quickly to the Elephant Sanctuary, which was also a great treat. Baby elephants playing in the mud provide endless smiles and entertainment. Wild boars and warthogs were also around, and there was a big rhino that I liked a lot! You can also adopt or sponsor the animals there, and I really wanted to "adopt" Solio the Rhino baby. Maybe for Christmas! This is the place: http://www.sheldrickwildlifetrust.org/index.asp
A long bus ride, welcome speech from our program organizers, and dinner with more chapati at our new hotel in Makuweni, southeast of Nairobi, ended our third day.
Friday, May 25th - Big Day. First, what is my favorite thing to do upon waking up in a brand new place? Go for an exploration run. Clearly. I had attempted to set up a plan with 4 others, but alas, only one woke up in time. Drew and I set out on dirt paths in some really pretty countryside, and it felt great to be free from Nairobi's chaos immediately. The air seemed thin, and we were huffing and puffing more than expected (blaming the altitude, obviously!), but it was a great way to start the day. Eggs for breakfast (and watermelon, which was the first fruit I'd had in awhile and was very excited!), and then we went to the district hospital. My group started by learning about the HIV clinic, and then we went on to the Maternity Health Clinic (MHC), where there were some great initiatives. For example, there are 15 minute classes daily for local women to come learn about things like breastfeeding, prenatal nutrition, etc. We asked some questions about malaria and pregnancy, vaccination practices in Kenya, ultrasound, HIV mothers, etc. and the nurses working there were very forthcoming and interesting. There was also a definite interest on their parts in us spreading the word about what they are doing there and what resources they need most.
After the HIV and MHC clinics, my group was scooped up by an excellent pediatrician, and the real excitement and interesting stuff began as he took us to see all the different departments. We visited numerous patients and saw how the physicians there deal with things like frequent dehydration and malnutrition alongside any other diseases (for example: dehydrated babies often need to get an IV cannula in their heads since veins are too tiny elsewhere). We also talked to the general surgeon, visited the brand new premies in their (shared) incubators, and saw an epileptic child mid-seizure among other things. I felt really grateful to have the opportunity to have access and firsthand exposure to these patients, but also to obtain information from the doctors at the same time. I found myself comparing this experience to the hospitals in Niger where I volunteered in college, and there were many similarities overall, but the baseline level of health was better here (Niger was also recovering from famine when I was there). There were also many fewer cases of malaria here, but seemingly more cases of TB. Of course, I don't know the details of which patients are sent to which hospitals in the area, etc., but these were my general impressions.
After this really exciting and interesting morning, we all boarded the bus with our passion for medicine reignited and got ready for a short drive and break before our next stop: an AMREF school visit to deworm and check compliance with new health promotion initiatives.
The arrival at the school was incredible. All the kids in their kelly green and pink uniforms were waiting for us at the entrance to their school "driveway" and were singing at full volume as we pulled in. Their energy and smiles were completely contagious and we all climbed off the bus eager and excited to meet and interact (and deworm) the kids.
The school has made many strides to comply with AMREF, and their deworming and health/sanitation initiatives were on full display for us. We got to see their new "VIP" latrine, a homemade museum displaying all their knowledge about healthy food, exercise, sanitation, disease, and ecology, and then we planted three new trees on their property. I was one of the three in our group chosen to plant, and the tree is now named after me! I hope I get to visit it someday again in the future. :)
Lunch was huge pots of rice and beans served to the lines and lines of kids for this special day (usually they bring lunch with them in plastic containers from home - picture old Marshmallow fluff tubs or something of that size used as lunch boxes). Proper hand washing was stressed, and the kids all sat around to eat and we were able to chat with them and play some games. I could have hung out with them for hours, even with my minimal Swahili competence. Their genuine joy and smiles were so uplifting.
Then, to top it all off, there was a great talent show at the end of our visit, with funny skits and BEAUTIFUL singing and dancing. The talent, joy and sense of community at that school was so humbling and really made me reflect a lot about my own life and place in this world. So many of these kids and teachers have so little, yet they walk hours daily in the name of education and to do the best they can with what they have. The students' discipline and focus was certainly better than that of any of the seventh graders I taught in Phoenix, and I wished so badly that I could do so much more for them. However, having learned from experience that this 'save the world' mentality is often more selfish than productive, I tried to just enjoy and absorb the experience and appreciate how many really great things were happening--and there are many.
Finally, as we climbed on top of the bus for photos, the clouds and thunder rolled in. We gave away some soccer balls (thanks Abby!), frisbees and other toys to the school as we pulled out the driveway. This was easily my favorite day so far, and I went to sleep with my spirit feeling very full.
Saturday, May 26th - Best day (Friday at the school) followed up by worst day :( Food poisoning had me up all night and Saturday was spent feeling pretty weak and sleeping a LOT. While I was really sad to miss a fun, community health day and ride bikes to visit local homes and families, I was VERY grateful that the symptoms only lasted one full day. And, everyone was really nice and accommodating. Sprite + toast + sleep --> fast recovery! (No more eating salad...maybe ever...)
Sunday, May 27th - We woke up early on Sunday, around 4:30am, for a pre sunrise start to our drive to Amboseli Game Park. This first animal drive was a nice taste for what would come in the future, and we saw some great elephants, hippos, ostriches, and crazy birds (it's easy to overlook the birds since the bigger animals are so cool, but they really are some of the most gorgeous, unique birds most people will ever see). Before the drive started, we were greeted (accosted?!) by several Masai people selling all of their gorgeous beaded jewelry...and most of us were unable to contain our excitement for our first opportunity to buy authentic souvenirs. Needless to say, I ended up with many more bracelets and necklaces than anticipated. They'll all find a good home though, I have no doubt.
After the game drive, we were able to visit the Masai village and they gave us an excellent show with traditional dancing to start. We then went into the (very fly infested!) village area and saw how they make fire, learned about their traditional medicines and medical practices, and visited their mud houses. It was really interesting to learn all about the Masai, and, since we were unable to get to Entasopia due to massive flooding, we were all really happy to have this immersion and cultural experience. We ended the visit by seeing the schoolhouse, a tin building with benches inside and adorable children eager to recite their alphabet and numbers in English for us.
After this visit, with our brains and memory cards full (and our wallets a little lighter), we got back on the bus to get to Kibwezi by nighttime. This would be our new home until Wednesday. On that first night, after dinner and settling in to our new place (half of us were in a VERY interesting separate building - imagine juvenile detention center turned into a hotel), we very sleepily listened to a powerpoint lecture about ultrasound. We were briefed on the techniques that we would be helping with and observing in the local hospital for the next few days. Patients would come from far away to be seen and have free ultrasounds performed by the experts who flew in with Dr. Macpherson.
Exhaustion. Today was certainly interesting, humbling, and eye-opening. Oh, and sleep inducing.
Monday, May 28th - In Kibwezi, Bilal and I got up with the 5:30 am morning prayer call and ran on the dirt "track" that the security guard led us to for our first running attempt in a new place. The next days we would venture out more, but this is where we stayed today. It was a great way to wake up, and we enjoyed the fresh air, some local kids cheering us on, and the security guard's big smile and vote of appreciation! Then we all put on our white coats to go to Makindu Hospital, where we'd be stationed for the next 2 and a half days.
We were able to see so much in our small groups. We took turns going on rounds with the doctor on call, reading through charts in wards with nurses, and being trained and working in the ultrasound clinic. Some of the most memorable things I learned about and saw on that first day: an abdominal aneurysm in a woman with hydatid cysts in her liver (unrelated to each other), several fractures and their method of using traction (ropes with bags of rocks to keep the bones separated), degloving and other injuries requiring skin grafts, a woman who had complications from Diabetes mainly because there was no insulin available to her (the pharmacy was out of stock...crazy to think of how frustrating such resource problems must be to doctors and patients), two men in decerebrate (thanks Neuro class for helping me recognize) posturing following stroke, many, many TB patients, and an AWESOME live C-section in the operating theater.
In the afternoon on Monday, some of us then went to do a community project with AMREF and helped the landscaping and progress of a new dispensary being built. Some people painted, and I spent the entire time lined up with local people in a huge line passing red clay bricks from one end to the other. Chanted songs kept the rhythm and kept us motivated. The fact that 2 people over the age of 75 were on either side of me (Alice on my right side was hilarious and tried to set me up with her youngest son WHILE we passed bricks). My two older neighbors had no signs of fatigue the entire time, which obviously, combined with my pride, kept me from stopping when my arms and back started screaming for relief. The blisters that surfaced only 20 minutes after we finished made me feel sheepish for my soft hands, but also appreciate their strength and resilience. Humbling yet again.
Tuesday, May 29th - The second day in Kibwezi Bilal and I ran off the track and went down a long road where lots of school children were walking. It was a beautiful sunrise, and many kids came and ran with us for a few steps, which was so much fun. Bilal and I were definitely wishing we knew more Swahili, but we tried and our attempts and accents were usually met with smiles and lots of laughter.
This day was my group's turn in the ultrasound clinic, and for the first hour or so we just saw several cases of "abdominal discomfort" without too many obvious causes - although the diet high in starch, which is the cheapest and most accessible food, does lead to a lot of chronic constipation, which we learned brings many people in. Unfortunately, the solution to 'eat more vegetables' is not always feasible. We also saw a woman with what looked to be filariasis, but turned out to be silicosis, according to Dr. Macpherson. Definitely interesting. We saw several pregnant women as well, and we learned that the technicians purposefully do not reveal the sex of the child even if they can tell because often times hearing the "wrong" gender will anger patients or husbands and lead to abuse or abortion attempts.
The last things we did before lunch was spend some time with the X-ray technician, who was really quirky and informative and could probably diagnose ever single patient on his own. All the X-rays are developed in an old-fashioned photo lab (think of high school photo class for the smell and ambience). We saw several fractures and a couple cases of TB.
Some Cokes and a late lunch and then we headed out to do another community project for the afternoon. This time, we were in a more remote area with gorgeous, scenery: cornfields, small clusters of huts, mango trees and vegetable gardens, and a huge blue sky with puffy clouds. The main tasks here were weighing children (on huge spring scales - think of the vegetable weighing baskets in the supermarket!), measuring arm circumference and height, passing out Albendazole and Vitamin A, and dancing with the children :) There was also a 'private' building where rice was being passed out to the older citizens so that they could get access to the supplies without having to fight for it from the younger, stronger people.
Dinner, Tuskers, charades, and bed finished day 2 in Kibwezi.
Wednesday, May 30th - Last day in Kibwezi. Best run of the week with even more kids joining us, lots of energy, and some fun attempts to carry the kids' jerry cans for them - so impressive that they run with those full every day in their little arms. On the last day at the hospital I was able to see some Ob/Gyn exams as well as a really intense snake bite on a young child that had to be cleaned out and packed. I also went around the female ward and pediatrics ward again to see what had changed in the patients from the first day. It was nice to have that familiarity about the cases that came with the fact that we had spent 3 consecutive days in one place. Makindu is definitely a very good and improving hospital, and, although it was the same "level" as the one we saw in Nairobi, it had a much better atmosphere.
Back on the bus to start our drive back to Nairobi. Lunch at Hunter's Lodge - it took roughly 1,000 years to get our food - but there was a gigantic (dinosaur size, seriously) pelican and a monkey with very bright blue anatomical parts to keep our attention for at least a little while. The rest of the bus ride to Nairobi was long but we were all pretty tired so it was also appreciated. In addition, our fanciest dinner thus far, at a wonderful Indian place called Haandi's. It was SO GOOD. We all ate our weight in delicious food that night and the prolonged lunch and bus ride were easily forgotten. With our trip to Masai Mara starting the next day, we all relaxed with our full bellies and got excited for the upcoming adventures.
Thursday, May 31st - Driving to Wilson airport for our flights on tiny planes to get to the Masai Mara. I was given a red laminated 'boarding pass' and waited with the blue, black, and yellow groups in the tiny gate area while we watched the small planes take off. I personally love small planes, and the short, 45 minute ride was a lot of fun, and seeing an elephant from a plane is pretty awesome.
We were greeted by Masai drivers and Intrepids safari vehicles to take us immediately on a game drive. Instantly wowed by elephants and insanely gorgeous expanses, they certainly know what they're doing when they arrange the itinerary and sweep you away to the game drive right away. Amazing. The drive was followed up by a delicious buffet of anything you could imagine to eat, and then we were taken to our luxury tent accommodations.
Angela and I shared tent #3, and the porch overlooking the river, the interior decor of dark wood and white linens, the plush bedspread, the amazing sink/shower area took our breath away. We were so excited we couldn't believe how lucky we were to end up in this security hideaway.
Our 3:30pm game drive gave us hippos, lions, gazelles, topi, cape buffalos, guinea fowl, hyenas (the Whitney Houston of lions...b/c a hyena is like a druggie looking lion to me!), gazelles, impalas, ostriches and baboons to stare at and admire from very, very close. An amazing sunset, ton of photos, many thanks to our driver Raphael, and a final buffalo stampede to watch ended the day perfectly. It was hard to imagine how anything could top today's excursion. Dinner with Masai dancers and a short visit to the bonfire (it was cold there!), and off to bed in our super fancy tent. Hot water bottles provided for our comfort...blissful.
Friday, June 1st - An early wake up by Gideon for our 6:30am game drive. Definitely chilly and too early for our liking, but the coffee, hot chocolate and cookies delivered with the "get up now!" made it much more tolerable. I could get used to this treatment. Some yoga on the porch to wake my body up and then I went with Angela and our full thermoses to meet Raphael and the rest of our group to head out. Big blankets were provided (they think of everything), and we saw the elusive black rhino and some giraffes before enjoying a very fancy 'bush breakfast'. Now, I imagined a bush breakfast as a rustic, cook over a kerosine stove/camping style sort of thing. Um, not really. Imagine an all-star buffet with hot food, cereal, fresh fruit and coffee set up in the grass near a river with table clothed tables, chefs in chef hats, and a very fancy bush toilet (= plushest port-o-potty I've ever experienced) set up not to far away for your convenience. Hardly roughing it. Feeling very spoiled!
Drove back to the resort after this to relax and Bilal and I decided to go on a nature walk for the middle of the day. It was just the two of us, a Masai man, Joseph, leading us and George, the man with a gun to protect us. Getting out of the vehicles after we had been so warned not to get out, had seen the lions in person, and had imagined how easy it would be to be devoured by these huge creatures, was SLIGHTLY disconcerting. And George's gun was small. Trust. We must trust them...!
The walk was great though, and I'm so glad we decided to do it. We got some great firsthand information about the local plants, saw a dead vulture in a tree (Joseph said from a jaguar!), walked upon a herd of zebras, and saw numerous gazelles and topi from a close proximity. It was also great to stretch our legs and enjoy the fresh air from a different perspective.
Some random interesting facts I learned: Masai don't eat fish - they are "snakes of the river", but they live off of milk; many runners in Kenya come from the area called El Doret.
On our 3:30 game drive, we had a SECOND rhino sighting (unheard of they said!), and it rained down on us for about 20 minutes, but it was actually a nice change of pace and Raphael valiantly got out among the lions to tie down the sides and keep the rain from coming into the car and soaking us. The Tuskers we had packed took the edge off as well! Some crocodiles and a baby hippo with a fresh bite on him in the river provided more entertainment, and we headed back for dinner and Angela and I enjoyed an amazing massage in the "massage tent" before bed.
Saturday, June 2nd - Today was our last day of the selective, and we started with another early 6:30 am game drive that took us to a new area, where we saw elands and gorgeous, rolling plains. We also saw more elephants as well, which I can't get enough of - they're such crazy looking animals if you really think about it! A huge, final buffet breakfast followed and then some of us decided to do the 10:30 game drive with a new driver, James. I was debating because we had already done so many drives, but all of us who went were given such a treat. We saw a cheetah! The one animal that we all wanted to see so badly but that no one had found yet. This meant that we had seen all of the Big Five, and we even saw this cheetah climb onto the jeeps' roofs and people took pictures from inches away. We patiently waited for awhile because we thought it might go for a kill, but eventually hot sun and grumbling stomachs pushed us to return to the main resort area. That cheetah was definitely the highlight of the Mara for me. What a grand finale.
A nap and lunch and then we boarded the small planes to get back to Nairobi. So hard to leave this exotic place - I hope I can return some day (and get Dr. Macpherson's 'special price' again, obviously!). Back in Nairobi, the group split and we said our goodbyes, and those of us staying in Kenya for a few more days settled in at the Comfort Hotel once again.
For the next few days, Christine, Sheneka, Joycy, and I did some final Nairobi sightseeing, including the National Museum, the Snake Park (chameleons, pythons, crocodiles, you name it), and the Holy Family Minor Basilica. We also spent remaining shillings at another Masai Market place and at Java Coffee House, which had amazing cappuccinos and 70s, 80s, and 90s music to keep us very happy. Finally, we enjoyed a very comfortable and fancy night at the Hilton care of Christine's mom, and took our respective crack-of-dawn flights out of Kenya on Tuesday. For me - on to Addis Ababa to meet Kwazo and continue the adventuring.
Kenya, you were very good to me!
London tour includes: the TUBE! yes!!, Big Ben, walking along the Thames to find a pub (thanks to tour guide Renae, Sheneka's friend who met up with us) and fill up on fish and chips, cheese sandwiches, Guinness (me), Pimms (Chris), and cider (everyone else), a Prince Philip sighting by Buckingham Palace, Westminster Abbey and climbing on lions in a famous square that starts with T that I can't remember the name of (follow up edit: Trafalgar), photos in a urine-reaking authentic red phone booth, and finally Hamleys Toy Store to leave us all with big smiles after our inner kids were let out for a few minutes.
Tube ride back to the airport...and Nairobi here we come!
Tuesday, May 22nd - AMREF welcome, tours and lectures about the Flying Doctors, Schisto, and cultural information. Memories vague due to jet lag-induced narcolepsy the entire day. Good first tastes of ugali, chapati and some other Kenyan foods. Check in at the Comfort Hotel and settling in with roomie Angela for some much needed rest under our mosquito net draped beds.
Wednesday, May 23rd - Some yoga in my room and a breakfast of cereal, toast, and tea, and we set out for KEMRI, which is kind of like the NIH of Nairobi. In our still fresh and clean white coats (they would be very orange-brown by the end!), our group toured the labs and learned about the main areas of research happening there. I loved seeing the malaria labs and found it very interesting to hear about the traditional medicines and plants that they are utilizing to manufacture chemotherapy options. We even got to see many of the plants and products they have concocted. The view of a rotavirus sample with the Scanning Electron Microscope was interesting as well as the discussion about the impact of Hepatitis in the country. Overall, I enjoyed seeing the commitment to research of diseases important in the region and comparing the facilities and approaches to my experience at Children's and in Doctor Zeichner's lab.
KEMRI was followed up with lunch and more lectures at AMREF and then a delicious dinner at Carnivore Restaurant, which is inexplicable. Think of the Animal Kingdom in Disney World, times 10, and REAL. There are more types of meat than you could ever imagine being roasted on a huge spicket when you walk in, and the waiters never stop coming by your dish with huge metal spears to offer you a taste of something new - ostrich, crocodile, and ox balls are the most memorable. Definitely check it out if you are ever there. Even vegetarians can eat til their hearts' content.
http://www.tamarind.co.ke/carnivore
Thursday, May 24th - Woke up very excited to finally get to do a morning run in Nairobi with the proper prep: security guard's instructions on where to go and the (voluntary?!) company of Bilal and Sharon. It felt so good to move my legs before the sun came up, and it was fun to see some locals out running too. Next it was giraffe time, and we took the big bus to the Giraffe Center. It was so nice! I don't know what I expected, but I was really impressed by the place. We all got to feed them (some people form their own mouths...awesome), and then we had a little lesson about the different types of giraffes, the history of the place, and the life of a giraffe. Plus, we passed around a huge giraffe tibia, which was clearly a highlight. It was massive in case you are wondering! The names of the giraffes there are: Kelly, Lynne, Helen, Abraham, and Ed. Angela and I decided that Ed was the special one, for obvious reasons. After the giraffes and a slight bus-waiting delay (the usual 30 minute minimum!), we went quickly to the Elephant Sanctuary, which was also a great treat. Baby elephants playing in the mud provide endless smiles and entertainment. Wild boars and warthogs were also around, and there was a big rhino that I liked a lot! You can also adopt or sponsor the animals there, and I really wanted to "adopt" Solio the Rhino baby. Maybe for Christmas! This is the place: http://www.sheldrickwildlifetrust.org/index.asp
A long bus ride, welcome speech from our program organizers, and dinner with more chapati at our new hotel in Makuweni, southeast of Nairobi, ended our third day.
Friday, May 25th - Big Day. First, what is my favorite thing to do upon waking up in a brand new place? Go for an exploration run. Clearly. I had attempted to set up a plan with 4 others, but alas, only one woke up in time. Drew and I set out on dirt paths in some really pretty countryside, and it felt great to be free from Nairobi's chaos immediately. The air seemed thin, and we were huffing and puffing more than expected (blaming the altitude, obviously!), but it was a great way to start the day. Eggs for breakfast (and watermelon, which was the first fruit I'd had in awhile and was very excited!), and then we went to the district hospital. My group started by learning about the HIV clinic, and then we went on to the Maternity Health Clinic (MHC), where there were some great initiatives. For example, there are 15 minute classes daily for local women to come learn about things like breastfeeding, prenatal nutrition, etc. We asked some questions about malaria and pregnancy, vaccination practices in Kenya, ultrasound, HIV mothers, etc. and the nurses working there were very forthcoming and interesting. There was also a definite interest on their parts in us spreading the word about what they are doing there and what resources they need most.
After the HIV and MHC clinics, my group was scooped up by an excellent pediatrician, and the real excitement and interesting stuff began as he took us to see all the different departments. We visited numerous patients and saw how the physicians there deal with things like frequent dehydration and malnutrition alongside any other diseases (for example: dehydrated babies often need to get an IV cannula in their heads since veins are too tiny elsewhere). We also talked to the general surgeon, visited the brand new premies in their (shared) incubators, and saw an epileptic child mid-seizure among other things. I felt really grateful to have the opportunity to have access and firsthand exposure to these patients, but also to obtain information from the doctors at the same time. I found myself comparing this experience to the hospitals in Niger where I volunteered in college, and there were many similarities overall, but the baseline level of health was better here (Niger was also recovering from famine when I was there). There were also many fewer cases of malaria here, but seemingly more cases of TB. Of course, I don't know the details of which patients are sent to which hospitals in the area, etc., but these were my general impressions.
After this really exciting and interesting morning, we all boarded the bus with our passion for medicine reignited and got ready for a short drive and break before our next stop: an AMREF school visit to deworm and check compliance with new health promotion initiatives.
The arrival at the school was incredible. All the kids in their kelly green and pink uniforms were waiting for us at the entrance to their school "driveway" and were singing at full volume as we pulled in. Their energy and smiles were completely contagious and we all climbed off the bus eager and excited to meet and interact (and deworm) the kids.
The school has made many strides to comply with AMREF, and their deworming and health/sanitation initiatives were on full display for us. We got to see their new "VIP" latrine, a homemade museum displaying all their knowledge about healthy food, exercise, sanitation, disease, and ecology, and then we planted three new trees on their property. I was one of the three in our group chosen to plant, and the tree is now named after me! I hope I get to visit it someday again in the future. :)
Lunch was huge pots of rice and beans served to the lines and lines of kids for this special day (usually they bring lunch with them in plastic containers from home - picture old Marshmallow fluff tubs or something of that size used as lunch boxes). Proper hand washing was stressed, and the kids all sat around to eat and we were able to chat with them and play some games. I could have hung out with them for hours, even with my minimal Swahili competence. Their genuine joy and smiles were so uplifting.
Then, to top it all off, there was a great talent show at the end of our visit, with funny skits and BEAUTIFUL singing and dancing. The talent, joy and sense of community at that school was so humbling and really made me reflect a lot about my own life and place in this world. So many of these kids and teachers have so little, yet they walk hours daily in the name of education and to do the best they can with what they have. The students' discipline and focus was certainly better than that of any of the seventh graders I taught in Phoenix, and I wished so badly that I could do so much more for them. However, having learned from experience that this 'save the world' mentality is often more selfish than productive, I tried to just enjoy and absorb the experience and appreciate how many really great things were happening--and there are many.
Finally, as we climbed on top of the bus for photos, the clouds and thunder rolled in. We gave away some soccer balls (thanks Abby!), frisbees and other toys to the school as we pulled out the driveway. This was easily my favorite day so far, and I went to sleep with my spirit feeling very full.
Saturday, May 26th - Best day (Friday at the school) followed up by worst day :( Food poisoning had me up all night and Saturday was spent feeling pretty weak and sleeping a LOT. While I was really sad to miss a fun, community health day and ride bikes to visit local homes and families, I was VERY grateful that the symptoms only lasted one full day. And, everyone was really nice and accommodating. Sprite + toast + sleep --> fast recovery! (No more eating salad...maybe ever...)
Sunday, May 27th - We woke up early on Sunday, around 4:30am, for a pre sunrise start to our drive to Amboseli Game Park. This first animal drive was a nice taste for what would come in the future, and we saw some great elephants, hippos, ostriches, and crazy birds (it's easy to overlook the birds since the bigger animals are so cool, but they really are some of the most gorgeous, unique birds most people will ever see). Before the drive started, we were greeted (accosted?!) by several Masai people selling all of their gorgeous beaded jewelry...and most of us were unable to contain our excitement for our first opportunity to buy authentic souvenirs. Needless to say, I ended up with many more bracelets and necklaces than anticipated. They'll all find a good home though, I have no doubt.
After the game drive, we were able to visit the Masai village and they gave us an excellent show with traditional dancing to start. We then went into the (very fly infested!) village area and saw how they make fire, learned about their traditional medicines and medical practices, and visited their mud houses. It was really interesting to learn all about the Masai, and, since we were unable to get to Entasopia due to massive flooding, we were all really happy to have this immersion and cultural experience. We ended the visit by seeing the schoolhouse, a tin building with benches inside and adorable children eager to recite their alphabet and numbers in English for us.
After this visit, with our brains and memory cards full (and our wallets a little lighter), we got back on the bus to get to Kibwezi by nighttime. This would be our new home until Wednesday. On that first night, after dinner and settling in to our new place (half of us were in a VERY interesting separate building - imagine juvenile detention center turned into a hotel), we very sleepily listened to a powerpoint lecture about ultrasound. We were briefed on the techniques that we would be helping with and observing in the local hospital for the next few days. Patients would come from far away to be seen and have free ultrasounds performed by the experts who flew in with Dr. Macpherson.
Exhaustion. Today was certainly interesting, humbling, and eye-opening. Oh, and sleep inducing.
Monday, May 28th - In Kibwezi, Bilal and I got up with the 5:30 am morning prayer call and ran on the dirt "track" that the security guard led us to for our first running attempt in a new place. The next days we would venture out more, but this is where we stayed today. It was a great way to wake up, and we enjoyed the fresh air, some local kids cheering us on, and the security guard's big smile and vote of appreciation! Then we all put on our white coats to go to Makindu Hospital, where we'd be stationed for the next 2 and a half days.
We were able to see so much in our small groups. We took turns going on rounds with the doctor on call, reading through charts in wards with nurses, and being trained and working in the ultrasound clinic. Some of the most memorable things I learned about and saw on that first day: an abdominal aneurysm in a woman with hydatid cysts in her liver (unrelated to each other), several fractures and their method of using traction (ropes with bags of rocks to keep the bones separated), degloving and other injuries requiring skin grafts, a woman who had complications from Diabetes mainly because there was no insulin available to her (the pharmacy was out of stock...crazy to think of how frustrating such resource problems must be to doctors and patients), two men in decerebrate (thanks Neuro class for helping me recognize) posturing following stroke, many, many TB patients, and an AWESOME live C-section in the operating theater.
In the afternoon on Monday, some of us then went to do a community project with AMREF and helped the landscaping and progress of a new dispensary being built. Some people painted, and I spent the entire time lined up with local people in a huge line passing red clay bricks from one end to the other. Chanted songs kept the rhythm and kept us motivated. The fact that 2 people over the age of 75 were on either side of me (Alice on my right side was hilarious and tried to set me up with her youngest son WHILE we passed bricks). My two older neighbors had no signs of fatigue the entire time, which obviously, combined with my pride, kept me from stopping when my arms and back started screaming for relief. The blisters that surfaced only 20 minutes after we finished made me feel sheepish for my soft hands, but also appreciate their strength and resilience. Humbling yet again.
Tuesday, May 29th - The second day in Kibwezi Bilal and I ran off the track and went down a long road where lots of school children were walking. It was a beautiful sunrise, and many kids came and ran with us for a few steps, which was so much fun. Bilal and I were definitely wishing we knew more Swahili, but we tried and our attempts and accents were usually met with smiles and lots of laughter.
This day was my group's turn in the ultrasound clinic, and for the first hour or so we just saw several cases of "abdominal discomfort" without too many obvious causes - although the diet high in starch, which is the cheapest and most accessible food, does lead to a lot of chronic constipation, which we learned brings many people in. Unfortunately, the solution to 'eat more vegetables' is not always feasible. We also saw a woman with what looked to be filariasis, but turned out to be silicosis, according to Dr. Macpherson. Definitely interesting. We saw several pregnant women as well, and we learned that the technicians purposefully do not reveal the sex of the child even if they can tell because often times hearing the "wrong" gender will anger patients or husbands and lead to abuse or abortion attempts.
The last things we did before lunch was spend some time with the X-ray technician, who was really quirky and informative and could probably diagnose ever single patient on his own. All the X-rays are developed in an old-fashioned photo lab (think of high school photo class for the smell and ambience). We saw several fractures and a couple cases of TB.
Some Cokes and a late lunch and then we headed out to do another community project for the afternoon. This time, we were in a more remote area with gorgeous, scenery: cornfields, small clusters of huts, mango trees and vegetable gardens, and a huge blue sky with puffy clouds. The main tasks here were weighing children (on huge spring scales - think of the vegetable weighing baskets in the supermarket!), measuring arm circumference and height, passing out Albendazole and Vitamin A, and dancing with the children :) There was also a 'private' building where rice was being passed out to the older citizens so that they could get access to the supplies without having to fight for it from the younger, stronger people.
Dinner, Tuskers, charades, and bed finished day 2 in Kibwezi.
Wednesday, May 30th - Last day in Kibwezi. Best run of the week with even more kids joining us, lots of energy, and some fun attempts to carry the kids' jerry cans for them - so impressive that they run with those full every day in their little arms. On the last day at the hospital I was able to see some Ob/Gyn exams as well as a really intense snake bite on a young child that had to be cleaned out and packed. I also went around the female ward and pediatrics ward again to see what had changed in the patients from the first day. It was nice to have that familiarity about the cases that came with the fact that we had spent 3 consecutive days in one place. Makindu is definitely a very good and improving hospital, and, although it was the same "level" as the one we saw in Nairobi, it had a much better atmosphere.
Back on the bus to start our drive back to Nairobi. Lunch at Hunter's Lodge - it took roughly 1,000 years to get our food - but there was a gigantic (dinosaur size, seriously) pelican and a monkey with very bright blue anatomical parts to keep our attention for at least a little while. The rest of the bus ride to Nairobi was long but we were all pretty tired so it was also appreciated. In addition, our fanciest dinner thus far, at a wonderful Indian place called Haandi's. It was SO GOOD. We all ate our weight in delicious food that night and the prolonged lunch and bus ride were easily forgotten. With our trip to Masai Mara starting the next day, we all relaxed with our full bellies and got excited for the upcoming adventures.
Thursday, May 31st - Driving to Wilson airport for our flights on tiny planes to get to the Masai Mara. I was given a red laminated 'boarding pass' and waited with the blue, black, and yellow groups in the tiny gate area while we watched the small planes take off. I personally love small planes, and the short, 45 minute ride was a lot of fun, and seeing an elephant from a plane is pretty awesome.
We were greeted by Masai drivers and Intrepids safari vehicles to take us immediately on a game drive. Instantly wowed by elephants and insanely gorgeous expanses, they certainly know what they're doing when they arrange the itinerary and sweep you away to the game drive right away. Amazing. The drive was followed up by a delicious buffet of anything you could imagine to eat, and then we were taken to our luxury tent accommodations.
Angela and I shared tent #3, and the porch overlooking the river, the interior decor of dark wood and white linens, the plush bedspread, the amazing sink/shower area took our breath away. We were so excited we couldn't believe how lucky we were to end up in this security hideaway.
Our 3:30pm game drive gave us hippos, lions, gazelles, topi, cape buffalos, guinea fowl, hyenas (the Whitney Houston of lions...b/c a hyena is like a druggie looking lion to me!), gazelles, impalas, ostriches and baboons to stare at and admire from very, very close. An amazing sunset, ton of photos, many thanks to our driver Raphael, and a final buffalo stampede to watch ended the day perfectly. It was hard to imagine how anything could top today's excursion. Dinner with Masai dancers and a short visit to the bonfire (it was cold there!), and off to bed in our super fancy tent. Hot water bottles provided for our comfort...blissful.
Friday, June 1st - An early wake up by Gideon for our 6:30am game drive. Definitely chilly and too early for our liking, but the coffee, hot chocolate and cookies delivered with the "get up now!" made it much more tolerable. I could get used to this treatment. Some yoga on the porch to wake my body up and then I went with Angela and our full thermoses to meet Raphael and the rest of our group to head out. Big blankets were provided (they think of everything), and we saw the elusive black rhino and some giraffes before enjoying a very fancy 'bush breakfast'. Now, I imagined a bush breakfast as a rustic, cook over a kerosine stove/camping style sort of thing. Um, not really. Imagine an all-star buffet with hot food, cereal, fresh fruit and coffee set up in the grass near a river with table clothed tables, chefs in chef hats, and a very fancy bush toilet (= plushest port-o-potty I've ever experienced) set up not to far away for your convenience. Hardly roughing it. Feeling very spoiled!
Drove back to the resort after this to relax and Bilal and I decided to go on a nature walk for the middle of the day. It was just the two of us, a Masai man, Joseph, leading us and George, the man with a gun to protect us. Getting out of the vehicles after we had been so warned not to get out, had seen the lions in person, and had imagined how easy it would be to be devoured by these huge creatures, was SLIGHTLY disconcerting. And George's gun was small. Trust. We must trust them...!
The walk was great though, and I'm so glad we decided to do it. We got some great firsthand information about the local plants, saw a dead vulture in a tree (Joseph said from a jaguar!), walked upon a herd of zebras, and saw numerous gazelles and topi from a close proximity. It was also great to stretch our legs and enjoy the fresh air from a different perspective.
Some random interesting facts I learned: Masai don't eat fish - they are "snakes of the river", but they live off of milk; many runners in Kenya come from the area called El Doret.
On our 3:30 game drive, we had a SECOND rhino sighting (unheard of they said!), and it rained down on us for about 20 minutes, but it was actually a nice change of pace and Raphael valiantly got out among the lions to tie down the sides and keep the rain from coming into the car and soaking us. The Tuskers we had packed took the edge off as well! Some crocodiles and a baby hippo with a fresh bite on him in the river provided more entertainment, and we headed back for dinner and Angela and I enjoyed an amazing massage in the "massage tent" before bed.
Saturday, June 2nd - Today was our last day of the selective, and we started with another early 6:30 am game drive that took us to a new area, where we saw elands and gorgeous, rolling plains. We also saw more elephants as well, which I can't get enough of - they're such crazy looking animals if you really think about it! A huge, final buffet breakfast followed and then some of us decided to do the 10:30 game drive with a new driver, James. I was debating because we had already done so many drives, but all of us who went were given such a treat. We saw a cheetah! The one animal that we all wanted to see so badly but that no one had found yet. This meant that we had seen all of the Big Five, and we even saw this cheetah climb onto the jeeps' roofs and people took pictures from inches away. We patiently waited for awhile because we thought it might go for a kill, but eventually hot sun and grumbling stomachs pushed us to return to the main resort area. That cheetah was definitely the highlight of the Mara for me. What a grand finale.
A nap and lunch and then we boarded the small planes to get back to Nairobi. So hard to leave this exotic place - I hope I can return some day (and get Dr. Macpherson's 'special price' again, obviously!). Back in Nairobi, the group split and we said our goodbyes, and those of us staying in Kenya for a few more days settled in at the Comfort Hotel once again.
For the next few days, Christine, Sheneka, Joycy, and I did some final Nairobi sightseeing, including the National Museum, the Snake Park (chameleons, pythons, crocodiles, you name it), and the Holy Family Minor Basilica. We also spent remaining shillings at another Masai Market place and at Java Coffee House, which had amazing cappuccinos and 70s, 80s, and 90s music to keep us very happy. Finally, we enjoyed a very comfortable and fancy night at the Hilton care of Christine's mom, and took our respective crack-of-dawn flights out of Kenya on Tuesday. For me - on to Addis Ababa to meet Kwazo and continue the adventuring.
Kenya, you were very good to me!
No comments:
Post a Comment