It seemed appropriate to close the blog with a slideshow of our favorite pictures and memories from Kenya. Though this is just a small sampling of our 3,000+ photos, we think these are the best representation of our time here. (Make sure the sound is audible on your computer)
We have mixed emotions about leaving but are very excited to see family and friends. We want to thank you all for your constant support of our crazy plan; this has truly been a memorable year in so many ways. We love you all and will see you soon!
Love,
M & E
Thursday, May 19, 2011
Goodbye to the coast!
After 9 months, we have left the Kenyan coast and Diani. We are now in Nairobi hanging out with Chris, Jamie, and their kids until we leave on Sunday.
We had an amazing home for 9 months and we will never forgot our morning sunrise, the amazing people we've met or the time we shared together. It was truly God's glory on display:
We are busy ticking down "lasts" in Kenya. Last time in Msambweni, last time in Mombasa, last time on the coast. Tomorrow will be the last McKenya post as well.
We had an amazing home for 9 months and we will never forgot our morning sunrise, the amazing people we've met or the time we shared together. It was truly God's glory on display:
We are busy ticking down "lasts" in Kenya. Last time in Msambweni, last time in Mombasa, last time on the coast. Tomorrow will be the last McKenya post as well.
Monday, May 16, 2011
Wrapping Things Up
We have now left Kijabe and I have headed down to the coast to wrap things up with my UTI project. E is in Nairobi with Jamie helping with the kids since Chris gave me a ride to the coast. We will be home in the US one week from today.
One last hospital blog written last week but not posted since Blogger was down:
After over a week in Kijabe, it’s been very interesting comparing between here and the hospital on the coast.
A few days ago, I was operating with Dr. Thomas on an umbilical hernia, and someone came into the room and calmly said that the power was going to go out in about 30 minutes, and it would be off the rest of the day. Not a problem, as we were just starting to wrap up the case and just had to close the skin.
We finished up and headed into the OR where Dr. Davis was operating. He was in the middle of a laproscopic cholecystectomy (gall bladder removal with the long instruments through the little ports, all while watching on a monitor). The case was on the complicated side, and it was looking like they wouldn’t finish within the allotted time. Sure enough, about 20 minutes later, the lights and many of the machines in the room turned off. The room had windows, so at least there was some light. The laproscopic equipment had about three minutes of battery backup, but soon it turned off as well. So, now there was a gall bladder loose in the abdomen. Dr. Davis expanded one of the port sites a little bit and fished around blindly with his finger and fortunately found the gall bladder without incident. It was improvisation at its finest, as there are no textbooks for doing laproscopic surgeries without power.
In another OR (one without windows), a surgeon was performing neurosurgery by flashlight. Amazing.
Apparently, KPLC (Kenyan Power and Lighting Company) will just cut power to certain locations for a day or so from time to time, and that day unfortunately came at the same time that the hospital generator wasn’t working.
In Msambweni, we lost power from time to time, but the procedures the we did and the equipment that we used could just as well have been used under an acacia tree in the middle of the Serengeti, so Msambweni was in some ways actually better equipped to deal with the unpredictability of Kenya, as the technology better matched the infrastructure (or lack thereof). In a way, Kijabe is a victim of its own success since the doctors there are performing to Western standards with Kenyan equipment.
One last hospital blog written last week but not posted since Blogger was down:
After over a week in Kijabe, it’s been very interesting comparing between here and the hospital on the coast.
A few days ago, I was operating with Dr. Thomas on an umbilical hernia, and someone came into the room and calmly said that the power was going to go out in about 30 minutes, and it would be off the rest of the day. Not a problem, as we were just starting to wrap up the case and just had to close the skin.
We finished up and headed into the OR where Dr. Davis was operating. He was in the middle of a laproscopic cholecystectomy (gall bladder removal with the long instruments through the little ports, all while watching on a monitor). The case was on the complicated side, and it was looking like they wouldn’t finish within the allotted time. Sure enough, about 20 minutes later, the lights and many of the machines in the room turned off. The room had windows, so at least there was some light. The laproscopic equipment had about three minutes of battery backup, but soon it turned off as well. So, now there was a gall bladder loose in the abdomen. Dr. Davis expanded one of the port sites a little bit and fished around blindly with his finger and fortunately found the gall bladder without incident. It was improvisation at its finest, as there are no textbooks for doing laproscopic surgeries without power.
In another OR (one without windows), a surgeon was performing neurosurgery by flashlight. Amazing.
Apparently, KPLC (Kenyan Power and Lighting Company) will just cut power to certain locations for a day or so from time to time, and that day unfortunately came at the same time that the hospital generator wasn’t working.
In Msambweni, we lost power from time to time, but the procedures the we did and the equipment that we used could just as well have been used under an acacia tree in the middle of the Serengeti, so Msambweni was in some ways actually better equipped to deal with the unpredictability of Kenya, as the technology better matched the infrastructure (or lack thereof). In a way, Kijabe is a victim of its own success since the doctors there are performing to Western standards with Kenyan equipment.
Wednesday, May 11, 2011
Rift Valley View
So Kijabe is poised on the side of the Rift Valley about halfway down the escarpment which is the word used to describe the sides of the Rift Valley.
You can see from this map that we're at about 2200 meters above sea level. The green gets lighter as you get closer to sea level:
View Kijabe in a larger map
This means that it's quite a bit colder than in Nairobi although cold is a relative term when you live on the equator so it's about 65 degrees during the day and low 50s at night. Nothing is heated so the nights are quite cold since it's the rainy season but it's very possible to get sunburned from the altitude and the equatorial sun. "Kijabe" means "place of the wind" in the Maasai language and after months of palm trees, the sound of the wind rustling the evergreens was quite nice.
You can see from this map how incredibly green the Right Valley is:
View Kijabe in a larger map
We have a direct view of Mount Longonot which is a dormant volcano that towers above the Rift savannah.
Besides Kijabe Hospital, Kijabe is also home to Rift Valley Academy or RVA, the world's largest boarding school for missionary children. Kids come from all over Africa to go to school at RVA while their parents serve in the field. 10% of the spots are reserved for Kenyans and are apparently ridiculously impossible to get since the school is so popular. The teachers are all missionaries who felt called to teach the kids and live on the campus with their families.
The combination of RVA kids, RVA staff, and the Kijabe hospital staff give the town a very different feel from the coast. There are a lot of Americans here so there is more taste of "home" though as previously mentioned, the grocery shopping leaves a lot to be desired.
We've really enjoyed our time in Kijabe. It's a beautiful place and watching the rain move over the Rift Valley has definitely been a highlight of our time in Kenya.
The school also has one of the most beautiful views in the world:
You can see from this map that we're at about 2200 meters above sea level. The green gets lighter as you get closer to sea level:
View Kijabe in a larger map
This means that it's quite a bit colder than in Nairobi although cold is a relative term when you live on the equator so it's about 65 degrees during the day and low 50s at night. Nothing is heated so the nights are quite cold since it's the rainy season but it's very possible to get sunburned from the altitude and the equatorial sun. "Kijabe" means "place of the wind" in the Maasai language and after months of palm trees, the sound of the wind rustling the evergreens was quite nice.
You can see from this map how incredibly green the Right Valley is:
View Kijabe in a larger map
We have a direct view of Mount Longonot which is a dormant volcano that towers above the Rift savannah.
Besides Kijabe Hospital, Kijabe is also home to Rift Valley Academy or RVA, the world's largest boarding school for missionary children. Kids come from all over Africa to go to school at RVA while their parents serve in the field. 10% of the spots are reserved for Kenyans and are apparently ridiculously impossible to get since the school is so popular. The teachers are all missionaries who felt called to teach the kids and live on the campus with their families.
The combination of RVA kids, RVA staff, and the Kijabe hospital staff give the town a very different feel from the coast. There are a lot of Americans here so there is more taste of "home" though as previously mentioned, the grocery shopping leaves a lot to be desired.
We've really enjoyed our time in Kijabe. It's a beautiful place and watching the rain move over the Rift Valley has definitely been a highlight of our time in Kenya.
The school also has one of the most beautiful views in the world:
Monday, May 9, 2011
Word of Life Church
As we come up on the end of our time here, we’ve been thinking back to all of the people we’ve met along the way. Without a doubt, the people who most impacted our time here are those from Word of Life Church in Diani, where we went to church on Sundays and where E taught Kindergarten. If it weren’t for that fateful Day 1 when E marched down the road looking for volunteer work and found it at Word of Life, our time where would have looked very different. Mary has been a guide for E through everything here and was the first person to invite us to church. On our first day, we stood up and introduced ourselves and said we were from the US. After the service, the pastor introduced himself as Dennis and said his wife, Allison, is American. Dennis and Allison hosted us for dinner many times, gave us tips on where/how to do things in Kenya and introduced us to Chris and Jamie Suel who are our closest friends in Kenya.
Ben was my spear-fishing partner in crime, Martin and Melanie and James and Jacinta were our Kenyan "couple-friends", and there are countless others who have shaped our time here.
Below are us with Dennis and Allison:
It is difficult living in a country with such disparity and an expectation of the “rich Americans” helping everyone they see (i.e. giving people money), so it was very refreshing to find a group of people who genuinely cared about us and didn’t expect anything from us other than love and respect.
I’m doing this rotation in Kijabe now because we were introduced to some of the doctors here by people from our church!
In case you're wondering what "Kenyan church" music is like, here is a video for you:
Obviously the words are in Swahili which is true about 80% of the time for the songs though the preaching is in English. Also, did you notice the ululation that the women does about 10 seconds in? It's a common sound in a lot of Kenyan and Arabic-inspired music and women do it to express strong emotion whether happy or sad.
Word of Life is our first church as a couple, and has truly been a surprise and a God-send for us. We’re just so thankful to have been lead to a place where we have been welcomed like family so far from home.
Ben was my spear-fishing partner in crime, Martin and Melanie and James and Jacinta were our Kenyan "couple-friends", and there are countless others who have shaped our time here.
Below are us with Dennis and Allison:
It is difficult living in a country with such disparity and an expectation of the “rich Americans” helping everyone they see (i.e. giving people money), so it was very refreshing to find a group of people who genuinely cared about us and didn’t expect anything from us other than love and respect.
I’m doing this rotation in Kijabe now because we were introduced to some of the doctors here by people from our church!
In case you're wondering what "Kenyan church" music is like, here is a video for you:
Obviously the words are in Swahili which is true about 80% of the time for the songs though the preaching is in English. Also, did you notice the ululation that the women does about 10 seconds in? It's a common sound in a lot of Kenyan and Arabic-inspired music and women do it to express strong emotion whether happy or sad.
Word of Life is our first church as a couple, and has truly been a surprise and a God-send for us. We’re just so thankful to have been lead to a place where we have been welcomed like family so far from home.
Friday, May 6, 2011
The Kijabe Hospital
Since Monday was a Kenyan holiday, we started in the OR on Tuesday, and operated Tuesday and Wednesday, and had a clinic day on Thursday. I’ll write a big surgery blog soon, but I just got home from clinic and it’s fresh, so that’s what you’ll get right now.
We rounded Thursday morning on our patients that were admitted post-op at around 8 am (I know, cushy schedule), and then headed to surgical clinic at around 8:45. Dr. Davis has his clinic every week on Thursdays, where he sees patients who have been referred and might need some kind of surgery. The clinic consists of about five very small rooms separated from a main waiting area by curtains. Though there are “appointments”, pretty much everyone is there first thing in the morning, so the waiting room was packed. Most patients traveled several hours to reach the hospital, and many traveled from other countries and had waited in Kijabe weeks to see the surgeon, so a day in a waiting room is no big deal. I hope to think about this when I get frustrated that my doctor is an hour late.
There were about 100 patients to be seen today, with a team consisting of me, Dr. Davis, and an intern. I had assumed that I’d tag along with Dr. Davis and his patients for most of the day, but it quickly became clear that I’d need to cut the cord and see patients on my own.
The first patient we saw was pretty amazing. She was from a Middle Eastern country and flew down to see one of the visiting surgeons who specializes in maxillofacial reconstruction. This young women fell on her face when she was two, and broke her upper and lower jaws in several places. It’s unclear if her parents did not get her medical care, or if it was grossly inadequate, but now her upper and lower jaw on the right side is completely fused together, and she hasn’t opened her mouth in 20 years. The growth of the bones in her face has been asymmetrical, so she’s quite disfigured. The doctor thinks that he can separate the portions of jaw tomorrow morning and start her on the road to recovery. I’m excited to see the case.
The next patient, I was on my own. I walked into the room and there are four Somalis, two men and two women. There is a Somali refugee camp a few hours away that houses about 300,000 displaced Somalis, many of whom come to the hospital for long-delayed medical care. A man quickly greets me and says that he lives in the US and can speak English. Thank goodness. I ask him where he lives in the US and he responds, “Columbus, Ohio”. Turns out he lives about a mile from where I grew up. Very small world. Anyways, we get down to business and figure out that the women has diffuse bone pain, large lymph nodes in her armpit and neck, and a breast mass. I examined the nodes, and then it came time to examine her breast. Hmm, they didn’t teach us the proper protocol for breast exam on a veiled Somali Muslim. I asked if I could examine her, and the men quickly left the room. The mass has actually ulcerated through the skin, so the pathology was pretty apparent. We did a needle biopsy, and within an hour has the results which showed ductal carcinoma. At this point, I called in backup (Dr. Davis) to discuss treatment options. She was very resistant to the idea of a mastectomy (understandably), and was repeatedly asking for “dawa” (drugs) instead. She ended up leaving without a scheduled surgery. Hopefully she comes back.
I saw a few more patients with ridiculously advanced disease, and then had my first patient who didn’t speak a lick of English. So, Swahili it was. I started out slowly, but got into the swing of things and was pretty happy with our communication level. I can definitely see how working in a clinic like this would teach you the language very quickly. Next step: start consenting patients for surgery in Swahili. This process was much slower, as I wanted to make sure that I was able to adequately explain the procedure and the associated risks. I’m sure some of the phrasing was very awkward, but it got the job done. Sentences like “mpira itakaa umeni na wiki moja” (the tube will live in your penis for one week) were abundant today. The most challenging patient of the day was a Somali man who brought his brother to translate, but only into Swahili. I think there was probably a lot lost in translation.
Clinic made me very excited about the possibility of returning at some point after I’m at least closer to being finished with my training. It was amazing to connect even a little with patients in a completely different language, though I’m sad that so many of the patients spoke Arabic and Kisomali, languages that I have no idea about. One of the American doctors here speaks English, Swahili, Kisomali, Arabic, Kikuyu, and some of several other tribal languages. No big deal.
Lots of surgeries on the schedule for tomorrow. I’ll have some pictures for the next blog.
We rounded Thursday morning on our patients that were admitted post-op at around 8 am (I know, cushy schedule), and then headed to surgical clinic at around 8:45. Dr. Davis has his clinic every week on Thursdays, where he sees patients who have been referred and might need some kind of surgery. The clinic consists of about five very small rooms separated from a main waiting area by curtains. Though there are “appointments”, pretty much everyone is there first thing in the morning, so the waiting room was packed. Most patients traveled several hours to reach the hospital, and many traveled from other countries and had waited in Kijabe weeks to see the surgeon, so a day in a waiting room is no big deal. I hope to think about this when I get frustrated that my doctor is an hour late.
There were about 100 patients to be seen today, with a team consisting of me, Dr. Davis, and an intern. I had assumed that I’d tag along with Dr. Davis and his patients for most of the day, but it quickly became clear that I’d need to cut the cord and see patients on my own.
The first patient we saw was pretty amazing. She was from a Middle Eastern country and flew down to see one of the visiting surgeons who specializes in maxillofacial reconstruction. This young women fell on her face when she was two, and broke her upper and lower jaws in several places. It’s unclear if her parents did not get her medical care, or if it was grossly inadequate, but now her upper and lower jaw on the right side is completely fused together, and she hasn’t opened her mouth in 20 years. The growth of the bones in her face has been asymmetrical, so she’s quite disfigured. The doctor thinks that he can separate the portions of jaw tomorrow morning and start her on the road to recovery. I’m excited to see the case.
The next patient, I was on my own. I walked into the room and there are four Somalis, two men and two women. There is a Somali refugee camp a few hours away that houses about 300,000 displaced Somalis, many of whom come to the hospital for long-delayed medical care. A man quickly greets me and says that he lives in the US and can speak English. Thank goodness. I ask him where he lives in the US and he responds, “Columbus, Ohio”. Turns out he lives about a mile from where I grew up. Very small world. Anyways, we get down to business and figure out that the women has diffuse bone pain, large lymph nodes in her armpit and neck, and a breast mass. I examined the nodes, and then it came time to examine her breast. Hmm, they didn’t teach us the proper protocol for breast exam on a veiled Somali Muslim. I asked if I could examine her, and the men quickly left the room. The mass has actually ulcerated through the skin, so the pathology was pretty apparent. We did a needle biopsy, and within an hour has the results which showed ductal carcinoma. At this point, I called in backup (Dr. Davis) to discuss treatment options. She was very resistant to the idea of a mastectomy (understandably), and was repeatedly asking for “dawa” (drugs) instead. She ended up leaving without a scheduled surgery. Hopefully she comes back.
I saw a few more patients with ridiculously advanced disease, and then had my first patient who didn’t speak a lick of English. So, Swahili it was. I started out slowly, but got into the swing of things and was pretty happy with our communication level. I can definitely see how working in a clinic like this would teach you the language very quickly. Next step: start consenting patients for surgery in Swahili. This process was much slower, as I wanted to make sure that I was able to adequately explain the procedure and the associated risks. I’m sure some of the phrasing was very awkward, but it got the job done. Sentences like “mpira itakaa umeni na wiki moja” (the tube will live in your penis for one week) were abundant today. The most challenging patient of the day was a Somali man who brought his brother to translate, but only into Swahili. I think there was probably a lot lost in translation.
Clinic made me very excited about the possibility of returning at some point after I’m at least closer to being finished with my training. It was amazing to connect even a little with patients in a completely different language, though I’m sad that so many of the patients spoke Arabic and Kisomali, languages that I have no idea about. One of the American doctors here speaks English, Swahili, Kisomali, Arabic, Kikuyu, and some of several other tribal languages. No big deal.
Lots of surgeries on the schedule for tomorrow. I’ll have some pictures for the next blog.
Tuesday, May 3, 2011
Kijabe Living
So while M is spending his time in the OR, I needed to find something to occupy my time. Per usual, it was impossible to set something up prior to arriving in Kijabe so I set about doing what I always do in Kenya: make it up as I go along.
The first order of business on Monday was keeping the doctor fed and watered. This is the first time in Kenya that we've lived in a town without a large food store. Although there are some small shops and a vegetable market, food shopping leaves much to be desired. The small shops carry about as much stuff as a mid-sized gas station so I've been having fun thinking up meals. The veggies are amazing though because of the constant growing season up here so we're definitely taking advantage of all of it. In addition to the food, we still need to purchase or boil/strain all of our water so I walked home with a 5 liter jug of water on my head. I still have to steady it with my hand but I've been practicing and my neck is getting stronger. Honestly, it's not that much easier than carrying things in your hands but the looks I get are priceless.
Tuesday dawned and M headed to the hospital (100 yards away). I had heard a tip that sometimes they needed volunteers to help prep the surgical kits so I headed down to the OR to see what I could find. I think they thought I was really weird but they gave me a gown, shoe covers, gloves, and a fancy hairnet and led me into the room where they prep the kits.
So as we've previously mentioned, very little in a Kenyan hospital is disposable and nothing is bought in a pre-packaged kit. So, if you've ever seen anyone tear open a packet of neatly folded and sterilized gauze, those have to be assembled by hand in Kenya. First, you take a giant 5-ft roll of gauze and cut a 6-inch square, then you fold it in thirds, and then in halves to make a neat little gauze towel. Now repeat for 2 hours. Then we prepared cotton balls and no, they don't buy the pre-packaged ones from CVS. They have a giant ball of cotton batting so you tear it off, ball it up in your hand, and make a cotton ball. Once we had prepped enough gauze and cotton balls, we began preparing kits.
Gauze piles:
When a surgeon enters the OR for a case, there are usually one or more specialized kits available with all the necessary tools for the procedure. So for example, the kit contains different instruments for a c-section vs. an ACL repair.
You can see pediatric instruments to the left in this photo as well as the bowls for gauze/cotton balls:
So with a really loud noise, several men entered and dumped all of the instruments used in the previous day's surgeries on the table. These instruments had already been washed at least once and now were ready to be re-packed. Everything was in a giant jumble: forceps, rods, basins, bowls, speculums, scalpels, etc.
They taught me to put together some of the basic kits and we began to assemble the instruments and the appropriate amount of gauze and cotton balls. When complete, these were wrapped in surgical material (the same material the surgical scrubs are made of) and taped closed. This entire packet goes into the auto-clave to be sterilized and then can be used in surgery. It had never occurred to me that they have to sterilize the gauze and cotton balls used in Kenya because they can't buy them sterile. It was amazing.
Another interesting thing was this sewing machine. They sew and repair all the sheets, surgical clothes, and scrubs onsite. Nothing is thrown away. I saw them piece together scraps in a sort of madras style surgical towel (I guarantee that sentence has never been written before now) so as not to waste anything.
Anyway, tomorrow I'm going to do something new since one can only fold gauze for a few hours before dying of boredom (well, if you're a spoiled American). It was really interesting though to see the functional pieces of the OR kits that the doctors use everyday so I'm glad I did it.
The first order of business on Monday was keeping the doctor fed and watered. This is the first time in Kenya that we've lived in a town without a large food store. Although there are some small shops and a vegetable market, food shopping leaves much to be desired. The small shops carry about as much stuff as a mid-sized gas station so I've been having fun thinking up meals. The veggies are amazing though because of the constant growing season up here so we're definitely taking advantage of all of it. In addition to the food, we still need to purchase or boil/strain all of our water so I walked home with a 5 liter jug of water on my head. I still have to steady it with my hand but I've been practicing and my neck is getting stronger. Honestly, it's not that much easier than carrying things in your hands but the looks I get are priceless.
Tuesday dawned and M headed to the hospital (100 yards away). I had heard a tip that sometimes they needed volunteers to help prep the surgical kits so I headed down to the OR to see what I could find. I think they thought I was really weird but they gave me a gown, shoe covers, gloves, and a fancy hairnet and led me into the room where they prep the kits.
So as we've previously mentioned, very little in a Kenyan hospital is disposable and nothing is bought in a pre-packaged kit. So, if you've ever seen anyone tear open a packet of neatly folded and sterilized gauze, those have to be assembled by hand in Kenya. First, you take a giant 5-ft roll of gauze and cut a 6-inch square, then you fold it in thirds, and then in halves to make a neat little gauze towel. Now repeat for 2 hours. Then we prepared cotton balls and no, they don't buy the pre-packaged ones from CVS. They have a giant ball of cotton batting so you tear it off, ball it up in your hand, and make a cotton ball. Once we had prepped enough gauze and cotton balls, we began preparing kits.
Gauze piles:
When a surgeon enters the OR for a case, there are usually one or more specialized kits available with all the necessary tools for the procedure. So for example, the kit contains different instruments for a c-section vs. an ACL repair.
You can see pediatric instruments to the left in this photo as well as the bowls for gauze/cotton balls:
So with a really loud noise, several men entered and dumped all of the instruments used in the previous day's surgeries on the table. These instruments had already been washed at least once and now were ready to be re-packed. Everything was in a giant jumble: forceps, rods, basins, bowls, speculums, scalpels, etc.
They taught me to put together some of the basic kits and we began to assemble the instruments and the appropriate amount of gauze and cotton balls. When complete, these were wrapped in surgical material (the same material the surgical scrubs are made of) and taped closed. This entire packet goes into the auto-clave to be sterilized and then can be used in surgery. It had never occurred to me that they have to sterilize the gauze and cotton balls used in Kenya because they can't buy them sterile. It was amazing.
Another interesting thing was this sewing machine. They sew and repair all the sheets, surgical clothes, and scrubs onsite. Nothing is thrown away. I saw them piece together scraps in a sort of madras style surgical towel (I guarantee that sentence has never been written before now) so as not to waste anything.
Anyway, tomorrow I'm going to do something new since one can only fold gauze for a few hours before dying of boredom (well, if you're a spoiled American). It was really interesting though to see the functional pieces of the OR kits that the doctors use everyday so I'm glad I did it.
Monday, May 2, 2011
A Change of Scenery
After many months of life on the coast, E and I are taking the roadshow to a new venue, known to Kenyans as “upcountry”. Geographically, it is further north from where we are now, and altitude-wise, it is also up, about 8,000 feet up where we’re going.
The actual experimental portion of the vaccine research has wrapped up, and the UTI project is thankfully going well and can continue in my absence for a while, so we’re taking the opportunity to head up to Kijabe to see what life is like there. As mentioned in earlier blogs, there’s a hospital there that was started nearly 100 years ago by African Inland Missions, and has since grown to be one of the largest and best hospitals in all of Kenya. The population that it serves is still largely the destitute, as I saw in Msambweni, but the standard of care is higher, as they are better staffed and have relatively more resources. I’ve been in touch with several of the surgeons there, and they’ve invited me to do a rotation there for two weeks. E selflessly encouraged me to do this rotation, even though it means that she can’t teach her kids this month and will have to find other projects to occupy herself with while in Kijabe. She’s too good for me, I swear.
Though we’re not leaving Kenya for almost a month, we’ve packing up most of our things to taken them to Nairobi. It’s amazing that we’re already at the point of “last this” and “last that”. Nine months has seriously flown by. We’re just trying to cherish these last few weeks here, as we realize that we were so blessed to have this opportunity, and we’re likely going to have only one shot at living in a foreign country before we start a family, so we’d better enjoy it! Definitely looking forward to another chapter in our lives when we get home, but the African nostalgia is starting to set in.
Stay tuned for updates from upcountry!
M
Wednesday, April 27, 2011
God bless the rains down in Africa
You didn’t think we would end the blog without a reference to the 80s song by Toto, did you? After waiting, 5+ months for daytime rain, we’ve reached the rainy season. We had no rain in Diani from October until late March when it began to rain overnight. Now that we’ve reached April, it is officially the rainy season and it is raining during the day!
In Kenya, they don’t celebrate spring, summer, winter, and fall and you’ll get funny looks if you refer to those seasons. They have short rains, long rains, and the rest of the time it’s just sunny. It was actually quite amusing learning the unit “weather” with the children at school because there were only four types of weather: sunny, cloudy, windy, or raining. No snow, sleet, hail, fog, or other unsavory weathers. Just sun or rain.
April and May are the long rains in Kenya meaning that it rains for longer than 5 minutes and can occasionally go the whole day punctuated by periods of the usual heat and humidity. During the hot, dry season (Dec-March), Mombasa only averages 2 cm of rain per month but in the rainy season, that climbs to 30 cm.
These pictures were taken 2 weeks apart. The difference is profound:
The effects of rain aren't limited, however, to grass growth. Remember for M's UTI project there was a lot of airborne contamination of the sample plates? That has been almost completely eliminated since it started raining because the contaminants are no longer in the air. We're expecting mold growth at any time from the dampness... So much for consistent experimental conditions.
I have always loved the smell of rain. It’s not really a smell you can describe but it’s always been a favorite of mine. Let me tell you, there is nothing so wonderful as the smell of rain in Africa after 5 months without it. It was so dry and dusty that the air was filmy and filtered before the rains started. The rain is such a blessing here.
Our first rain in Msambweni, we ran outside to play in the rain barefoot. Needless to say, the locals think we're crazy.
"It’s gonna take a lot to drag me away from you"
"There’s nothing that a hundred men or more could ever do"
"I bless the rains down in Africa, I bless the rains down in Africa"
In Kenya, they don’t celebrate spring, summer, winter, and fall and you’ll get funny looks if you refer to those seasons. They have short rains, long rains, and the rest of the time it’s just sunny. It was actually quite amusing learning the unit “weather” with the children at school because there were only four types of weather: sunny, cloudy, windy, or raining. No snow, sleet, hail, fog, or other unsavory weathers. Just sun or rain.
April and May are the long rains in Kenya meaning that it rains for longer than 5 minutes and can occasionally go the whole day punctuated by periods of the usual heat and humidity. During the hot, dry season (Dec-March), Mombasa only averages 2 cm of rain per month but in the rainy season, that climbs to 30 cm.
These pictures were taken 2 weeks apart. The difference is profound:
The effects of rain aren't limited, however, to grass growth. Remember for M's UTI project there was a lot of airborne contamination of the sample plates? That has been almost completely eliminated since it started raining because the contaminants are no longer in the air. We're expecting mold growth at any time from the dampness... So much for consistent experimental conditions.
I have always loved the smell of rain. It’s not really a smell you can describe but it’s always been a favorite of mine. Let me tell you, there is nothing so wonderful as the smell of rain in Africa after 5 months without it. It was so dry and dusty that the air was filmy and filtered before the rains started. The rain is such a blessing here.
Our first rain in Msambweni, we ran outside to play in the rain barefoot. Needless to say, the locals think we're crazy.
"It’s gonna take a lot to drag me away from you"
"There’s nothing that a hundred men or more could ever do"
"I bless the rains down in Africa, I bless the rains down in Africa"
Tuesday, April 26, 2011
Ngorongoro McCrater
As you can see from the previous post, we had an awesome time with JPB in the Serengeti. We topped off our Northern Tanzania roadtrip with a stop at the Ngorongoro crater. Named a UNESCO World Heritage site in 1979, the Ngorongoro crater is one place we were told not to miss in east Africa. The “crater” is actually the collapsed caldera of a volcano that was once taller than Kilimanjaro; now it’s a massive, bowl-like plain that is now home to the largest concentration of predators (and presumably their prey) in the world. It is the largest, intact, unfilled caldera in the world (apparently they usually fill with water and make lakes). The panoramic shots above are from John's new camera.
Anyway, on to what we did at Ngorongoro. After picking up a ranger from the station, we went on a little crater rim hike, which afforded amazing views of the crater floor. Our guide carried an AK-47, which is pretty much carried like pepper spray in Africa, as hikers occasionally run into ornery Cape Buffalo. We came across some fresh elephant dung, but nothing dangerous. We’re at about 7,000 feet on the crater rim.
As we drove around the crater rim to our lodge, I asked E if every time we mentioned the crater, she thought about her maiden name, and she said “yes, but I didn’t mention it because I was afraid of what you guys would start saying”. Lightbulb. This was immediately followed by us making juvenile comments of varying degrees of lewdness that you’d expect from a pair of Ivy League grads. For 15 straight minutes. She was thrilled.
We stayed at a lodge on the east side of the rim, which was perfect for the sunset. The lodge was decidedly 70’s in styling, but with that location and view, I’m not sure how much an update would add.
Sunset over the lodge:
In the AM, we drove down to the crater floor for a game drive. We saw an incredible seven rhinos, which are next to impossible to see in most of Africa, as their number were decimated by poaching and have only recently begun to recover. There is also a small alkaline lake in the crater, which is home to thousands of flamingos. The other animals were similar to those we saw before, but we did come across several prides of lions in a small area, as the pride range is much smaller due to the amazing population of prey in the crater. The main difference was the scenery of vast open plain in the Serengeti v. the bowl-like feeling of Ngorongoro.
This guy was rolling over in the dirt like a cat:
We sat down at a picnic area for lunch, and we were all reflecting on how great the trip had been. I said “it’s been a safari njema (a good trip)”. Not more than three seconds after saying this, a hawk dive-bombed JPB, trying to get his chicken bones. It brushed his arm, he let out a girlish scream, but was no worse for wear in the end.
From there, we drove to Arusha, had Ethiopian food for dinner, stayed the night, and caught the morning bus back to Nairobi (about six hours). We were exhausted from so much driving and travel, but very happy with the trip and how (amazingly) smoothly things had gone. For our last dinner in Nairobi, JPB treated us to Carnivore, an East African landmark, which used to serve all sorts of game meat, but now does less exotic meat, but lots of it. It’s a lot like a Brazilian steakhouse. Crocodile, camel, and ostrich were the more exotic selections, which went along with lamb, pork, beef, chicken, ribs, calf heart, and chicken wings (to name a few).
We had a great time with JPB and miss him. It truly was a safari njema (cue bird dive-bomb).
Sunday, April 24, 2011
The Serengeti
After our tour of Zanzibar, we headed to Arusha, Tanzania to begin our safari. We began our visit with a brief guided walk through a town called Mto Wa Mbu. This translates in Swahili to "mosquito river" so needless to say, we didn't linger long before heading to Lake Manyara.
Lake Manyara National Park is one of Tanzania's smaller parks but it gave JPB a chance to get his safari legs. Lake Manyara's claim to fame is that the park borders the escarpment which is what the locals in Kenya and Tanzania call the sides of the Rift Valley. It's really beautiful and full of many elephants, baboons, and giraffes.
See the hills behind the baby giraffe, that's the escarpment:
Even if you can't see it, isn't he cute??
The next day, we headed to our main attraction, the Serengeti. Serengeti derives its name from the Maasai word for "endless plain" which is a pretty accurate description of the 12,000 square mile park. The Serengeti is home to the largest land migration on earth each year when more than 2 million animals travel in a circle from the southern Serengeti to the Maasai Mara in Kenya and back following the rains that produce the grass they need.
See below for a map of the great migration:
At this time of year, the migrating animals and the predators that hunt them are in the central Serengeti. They have just given birth to this year's babies and are gathering together to begin the migration. Although we didn't see the full group of animals since they're still gathering, it was still a crazy sight to behold:
See all those white spots? Those are zebra:
And all those dots? Those are wildebeasts:
Now the name "The Great Migration" sounds like a noble, determined, organized movement from one place to another. This is false advertising. In reality, the animals (and wildebeasts in particular) stampede back and forth over the plains until they reach a critical mass and start to starve, then one day they stumble on green grasses in one direction and start to move towards it. We literally watched one group of wildebeats and zebras stampede across the same river and back three times since they're all confused and on edge. The huge congregation of animals brings a lot of predators so the animals are constantly skittish and terrified so that any change of scenery freaks them out. For example, they constantly stampede across roads since it freaks them out that there's no grass:
This is especially entertaining because there are hilarious pile-ups, balks, and general animal hysteria.
Beyond the great migration, we saw many other animals. Since we've already extensively narrated safari, I'll just post them for your viewing pleasure:
Full moon at dawn over the Serengeti:
Team Safari 2k11:
It was a really wonderful experience especially since we got to stay in the central Serengeti overlooking a watering hole. We were so thankful that JPB joined us and that we still had another day of touring left.
Lake Manyara National Park is one of Tanzania's smaller parks but it gave JPB a chance to get his safari legs. Lake Manyara's claim to fame is that the park borders the escarpment which is what the locals in Kenya and Tanzania call the sides of the Rift Valley. It's really beautiful and full of many elephants, baboons, and giraffes.
See the hills behind the baby giraffe, that's the escarpment:
Even if you can't see it, isn't he cute??
The next day, we headed to our main attraction, the Serengeti. Serengeti derives its name from the Maasai word for "endless plain" which is a pretty accurate description of the 12,000 square mile park. The Serengeti is home to the largest land migration on earth each year when more than 2 million animals travel in a circle from the southern Serengeti to the Maasai Mara in Kenya and back following the rains that produce the grass they need.
See below for a map of the great migration:
At this time of year, the migrating animals and the predators that hunt them are in the central Serengeti. They have just given birth to this year's babies and are gathering together to begin the migration. Although we didn't see the full group of animals since they're still gathering, it was still a crazy sight to behold:
See all those white spots? Those are zebra:
And all those dots? Those are wildebeasts:
Now the name "The Great Migration" sounds like a noble, determined, organized movement from one place to another. This is false advertising. In reality, the animals (and wildebeasts in particular) stampede back and forth over the plains until they reach a critical mass and start to starve, then one day they stumble on green grasses in one direction and start to move towards it. We literally watched one group of wildebeats and zebras stampede across the same river and back three times since they're all confused and on edge. The huge congregation of animals brings a lot of predators so the animals are constantly skittish and terrified so that any change of scenery freaks them out. For example, they constantly stampede across roads since it freaks them out that there's no grass:
This is especially entertaining because there are hilarious pile-ups, balks, and general animal hysteria.
Beyond the great migration, we saw many other animals. Since we've already extensively narrated safari, I'll just post them for your viewing pleasure:
Full moon at dawn over the Serengeti:
Team Safari 2k11:
It was a really wonderful experience especially since we got to stay in the central Serengeti overlooking a watering hole. We were so thankful that JPB joined us and that we still had another day of touring left.
Monday, April 18, 2011
Hiatus
Internet is slow in the Serengeti but safari is amazing. We'll be back in a few days. Love you all!
Saturday, April 16, 2011
Spice Tour
So after our amazing day of snorkeling and lounging yesterday, we wanted to see a little of what made Zanzibar globally famous. No not Jack Black, but rather spices. Zanzibar was at one time the largest exporter or spices in the world, and though places like India and Indonesia have taken a large share of the spice industry from Zanzibar, a large industry remains.
We were picked up from our hotel at around 9 am and then drove 30 or so minutes to the spice plantation where the tour was done. We were led by a university student who was studying for an exam in communication off of his cheat sheet while we walked between the different spice sections. Multitasking like an American.
We started with turmeric, which is a root related to ginger. He passed around cut sections of the root, and encouraged us to smell them. He also warned us that if we tasted it, it would stain our teeth, but for some reason, I didn’t believe him. 8 hours later, I’m writing this blog with yellow teeth.
We then walked through the following spice/fruit areas: cinnamon (the leaves smelled like cinnamon, but the roots like eucalyptus!), ginger, nutmeg, mace (nutmeg and mace are actually the same plant!), cloves (Zanzibar is famous for cloves), curry, starfruit, bananas, vanilla (grows on a vine and has to be hand-pollinated because the bees that pollinate them are only found in Mexico) , birdseye peppers (JBP couldn’t even tolerate the sight of them), among others.
The red is the mace and the dark colored nut in the center is what you grind to get nutmeg:
There were a few coconut trees, and one of the local boys gave us a demonstration of climbing the trunk to harvest some coconuts for us. He sang the whole way up, as apparently the rule is that if you’re singing, you can’t be held responsible if a coconut falls on the head of a passerby. Actually, this makes good sense. Of course, I asked to try to climb as well, as it looked so easy. Apparently, a lifetime of practice makes it look easier than it is. I made it up a few feet, at which point I had succeeded in making my clothes filthy and skinning up my arms.
Notice John's shoulder for reference on how high I climbed:
Fortunately, our next stop was the iodine tree, which bleeds the famous antibacterial fluid. After rubbing that salve on my wounds, we progressed though the red mahogany and teak sections, passed through the spice market, and then sat on some mats for a “spice lunch”, which consisted of pilau (spiced rice), coconut curry, and spinach. The food was pretty good, though the pilau had whole cloves and big pieces of cinnamon bark, which proved slightly fibrous. We then headed back to the van in a deluge, which was actually quite refreshing.
That drop you can see on the right of the bark is iodine (click to make it larger). When you cut the tree, it bleeds iodine:
The deluge starting:
We haven't seen daytime rain since September so this was very exciting. The other tourists thought we were a bit strange:
The tour was actually really fun. It was cool to see what the spice plants look like, as aside from things like thyme and basil, we in the Western world don’t ever see spice plants. Here, spices are grown everywhere and are quite a bit cheaper than in the US. Our hotel serves homemade jams at breakfast with a ridiculous amount of vanilla bean in the jam, which is just delicious and not economically feasible in the US.
After the tour, we took the requisite McRun though Stone Town, which is the part of town with very narrow alleys and people who are very interested in giant and tiny Americans running around in the middle of the afternoon.
We have our last night in Zanzibar tonight, and then we head Arusha, in central Tanzania. Stay tuned!
We were picked up from our hotel at around 9 am and then drove 30 or so minutes to the spice plantation where the tour was done. We were led by a university student who was studying for an exam in communication off of his cheat sheet while we walked between the different spice sections. Multitasking like an American.
We started with turmeric, which is a root related to ginger. He passed around cut sections of the root, and encouraged us to smell them. He also warned us that if we tasted it, it would stain our teeth, but for some reason, I didn’t believe him. 8 hours later, I’m writing this blog with yellow teeth.
We then walked through the following spice/fruit areas: cinnamon (the leaves smelled like cinnamon, but the roots like eucalyptus!), ginger, nutmeg, mace (nutmeg and mace are actually the same plant!), cloves (Zanzibar is famous for cloves), curry, starfruit, bananas, vanilla (grows on a vine and has to be hand-pollinated because the bees that pollinate them are only found in Mexico) , birdseye peppers (JBP couldn’t even tolerate the sight of them), among others.
The red is the mace and the dark colored nut in the center is what you grind to get nutmeg:
There were a few coconut trees, and one of the local boys gave us a demonstration of climbing the trunk to harvest some coconuts for us. He sang the whole way up, as apparently the rule is that if you’re singing, you can’t be held responsible if a coconut falls on the head of a passerby. Actually, this makes good sense. Of course, I asked to try to climb as well, as it looked so easy. Apparently, a lifetime of practice makes it look easier than it is. I made it up a few feet, at which point I had succeeded in making my clothes filthy and skinning up my arms.
Notice John's shoulder for reference on how high I climbed:
Fortunately, our next stop was the iodine tree, which bleeds the famous antibacterial fluid. After rubbing that salve on my wounds, we progressed though the red mahogany and teak sections, passed through the spice market, and then sat on some mats for a “spice lunch”, which consisted of pilau (spiced rice), coconut curry, and spinach. The food was pretty good, though the pilau had whole cloves and big pieces of cinnamon bark, which proved slightly fibrous. We then headed back to the van in a deluge, which was actually quite refreshing.
That drop you can see on the right of the bark is iodine (click to make it larger). When you cut the tree, it bleeds iodine:
The deluge starting:
We haven't seen daytime rain since September so this was very exciting. The other tourists thought we were a bit strange:
The tour was actually really fun. It was cool to see what the spice plants look like, as aside from things like thyme and basil, we in the Western world don’t ever see spice plants. Here, spices are grown everywhere and are quite a bit cheaper than in the US. Our hotel serves homemade jams at breakfast with a ridiculous amount of vanilla bean in the jam, which is just delicious and not economically feasible in the US.
After the tour, we took the requisite McRun though Stone Town, which is the part of town with very narrow alleys and people who are very interested in giant and tiny Americans running around in the middle of the afternoon.
We have our last night in Zanzibar tonight, and then we head Arusha, in central Tanzania. Stay tuned!
Friday, April 15, 2011
Chumbe Island
Our first full day on Zanzibar was spent on Chumbe Island (confusing that we spent our first day elsewhere but it’s true!). This island is in the Zanzibar archipelago but is one of the smaller islands and was not permanently inhabited until the early 1900s when a lighthouse was built there.
This island now has an eco-resort and allows day-trippers to come over and use their facilities on a limited basis. We left Zanzibar by a 15-ft boat for a 45 minute motor over to the island and it looked gorgeous:
Our first stop was our private “banda” for the day. The bandas (and everything else on the island) were built to exacting eco-lodge standards. The lodges are open-air and constructed entirely of bamboo, coconut trees, and palm trees. The palm tree roof collects water in fill a giant cistern under each banda since there is no fresh-water source on the island. The water runs off the roof and through a series of sand filters before entering the cistern. M, obviously, was fascinated especially when it began to rain and he could see the whole thing close-up. Dirty water from showering is collected, cleaned, and reused in the kitchen garden and all toilets are composting, etc. It was a really neat operation and a far cry from most of East Africa which is littered with plastic water bottles. Since water processing is so time consuming, anyone who can afford it will simply buy water in plastic jugs or bottles. There aren’t trashcans anywhere in public so people just throw them on the ground.
The banda:
Water filtration:
The main reason for our trip was the reef off the island so we headed down to do a little snorkeling. One really unique thing about this reef is that scuba divers are not allowed. Scuba diving is a bit of a double-edged sword in terms of conservation. Done well, it allows people to appreciate and see the biodiversity which makes them more likely to protect it. It is usually not done well. Many companies are eager to get the high-paying folks onto the reef as fast as possible. Using unfamiliar (and sometimes very old) equipment, divers will often empty their air bladders and go crashing into the reef, swim too close to coral, or try to touch or chase corals or other animals because they forget it’s not allowed. This reefs protected status made it some of the best snorkeling I have ever seen:
Less than 20 ft below us were huge corals in colors I have never seen like blue or green. There were tons of fish including some 150-lb grouper (delicious according to M), lobster, and giant clams. JPB’s new camera allows underwater photos so we took a lot.
After about an hour of snorkeling, we retired to the beach for a delicious lunch and then naps in our banda. Since it’s rainy season, we got a storm from 2-4 which was delightful for sleeping since it broke the heat.
We returned back to Stone Town in Zanzibar (the main town on the island) around 5 PM. We showered up quickly before heading back out to happy hour. The Tanzanians are generally acknowledged to be more polite than the Kenyans, even by the Kenyans themselves, so there is significantly less harassment here than in Mombasa. The boys quickly found their favorite spot, Forodhani Park, where they were 30 tables set up selling fresh seafood skewers ready to be grilled to order. M has never met a fish or streetfood that he didn’t like and apparently JPB feels the same way. So, streetfood dinner it was! Tuna, barricuda, crab, prawn, and octopus skewers were all quickly procured and enjoyed:
After filling our stomachs, we headed to a local bar where the chief amusement is watching the car ferry to the mainland load each night. There is no ramp so the ferry comes straight to the beach and then cars race down the beach so they don’t get stuck in the sand narrowly avoiding crashing into other cars and bystanders. This was a source of endless amusement and proves once again that Kenyans (and apparently Tanzanians) can put up with a lot of angst.
This island now has an eco-resort and allows day-trippers to come over and use their facilities on a limited basis. We left Zanzibar by a 15-ft boat for a 45 minute motor over to the island and it looked gorgeous:
Our first stop was our private “banda” for the day. The bandas (and everything else on the island) were built to exacting eco-lodge standards. The lodges are open-air and constructed entirely of bamboo, coconut trees, and palm trees. The palm tree roof collects water in fill a giant cistern under each banda since there is no fresh-water source on the island. The water runs off the roof and through a series of sand filters before entering the cistern. M, obviously, was fascinated especially when it began to rain and he could see the whole thing close-up. Dirty water from showering is collected, cleaned, and reused in the kitchen garden and all toilets are composting, etc. It was a really neat operation and a far cry from most of East Africa which is littered with plastic water bottles. Since water processing is so time consuming, anyone who can afford it will simply buy water in plastic jugs or bottles. There aren’t trashcans anywhere in public so people just throw them on the ground.
The banda:
Water filtration:
The main reason for our trip was the reef off the island so we headed down to do a little snorkeling. One really unique thing about this reef is that scuba divers are not allowed. Scuba diving is a bit of a double-edged sword in terms of conservation. Done well, it allows people to appreciate and see the biodiversity which makes them more likely to protect it. It is usually not done well. Many companies are eager to get the high-paying folks onto the reef as fast as possible. Using unfamiliar (and sometimes very old) equipment, divers will often empty their air bladders and go crashing into the reef, swim too close to coral, or try to touch or chase corals or other animals because they forget it’s not allowed. This reefs protected status made it some of the best snorkeling I have ever seen:
Less than 20 ft below us were huge corals in colors I have never seen like blue or green. There were tons of fish including some 150-lb grouper (delicious according to M), lobster, and giant clams. JPB’s new camera allows underwater photos so we took a lot.
After about an hour of snorkeling, we retired to the beach for a delicious lunch and then naps in our banda. Since it’s rainy season, we got a storm from 2-4 which was delightful for sleeping since it broke the heat.
We returned back to Stone Town in Zanzibar (the main town on the island) around 5 PM. We showered up quickly before heading back out to happy hour. The Tanzanians are generally acknowledged to be more polite than the Kenyans, even by the Kenyans themselves, so there is significantly less harassment here than in Mombasa. The boys quickly found their favorite spot, Forodhani Park, where they were 30 tables set up selling fresh seafood skewers ready to be grilled to order. M has never met a fish or streetfood that he didn’t like and apparently JPB feels the same way. So, streetfood dinner it was! Tuna, barricuda, crab, prawn, and octopus skewers were all quickly procured and enjoyed:
After filling our stomachs, we headed to a local bar where the chief amusement is watching the car ferry to the mainland load each night. There is no ramp so the ferry comes straight to the beach and then cars race down the beach so they don’t get stuck in the sand narrowly avoiding crashing into other cars and bystanders. This was a source of endless amusement and proves once again that Kenyans (and apparently Tanzanians) can put up with a lot of angst.
Subscribe to:
Posts (Atom)