What I miss from home:
1) Matt, my parents, my siblings, my grandparents
2) Brushing my teeth without bottled water
3) Knowing how much things actually cost
4) Not eating curry and rice every night for dinner
5) Speaking the language (actually being able to TALK to my patients)
6) Alone time
7) Not having to worry about stepping in fresh cow dung on my walk to work
8) Not being stared at everywhere you go
9) People knowing my name – not just “Hey, muzungu!”
10) Not having to carry toilet paper with you everywhere
11) Driving on the right side of the road
12) Not watching people die on a daily basis
13) Drinking tap water
14) The pace in which you can get things accomplished
15) Being on the same time
16) Being ON time
17) Not having to take malaria prophylaxis
18) My mom to take care of me when I’m sick
19) Matt
20) Katie : (
21) Soy milk
22) Not having to wear a watch
23) Not sleeping under a mosquito net
24) Driving
25) The people
What I love about being here:
1) Being able to walk to work
2) PASSION FRUIT JUICE
3) Always having friends around
4) Weekend excursions
5) Learning the language/culture
6) Trying new things
7) Being popular (haha, they just love me for my hair)
8) Seeing the difference you can make in someone’s life
9) The music
10) The difference a simple smile makes
11) How excited people are to talk about Obama
12) The number of times a day I get asked if I know Obama personally
13) The number of times I get asked if I’m related to Obama
14) The number of times I get asked if Ashley and I are sisters
15) Everyone’s go-with-the-flow attitude
16) Telling Benson Obama called to tell him “hi”
17) The power of a Jolly Rancher
18) Leyah’s enthusiasm
19) Realizing I’m in Africa
20) Talking to the tomato lady
21) Embarrassing Dennis
22) Learning
23) Watching the Kenyan runners
24) Drinking water out of wine and vodka bottles
25) The people
Monday, January 26, 2009
Friday, January 23, 2009
'Cause I'm Your Lady
Tonight was probably the most fun I’ve had since I’ve come to Africa. About 14 of us went out to eat at The Klique as we heard their vegetable pizza was supposed to be delicious. Unfortunately, when we arrived, they claimed the oven was broke. We didn’t quite believe it and think they told us this because they would make more if we each ordered an individual meal. Whatever, it’s the price you pay for being a muzungu. After a good meal and interesting conversation, we decided to head over to The Wagon Wheel. There was a local Luhya (a tribe in Kenya) band playing live music and the place was quite crowded. Upon arrival, we learned they are the most popular band in Eastern and Central Africa – or at least according to them. Anyways, the Kenyans were all out dancing, enjoying themselves to the beat of the drums and African rhythm and we thought, “what the heck, why not?” and joined them out on the floor. They LOVED us! There were so many people on the dance floor that we each had our own dance instructor and learned some of the common dance moves.
All was going well until Nick, an IU medical resident, found himself a lady who liked him a little too much. I’m so used to guys having to help bail me out from dancing with other creep-os and this was the first time I would get to bail a guy out as he was giving me the “come-dance-with-me-get-her-away-from-me eyes.” As I was working my way over to him and picking my path, I realized everyone was looking and pointing at me. Before I knew it, I had been picked up and carried onto stage with the band!! The lead singer took me by the hand, asked my name, introduced me to the crowd, and started to sing his next song. It was all in Kiswahili, so I’m not quite sure what it was about, but I suspect it was a song about a lady as everyone kept pointing at me during the refrain of the song and I heard my name mentioned once or twice. Long story short, I danced on stage holding hands with the lead singer for the entire song (which lasted about 15 minutes!). Eventually I got Alan to come up and dance with me so I wasn’t the only muzungu up there. We danced together and the last few minutes Ashley came up to join as well, but the majority of the time I was up there with all eyes on me! I had a few ladies in the front that kept telling me to move my hips more but I just wanted to holler, “I’M WHITE! I CAN”T MOVE THAT FAST!” So, I was a hit and I got many compliments on my dance moves from the Kenyans and Americans alike. Sonak was in the crowd and I could see him shaking his head as if he was saying, “what are my students doing?!”
Oh, great African memories….
All was going well until Nick, an IU medical resident, found himself a lady who liked him a little too much. I’m so used to guys having to help bail me out from dancing with other creep-os and this was the first time I would get to bail a guy out as he was giving me the “come-dance-with-me-get-her-away-from-me eyes.” As I was working my way over to him and picking my path, I realized everyone was looking and pointing at me. Before I knew it, I had been picked up and carried onto stage with the band!! The lead singer took me by the hand, asked my name, introduced me to the crowd, and started to sing his next song. It was all in Kiswahili, so I’m not quite sure what it was about, but I suspect it was a song about a lady as everyone kept pointing at me during the refrain of the song and I heard my name mentioned once or twice. Long story short, I danced on stage holding hands with the lead singer for the entire song (which lasted about 15 minutes!). Eventually I got Alan to come up and dance with me so I wasn’t the only muzungu up there. We danced together and the last few minutes Ashley came up to join as well, but the majority of the time I was up there with all eyes on me! I had a few ladies in the front that kept telling me to move my hips more but I just wanted to holler, “I’M WHITE! I CAN”T MOVE THAT FAST!” So, I was a hit and I got many compliments on my dance moves from the Kenyans and Americans alike. Sonak was in the crowd and I could see him shaking his head as if he was saying, “what are my students doing?!”
Oh, great African memories….
The White Masai in Tanzania
The internet hasn’t been working very reliably the past week so I’m sorry to have left you on the edges of your seat. This past weekend we went to the Masai Mara (a national park) in southwestern Kenya. This is the northern tip of Serengeti National Park found in Tanzania. This savannah is one of the best world-wide and was absolutely amazing. I can’t begin to describe how wonderful it was so, as a preface, my writings may sound lame…
This trip will always remain so magical to me and I’m unsure any vacation could ever trump it. If anyone has the chance to take a 16 hour car ride through Sub-Saharan Africa I recommend it without reservation. Watching Kenya fly by the car window was quite an event. The topography changed so fast and so frequently it was hard to believe we were still in the same country. We started out in Eldoret, which is located at the edge of the Rift Valley. From there we passed through the mountains which are covered in tea fields which are such a bright, beautiful shade of green it felt like we were driving through a painting. We left before 6am, so the sun was rising as all the workers were busy picking tea leaves with large baskets on their back in the midst of the acres and acres of fields in the morning light. Gorgeous.
My personal favorite part of the trip was when we stopped to fill up the gas tank at a station and the four of us ladies used the restroom. Ashley and I went into our respective stalls (with walls and doors from ground to ceiling) and we each heard a click, a moment of silence, then Ashley saying, “uhm, I think I’m stuck” She was stuck alright. The door knob fell off and there she was. Sarah, Johanna, and I tried body slamming the door and at one point I pulled out a Tae-Bo kick (we’ve been doing these workouts periodically since we’ve arrived) but the dang door wouldn’t move. Eventually I had to go get our driver who saved the day by pulling out some contraption from his pocket and easily flipping the door open like this happened every day. It was pretty entertaining.
From there, we passed through the dessert-like area where the Masai tribe live. Talk about living in isolation. There was nothing there, and I mean nothing…no visible trees, animals, water. Nothing. And these Masai lived in the middle of it. It was so dry and dusty and every so often there would be a cluster of dried mud huts surrounded by brush where numerous families lived. It seemed like such a desolate life, but I suppose if you don’t know anything else, it wouldn’t seem so strange to you. The Masai are beautiful people. They dress in the most brightly colored fabric. They don’t really wear clothes so much as they wrap this cloth around them to make elaborate outfits. Their favored color is red as lions are said to be scared of it and thus shy away from the people. One of their main traits for women and men alike is to stretch out their earlobes. This is seen as beautiful in their culture so all the elders have stretched their earlobes almost to their shoulders. I’m pretty sure I saw a couple earlobes I could put my fist through. (which reminds me, Camille, you’ve been wanting your ears pierced…) They decorate themselves with brightly colored beads which stand out beautifully against their skin and cloth. Their diet mainly consists of meat, milk, and blood (yum). I wasn’t able to take any pictures as the Masai reserve the right to stone you for a photograph. Not a risk I was willing to take. If you’re interested in seeing some info on them (and I highly recommend you do) google “Masai” and read up. They’re very interesting.
Upon passing through the dessert area, we entered the Savannah and eventually came to the Masai Mara. It is named this as the land was unfortunately taken away from the Masai people to form the park. They are generally nomadic people so I suppose when the land was taken away, they just moved to the desert. The savannah is so beautiful, and this is where all the animal action happened! We were told not to expect much as we came during migration season and a majority of the animals move to Tanzania for the dry season. Our driver was great and seemed to have a sixth sense for where the animals were located. He said the animals left in the Mara were Kenyan residents and not allowed to cross the border. Haha! Everyone talks about the Big Five when you go on game drives. This consists of elephants, lions, leopards, rhinos, and water buffalo. We were told it is very rare to see leopards, rhinos, and cheetahs in the mara so we didn’t get our hopes up too much, but we made these animals our goals.
We went on four game drives while there. Two sunrise and two sunset. Our first game drive was Saturday evening and what was the first thing we saw? A giant leopard! Not only that, but he had drug a huge antelope into a tree and was eating it for dinner! We were so close we could hear the bones crunching. I know this sounds morbid, but it was so fascinating that we couldn’t turn away. Apparently this is so rare that even our guide was excited and taking pictures! Beyond the leopard we saw elephants and babies, monkeys, baboons, GIRAFFES, wildebeest, hippos, crocodiles, lions, lionesses, cheetah (four grown cheetah and two baby cubs!! – also rare!), impala, antelope, gazelle, secretary birds, meerkats, warthogs and babies (they look just like Pumba!), zebra, ostriches, antebeasts, hyenas, and basically every other animal you could think of except a rhino. It was a pretty fruitful trip! The best part was that we went down into Tanzania (my second African nation!!!). This is supposedly illegal to do without a visa, but our guide liked us so much that he took us down. (shhh, don’t tell anyone). We also got so close to some lions that I could have reached out and petted them if I wanted to. They’re so cute and fluffy it was kind of hard to resist the temptation. At one point though I locked eyes with one and, while we were staring at each other, I imagined his cat-like reflexes jumping up and snagging me. I closed the window after that.
Ashley and I decided that everything from the Mara can be related back to some Disney film. Mainly The Lion King, but we also found The Rescuers Down Under, Dumbo, and many others being played out in front of us. Luckily we encountered Rafikis, Nalas, Mufasas and Timons rather than Scarface, Shenzi, Banzai, and Ed. I was, however, slightly disappointed we didn’t get to visit Pride Rock.
Our lodge, Keekorok, was another experience in itself. For being in the middle of nowhere it was absolutely amazing! It reminded me of a five-star resort and they served three gourmet buffet meals a day. The best part was that it was not a gated lodge so the animals wandered freely amongst our cabins. We would wake up in the morning to impala outside our door or zebra just outside our window. That would never happen in the states. We had to ensure our doors were locked when we left as the monkeys were quite mischievous and loved to come in and cause trouble. Another best part was the hippo bar! Below our house was a lake where hippos lounged 24/7 and there was an enclosed veranda on the shore where we could sit and watch hippos. They’re such funny, pudgy creatures. We were there for three days/two nights and sadly returned to Eldoret Monday night. It was such a great time and I would love to go back again to relive the magic.
This trip will always remain so magical to me and I’m unsure any vacation could ever trump it. If anyone has the chance to take a 16 hour car ride through Sub-Saharan Africa I recommend it without reservation. Watching Kenya fly by the car window was quite an event. The topography changed so fast and so frequently it was hard to believe we were still in the same country. We started out in Eldoret, which is located at the edge of the Rift Valley. From there we passed through the mountains which are covered in tea fields which are such a bright, beautiful shade of green it felt like we were driving through a painting. We left before 6am, so the sun was rising as all the workers were busy picking tea leaves with large baskets on their back in the midst of the acres and acres of fields in the morning light. Gorgeous.
My personal favorite part of the trip was when we stopped to fill up the gas tank at a station and the four of us ladies used the restroom. Ashley and I went into our respective stalls (with walls and doors from ground to ceiling) and we each heard a click, a moment of silence, then Ashley saying, “uhm, I think I’m stuck” She was stuck alright. The door knob fell off and there she was. Sarah, Johanna, and I tried body slamming the door and at one point I pulled out a Tae-Bo kick (we’ve been doing these workouts periodically since we’ve arrived) but the dang door wouldn’t move. Eventually I had to go get our driver who saved the day by pulling out some contraption from his pocket and easily flipping the door open like this happened every day. It was pretty entertaining.
From there, we passed through the dessert-like area where the Masai tribe live. Talk about living in isolation. There was nothing there, and I mean nothing…no visible trees, animals, water. Nothing. And these Masai lived in the middle of it. It was so dry and dusty and every so often there would be a cluster of dried mud huts surrounded by brush where numerous families lived. It seemed like such a desolate life, but I suppose if you don’t know anything else, it wouldn’t seem so strange to you. The Masai are beautiful people. They dress in the most brightly colored fabric. They don’t really wear clothes so much as they wrap this cloth around them to make elaborate outfits. Their favored color is red as lions are said to be scared of it and thus shy away from the people. One of their main traits for women and men alike is to stretch out their earlobes. This is seen as beautiful in their culture so all the elders have stretched their earlobes almost to their shoulders. I’m pretty sure I saw a couple earlobes I could put my fist through. (which reminds me, Camille, you’ve been wanting your ears pierced…) They decorate themselves with brightly colored beads which stand out beautifully against their skin and cloth. Their diet mainly consists of meat, milk, and blood (yum). I wasn’t able to take any pictures as the Masai reserve the right to stone you for a photograph. Not a risk I was willing to take. If you’re interested in seeing some info on them (and I highly recommend you do) google “Masai” and read up. They’re very interesting.
Upon passing through the dessert area, we entered the Savannah and eventually came to the Masai Mara. It is named this as the land was unfortunately taken away from the Masai people to form the park. They are generally nomadic people so I suppose when the land was taken away, they just moved to the desert. The savannah is so beautiful, and this is where all the animal action happened! We were told not to expect much as we came during migration season and a majority of the animals move to Tanzania for the dry season. Our driver was great and seemed to have a sixth sense for where the animals were located. He said the animals left in the Mara were Kenyan residents and not allowed to cross the border. Haha! Everyone talks about the Big Five when you go on game drives. This consists of elephants, lions, leopards, rhinos, and water buffalo. We were told it is very rare to see leopards, rhinos, and cheetahs in the mara so we didn’t get our hopes up too much, but we made these animals our goals.
We went on four game drives while there. Two sunrise and two sunset. Our first game drive was Saturday evening and what was the first thing we saw? A giant leopard! Not only that, but he had drug a huge antelope into a tree and was eating it for dinner! We were so close we could hear the bones crunching. I know this sounds morbid, but it was so fascinating that we couldn’t turn away. Apparently this is so rare that even our guide was excited and taking pictures! Beyond the leopard we saw elephants and babies, monkeys, baboons, GIRAFFES, wildebeest, hippos, crocodiles, lions, lionesses, cheetah (four grown cheetah and two baby cubs!! – also rare!), impala, antelope, gazelle, secretary birds, meerkats, warthogs and babies (they look just like Pumba!), zebra, ostriches, antebeasts, hyenas, and basically every other animal you could think of except a rhino. It was a pretty fruitful trip! The best part was that we went down into Tanzania (my second African nation!!!). This is supposedly illegal to do without a visa, but our guide liked us so much that he took us down. (shhh, don’t tell anyone). We also got so close to some lions that I could have reached out and petted them if I wanted to. They’re so cute and fluffy it was kind of hard to resist the temptation. At one point though I locked eyes with one and, while we were staring at each other, I imagined his cat-like reflexes jumping up and snagging me. I closed the window after that.
Ashley and I decided that everything from the Mara can be related back to some Disney film. Mainly The Lion King, but we also found The Rescuers Down Under, Dumbo, and many others being played out in front of us. Luckily we encountered Rafikis, Nalas, Mufasas and Timons rather than Scarface, Shenzi, Banzai, and Ed. I was, however, slightly disappointed we didn’t get to visit Pride Rock.
Our lodge, Keekorok, was another experience in itself. For being in the middle of nowhere it was absolutely amazing! It reminded me of a five-star resort and they served three gourmet buffet meals a day. The best part was that it was not a gated lodge so the animals wandered freely amongst our cabins. We would wake up in the morning to impala outside our door or zebra just outside our window. That would never happen in the states. We had to ensure our doors were locked when we left as the monkeys were quite mischievous and loved to come in and cause trouble. Another best part was the hippo bar! Below our house was a lake where hippos lounged 24/7 and there was an enclosed veranda on the shore where we could sit and watch hippos. They’re such funny, pudgy creatures. We were there for three days/two nights and sadly returned to Eldoret Monday night. It was such a great time and I would love to go back again to relive the magic.
Friday, January 16, 2009
Let Them Eat Cake
Marie Antoinette was thought to have used this phrase during a famine caused by a bread shortage just prior to the French revolution in the late 18th century. Upon being alerted that her people were starving due to having little bread to eat, she is said to have replied, "Then let them eat cake."
Sometimes I think this is how the hospital staff feels about our patients. Work seems to be more frustrating by the day, and we seem to be falling further behind. In the states, in order to pass med school, internship, or residency, it is required to come to work everyday. This only makes sense. However, here, the medical students, medical interns, and medical residents generally come whenever they feel like it and this doesn’t seem to be very often.
I am nervous every morning as I walk to work because I don’t know how many of my patients survived the night and I’m generally upset as I walk home from the lack of progress we made throughout the day. I think the most upsetting loss was a 16 year old boy who was wrongly diagnosed with a glioblastoma causing an infarct of a portion of his brain. They do not treat this here and gave the boy little chance of survival on his own. As we watched him lay there day after day, he slowly became weak, stopped moving, became mute, and was unable to breathe completely on his own. He developed a new onset murmur, Janeway’s lesions on his palms and soles of his feet and Osler’s nodes on the pads of his fingertips. These are all classic signs of late stage infective endocarditis in which bacteria grows on the valve of the heart. He was placed on oxygen and had an x-ray of his chest that found a cardiac tamponade needing to be tapped and the fluid tested. Turns out the boy had thrown an emboli of bacteria into his brain causing an infarct while he slowly deteriorated as more of his brain died. His last chance was to tap the fluid and treat with appropriate antibiotics. Problem was, no one wanted to do this and, while they went back and forth about who’s job it was, the boy passed away. Such a loss. I’ve never felt so helpless watching him lay there suffering.
You always know in the hospital when a death has occurred. The culture states that if you do not mourn loudly and very audibly, then you are not grieving properly. So, every time a patient passes away, family members wail and cry loud enough to fill up all four wards. It’s very uncomfortable listening to someone in such distress and wondering if it could have all been easily prevented.
On a happier note, we do make many good saves and those stories are always a welcome relief from the normal day. We found a 16 year old boy with Non Hodgkin’s Lymphoma. I dosed his chemotherapy regimen (first time I’ve ever dosed chemo…a little scary, but I suppose you have to start somewhere) along with prescribing adequate fluids, antiemetics, and pain medications as the doctor did not think to add these (pharmacists can prescribe here). He received his first round of chemo yesterday while we were on the wards and Mercy, a Kenyan pharmacy student I recruited to help me speak Swahili, and I talked with him while he received it. He was very scared and crying, so we sat on his bed and talked with him until he fell asleep. Today he was looking slightly better and his father was there rocking him so he was in brighter spirits. I can only imagine how scary it is to be in the hospital all alone at 16 when you’re unaware of what to expect. I was very happy to see his father today.
We have been without electricity on and off both at the hospital and at our house the past few days. We had a wind storm (which here, during the dry season, equals a dust storm) and this easily knocked the electricity out for a majority of town. We got a good laugh when it went out while Avery was in the shower and he ran into the door. Unfortunately, this also means our internet goes on and off so its been touch and go the past few days.
Tonight (Friday night) we are going in town to listen to a live, authentic African band. Then, we are heading out early in the morning to go to the Masai Mara with a few other people. We will go on some game drives and hopefully see lots of animals. I’ll be sure to include some stories if everyone is interested.
Sometimes I think this is how the hospital staff feels about our patients. Work seems to be more frustrating by the day, and we seem to be falling further behind. In the states, in order to pass med school, internship, or residency, it is required to come to work everyday. This only makes sense. However, here, the medical students, medical interns, and medical residents generally come whenever they feel like it and this doesn’t seem to be very often.
I am nervous every morning as I walk to work because I don’t know how many of my patients survived the night and I’m generally upset as I walk home from the lack of progress we made throughout the day. I think the most upsetting loss was a 16 year old boy who was wrongly diagnosed with a glioblastoma causing an infarct of a portion of his brain. They do not treat this here and gave the boy little chance of survival on his own. As we watched him lay there day after day, he slowly became weak, stopped moving, became mute, and was unable to breathe completely on his own. He developed a new onset murmur, Janeway’s lesions on his palms and soles of his feet and Osler’s nodes on the pads of his fingertips. These are all classic signs of late stage infective endocarditis in which bacteria grows on the valve of the heart. He was placed on oxygen and had an x-ray of his chest that found a cardiac tamponade needing to be tapped and the fluid tested. Turns out the boy had thrown an emboli of bacteria into his brain causing an infarct while he slowly deteriorated as more of his brain died. His last chance was to tap the fluid and treat with appropriate antibiotics. Problem was, no one wanted to do this and, while they went back and forth about who’s job it was, the boy passed away. Such a loss. I’ve never felt so helpless watching him lay there suffering.
You always know in the hospital when a death has occurred. The culture states that if you do not mourn loudly and very audibly, then you are not grieving properly. So, every time a patient passes away, family members wail and cry loud enough to fill up all four wards. It’s very uncomfortable listening to someone in such distress and wondering if it could have all been easily prevented.
On a happier note, we do make many good saves and those stories are always a welcome relief from the normal day. We found a 16 year old boy with Non Hodgkin’s Lymphoma. I dosed his chemotherapy regimen (first time I’ve ever dosed chemo…a little scary, but I suppose you have to start somewhere) along with prescribing adequate fluids, antiemetics, and pain medications as the doctor did not think to add these (pharmacists can prescribe here). He received his first round of chemo yesterday while we were on the wards and Mercy, a Kenyan pharmacy student I recruited to help me speak Swahili, and I talked with him while he received it. He was very scared and crying, so we sat on his bed and talked with him until he fell asleep. Today he was looking slightly better and his father was there rocking him so he was in brighter spirits. I can only imagine how scary it is to be in the hospital all alone at 16 when you’re unaware of what to expect. I was very happy to see his father today.
We have been without electricity on and off both at the hospital and at our house the past few days. We had a wind storm (which here, during the dry season, equals a dust storm) and this easily knocked the electricity out for a majority of town. We got a good laugh when it went out while Avery was in the shower and he ran into the door. Unfortunately, this also means our internet goes on and off so its been touch and go the past few days.
Tonight (Friday night) we are going in town to listen to a live, authentic African band. Then, we are heading out early in the morning to go to the Masai Mara with a few other people. We will go on some game drives and hopefully see lots of animals. I’ll be sure to include some stories if everyone is interested.
Tuesday, January 13, 2009
Kakamega Rain Forest
Caution: This is a long one…
The social aspect of living at IU house is pretty great. It’s similar to living in dorms – just in a house – where all 40 of us live, eat, and work together. The cool thing is we’re all medical and can have some pretty interesting conversations. Someone is always ready to do something and there is never a dull moment. Ashley and I have been waking up every morning before work to run. We get up when the sun rises (around 6am) and take a nice jog through the farm lands close to our house. Sounds good, right? Except we are at an elevation of 5,000 ft. You can really feel the altitude difference in everyday things such as climbing the stairs, walking to work, and exercising. The first day, we about died as it is all hills here. We cracked up when we were both huffing ½ mile down the road and had to walk even though we both run at home. We have worked our way up to 1 ½ miles, but I tell you, it’s hard. Eldoret is the training place for many world class runners specifically for the elevation and hills. Many Olympic gold medalists have trained here and when a pack of them are out running for the morning it really is amazing to watch. They are so lean and fast and look just like on TV during the Olympics. The Kenyans are proud of us though. They even clap sometimes when we go puffing by….which makes us laugh all the harder.
Sonak has a second-hand living room set up with a TV and some game systems (including rock band – Anna’s jealous) and the medical students and residents and the four of us gather to hang out and watch movies. We watched Slum Dog Millionaire which our preceptor, our role model, ripped from the internet. It was very good, I recommend it. Has a nice Bollywood ending to poke fun at.
We also get to play sports in the evenings which are another good way to get some exercise. So far we have only taken part in soccer and volleyball. Ashley and I frequently cream Avery, Alan, and whoever else dares take us on in volleyball. We make a good team.
This brings us up to the past weekend. I explained earlier about our goat-roast on Friday evening. Our Kenyan counterparts in the hospital joined us and it was a great way to socialize and meet others from the hospital. It was just unfortunate a young goat had to lose its life in the process.
How often does one get to go camping in the rain forest? Not many, so sign me up! We left early Saturday morning to head to the Kakamega Rain Forest which is in the Western Province. About a 2 hour drive from where we are in the Rift Valley Province. The drive was incredible as the roads are pretty much potholes within another pothole. Many times we flat out abandoned the roads and drove in the fields next to them. The children were quite excited to see us pass as it’s not everyday you get to see a “muzungu!” as the children yelled and waved at us. This literally translates to “whitey!” which is what they call all foreigners. They were very excited to practice their English such as “Give me my can-dy” (aw, Haiti memories, Julie, they just need to whisper it creepily into our ears) and “How are you? Give me money” and, my personal favorite, “Take me to Chicago.”
So we actually stayed in little cabins as none of us had the foresight to pack tents, sleeping bags, and other camping gear in our carry-on. We stayed at the Rondo Hotel in the middle of the forest where electricity was scarce and animals were high. Within minutes of arriving we were greeted by monkeys chattering in the trees, birds squawking, and mosquitoes buzzing. It was great. As the forest is very deep and grown up, you are not allowed to venture out without a trained guide. Our guide was Joe and he was pretty darn cool. He was very intelligent and taught us about the ecosystem of the forest. He actually trained in forestry at a nearby school and has a deep passion for preservation of the forest. This is a few things he taught us:
- The Luau are the tribe which lives around the forest
- Kakamega is the only rainforest in Kenya and home to 70% of butterfly species in the world
- Three kinds of monkeys, the grey, red, and black and white collubus live here
- Other animals he pointed out were wild pigs, baboons, flying squirrel, mongoose, and small antelope
Dad: You would have loved walking through the woods and checking out the trees, though you couldn’t have brought your saw mill along for furniture. Many of the trees’ bark are used for traditional medicine to treat malaria, upset stomach, fever, and other things. There is also the Demon Tree which is not allowed to be cut down as tribal folklore states if you chop this particular type of tree, it is inviting demons into your home.
Mom: The flowers were absolutely gorgeous and I even saw a chrysanthemum like Grandma has next to the house. Every color you could imagine for flowers…neon orange, pink, and yellow as well as purple, blue, and red. It was wonderful walking through with the massive amounts of butterflies swirling around you. Also, there are native ferns here that grow to be about 7 ft tall. I don’t think you could have hung those off our porch like you do ours at home!
Elliott: Again, the butterflies. Your collection would have quadrupled easily. There was one butterfly in particular I tried to photograph for you. It is called the “map” butterfly as when it closes its wings it looks like the map of Africa. Kakamega is also the home to many species not found anywhere else in the world.
Camille: You would have had to hang tight with your guide as I’m sure you wouldn’t have been able to find your way out. Swinging vines fell from every tree and we attempted to swing across a rapid on one. OK, just kidding, but we would have had fun attempting it together.
Anna: (and Oriana) MONKEYS EVERYWHERE!! Some were particularly cute with babies on their back. The black and white collubus looked kind of like a skunk though with its pattern. I took pictures for you but it will be a bit to get them to you.
I had a hard time focusing on the forest as I was watching my feet closely. Probably the most hypervigilant I’ve been all trip. Kakamega is home to the viper and 17 other poisonous snakes. Yuck.
We hiked most of the day on Saturday including one four hour hike in the evening. We made it to the top of the tallest mountain in the forest to watch the sun set above the canopy of trees. The colors were gorgeous and it was such a feeling of accomplishment knowing we made the 6,396 ft trek to the top – and that’s not including the already 5,000 ft elevation! The sad part of the trip was that the top of the mountain had actually burned the week before and everything was covered in black soot – including us from the knees down.
We made a small stop enroute to the top of the mountain to check out a bat cave. Joe asked us to bring our torches along but, having left that one on the plane as well, I took my flashlight. Mike, a med student, Avery, Alan, Ashley, and I went in with the first group Joe took. We went in the cave about 200 ft before we found the first group of bats. Joe blinded them with the light so we could get pictures of their beady eyes and disgusting little rodent bodies. Everything was going well until Joe wanted to move further into the cave and Ashley decided she didn’t want to pass the bats. The order we were in was the same as I mentioned above: Mike, Avery, Alan, Ashley, and me last. Ashley grabbed onto Alan about the time he stepped in a pile of guano – or maybe it was mud – and she slipped in it too. I’m not sure of the order of events but it ended with Ashley and I screaming and startling the entire cave of bats. They took off flying as the two of us ran toward the entrance leaving our boys and guide behind. No one shared with us that if we kept the light by our faces they would leave us alone, no, instead we ran with bats hitting our faces and brushing our backs and nasty little bat wings fluttering next to our ears. I started half laughing, half screaming, as I thought I would pass out from fright otherwise. I eventually made it to the cave entrance to a bunch of flashes as the other med students, who heard us (and the bats) coming and had their cameras prepared to get us on our run out. They are quite amusing shots and we now have a good story to tell. Unfortunately, we caught jungle fever from the bats and ended up dancing under the moon with vipers. Okay, that’s a lie (only the jungle fever part), but I did it for Scott because he cracks himself up.
We crashed after our hike and woke the next morning for breakfast and our last hike in the forest. We made this one a silent hike which is quite a feat for 12 twenty-something year olds traipsing through the forest. This was nice as it was also Sunday and we got to enjoy the beauty of outside in reflective thought. After a bumpy two hour ride home, we prepared ourselves for the coming day of work. It was a nice weekend to bring all our housemates closer together and to have a little fun exploring the Kenyan terrain. We are already at work planning our next getaway. The possibilities are endless.
The social aspect of living at IU house is pretty great. It’s similar to living in dorms – just in a house – where all 40 of us live, eat, and work together. The cool thing is we’re all medical and can have some pretty interesting conversations. Someone is always ready to do something and there is never a dull moment. Ashley and I have been waking up every morning before work to run. We get up when the sun rises (around 6am) and take a nice jog through the farm lands close to our house. Sounds good, right? Except we are at an elevation of 5,000 ft. You can really feel the altitude difference in everyday things such as climbing the stairs, walking to work, and exercising. The first day, we about died as it is all hills here. We cracked up when we were both huffing ½ mile down the road and had to walk even though we both run at home. We have worked our way up to 1 ½ miles, but I tell you, it’s hard. Eldoret is the training place for many world class runners specifically for the elevation and hills. Many Olympic gold medalists have trained here and when a pack of them are out running for the morning it really is amazing to watch. They are so lean and fast and look just like on TV during the Olympics. The Kenyans are proud of us though. They even clap sometimes when we go puffing by….which makes us laugh all the harder.
Sonak has a second-hand living room set up with a TV and some game systems (including rock band – Anna’s jealous) and the medical students and residents and the four of us gather to hang out and watch movies. We watched Slum Dog Millionaire which our preceptor, our role model, ripped from the internet. It was very good, I recommend it. Has a nice Bollywood ending to poke fun at.
We also get to play sports in the evenings which are another good way to get some exercise. So far we have only taken part in soccer and volleyball. Ashley and I frequently cream Avery, Alan, and whoever else dares take us on in volleyball. We make a good team.
This brings us up to the past weekend. I explained earlier about our goat-roast on Friday evening. Our Kenyan counterparts in the hospital joined us and it was a great way to socialize and meet others from the hospital. It was just unfortunate a young goat had to lose its life in the process.
How often does one get to go camping in the rain forest? Not many, so sign me up! We left early Saturday morning to head to the Kakamega Rain Forest which is in the Western Province. About a 2 hour drive from where we are in the Rift Valley Province. The drive was incredible as the roads are pretty much potholes within another pothole. Many times we flat out abandoned the roads and drove in the fields next to them. The children were quite excited to see us pass as it’s not everyday you get to see a “muzungu!” as the children yelled and waved at us. This literally translates to “whitey!” which is what they call all foreigners. They were very excited to practice their English such as “Give me my can-dy” (aw, Haiti memories, Julie, they just need to whisper it creepily into our ears) and “How are you? Give me money” and, my personal favorite, “Take me to Chicago.”
So we actually stayed in little cabins as none of us had the foresight to pack tents, sleeping bags, and other camping gear in our carry-on. We stayed at the Rondo Hotel in the middle of the forest where electricity was scarce and animals were high. Within minutes of arriving we were greeted by monkeys chattering in the trees, birds squawking, and mosquitoes buzzing. It was great. As the forest is very deep and grown up, you are not allowed to venture out without a trained guide. Our guide was Joe and he was pretty darn cool. He was very intelligent and taught us about the ecosystem of the forest. He actually trained in forestry at a nearby school and has a deep passion for preservation of the forest. This is a few things he taught us:
- The Luau are the tribe which lives around the forest
- Kakamega is the only rainforest in Kenya and home to 70% of butterfly species in the world
- Three kinds of monkeys, the grey, red, and black and white collubus live here
- Other animals he pointed out were wild pigs, baboons, flying squirrel, mongoose, and small antelope
Dad: You would have loved walking through the woods and checking out the trees, though you couldn’t have brought your saw mill along for furniture. Many of the trees’ bark are used for traditional medicine to treat malaria, upset stomach, fever, and other things. There is also the Demon Tree which is not allowed to be cut down as tribal folklore states if you chop this particular type of tree, it is inviting demons into your home.
Mom: The flowers were absolutely gorgeous and I even saw a chrysanthemum like Grandma has next to the house. Every color you could imagine for flowers…neon orange, pink, and yellow as well as purple, blue, and red. It was wonderful walking through with the massive amounts of butterflies swirling around you. Also, there are native ferns here that grow to be about 7 ft tall. I don’t think you could have hung those off our porch like you do ours at home!
Elliott: Again, the butterflies. Your collection would have quadrupled easily. There was one butterfly in particular I tried to photograph for you. It is called the “map” butterfly as when it closes its wings it looks like the map of Africa. Kakamega is also the home to many species not found anywhere else in the world.
Camille: You would have had to hang tight with your guide as I’m sure you wouldn’t have been able to find your way out. Swinging vines fell from every tree and we attempted to swing across a rapid on one. OK, just kidding, but we would have had fun attempting it together.
Anna: (and Oriana) MONKEYS EVERYWHERE!! Some were particularly cute with babies on their back. The black and white collubus looked kind of like a skunk though with its pattern. I took pictures for you but it will be a bit to get them to you.
I had a hard time focusing on the forest as I was watching my feet closely. Probably the most hypervigilant I’ve been all trip. Kakamega is home to the viper and 17 other poisonous snakes. Yuck.
We hiked most of the day on Saturday including one four hour hike in the evening. We made it to the top of the tallest mountain in the forest to watch the sun set above the canopy of trees. The colors were gorgeous and it was such a feeling of accomplishment knowing we made the 6,396 ft trek to the top – and that’s not including the already 5,000 ft elevation! The sad part of the trip was that the top of the mountain had actually burned the week before and everything was covered in black soot – including us from the knees down.
We made a small stop enroute to the top of the mountain to check out a bat cave. Joe asked us to bring our torches along but, having left that one on the plane as well, I took my flashlight. Mike, a med student, Avery, Alan, Ashley, and I went in with the first group Joe took. We went in the cave about 200 ft before we found the first group of bats. Joe blinded them with the light so we could get pictures of their beady eyes and disgusting little rodent bodies. Everything was going well until Joe wanted to move further into the cave and Ashley decided she didn’t want to pass the bats. The order we were in was the same as I mentioned above: Mike, Avery, Alan, Ashley, and me last. Ashley grabbed onto Alan about the time he stepped in a pile of guano – or maybe it was mud – and she slipped in it too. I’m not sure of the order of events but it ended with Ashley and I screaming and startling the entire cave of bats. They took off flying as the two of us ran toward the entrance leaving our boys and guide behind. No one shared with us that if we kept the light by our faces they would leave us alone, no, instead we ran with bats hitting our faces and brushing our backs and nasty little bat wings fluttering next to our ears. I started half laughing, half screaming, as I thought I would pass out from fright otherwise. I eventually made it to the cave entrance to a bunch of flashes as the other med students, who heard us (and the bats) coming and had their cameras prepared to get us on our run out. They are quite amusing shots and we now have a good story to tell. Unfortunately, we caught jungle fever from the bats and ended up dancing under the moon with vipers. Okay, that’s a lie (only the jungle fever part), but I did it for Scott because he cracks himself up.
We crashed after our hike and woke the next morning for breakfast and our last hike in the forest. We made this one a silent hike which is quite a feat for 12 twenty-something year olds traipsing through the forest. This was nice as it was also Sunday and we got to enjoy the beauty of outside in reflective thought. After a bumpy two hour ride home, we prepared ourselves for the coming day of work. It was a nice weekend to bring all our housemates closer together and to have a little fun exploring the Kenyan terrain. We are already at work planning our next getaway. The possibilities are endless.
Sunday, January 11, 2009
Workin' Hard For No Money
Thursday and Friday were my first two official days on the Nyayo wards. I am currently assigned to the all male ward. I believe later we will switch things up so I will spend time in the women’s ward, pediatric ward, and the inpatient psychiatric unit. I will be the only one on the inpatient psych ward as no one else wanted to. My interest in psych prevailed on top of the fact that three psychologists are here from Brown and I can work with them in their research which may get published.
The work here is difficult, and that’s not even factoring in the emotional component. Thursday I rounded with Sonak, my preceptor, so he could show me the ropes. With 30 patients to round on, it took 4.5 hours. My legs and back were killing me. Our main jobs as pharmacists are to order medications when the doctors prescribe them (they do not write orders themselves) as well as ordering medications when we feel they need to be. This means you must hang on to every word the doctor says which is harder than you think because Kenyans are THE most soft spoken people I have ever encountered in my life. On top of this, we must ensure the patient actually receives the medications they are prescribed as the nursing staff here has a tendency to just skip over patients or not give meds if its too time intensive. When we’re talking antibiotics and antiretrovirals, this is a HUGE issue and builds worries of resistance.
I learned a lot from talking with Sonak on Thursday and learned even more just from watching. On a side note, they do not use IV pumps here so there are no set infusion rates. Everything is hung and flows by gravity. I saw a patient in bed receiving a blood transfusion. The bag was hanging on the IV pole, but the nurse hadn’t put the patient’s IV in correctly and so the blood was simply flowing over his arm and onto his sheets so he was literally lying in a gigantic pool of blood. Sonak urges doctors here to not give blood transfusions unless they absolutely can not avoid it as donated blood is not checked for HIV/AIDS or hepatitis which puts patients at an enormous risk I’m sure they are unaware of.
Friday I was to be on my own but I paired up with Evelyn, a pharmacy student from here at Moi. I learned more from her than I thought was possible in one day. I suppose when you don’t know anything there is no where to go but up! She trained me in the therapy of toxoplasmosis, PJP pneumonia, malaria, TB, and cryptococcal meningitis. All of which are not seen often in the states and can be acutely life threatening (some within hours) if not treated properly right away. She was a wealth of information and also very sweet. Rounds on Friday only lasted 2.5 hours as I had a different medical resident (called registrars here) and the attending came so everything was much more efficient.
Friday we also had our first patient pass away. Day 2. There’s no easing your way into this. The lady was up and talking just fine with the team one minute, and ten minutes later she was found dead in her bed. They suspect a pulmonary embolism but no one really knows as x-rays, labs, and every other test takes forever to get back. They also do not do autopsies as they would probably not get much else done with the time they would need to spend on all the deaths. It is just so unfair and frustrating. Kind of feels like a punch in the gut and all the wind is knocked out of you.
It is so bizarre here. Patients are allowed to get up and move around at their leisure. You’ll pass a man in the hallway and, 20 minutes later, you’ll round on him and learn he has a hemothorax with a collapsed lung (blood filling the space between the lung and chest cavity causing the lung to collapse), advanced AIDS, and TB! A patient like this in the states would be in isolation and bed ridden for days on medical orders and here he is strutting around the hallways and outside on the grounds. You can never guess here which the patient is and which a visitor is. The Kenyans are so tough and can put up with a lot. I really respect them. As one Kenyan explained to me, “we are very simple people, but God still smiles on us.”
The work here is difficult, and that’s not even factoring in the emotional component. Thursday I rounded with Sonak, my preceptor, so he could show me the ropes. With 30 patients to round on, it took 4.5 hours. My legs and back were killing me. Our main jobs as pharmacists are to order medications when the doctors prescribe them (they do not write orders themselves) as well as ordering medications when we feel they need to be. This means you must hang on to every word the doctor says which is harder than you think because Kenyans are THE most soft spoken people I have ever encountered in my life. On top of this, we must ensure the patient actually receives the medications they are prescribed as the nursing staff here has a tendency to just skip over patients or not give meds if its too time intensive. When we’re talking antibiotics and antiretrovirals, this is a HUGE issue and builds worries of resistance.
I learned a lot from talking with Sonak on Thursday and learned even more just from watching. On a side note, they do not use IV pumps here so there are no set infusion rates. Everything is hung and flows by gravity. I saw a patient in bed receiving a blood transfusion. The bag was hanging on the IV pole, but the nurse hadn’t put the patient’s IV in correctly and so the blood was simply flowing over his arm and onto his sheets so he was literally lying in a gigantic pool of blood. Sonak urges doctors here to not give blood transfusions unless they absolutely can not avoid it as donated blood is not checked for HIV/AIDS or hepatitis which puts patients at an enormous risk I’m sure they are unaware of.
Friday I was to be on my own but I paired up with Evelyn, a pharmacy student from here at Moi. I learned more from her than I thought was possible in one day. I suppose when you don’t know anything there is no where to go but up! She trained me in the therapy of toxoplasmosis, PJP pneumonia, malaria, TB, and cryptococcal meningitis. All of which are not seen often in the states and can be acutely life threatening (some within hours) if not treated properly right away. She was a wealth of information and also very sweet. Rounds on Friday only lasted 2.5 hours as I had a different medical resident (called registrars here) and the attending came so everything was much more efficient.
Friday we also had our first patient pass away. Day 2. There’s no easing your way into this. The lady was up and talking just fine with the team one minute, and ten minutes later she was found dead in her bed. They suspect a pulmonary embolism but no one really knows as x-rays, labs, and every other test takes forever to get back. They also do not do autopsies as they would probably not get much else done with the time they would need to spend on all the deaths. It is just so unfair and frustrating. Kind of feels like a punch in the gut and all the wind is knocked out of you.
It is so bizarre here. Patients are allowed to get up and move around at their leisure. You’ll pass a man in the hallway and, 20 minutes later, you’ll round on him and learn he has a hemothorax with a collapsed lung (blood filling the space between the lung and chest cavity causing the lung to collapse), advanced AIDS, and TB! A patient like this in the states would be in isolation and bed ridden for days on medical orders and here he is strutting around the hallways and outside on the grounds. You can never guess here which the patient is and which a visitor is. The Kenyans are so tough and can put up with a lot. I really respect them. As one Kenyan explained to me, “we are very simple people, but God still smiles on us.”
Happy Birthday, Mom!
Mom's birthday was on Friday. I wasn't able to post it then, but I was able to talk to her on the phone which was great. So, Happy Birthday, Mom! I love you!
Friday, January 9, 2009
Manje
Creole for "food" because I don't know the word in Kiswahili...
We slaughtered and are roasting a goat tonight over an open fire for dinner.
I may become a vegetarian after this.
The goat was so cute...
We slaughtered and are roasting a goat tonight over an open fire for dinner.
I may become a vegetarian after this.
The goat was so cute...
Thursday, January 8, 2009
Jambo, Rafiki
Kiswahili for Hello, Friends! My time here is paying off.
This morning we had the most amazing juice made from Passion fruit. Delicious. We drank this and ate homemade bread on the way to the airport. We were afraid we were going to miss the flight as we only got there 20 minutes before take off, but our worries were eased when we arrived and realized the four of us made up 1/3 of the passengers and they would hold the plane if needed. We made it just fine.
Our flight to Eldoret went smoothly. It was a pretty unique experience. Our plane was a little twin engine jet that sat about 15 people plus the pilot. I was behind the pilot and one of the propellers was to my left so it was quite loud. The surprising thing was that our flight attendant, who passed out snacks before we took off, was also the co-pilot. Or so we thought until we took off and she turned out to be a STUDENT pilot! She did well though. Just a bit wobbly on the landing but I suppose I would be too trying to land in the middle of a field! We flew low and got a good view of the terrain. I was actually able to watch over the pilot’s shoulder to see out ahead which isn’t a view you get often. I didn’t realize how mountainous Kenya is. We flew to the west and I’m pretty sure we were able to see Mount Kilimanjaro in Tanzania to the south in the far distance.
The airport was a dream. All open air to the 70 degree weather, maybe 20 other people besides us, and all in the middle of the field surrounded by the most beautiful view you’ve ever seen. Our preceptor, Sonak, picked us up from the airport. Here, they drive on the left side of the road and the steering wheel is also on the left. I suppose this is from the strong British influence. Sonak drove us through town and gave us a tour. There aren’t really rules to travel other than “don’t get hit.” So this meant we were weaving in and out of traffic –both sides—and pedestrians at a high rate of speed. Kenya is much greener and cleaner than I expected. I suppose I was expecting to have similar surroundings to Port-au-Prince, Haiti, but there are lots of trees, no humidity, and people pick up after themselves for the most part.
Upon arrival to the IU house we were assigned our rooms (Ashley and I in the Candelabra room and Alan and Avery in the Sausage Tree room). Our rooms are right across the hall from each other and we share a bathroom. It’s nice to have everyone close. We then took a tour of the hospitals in which we will work. I suppose at this time I should take the time to explain for everyone what I’m doing here.
I’m on a two-month Adult Medicine rotation for my last year of pharmacy school. I will be working at Moi Teaching and Referral Hospital (MTRH) as well as AMPATH, a hospital set up specifically for HIV/AIDS patients. Moi University is a medical school named after a past president. Apparently, the tradition here is when someone is elected president in Kenya, he makes significant donations and improvements to his hometown and tribe. This is why there is such a vested interest in the elections, thus helping to explain the post-election violence last winter. (Speaking of, a lot of the violence happened right here in Eldoret and there are still about 1,000 displaced people living in tents on the edge of town). MTRH and AMPATH hospitals are directly next to each other and connected by an outdoor corridor. The center is huge and they are still expanding through donations and grants with a beautiful 3 story mother-and-baby hospital newly built. They are only waiting to open it by hiring staff. MTRH has four wards: males, females, male children, and female children. Each ward has 6 “cubes” and each cube has 8 beds and each bed has 2 patients…this equals a lot of patients. Each of us four will be assigned to a ward. We will find which ward we are assigned to on Monday. The smell of the hospital is unbelievable. You about hit the deck just walking in. Combine body odor, human waste, and just the normal hospital smell from a couple hundred people and multiply that by 1000 and that can give you an idea of what it smells like. The UNC medical resident we are with actually threw up about 5 separate times and had to eventually leave. The tuberculosis prevention mechanism (as you know, TB is contagious and spreads via cough droplets and subsequent inhalation) is open windows at the end of each cube. Not very reliable. This does provide a nice breeze which is nice as it is quite crowded and hot in the hospital. MTRH care is all on the patient to pay. For example, though x-rays cost about 25 cents US, patients can’t afford the cost and usually go without. This also applies to surgeries, medications, and other basic, essential care which is quite discouraging.
AMPATH on the other hand is a free service to HIV/AIDS patients. Currently about 75,000 patients are treated with appointments on a regular basis and free ARVs (antiretrovirals). We are responsible for assuring patient compliance and reviewing patients charts to identify drug interactions and initiate medications where necessary. AMPATH smells better but is just about as crowded a place as Moi.
We were all overwhelmed with our responsibilities we learned on the tour so Sonak gave us the afternoon off to unpack and get settled in to our new Kenyan life. With the 8 hour time difference and travel we were getting pretty sleepy so we took power naps and checked out the IU house compound. For dinner, everyone at the IU house –about 30 of us, went out to eat at an Indian restaurant in town. The med students and residents here were going out to explore Eldoret night life, but we elected to head home and sleep to try and adjust to the time. Everyone keeps telling us to give it a few days and we’ll be pros both at the Kenyan life and our duties at the hospital…I trust they’re right because at this point, the 4 of us are in over our heads. We have to prepare ourselves to work and to work hard. Everything we do is not for our job or because our preceptor asked us to do it. Our work here is to ensure patients survive. And that is motivation in itself.
This morning we had the most amazing juice made from Passion fruit. Delicious. We drank this and ate homemade bread on the way to the airport. We were afraid we were going to miss the flight as we only got there 20 minutes before take off, but our worries were eased when we arrived and realized the four of us made up 1/3 of the passengers and they would hold the plane if needed. We made it just fine.
Our flight to Eldoret went smoothly. It was a pretty unique experience. Our plane was a little twin engine jet that sat about 15 people plus the pilot. I was behind the pilot and one of the propellers was to my left so it was quite loud. The surprising thing was that our flight attendant, who passed out snacks before we took off, was also the co-pilot. Or so we thought until we took off and she turned out to be a STUDENT pilot! She did well though. Just a bit wobbly on the landing but I suppose I would be too trying to land in the middle of a field! We flew low and got a good view of the terrain. I was actually able to watch over the pilot’s shoulder to see out ahead which isn’t a view you get often. I didn’t realize how mountainous Kenya is. We flew to the west and I’m pretty sure we were able to see Mount Kilimanjaro in Tanzania to the south in the far distance.
The airport was a dream. All open air to the 70 degree weather, maybe 20 other people besides us, and all in the middle of the field surrounded by the most beautiful view you’ve ever seen. Our preceptor, Sonak, picked us up from the airport. Here, they drive on the left side of the road and the steering wheel is also on the left. I suppose this is from the strong British influence. Sonak drove us through town and gave us a tour. There aren’t really rules to travel other than “don’t get hit.” So this meant we were weaving in and out of traffic –both sides—and pedestrians at a high rate of speed. Kenya is much greener and cleaner than I expected. I suppose I was expecting to have similar surroundings to Port-au-Prince, Haiti, but there are lots of trees, no humidity, and people pick up after themselves for the most part.
Upon arrival to the IU house we were assigned our rooms (Ashley and I in the Candelabra room and Alan and Avery in the Sausage Tree room). Our rooms are right across the hall from each other and we share a bathroom. It’s nice to have everyone close. We then took a tour of the hospitals in which we will work. I suppose at this time I should take the time to explain for everyone what I’m doing here.
I’m on a two-month Adult Medicine rotation for my last year of pharmacy school. I will be working at Moi Teaching and Referral Hospital (MTRH) as well as AMPATH, a hospital set up specifically for HIV/AIDS patients. Moi University is a medical school named after a past president. Apparently, the tradition here is when someone is elected president in Kenya, he makes significant donations and improvements to his hometown and tribe. This is why there is such a vested interest in the elections, thus helping to explain the post-election violence last winter. (Speaking of, a lot of the violence happened right here in Eldoret and there are still about 1,000 displaced people living in tents on the edge of town). MTRH and AMPATH hospitals are directly next to each other and connected by an outdoor corridor. The center is huge and they are still expanding through donations and grants with a beautiful 3 story mother-and-baby hospital newly built. They are only waiting to open it by hiring staff. MTRH has four wards: males, females, male children, and female children. Each ward has 6 “cubes” and each cube has 8 beds and each bed has 2 patients…this equals a lot of patients. Each of us four will be assigned to a ward. We will find which ward we are assigned to on Monday. The smell of the hospital is unbelievable. You about hit the deck just walking in. Combine body odor, human waste, and just the normal hospital smell from a couple hundred people and multiply that by 1000 and that can give you an idea of what it smells like. The UNC medical resident we are with actually threw up about 5 separate times and had to eventually leave. The tuberculosis prevention mechanism (as you know, TB is contagious and spreads via cough droplets and subsequent inhalation) is open windows at the end of each cube. Not very reliable. This does provide a nice breeze which is nice as it is quite crowded and hot in the hospital. MTRH care is all on the patient to pay. For example, though x-rays cost about 25 cents US, patients can’t afford the cost and usually go without. This also applies to surgeries, medications, and other basic, essential care which is quite discouraging.
AMPATH on the other hand is a free service to HIV/AIDS patients. Currently about 75,000 patients are treated with appointments on a regular basis and free ARVs (antiretrovirals). We are responsible for assuring patient compliance and reviewing patients charts to identify drug interactions and initiate medications where necessary. AMPATH smells better but is just about as crowded a place as Moi.
We were all overwhelmed with our responsibilities we learned on the tour so Sonak gave us the afternoon off to unpack and get settled in to our new Kenyan life. With the 8 hour time difference and travel we were getting pretty sleepy so we took power naps and checked out the IU house compound. For dinner, everyone at the IU house –about 30 of us, went out to eat at an Indian restaurant in town. The med students and residents here were going out to explore Eldoret night life, but we elected to head home and sleep to try and adjust to the time. Everyone keeps telling us to give it a few days and we’ll be pros both at the Kenyan life and our duties at the hospital…I trust they’re right because at this point, the 4 of us are in over our heads. We have to prepare ourselves to work and to work hard. Everything we do is not for our job or because our preceptor asked us to do it. Our work here is to ensure patients survive. And that is motivation in itself.
Wednesday, January 7, 2009
Leavin' On A Jet Plane...
I have just arrived at my hotel in Nairobi, Kenya. It is 10 o’clock pm local time and about 2 o’clock in the afternoon back at home. The flights went well, though very long. I flew with Avery, my cousin, and Ashley, a girl from my pharmacy class. We met up with Alan, our fourth pharmacy student, later in Nairobi. They are who I will be spending all my time with.
Our first leg from Indy to Detroit went fast and was easy other than having to say bye to my family and friends. Detroit to Amsterdam was a long flight but tolerable. We were each able to watch our own movies so I watched The Duchess to occupy 2.5 hours of the 8 hour flight. Being the pharmacists that we are, we were convinced we would get DVTs from the long flight and throw a clot so we made sure to get up and make regular laps around the 777. At one point Avery told us if he passes out to just leave him, which we told him we would.
By the time we reached Amsterdam, we were delirious of sleep deprivation (about 3 am home time) and waited half awake for our connecting flight to Nairobi (another 8 hour flight). I was able to sleep the first 3 hours then watched the movie Blood Diamond. It was really good but probably not the best choice on our way to Africa. It is the true story about conflict diamonds in Sierra Leone and portrays lots of violence and child soldiers. By the end of it I was pretty convinced I was heading into a war zone. We flew through Europe then over Libya, Egypt, The Sudan, Ethiopia, and then finally Kenya. It was incredible seeing the Sahara Desert. Then over the Sudan we passed refugee camps which were astonishing sights. Very heartbreaking, but another eye opener to what we may encounter in Kenya.
By the time Nairobi was in sight, the three of us were miserable and convinced we had pressure sores on our bums. Not to mention how dirty we felt after a full 24 hours of traveling. We gathered our luggage, purchased our visas and met our driver to take us to our hotel for the night in Nairobi. On the way I thought my eyes were playing tricks on me from the lack of sleep. I was staring out the matatu (taxi) window and next to us, on the road, a 15 foot giraffe was walking along!!! In the middle of downtown Nairobi! It was the PERFECT way to start out my African adventure as giraffes are my favorite animal! Our driver then gave us a mini Kiswahili lesson and rolled us out at the Fairview hotel…”the country inn, in town”. Or so they claim. The hotel was wonderful – all white and clean—and we met Alan there. After sending arrival emails to our parents we showered and hit the hay around 12am with a wakeup coming at 5am to catch our flight to Eldoret. A long, but very fun experience!
Our first leg from Indy to Detroit went fast and was easy other than having to say bye to my family and friends. Detroit to Amsterdam was a long flight but tolerable. We were each able to watch our own movies so I watched The Duchess to occupy 2.5 hours of the 8 hour flight. Being the pharmacists that we are, we were convinced we would get DVTs from the long flight and throw a clot so we made sure to get up and make regular laps around the 777. At one point Avery told us if he passes out to just leave him, which we told him we would.
By the time we reached Amsterdam, we were delirious of sleep deprivation (about 3 am home time) and waited half awake for our connecting flight to Nairobi (another 8 hour flight). I was able to sleep the first 3 hours then watched the movie Blood Diamond. It was really good but probably not the best choice on our way to Africa. It is the true story about conflict diamonds in Sierra Leone and portrays lots of violence and child soldiers. By the end of it I was pretty convinced I was heading into a war zone. We flew through Europe then over Libya, Egypt, The Sudan, Ethiopia, and then finally Kenya. It was incredible seeing the Sahara Desert. Then over the Sudan we passed refugee camps which were astonishing sights. Very heartbreaking, but another eye opener to what we may encounter in Kenya.
By the time Nairobi was in sight, the three of us were miserable and convinced we had pressure sores on our bums. Not to mention how dirty we felt after a full 24 hours of traveling. We gathered our luggage, purchased our visas and met our driver to take us to our hotel for the night in Nairobi. On the way I thought my eyes were playing tricks on me from the lack of sleep. I was staring out the matatu (taxi) window and next to us, on the road, a 15 foot giraffe was walking along!!! In the middle of downtown Nairobi! It was the PERFECT way to start out my African adventure as giraffes are my favorite animal! Our driver then gave us a mini Kiswahili lesson and rolled us out at the Fairview hotel…”the country inn, in town”. Or so they claim. The hotel was wonderful – all white and clean—and we met Alan there. After sending arrival emails to our parents we showered and hit the hay around 12am with a wakeup coming at 5am to catch our flight to Eldoret. A long, but very fun experience!
Subscribe to:
Posts (Atom)