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The Africa Journal

My Two Weeks on a Project CURE Mission

Project CURE Folks and the Kenyan Clinic Staff

(Times are in military time.)

6/21/07 1848 - Washington/Dulles airport. First leg of trip done. The flight was good, a little bumpy leaving Denver. I have a 3 hour layover then on to Heathrow. I’m travelling with Mary F. and Lorraine S. Mary is a Nurse Practitioner. Lorraine is an RN. Mary is sweet and has gentle energy. Lorraine is a go-getter. I’m somewhere in between. I think this will be fun. Art had a hard time this morning with me leaving. I’m betting he cried on the way home. Strangely I didn’t feel like crying. I felt like it at first but was ok after a short time.

6/21/07 1954 - I forgot how much I love airports. I love being in an airport, all the people going places or coming back home from exotic ports of call. Back in the Stapleton days, we used to watch the planes take off & land. The airport was only a few blocks from our house. I used to collect the flight information books from the airlines when we would pick up/drop off folks. Once I was home, I would look at the booklets and plan my trips all over the world. I wish I had kept those. I wonder if they would be worth something now.

6/22/07 1651 - Heathrow Airport. I have been here since 10 AM. I have a few hours to go yet. Mary and Lorraine got a hotel room. Anne (another team member from California who met up with us in D.C.) and I stayed at the airport. I couldn’t afford to split a $200+ room. I napped in the “Quiet Area” but am still really tired though. I’ll sleep on the plane. I will be in Africa tomorrow! WOO-HOO!!! P.S. International airports are fun! Up to now, I had never been in one outside the U.S. There are so many people from all over the world here in this one place. It again re-affirms my feeling of being a citizen of the world.

6/22/07 1846 - Heathrow. I’m sitting in front of a window looking at the plane that will carry us to Kenya. It says “Kenya Airlines” on the side… This is really happening! It’s sinking into my head now that this is real. Oh my God! I’m going to be in Africa tomorrow morning! I took a picture of the plane—a dorky thing to do no doubt but who cares!

6/23/07 0240 - On the plane. We are finally in African air space. I filled out my declaration card. It is REAL! We have 4 more hours to Nairobi. My ankles and feet are swollen from the two days of travel. Overall though, I feel pretty good—tired but good. Anne and I had a relaxing time in Heathrow. Mary and Lorraine went to a hotel for the day. I hope they made the flight. They weren’t in sight when Anne and I boarded. It was hard to scope out the plane, will have to see when we land if they did. So far it has been a good trip. I emailed Art from Heathrow letting him know I was fine. I hope it helps him feel better. I miss him. Now it has hit me, I wish he could share this trip with me but I think this one is for me alone.

6/24/07 0215 - Nairobi. We finally made it! Dr. Sawa put us up in the guest house of the research center/university where he works for the night. He felt we would all be too tired to tolerate an 8 hour drive to Mbita. He was right. I’m up early but will try to snooze more after I write. The research center is called ICIPE (International Center for Insect Physiology and Ecology). They study insect transmitted diseases, mainly malaria. Malaria is a large problem as the organism mutates very quickly making treatment difficult. I took some photos of the center, it’s very pretty here. We are about 100 miles south of the equator and it is very humid here.

Nairobi is an interesting city. It’s a mix of terrible poverty but wants to grow and be a voice in the world. There are cars everywhere, and traffic lights are only decoration. Not quite as bad as Rome but darn close. Driving down the roads you see the Acacia trees filled at one place with huge storks. Several hundred, in fact, perched in the tops of the trees right over the traffic. Other trees are filled with egrets of various colors. There is a crow relative here but much larger and looking like a combination of crow and magpie. The white is on the chest like a bib and goes around the neck. It’s beautiful. Weather—it was cool and very hazy today. This is winter now, we are below the equator, and it is June. Dr. Sawa says Mbita will be warmer.

One other note about Nairobi that startled me—the police and guards around the airport with the machine guns and other heavy weaponry. I didn’t expect that. One other way of knowing I am not in America anymore.

Let’s talk about the team—Dr. Patrick S.: a tall good looking man with an open, generous heart and a ready laugh. He is very smart and well-read regarding world politics. Great energy! He was born about 25 km from Mbita. He studied some in the U.S. for three years. It’s very clear he is trying to help and be of service to his people in any way he can. We are the first team to come help him. I’m so honored to be here. He is 36-years-old.

Dr. Stephanie T.: She is our team leader. A pediatrician, she has been practicing for about five years. She is in her early 30s and I think is trying to figure out her place in the world. She too is very smart, loves to travel and explore. She has a good sense of humour and fun.

Steve T.: Stephanie’s husband. He is a total cutie and sweet as can be. He’s generous, smart, and funny. I really like him. He and Steph are a good match for each other. They like to explore and learn about the world together.

Mary F.: 66-years-old and our senior most member. She’s smart and can be savvy but I don’t think she trusts herself with it completely. She has gentle energy with an open caring heart. She is also an avid bird-watcher; this will be a fun adventure for her.

Lorraine S.: 50 something and a real dynamo! She is a go-getter and hates unfair practices/politics. She is very savvy about the world and has definite opinions on how things can be changed. She is not one to go out quietly but with a bang. She also has a great laugh!

Kathy G.: Early 50s. Whew! She is a petite little cyclone of female energy. She travels a lot and is very politically informed. She has lots of energy, wants to be of service and better the world. She does.

Anne B.: A business manager, 46-years-old. In some ways, she is the most out of place person here. She’s a lesbian w/ 14-year-old twins (boy/girl). She too wants to serve and have her life mean something but underneath is fear. She’s afraid of eating unfamiliar things, and worries a lot. I haven’t really seen her relax yet. She’s always on edge about something, a classic example of “what you fear comes near.” She just “knew” something would happen to her luggage way back at DIA and sure enough it did. Only one bag showed up with us. The other bag hopefully came in last night, but we’ll find out later today.

As I said earlier, Nairobi is a blend of change; growth, poverty, and indecision. The police guards at the entry to the airport are armed with machine guns. Even around the campus here, the guards at the gates are armed and the fence has rolled barbed wire at the top. Some wall tops in the city have glass shards sticking up in the concrete instead of wire. (Note, Dr. S. stated that this was to save money. The wire is very expensive but broken glass can be found anywhere.) I feel safe here on campus but aware at all times. The energy of the land itself is gentle feminine and a powerful force. I’m looking forward to today’s trip to Mbita.

6/24/07 0940 - Mbita, Kenya ICIPE center, St. Jude clinic. Where to start this day? We drove from Nairobi to Mbita in about 12 hours (w/ a two hour lunch break and several restroom breaks). We drove along a northern ridge of the Rift Valley then down into the bottom and through the valley itself. It was truly one of the most beautiful sights I have ever seen. How did Dorothy know she wasn’t in Kansas anymore? She saw the most fantastical sights when she opened her front door after landing in Oz. How did my brain finally register that I was in Kenya? When we drove along the northern ridge of the Rift valley, we came around a curve and there, walking along the same dirt path as his fellow Afrikaners, was a very large male baboon. No one was taken aback at this enormous baboon walking along. The relationship here with the animals is very different than what we have in the States. Here the people realize they are one with all creatures of the earth—they haven’t lost that connection.

In the first part of the valley there was a section of 10 or so km where we saw giraffes, zebras, and gazelles. I was riding in Dr. S.’s car along w/ Stephanie. Later on, a very large hawk landed on the road in front of us, picked up some carrion and flew to its partner alongside the road. I told Steph and Dr. S. about the significance that Native Americans would place on that. Dr. S. was very interested in that.

Africans walk everywhere. Only the rich can afford cars. There is a bus system here, like our greyhound system but the “busses” are not in great shape and one never knows if the next one will really show up as breakdowns are common. There were very few stretches of road where no one was walking somewhere. Some of the paths along the hillsides were scary at best. Let me say a word here about roads in Kenya. I will not complain anymore about dirt roads in the States after having been driven 12 hours over these roads. Wow! These roads are really terrible! We were on them after the rainy season too so they had not been graded down. There were deep ruts, large rocks, and huge mounds that we drove around and over. Dr. S. drove on the roads like a race car driver, Steph was in the front seat, and I was in the back. We were thrown around and we got a huge case of the giggles on the trip. I couldn’t stop laughing at the absurdity of it all. Dr. S. watched us laughing and then he started in on it. It was one of the most funny road trips I have been on up to that point in time. I didn’t know then that another funnier trip was in store for us.

The African landscape: At times the fields of corn, tobacco, and coffee look like the Midwest but then you turn around and see an Acacia tree with the hanging nests of this little tiny bird with a huge voice flying around. Or I see what looks like a grove of pine trees from a distance, and then up close it’s really a type of fern. Livestock and people roam around equally here. The roosters are the biggest I have ever seen. Dr. S. says that’s because they only die for one of three reasons: old age, they stop mating, or they get eaten for a special occasion (death of an important elder, marriage, etc.)

Here in Mbita we are in Masai territory. We saw all ages of Masai men and boys with their cattle and goats. Most of the grass huts from the old days are gone, replaced with tin roof shacks. You can still see some of the grass huts but you have to look closely. They are a tall, proud people. They are also graceful and beautiful. You can tell they are part of the land here and would fit in nowhere else on Earth except here.

The guest housing at the ICIPE center are almost camp like. Kathy and I are sharing a room. It’s a comfortable room; we each have a double bed with mosquito netting hanging from the ceiling. There is a desk and some chairs. There is also a television but they only get one station here. Our balcony faces Lake Victoria and as I write this, I can hear the waves lapping at the shore (NOTE: Lake Victoria is one of the three largest freshwater lakes in the world. You cannot swim in it, however; there is big-time schistosomiasis in this water and also a large amount of hippos). It is very humid but cool right now. It will be hotter here than in Nairobi as we are 1,000 feet lower in elevation. Nairobi was at about 7,200 ft higher than Denver. Fortunately, there is almost always a good breeze because of the lake. That helps a lot.

I understand now why authors have a difficult time describing this place. They all eventually say in one way or another, go to Africa for yourself and then we’ll talk. There is a mystery about this land that is difficult to describe. It feels old here. There are secrets here that the natives know and very few outsiders know about. When I was in Italy with mom, I felt the age of the place because of the buildings and statues. In Africa, those kinds of things don’t exist here. You feel the centuries in the land itself. Time moves here slowly, and it doesn’t care about your rat race back home. You are here now and it will move you into that silent space too.

6/25/07 0655 - Day 1 of clinic. There is enough similarity in the morning bird song to wake me around 6 AM. There is enough difference that I want to see the birds making some of the weirdest calls. There is a morning dove that looks like ours but whose call is different. It has a trill to it that just sounds like the jungle.

I stand on the balcony in the morning clear air. I can hear the roosters and a monkey or baboon from somewhere along the lake shore. Sound carries far in the damp air of morning so who knows how far away it is? There is an electric fence along the lake side of the campus. I was told last night at dinner it’s to keep the hippos from coming onto the campus. They stay in the water in the daytime and come out at night to eat and graze along the shore. There are more deaths from hippos than any other animal. I think it is due to the fact that everyone comes to the waters edge during the day when the hippos are under water. They wash clothes, themselves, dishes and some wind up disturbing a hippo.

Yep, I am SO not in Colorado anymore.

6/25/07 1857 - Mbita Point, end of day 1. Well, we saw approx 125 patients today, from infants to seniors. I did an I&D (incision and drainage) wound care on a 14-year-old girl with a 9 cm laceration on her shin from three days prior. Tomorrow I have two dressing changes and a 0800 ganglion cyst removal w/ Dr. S. We had a week old infant come in with an infected umbilicus (belly button) and sepsis. I got blood and got an IV started but it came out when she started to fight us. She was very dehydrated and her veins were terrible. Dr. S. says we’ll be busier tomorrow now that word is getting out that we are here.

On a different note: I saw my first African eagle. He must have a nest nearby. His darker feathers aren’t the brownish-black of ours but more of a brownish-red. He is a real beauty. I would love a feather from him. It’s so humid and hazy. This is the end of the rainy season but the nights are so hazy I haven’t seen the stars yet, but there’s time yet. It’s time to go to dinner.

6/25/07 2142 - Evening note. I forgot to write on the 6/23/07 note that I called Art that afternoon to let him know I had made it okay. It was so nice to hear his voice. I cried after I got off the phone with him. In fact, I was crying at the end of the conversation. I do miss him a great deal but it is helping me to know he is so supportive of my doing this. It is hard to hear the loneliness in his voice.

One of the hardest adjustments here is our “western” concept of medicine vs. what will actually work for these people. Case in point, the septic infant. Dr. Steph wanted to do the following: CBC, Chem 7, blood cultures, IV drip, and a LP (lumbar puncture). What we actually did do: attempted the IV and got a CBC and glucose. We used a hydration mix of water and a Gatorade-style mix from Steve’s backpack. Hopefully the parents did the transfer to the nearby hospital. We’ll find out tomorrow.

Seeing life like this makes me examine mine pretty closely. They survive on so little here but are happy to give all they have to each other. On the drive here, I asked Dr. S. what the cancer rate is here. He said, and I quote, “We don’t have cancer here because no one lives long enough to get that.” There is a thought that gives you pause. We were silent after that one for a bit.

Tonight at dinner we had our cultural lesson with a man who has lived here for 3 1/2 years as a missionary teacher. The school has 60 percent AIDS orphans in their care and all students get their medical care from the clinic. We were talking about the Kenyan attitude regarding death. He and Dr. S. said that in the days before AIDS, death of someone in the village was a big deal. Everyone mourned. Now, with AIDS, it seems they have all realized they will die young and so looking beyond tomorrow is very hard for them. Where they are trying to change this process is with the children. Give them an education and opportunities and they will see that it doesn’t have to be that way.

I don’t think I have ever been so grateful for all that I have in my life and yet so ashamed of the excess. What I consider “little luxuries” are riches beyond compare to these people. What I make in a paycheck is what they see in a year if they are lucky. Most live on 3-10 dollars a day. I am rich in comparison.

6/26/07 0626 - I mentioned before the morning sounds but let me elaborate a little. I have lived and visited some places with serious amounts of sounds of wildlife. Well, this is the jungle baby! TV shows don’t do justice to the amount of noise there is here. It comes from everywhere and there are so many different kinds, it is almost chaotic but not quite. This is the way it is supposed to sound in the jungle.

6/26/07 1750 - Day 2 of clinic. Dr. S. keeps pushing me to do stuff I know how to do but can’t do in the States because I’m a medical assistant/surgical technician. This morning we did the ganglion cyst removal and all went well. The woman was convinced that a witch had cursed her and this is why she grew this lump on her wrist. Superstitions still run very deep here and so unusual things that grow on the body are usually seen as the product of some sort of sorcery. Dr. S. tries to gently talk to his patients about this and they listen but I’m not sure how much it really changes their minds. I did the dressing change on the girl with the leg laceration. In the afternoon we worked on one of the builders who sliced his thumb open so we stitched him up.

I finished up at about 5-ish after doing a debridement on one of the worst wounds I have ever seen (mind you, this is graphic and one of the most difficult afternoons I have ever had. It scarred me in some ways). Patient's name was Moses and his right ankle/foot were bad—from ankle to base of toes, from side to side all open wound right down to the muscle layer. He got a small wound sometime back in December (6 months prior) which never healed. He went to the hospital once and they cleaned it up and dressed it. He was supposed to go back for further care but didn’t and was doing the care himself. He was using healing herbs on the wound but because he himself was not a healer, he didn’t know to take the old herbage off before placing new herbs on. So the herbs were becoming embedded into the muscle layer and becoming more infected. We are planning on doing a real thorough cleaning tomorrow with an anesthesia block but today I tried to remove all I could with no anesthetic, just a tablet of Oxycodone for him. Scott stood by and helped the patient while I scrapped bits of blackened herbage from his muscle layer. Dr. S. was impressed with my work, I could tell. I told Scott I had earned my beer tonight and he told me he would be proud to buy it for me.

This was VERY hard for me to do—no anesthesia, a spray of “freezing” Dermoblast to try and make it easier for Moses. In the States, he would have had some sort of block and IV sedation, with pain meds to take at home. Here he got spray, Oxycodone courtesy of Kathy (her own pain meds that she brought), and a wet cloth on his head and Scott’s hand to hold. However, he made no sound except to answer when I asked him if he was doing okay. I cannot begin to imagine to pain he felt but because he knew I was trying to help him, he stayed quiet and let me do my work. We’re in the jungle now! Grassroots medicine at its finest, baby!

6/26/07 2110 - Kathy and I are in our room reading some before bed. We can hear the hippos on the shore. Our balcony faces the lake and the shoreline is about 200-300 feet away. We can’t see them, too many trees in the way, but we can hear them. So cool! There are hippos in my backyard.

6/27/07 0650 - Day 3. I can understand now why the campus has the electric fence along the shoreline. The hippos were out there last night in the early morning hours. Several times they made a sound that to my sleepy brain sounded like a heavy piece of furniture being pulled across the floor, then I realized it was coming from outside. One of the guards told me that it was a male hippo making the really heavy sounding noise. He thought it might be from an alpha male making his presence known to a lesser hippo. I hope to see one. Kathy says we’ll see plenty of them in the Masai Mara.

6/27/07 1819 - I’m tired. This morning was busy with procedures. Did another I&D without local. It’s interesting. I’m a healer so I hate causing pain like that, but Dr. S. says unless it’s really bad, no local because these people are already scared. Just cut quickly, be sure of yourself, and do the job. They come expecting it to hurt but if you are confident about your ability, they will take it and still thank you profusely for caring for them.

God, if we even considered doing that in the States, we would be behind bars so quickly. We have so many advantages but I think now some are disadvantages. We are so far removed from it all in our clean antibacterial environments. We consume too much, we buy too much, and we live without purpose. I like my things don’t get me wrong, but I also know that I’m more aware of the rest of the world around me.

These people here are the most patient, giving, and strong people I have ever met. Only the children really cry out when it hurts but even when it’s done and they are settled, they are patient too. They will wait hours to be seen if they are really sick. Some have come for the free meds but we are savvy to them and send them home.

We are seeing malaria here. It’s hard to treat as many go to the “chemist”—a non-medical person who sells meds to anyone who asks. People have a headache, go to the chemist, and he gives them antimalarials. Drug resistance is high here and growing.

This afternoon a group of school girls were here to be seen. None were really sick. They all claimed to have the same vague symptoms—headache, fever, stomach ache, diarrhea that we hear all the time. They were coming over to me and touching my arm, so I touched them back and made them laugh. Teenage girls are the same everywhere—hell, kids are the same everywhere. These girls just loved my hair. The humidity makes the curls very distinct. They kept running their fingers thru it and saying how soft and pretty it was. Need to bring my camera tomorrow.

This is the first day that I felt homesick. I miss Art.

6/27/07 2118 - It’s interesting to see who is adjusting to the environment here and who is having issues. Dr. Steph is a very caring doctor but she is also a “newbie” in many ways having practiced only about 5 years. She wants to do all the bells and whistles for the kids and is getting frustrated because she can’t. She tries to get parents to admit the kids to the hospital but Dr. S. says “no”—the patient can go home and come back either tomorrow or whenever he thinks is necessary. Steph will ask later why he did that and he says these people a) don’t have the money to get there and back, and b) they can care for the child just as well. Steph gets so frustrated at times.

I just keep thinking—people have been living this way for a really long time and will continue to do so long after we are gone back home. We are here to do what we can to make things a little better for these people and learn what we can from them—then we move on, using the wisdom, and carrying those gifts home to our loved ones. I sound so serious and stuff here but this place makes you think about your life. I would like to come back here someday.

6/28/07 1755—A little ill today. Came back to the room around 1030-1100. I felt a migraine coming on and had some diarrhea too. Took a dose of Cipro and Ibuprofen and slept off and on all day. I hate missing clinic but I would rather be down one day than several. I didn’t eat lunch but will have dinner though.

I think I know where the eagle nest is—too bad I don’t have a really good camera. Need a telephoto lens for it. There are also hawks here. Somewhere between 5-10 of them fly around the campus. They love to fly on the currents coming from the lake when the tide changes. It will go from being very still to waves and breezy in mere seconds when the tide comes in. I wish I could go into the water.

6/29/07 1805—I’m sitting by the lake watching the eagle pair (yes, both) go fishing for dinner. I saw one get a fish. Talk about a National Geographic moment. It brought tears to my eyes. Thank you Great Spirit for allowing me to watch them soar on the currents. God, they fly so close. I have had one fly so close overhead I could see individual feathers. Sometimes when one is perched in a tree, it looks right at me as I walk the road to the clinic. I think I know which tree they live in. It’s right behind the clinic itself. Talk about the place being blessed. I hope the picture I took turns out well.

Jean Feist made it in today (NOTE, she is the director of getting teams together for Project C.U.R.E. and this was her first time going to a field clinic). We had lunch with her and she mostly observed us in action, took notes, talked with us about our impressions/improvements/recommendations we have. And we have plenty of the above.

Goddess, this place brings out strong emotions in me. The lake is very rough tonight with the tidal shift. I’m not sure if that is due to a weather system coming in (there are dark clouds coming in from the east) or whether it’s because the full moon is tomorrow night. There are many white caps on the water. I feel so far removed from it all right now. The city and all that is my life seems so far away to me right now. I could almost disappear here. Just me, the lake, my journal, and my crossword puzzle book.

6/29/07 2120-  Dinner conversations here are fun. We compare notes, funny happenings, etc. Scott talked about a kid screaming when he went to take his temp, yelling out “white man!” in Luo. I forget what the actual word is right now but we hear it a lot. I talk about the teenage girls loving my hair and that they can’t quite figure it out. I look sort of white because my skin is light but I have such thick curly hair like theirs but it’s softer. Steph scares some of the kids when she moves too fast to examine them. She hasn’t learned that you approach people here in a slower manner, not like you do back home in America. For many of the kids, we are the first white people they have seen. Anne is great with them. She passes out stickers, friendship bracelets, bandannas, and toys. They LOVE it! They also LOVE to have their pictures taken, especially with the digital cameras where they can see the image right away. I almost caused a riot today. The Mbita International School is next to the clinic and the playground is behind us. Between the two main clinic buildings, you can see the playground. I heard some of the boys drumming on a bucket and singing. I watched them for a bit then I took out the camera. Several boys saw this and jumped over a small hedge and came to the fence to have their picture taken. More kids saw them running to me and they came running! It was like a migration, all of them came running over and laughing! Anne had her camera too and remarked that she was kind of glad there was a fence there. I was too, we would have been run over with enthusiasm.

Back to dinner conversation—Lorraine had a great story. An elderly lady was talking to her about her chronic diarrhea. Lorraine (who is a New Yorker with a good tan) asked what the diarrhea looked like, what color was it? The woman thought about it for a bit, then shyly pointed to Lorraine’s arm and said “that color.” So while all the talk was going on about being white and kids seeing us for the first time, Lorraine pops in and says “well at least you all haven’t been told you are the color of diarrhea!” We all busted up! Dr. S. was laughing so hard he almost fell back in his chair. Too funny!

6/30/07 1600 - Full moon. We saw the hippos this morning. Mary, Lorraine, and Jean went down to the gate to see if any were still on shore. I met them down there. No luck. We walked along our side of the fence on the shoreline and were bird-watching and gabbing. Then we heard it: a very distinctive hippo grunt. I thought it was coming from over on the left along the shoreline. Sure enough, about 300-350 feet out in the water were three hippos. The heads were massive! The cool part was that further down the shoreline were the village women doing their laundry. We watched for awhile. It was so cool. This was a real Africa moment.

The people and animals for the most part coexist well. When an animal kills a human, there is no rushing out to kill that particular animal. They say the human must have done something to make the animal angry or they were just unlucky. There is no blame placed on the creature. The animal was just being itself. We in the States have removed ourselves so much from our environments that it is dangerous.

I would love to bring some things here to make life easier—Kathy and Lorraine want to do a toothbrush drive, but I also don’t want it to change that way. Why? The “unhappiness” these people feel comes from the fact that they know there is a more luxurious life out there but they don’t know the price of such things. They would lose the peaceful center that they have, some have already lost that. Some have gone out, like Dr. S., and come back to serve their own people. If you’re thinking I gaga over Dr. S., you’re right. I am in a way. But not like you think, although he is a tremendously handsome man. I would work with him anytime, anywhere because I respect him. He knows his people, he understands them. He knows they have some beliefs that are considered to be “primitive” but he doesn’t make them feel bad for it. He gently chides them using humor and makes them laugh. Slowly he educates them without demeaning them. The way it should be done. He also knows medicine. He is a smart, funny, compassionate man. His family and this village are very blessed to have him here. He told me I would be welcome anytime. I might take him up on that.

6/30/07 1755-  It’s hard to believe I have been here for a week now. Harder to realize we only have one clinic day left. Monday we are at Rusinga Island.

There’s an ICIPE party tonight—one of the chief admin people is leaving and it is a farewell bash. We are invited as honored guests. There will be food, drink, and dancing—not a bad way to end the week. We estimate we saw close to 800-850 patients this week. Who knows how many we’ll see on Monday? We could top 1,000.

7/1/07 0734 - Sunday. A day for rest. We are going to Mass this morning w/Dr. S. Catholic Mass in Kenya. Interesting.

The party last night was very interesting. Those who talked about the doctor spoke of his patience, kindness, lack of temper, caring, and compassionate ways. He spoke of himself and what he had accomplished at ICIPE in the last 5 years. But he didn’t talk thru his ego about it; merely that he had gotten those things done. You can tell the difference between the tribal man and those who have been “corrupted” by the great white machine because the ego kicks in. By themselves, these people don’t have an ego as we understand it.

The other great part of last night was the meal we had. It’s funny, I have spoken earlier that we Americans are removed from our environment and one of our dishes last night is a case in point. Every day we have been here, there have been three goats tied up by the kitchen. Most of the team assumed that they were for the milk. However, when we walked over to the party, someone noticed that one of the goats was gone. Surprise! It was one of the main dishes, goat stew. It was quite good. A tiny bit gamey but it was good. I think I was the only one in the team who ate it. Everyone else was a little queasy about it. I still think it’s amusing. On the reservation, this wouldn’t have been a big deal. I grew up having venison, fish, and chicken that I knew was freshly butchered. Our society as a whole has no idea where their food comes from.

7/1/07 2131 - So much to write, where to start? We went to mass at Dr. S.’s church. A 2 1/2 hour mass with some of the best music I have heard in church. The choir was awesome! They had great harmonies, clear annunciation, and a wonderful sense of fun, accompanied by drums, tambourines, keyboard, and rhythm sticks in an Afro-Latin-Caribbean style that rocked! Of course, we in the States forget that this is where it all came from musically. It was long but really fun.

This evening we went to Rusinga Island to a resort, Rusinga Island Lodge, for cocktails. What a gorgeous place! We saw the sun set over Lake Victoria—it was stunning. It was slightly hazy and so the sun made some terrific colours in the clouds and on the water. I went out onto the pier over the lake. It was so peaceful and quiet. We could have stayed there for awhile. On the way back to Mbita we realized that the sky was the clearest we had seen so far. It was still a wee bit hazy so we couldn’t get the full impact of the night sky but I did see the Southern Cross for the first time (just like the song). I never thought I would get to see that, it was beautiful! Hopefully the Masai Mara will have clearer skies (away from the humidity of the lake) and we will get the impact of the real night sky. I have heard it is stunning—no lights for hundreds of miles around and we will really see what we have been missing. The full moon tonight is gorgeous. Such beauty here and also such ugliness—it makes my head spin sometimes.

7/2/07 1834 - Last day of clinic and stay at Mbita Point/ICIPE. I’m sitting by the lake watching the sun go down over the top of Rusinga Island. With the haze and wood smoke from the dinner fires, it looks like Bali-Hai from the movie South Pacific. The birds are singing around me, the waves are gently lapping at the shore. It really doesn’t get much better than this—only better if Art were here with me to share this.

Today we had our last clinic on Rusinga in a church. We saw about 150-200 patients. How can I put into words the gratefulness of the people when they shake our hands after we have taken care for them? All of us fully realize that we can’t cure them all for forever and we get frustrated w/ that feeling. We work in health care for a reason—to help people—and here the problems seem insurmountable. One man was so grateful that I had taped the lid of his cough medicine; he had to ride his bike back home 8km and it might have spilled. He took my hand and praised God for sending me here. We have been told by some of the elders that the very fact that we now know of their existence has changed their lives. God knows it has changed mine. My heart and mind are filled with emotion thinking of all the faces and lives that have touched mine.

I saw Moses this morning before we left. (His was the foot debridement I did early on.) He took my hand in his and, with tears in his eyes, told me he knew he would get better because of the care I gave him. (NOTE, Dr. S. told me several months later that his foot was doing great and the skin was growing back over the top of the foot. He had every hope that it would be a complete recovery.) Moses said he would pray for my safe return home and maybe Africa would bring me back someday. We hugged tightly and I told him I would pray for him as well. I cried too because I knew that this time here had opened my heart in so many ways.

Without a doubt, this has been the most rewarding experience of my life. This has been real grass-roots medicine. I would recommend at least one experience like this for every person who says they want to change the world. Ok then, do it. Find an organization and go do it. I also recommend going out of country to do it. The perspective one brings back from something like this is profound. Even our poor in the States have it better than here. How’s that for a mind glimpse? Processing will take a while from this trip. The hard work is now done and it’s time for some fun. Dr. S. is coming with us as our guide to the Masai Mara. We leave tomorrow after breakfast for the safari!

7/2/07 2112 - Mbita Point. Staff of St. Jude clinic: Dr. Patrick S. - head of the clinic; Nick M. - Nurse; George O. - Lab tech; Annie M. - Receptionist; Hellen - Housekeeper. Stellar people, each and every one, they opened the clinic and their hearts to us and made us feel more than welcome; we became part of their St Jude clinic family. They serve their people and do a fine job of it. I am honoured to have been part of this team. Annie’s daughter and niece came by while we were having dinner and gave us a little concert. They sang six songs and read a poem they had written. One of the songs was written by them as well. Beautiful voices!

Given enough opportunity, the children of Africa will be able to change the world. They just need the chance. I haven’t felt more like taking one home with me than I did today. I played tag with some of the kids after clinic. They love to play and laugh with you. This one child who was being seen by Steph—very sick, high fever—simply took my hand as I walked him to the lab, then to Steph. Such trust, it made my heart ache and my eyes tear. They know we aren’t here long enough and that we can’t fix it all. The fact that we try and do what we can with what we have—we smile, hug, hold a hand, and just plain give a shit—is more than enough for them. As the Elders said, the very fact that we know of their existence changes things for all of us.

I know how I seem to be going on about this but how do I put into words what I have experienced here? Maybe there isn’t a way right now. It’s too fresh and the emotions are too high. My heart and mind feel so terrifically full right now. I have never felt this way before.

I have shared with the team that the tribal differences between Native Americans and the Kenyans are not really that different after all. The basic mentality is the same. It’s a mindset of being part of a community, the “we are all one people” concept. This is something I feel that many white people don’t get anymore. I told Dr. S. that this is why I felt more at home right away, we are similar people. He smiled and laughed and said, “Yes, that makes sense to me. You were more at home here because of who you are.” I can’t wait to talk to Mom about this. It will be a long conversation.

7/3/07 1910 - We left Mbita for the Masai Mara. The African landscape is so incredibly beautiful in an ethereal way. The scenery can change so much with just a turn in the road. We are staying in the Mara Springs Lodge just outside the reserve. As we pulled into the camp (very large Army style tents with toilets and showers), we saw lots of elephant dung and baboons. We got our things into the tents, had some lunch, took a quick nap, and headed into the Mara for a short introduction. Short because we left at 4 PM and the gates close at 6 PM. No camera for this trip—this was just for me.

Can I just say WOW! We saw four different kinds of gazelles, wildebeest, water buffalo, giraffes, zebras, elephants, and yes, a pride of lions—three females and two males. I couldn’t get my mind around it for a bit. It was so incredible that I was actually there. Note to anyone reading this—bring a really good camera with a telephoto lens for any safari. You need that lens for the birds in the trees. The female lions came close to the car, about 5-6 feet away. The energy coming from them was just fantastic! These were not the tired, listless cats of the zoo that I grew up with. These were wild cats of Africa with their own power. The elephants were slow, graceful creatures. Their energy feels so incredibly ancient I cannot even attempt to describe. I have a new love for these massive creatures. Giraffes are also long and graceful with certain elegance; they remind me of very tall ballet dancers. Tomorrow we spend the day here.

This is part of the mystery of this land. These creatures that I grew up seeing behind glass or in enclosures are so different from the wild ones I have seen today. The energy coming from the lions was just amazing! To look into their eyes, one can see the wisdom and ferocity that makes them survive in this climate. So alive!

7/4/07 0656 - 4th of July. This will definitely go down as one of the most interesting ways I have spent the 4th of July. We’re spending the entire day on the Mara, from opening to closing. I heard the baboons in the trees last night. The males make particular grunting noises that I think are either mating calls or territory issues.

One interesting note: there is a huge difference between the sounds of the daytime and the sounds of the night time. However, there is a time in the pre-dawn hours when all noise just stops and it becomes silent. It happens somewhere between 4-4:30 AM. All becomes silent. You don’t realize how noisy the jungle is until there is no noise. It’s as if everything is now waiting for the sun to come up. It’s weird but somehow spiritually right.

7/4/07 1816 - Back from safari. I will list the animals I know the names of that I saw today: antelope, several different types of gazelles, hippos, crocodiles, jackals, hyenas, lions, elephants, zebras, giraffes, wildebeest, water buffalo, warthog, ostriches, guinea hens, secretary birds, vultures, eagles, hawks, kites, dik-dik, baboons, blue monkeys, egrets, storks, mongoose, turtle, frog, a black cobra, and numerous birds/butterflies/insects I have no name for.

The best photo opportunity came this morning. We found a pride of lions with their water buffalo kill from the night prior. The buffalo was just a shell when we found them so the cats were all full and happy. There were three other safari cars with us. We all just parked around the cats as they slept, played, and just were big cats being themselves. Two of the females came to lay in the shade of our car. I leaned out the middle window and got a shot of them. They were about 4 feet from me and looking right at me. I felt no fear or anything negative from them. They were well-fed. As long as my energy was one of love, they were ok. It was incredible. They both walked right under my window, so close I could have touched them if I out my hand out. I felt like I was in a Wild Kingdom program. It was just so amazing, I cannot put into words how awesome it was that we were just watching these cats in the middle of the plain. I wanted to touch the backs of the cats as they walked under the window, I could smell them though. It wasn’t a bad smell—just warm grassy cat smell.  

7/4/07 1930 - Had some tea and took a shower. I had to wash my hair. All the dust was making me itch. Teatime is big here, a British leftover. The tea grown here is very good with a rich flavour. I like it.

Anyway, today was just amazing! We got out on the Mara at opening of the gates 6 AM. We drove all over. I forgot to say that Dr. S. was driving us in the ICIPE Toyota Land Cruiser. We went everywhere in that car. Even down a riverbank, through the Mara river and up the other side of the riverbank. Most of us on the team were not sure we would make it but Patrick was sure. So, on we went. I hit my head on the ceiling as we went down the side of the riverbank. Let me tell you here, it was almost a vertical wall. Over the river and through the woods took on a whole new meaning here. We even got lost out there for a while but Patrick knew there was a road. We just wound up driving south until we hit it again. The Mara has a main road that goes all the way around it like a circle so you can always run into it at some point. The southern part of the road runs alongside the border between Kenya and Tanzania (the Masai Mara reserve is the Kenyan part of the Serengeti reserve which is in Tanzania).

At one point, we had to stop and take a bathroom break out in the middle of nowhere. Several of us had to relieve ourselves so the others stood in a circle around us facing out and they watched the grass for animals while we took care of business. Why all this? Because lions are the same color as the grasses and you might not see them until it’s too late. The black cobra we saw was crossing the road ahead of the truck when we finished. I’m not sure how long it was as the head had already crossed the road and was in the grass when we spotted it. Our guesstimate was about 10-15 feet long.

Driving all over the Mara was some of the best fun I have had. We stopped and had lunch under some acacia trees and listened to the breeze and just enjoyed the moment. Once we found our road again on the southern end of the reserve, Patrick recalled a good spot to see crocodiles. We drove and parked, a guard came up and told us that there were many crocs out there today and to be very careful. This area has at least ten armed guards on duty while the park is open because of the numerous crocodiles that reside there. We had to hike in quite a way but once we found the spot, it was well worth it!

There were at least 15 crocodiles on the bank of the Mara river lying in the sun. Boy, let me tell you—these bad boys were huge! There was one, however, that the guards told us about. He is called Uncle Charlie and when he had all of his tail, he was about 25 feet long. He got into a run-in with a hippo and now was about 20 feet long. It was weird looking at him through the binoculars and seeing teeth marks on his tail end.

We also found a pooling place in the river where some 30-40 hippos were hanging out. I took some great pictures of this. One interesting thing about hippos in the water: when it is time to come up for air, the male alpha will stick his head out first to check for danger. Then, through some unknown signal, they all come up about ¼ of the way, stop, then come up all the way. They breathe for 1-2 minutes then all go back under at the same time. The unknown signalling was really something to watch. You never get to see that at a zoo.

I must include here some of the better “Patrick’isms.” He has a way of talking and using certain phrases that just make me laugh. When asked how he is doing today, he might answer “I’m feeling deadly,” meaning feeling fantastic. If he is annoyed he will say “This __ is joking. Go home/school/whatever.” A most profound thought one night when he had one too many Patrick-cocktails was “Dead buffalo do not move.” The Patrick cocktail consists of Coca cola, gin, brandy, and scotch. Whew! When asked if we will get somewhere on time, he will answer “we are there like a problem.” When we asked him if it was legal to drive off road in the Mara like we were (no, it wasn’t really legal), he answered “they know who I am, I have connections.” The car did have diplomatic plates. If someone is getting annoyed or agitated, he will say “they are chaotic.” “Good morning” is said no matter what time of day it is.

7/5/07 1955 - Nairobi airport. It’s hard to realize I am sitting in a busy airport. Note, I’m listening to some twangy-country western music on the overhead system and I do mean twang! I’m listening to some 7-8 different languages being spoken around me and Conway Twitty is being played on the overhead system. Talk about weird! We’re getting ready to go home. Just yesterday we were 4-wheeling it through the Mara in the bush. Maybe it’s a good thing I have a few hours here to start to re-align myself with the modern world before I hit Denver.

This experience is far and above anything I have done to this point in my life. I am so glad I came here. The impact on my life is amazing. I’m not sure to what extent or how deeply I am changed.

Kenya, and much of Africa I assume, is a land of contradictions, incredible beauty and ugliness, traditions, new technology, tribes, and cities. The people are on the verge of coming into their own and you can feel it in the air. Most of all though, at the heart of each Kenyan is family, country, and a relaxed simplicity to the day. Hakuna Matata (in Swahili) means no worries. Each day and event will unfold as it should (just one more similarity to Native American thinking. We have Indian Time—we’ll do it as soon as Great Spirit has us do it. Drives white people crazy on the reservations.)

I told Patrick I would gladly work with him anytime, anywhere. He smiled and told me the same. God willing, we’ll have that chance again.

7/6/07 0844 - It’s the second leg of journey home. I’m flying over the Atlantic on the way to Washington. I’m on my own now. Anne and I flew from Nairobi to Heathrow and we parted there. She lives in San Diego. Jean, Scott, and Steph flew to London on another flight. Kathy is staying in Kenya for another two weeks than she is going to Cairo. She won’t be home until the end of July. Mary and Lorraine stayed in Kenya for another week of safari adventures.

I could tell Patrick was sad to see us go. He made us all promise to keep in email contact. He gave me the bracelet he bought in the Mara made by a Masai woman he knew. It’s a wonderful gift that I will treasure for the rest of my life. Patrick is simply one of the most amazing men I have had the pleasure of not only meeting but working with, side by side. His caring, compassionate heart for his people drives everything he does. We got to meet his family—a beautiful wife and his handsome son. He is smart, funny, and knows how to enjoy life. I learned a lot from him.

I miss the others already. We gelled so quickly and well into a team. Folks had quirks and all but we focused on the work to be done and eventually those quirks just became part of who they were. We laughed a lot, humor kept us going when the reality became almost too much to bear. I am tired though and in need of processing this experience. In that way, it’s almost like Italy. There was so much to see and do after awhile you were just overwhelmed with it all.

My home and my love await me. My life goes on the path with this new experience and I am changed. Incorporating this wisdom, the insights, memories, and stories and sharing with others is what I have to look forward to. I encourage others to follow my lead and to go out there and do something like this too. I recall those lives I touched and who touched mine. For now, I am “Out of Africa” and on my way home.

Final Note, I am still in touch with Dr. S. We email several times a year. He was very happy to see a son of Kenya become our president. Kathy is on my Facebook. Scott and Steph had a baby after we all came back. I think they still travel doing field medicine when they can.

I really do recommend doing something like this to anyone who dreams of changing the world. It will change you in ways you cannot even imagine. You have my total support should you choose to do so.

Some Kenyan Children at the School Next to the Clinic

Dr. Sawa; the Infectious Disease Doctor We Worked With

Crossing the Rift Valley We Saw These Zebras

On Safari in the Masai Mara

Hilary Miminguaquay
Hilary Miminguaquay

I live in Denver, CO and married to the most amazing woman of my dreams. I work in health care, sing with the Denver Women's Chorus and am an improvisation actor. I love books, music, needlework crafts, cooking, walks and much more.

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