Good to be home

... but also bittersweet because we will miss our friends in Kenya!

Sorry that I disappeared for a while... the internet at the IU Compound became very unreliable and I could no longer access the site, let alone post on it, for a few weeks. After that I just got frustrated and stopped trying.

But now, our group is back home in the States, safe and sound. We have all started our next rotations, except for Megan, who has her month off! We had a terrible time trying to get home on British Airways - we were stranded in Nairobi one night, then London a second night, then finally home a full 24 hours behind schedule. With the travel delays, we only had a day back in the States before starting at our next site! Talk about a whirlwind week!

My latest rotation is at a Community Clinic in Lafayette, Indiana. The contrast between the needy in Lafayette and the needy in Africa is amazing. It makes me appreciate everything we take for granted here... running water, shoes, roads, technology. We have so much. We live in a society of just mind-boggling superfluity. In Kenya, the people face life-and-death issues everyday. Their struggles are on an entirely different level. And yet, the Kenyan people are so thankful, gracious, and kind.

I am very thankful for my experiences in Kenya. I hope that you have enjoyed sharing the stories and experiences with me. I welcome your comments, either on the site or email me at athornton@purdue.edu. Thank you, and take care!

Sunrise hike crew. From left: Bhumi, Kathy, Gosia, Amy, Kelly, and Abby




Ken and Megan hang out on the porch at our house in the Rondo campsite.

Kakamega Rainforest

One thing I have learned about Kenyan people is that they have a different perception of time compared to us over-stressed Americans. For example, if you set up a meeting with a Kenyan friend and 10, then rest assured they will be there around 10:30, but certainly by 11. I once attended a class for fourth-year Kenyan medical students, and the professor showed up 40 minutes late! I couldn’t believe that the students simply stayed around and waited – life definitely runs by a different watch here.

So, when we arranged a weekend at the Kakamega rainforest, I was really happy and looking forward to the trip. A group of American women from Utah had gone a few weekends before, and they raved. They told us that it was about 2.5 hours away.

My friend Ken, a local Kenyan associated with the IU program, had other ideas.

“Two and a half hours away!” he exclaimed. “Kakamega? No way – it only takes an hour and fifteen to get there.”

We left at 7:50am on Saturday, and I was pretty dubious. Ken and I joked around about making a bet, but nothing official was done.

At 10:13am, after a gut-jolting ride across pothole-strewn roads, we arrived at our campsite in Kakamega. I gave Ken a glance. “Just as I said!” he proclaimed with a smile, “An hour fifteen to Kakamega.” And I couldn’t help but smile.

The campsite, Rondo, was a beautiful resort-style site, with gorgeous landscaping and delicious food. We stayed in houses with large bedrooms (2 occupants to a room) and a private bathroom for each bedroom – very luxurious accommodations. We had an early lunch, then set off on our first rainforest hike.

We had three guides on the hike – Ben, Abraham, and Wyclef. We started our adventure with a quick tour and history of the Rondo grounds, then entered the forest. Apparently the rainforest at Kakamega was originally over 240,000 hectares, but today spans just 24,000 hectares due to human development and deforestation. The lions, elephants, giraffes, and other large game have permanently left the forest. Today, it is known for butterflies, monkeys, and scientific research. We hiked through both secondary (younger) rainforest, and primary (older, thicker) rainforest. We saw some beautiful birds, flashy butterflies, and noisy monkeys. Mostly, I enjoyed the freshness and serenity of the forest. The hike was pleasant, and not too strenuous; the most stressful part was crossing the rickety clapboard bridges that spanned the small rivers along our path. We continued for about 2 hours, and reached a raging river.

After resting at the riverbed, we continued on the trail and a soft rain began to fall. Mostly we were sheltered by the forest canopy, but eventually we entered a clearing, then hiked through the forest another short ways until the trail ended and we were walking along the road. The rain fell pretty steadily, and I couldn’t help but feel foolish for not taking an umbrella to the rainforest. We finally got back to camp, showered up, and the staff started the fire in our living room fireplace. It was wonderful to spend an afternoon relaxing and enjoying the fire, then at 4pm the staff brought us tea and chocolate cake! At that point, I knew I never wanted to leave – a gorgeous, aromatic fire, delicious cake, hot tea, and good friends. Rondo really knew how to host its guests! We hung out until dinner, which was chicken, potatoes, and carrots. It sounds plain, but it was the first well-prepared American style dinner I’ve had since being in Africa! It was very good.

After dinner, we all played some Catch Phrase. In the game, players must describe a phrase without using any of the words in the phrase, and get their teammates to guess. It is hysterical, because English is a second-language to our Kenyan friends. They are a trip! During the game, our friend Ken would get so excited he couldn’t even talk, he would just wave his hands and say, “Come on, guys!! Come on!!” The Americans also try to use some Swahili to get their team to win. Jeremy was trying to get his team to guess “grated cheese”. The word for “great” in Swahili is “Safi”. So Jeremy tried, “OK, what does ‘safi’ mean?” Unfortunately, we haven’t had many lessons, and the Kenyans have taught us some choice words, so all of Jeremy’s teammates gleefully yell, “SHIT!”

“No, no, no… not MAFI, SAFI!” “Ohhhhhhh.” And the laughter continues.

Needless to say, I about split my gut on several occasions throughout the night. We finally hit the hay because we had a very early start… O’dark thirty (Maria, that one’s for you) we were up and starting our sunrise hike. In the pitch dark, we’re walking through the ditch-covered roads, then into the root-covered forest! Good thing I had my trusty mini Mag-lite! Finally we came to a hill that started as a gradual slope, then suddenly ramped up to a grass-covered cliff of about 90 degrees. My friends persevered, but I will admit I was sucking wind. I am out of shape! Sweating, coughing, and chest heaving, I pulled myself to the top. The view made it all worth it – the rainforest stretched out below us, with snakes of mist twisting through the shallow gullies. As we watched, the sun began to paint the sky and clouds in beautiful hues, then it crested over the horizon and spilled onto the forest and our vantage point. I may have been ornery when I woke up, but in those moments I enjoyed a personal peace that was shared between the onlookers.

After the surnrise, we hiked down the cliff a short ways to the Bat Cave! What sunrise hike is complete without a jaunt in the Bat Cave? The cave was dug and abandoned by gold-miners many years ago. I’m glad I did it, but it was definitely a challenge – close walls, nasty, deep mud, guano everywhere, the humidity and stench… it was pretty rough. However, the bats were really cool, and the pictures we got are also pretty impressive. After the cave we hiked back to camp and showered up, then enjoyed an awesome breakfast – bacon and eggs, one of my all-time favorites! Another treat I hadn’t had since coming to Africa is bacon. I had been craving it, and my vegetarian friends helped me out by donating their bacon to the cause! After breakfast we packed up and headed back to Eldoret – another successful weekend trip completed.

Only three weeks left! And actually, we will be traveling Wednesday through Friday of our last week, leaving only 2 and a half weeks! Time goes by so fast…

Is is worth it to wake up early, on the weekend, in the cold and the dark, hike through the forest, and climb an impossibly steep hill/cliff??

you tell me...

Bhumi, Laurine, Megan and I pose with our Masai host, Jeremiah. Jeremiah is the son of the chief of his village. He showed us around, answered our questions, and helped us shop for goods in the Masai market.

This is one of many photos of our first encounter with elephants. The sun was almost ready to set, giving the entire scene a soft and beautiful glow.

Masai Mara gives me a reason

Masai Mara was an amazing, whirlwind trip, and I can’t believe it is already here and gone. In hindsight, I almost wish we had stayed for another day because there is so much to see in the park.

We left early Friday morning, bumping and careening our way along in the matatu until we reached the smooth roads (about 3 hours into our journey). Along the way, I also had my first experience using an authentic Kenyan restroom, which translates to a hole in a poorly-ventilated stall. If you need details on this, you’ll have to wait until I come back home and we can talk face-to-face. Suffice it to say, it’s a good thing those Kenyan engineers design the operation to be graded toward the hole. In any case, we arrived to the Fig Tree Camp after 8 hours on the road. We grabbed lunch at the restaurant, and discovered that meals at Fig Tree are buffets, with a soup course first, and plenty of desserts! We certainly didn’t go hungry this weekend, especially considering the meals were included!

Next, we brought our bags to our rooms, and prepared for our first game drive. We started out at 4pm, and had two full hours in the park. The first ride was incredible, as everything around us was new. The Mara is different from Lake Nakuru; it is a huge, sweeping stretch of plains, groves, and brushland, where all of Africa’s beautiful wildlife roam free. Well, mostly free. That is, when they’re not surrounded by an intrusive matatu paparazzi! We streaked across the plains, enchanted by the herds of zebras, antelopes, gazelles, and impala. We joked around that the zebras are so commonplace to us now, they don’t even inspire a snapshot. Instead, the adjusted attitude is, “Oh, those are just zebras,” and “Not another zebra!” The real excitement started when we came across our first lions! Actually, we were tipped off by the crowd of matatus (what’s goin on over there?), and found a male lion relaxing in a cool clay enclave while his lioness counterpart hid in the brush above him. We went bananas. Oh my gosh, it’s a lion! And there’s the female! Whoaaaaa. We quickly and astutely took note of the wildlife safari etiquette – when your matatu driver takes you to a good “find”, he jockeys for position with the other drivers to get you as close as he possibly can, within breath-smelling distance if at all possible. He then promptly cuts the engine and all matatu passengers commence to exclaim their immediate feelings to one another in excited, slightly hushed whispers.

Cameras blazing, we showed the lion our appreciation of his majesty. The indifferent lion tolerated us until the lioness made her way down to the enclave to join him. We clicked and clicked, and then the lions did what lions do best. Roar? Et eh. Kill something and eat it? Nope. Gracefully race across the plains? No, no, no. They started getting it on! Embarrassed, I awkwardly put down my camera and tried to decide where to look. Fortunately, my trusty colleagues had better instincts than mine – what did they do? They took a video! We followed the lion pair as they crossed the small stream and then laid down in the grass for a nap. Our driver informed us that adult male lions mate approximately 300 times a week. That’s about twice an hour, non-stop, round the clock. I guess it’s a good thing it only took about 45 seconds. Apparently, the lions rest for at least 15 to 20 minutes after each escapade, so we sat around in the matatu, hushed whispers flying, and waited for the lions to move again. It took about 40 mnutes, but they did finally stir, decided to give the crowd of matatus something to talk about, and then laid down again! After this we took off, because it was obvious that this particular pair were a little more into themselves than doing something exciting like roaring or hunting.

We moved on, viewing more of the “common” Mara wildlife, such as zebras, antelope, and wildebeest. Next, we encountered a pair of young male lions napping with a lioness. No steamy stories here, just plain observation. We took off, and next found a group of elephants grazing in the plains. The sun was at the point where it is just beginning to approach the horizon, casting lovely rose and peach rays across the plains. The elephants looked magnificent, and we took tons of pictures. Happy as clams, we finally had to depart because the park hours were past closing. We saw a gorgeous sunset, and even happened across a trio of startled lions on our way back to the camp. All in all, the first game drive was spectacular. We headed back for dinner, then showered up and crashed because we had an early start the next morning.

Saturday, we woke up early, to start our morning game drive at 6:15am. It was rough getting up so early on a trip, but well worth it – we were out before all of the other matatus, and our dedication paid off; we actually watched the sun rise over the plains, as an adult male lion was passing through. Our driver positioned us perfectly, and we caught some amazing pics. The whole scene was surreal, and exquisitely beautiful. We feasted our eyes on the lions for a while, then took off once the matatu congestion began. We saw a pair of giraffes further out on the plains and caught up with them, a mother-offspring pair. Next, we followed a trio of hyenas for a short ways. It was interesting that two of the three spotted hyenas were wearing collars. Our guide, Eric, told us that they are tracked by researchers. Next, we saw a group of lionesses, including one mother playing with her two young cubs, which was delightful. Other highlights included two more families of elephants, some elands, a vulture, and an owl. Then, it was time to head back to camp to get ready for the Masai village!

This was a remarkable and unique experience, and I am very glad we went. To keep things brief, we got to tour a Masai village. The Masai are one of the oldest tribes, and most Masai people still keep the Masai cultural traditions, which include specific ceremonies, certain dress and decoration, and a nomadic lifestyle. We got to see and participate in the women’s dance, tour and learn about a Masai home, and see the men dance. I really enjoyed it, and our host, Jeremiah, was wonderful about answering our questions and explaining the traditions of his people.

We came back to the camp and had some time to enjoy the pool, grab lunch, and take a nap at the pool in the sun. Then, we had our second evening game drive, where we saw hippos for the first time! To be honest, they were a little poky. All you could really see was the top of their heads and their nostrils as they rose to the surface for a breath. I was hoping that they would go up onto the banks of the river, but no such luck. We did, however, get to see a couple of spats where one hippo rubbed another the wrong way and they tussled in the water. They also barked a little bit, which was cool. Then, back to laying around in the cool mud. On this drive, we also saw a male ostrich, more lions and elephants, as well as a wonderful sunset. Then, we headed back to camp for dinner, and rest.

Sunday, we again got up early for a game drive, hoping to see leopards and cheetah. We drove all around for quite a while without any success. The highlights from this drive were a group of giraffes, elands, and a warthog family. Then, we headed back to the camp for breakfast, and then to start the long journey home.

In Kenya, we always hear about the “Big Five”, which are the African animals with the most celebrity: lions, elephants, rhinos, water buffalo, and leopards. Now, I have seen all of the Big Five except for leopards. Leopards are usually only seen in Lake Nakuru, which we have already visited, and Masai Mara. So, it seems that Masai Mara has given me a reason to return to Africa.

A lion and lioness greet each other in the early morning on the plains of the Masai Mara. Herds of antelope and zebras keep their distance from the well-respected pair. In the distance, hot air balloons are just setting off on their adventures.

Now that's what I call a successful weekend of shopping! Kelly (left), and Gosia (right) are showing off their new African masks. There are Masai warriors and women, giraffe-print, and a majestic elephant all on one mask, which is meant to show the connection the African people have with each other and with the animals.

Here we are at Tony's house! The feast put on by Tony and his wife Lucy was amazing - and all from fresh, delicious ingredients! Tony taught us how to make home-made chapati, which are cirles of flat, soft, fried bread. Chapati goes very well with other Kenyan dishes such as sikumu wiki (dark sauteed greens), beef stew, matoke (mashed potatoes with mashed bananas), and mung beans (lentils). Back: Amy, Kelvin, and Jeremy. Middle: Megan, Bhumi, and Gosia. Front: Mwangi, Tony, and Lucy.

African Feast

At IU House, we have some very talented people who make us tasy and nutritious meals for lunch and dinner. I have had spinach casserole (one of my favorites), mung beans (lentils and onions in brown sauce), curry chicken, eggplant vegetable skillet, and countless varieties of ground beef in different sauces. One of the chefs, Julius, is also famous for the cakes he makes. My favorite is the mocha cake - he has only made it once. Now that I'm thinking about it, I should ask him to make it again!

But the reason I got into all of this is because tonight, we had an African feast. One of our colleagues at work, Tony, invited us to come to have lunch at his house, which was extremely generous of him. Now, when I say lunch, it is because we made plans to meet at 12pm. In reality, we left to go grocery shopping at 12pm, finished at 1, met Tony at the matatu station at 1:30, and got to his house around 2. When we got there, his wife, Lucy, had already been cooking, and Tony invited us to sit, relax, and visit. We had a great time! Mwangi, Kelvin, Kelly, Jeremy, Gosia, Bhumi and I hung out, chatted, and listened to rock music (Tony's favorite).

Next, Tony taught us how to make chapati, a traditional African thin bread. From scratch, he made the dough, rolled out the tortillas, and cooked them in the fry pan! He and Lucy made it look easy, but I know better - if I were to attempt to make chapati there's no way they would come out as good-looking and tasting!

After the chapati were made, the table was set. I was incredulous at the amount of food, and all the different types! There was stewed beef with white potatoes, matoke (mashed potatoes with mashed bananas), sikumu wiki (dark greens, my favorite!), a cabbage dish, rice, chapatis, mung beans (the best I have had), another beef dish, a tomato-red onion-parsely salad, it was amazing. And the food was so delicious, so fresh; it was the best meal I have had since I have been in Africa. We all chowed down like we had never seen food before. I had seconds. Then, I had thirds. =) We ate until we couldn't fit another bite, then settled in to relax, tell stories, and hang out. We weren't visiting too long before the dessert came out - fresh fruit salad, with mango, pineapple, and bananas. The fruit here is so sweet and delicious, the fruit salads are out of this world. Somehow, we found room. After this, we were ready to burst.

I couldn't thank Tony and Lucy enough. I told Lucy it was the best food I had had in Africa, and she beamed. What an exceptional cook! It was an honor to get to have lunch with Tony and his family, and I'm sure I won't eat like that again!

An Update on Life in the Wards

Believe it or not, I have just completed Week 3 of being in Africa! I feel like I am finally beginning to get the hang of "Life in the Wards". At the Moi Teaching and Referral Hospital (MTRH) where I work, there are several wards - Men, Women, Pediatrics, etc. For the past week, I have been rounding with the medical staff for the Women's Ward, Firm 1. This means that I round on all the patients on the left side of the Women's Ward. The number of patients can range from 21 to 42 - there are 21 beds, but when space gets tight, we often have two patients to a bed. This past week, we have had an average of 30 patients.

As this is my first clinical rotation, it has been tricky for me to figure out how to keep up with the infinite changes made during rounds. We have patient monitoring forms that we use to keep up to date on the patients' progress, but during rounds we are also resolving out-of-stock medication issues, asking nurses about missed medications, checking doses, looking up drugs that are specific to Kenya and not seen in the US, trying to answer drug info questions, the list goes on. Add to this the fact that medical rounds sometimes include 10-12 medical students and Kenyan people tend to murmur when they speak (including when they present patient cases), and you will see that it is a difficult environment for a pharmacy student to tackle! Imagine a large team of 15 people trying to huddle around a single patient's bed while nurses maneuver through, birds squawk outside, patients across the room are calling out, and a maintenance crew is using a power drill to hang new curtain railings. Quite a sight!

After medical rounds, we usually try to follow-up on medication issues, and make sure patients are getting the medicines they need. By then, it is usually lunch time, and we walk back to IU House for lunch at 1pm. The walk back is pleasant enough if it is not raining. This past week, there was not a single day when it didn't rain. When the rains really get nasty, the entrance to the hospital floods, and parts of the roads become great, muddy rivers. The mud is this red clay that looks terrible on clothes and gets all over everything. It is impossible to look professional and well put-together when you have just tromped through the mud for 15 minutes! Add to this the fact that matatu drivers make sport out of polka-dotting the muzungus (white people, aka us) by splashing us as they drive through the puddles, and you will see that the walk home is sometimes a bigger adventure than the morning rounds!

After rounds we usually have a meeting with our preceptor, where we review patients and have educational presentations on common disease states and medications. Then, we go back to the hospital to follow up on any loose ends and review charts!

I am happy that I am finally getting to know some of the staff at the hospital. We work closely with nurses, doctors, students, and pharmacy staff, and it is challenging to remember so many names, faces, and titles. My goal for next week will be to know all of my nurses - they are our right-hand people, as they are responsible for administering meds to the patients. Without them, patient care does not happen!

But, that's thinking about Monday - for now, I'm going to think about shopping and actually getting some sleep this weekend!

We are on the porch of the bar at our campsite in Jinja, Uganda. The Nile River is behind us - we rafted past this spot earlier in the day! From left, Abby, Megan, Kelly, Gosia, Priti, and I.

Adventures on the Nile

For our second safari, we thought big… and took off across the border to Uganda. In Uganda, there is whitewater rafting on the Nile River. There are now plans to put a dam on the Nile, which will end the whitewater rafting in Jinja, Uganda. So, obviously we had to go!

We started out on Friday afternoon and arrived at around 7pm. The company is called Nile River Explorers, and they have a campsite with bandas (simple huts) and dormitory-style rooms with several bunk beds per room. We were a group of 17, and took up several rooms and a banda! We went to a restaurant called The Black Lantern for dinner, right onsite. Gosia and I split our meals – so we each tried chicken curry and tilapia (from the Nile!) curry. I preferred the tilapia – it was very fresh and well-spiced. Feeling refreshed and well-fed, we headed up to the campsite’s social center, the bar. There is a beer called the Nile Special, which of course we had to try. I liked it – it was light, crisp, and kind of hoppy, with a slightly bitter finish. The bottle was 500ml, and cost about 100 Ksh (about $1.50). How long do I get to stay in Africa, again?

The next morning, we were up early and ready to raft! We had a light breakfast at the Explorer main office, watched some very inspiring clips of yesterday’s rafters, and got ready to take on the Nile! This consisted of walking outside and putting on very fearsome-looking helmets, and our lifejackets, of course. We were taken by truck to the Nile, where we divided up into groups of 7 and met our guides.

My group decided we were going to go all-out and take on the toughest rapids, instead of taking the calmer, “chicken” way. I had Rhonda, Natalie, Stacy, Kelly, Gosia, and Peter in my raft, and we were total whitewater rockstars. Some people had been rafting in the states, including Rhonda, Kelly, and Stacy, for others it was the first time (like me!). Stacy told me in the middle of the trip that rafting in the US has easier grades than we found in Uganda. What a way to start! I’m pretty sure I fell in love with whitewater rafting. The thrill is intense – first, you’re in calm water, and you hear the rushing of the rapids ahead of you. That’s when the chill and rush of adrenaline starts – its do or die time with you pitted against nature! Then, you’re coursing through the rapid, at the complete mercy of the waves and the skill of your guide! During the trip through the rapid, anything can happen. You might sail right through unscathed, everyone in the raft intact and screaming like banshees. Or, you might get thrown off the raft while your friends make it through. You may even have the Nile own you and flip your raft over, spilling your entire crew into the river like ragdolls. It was the most unpredictable, intense, exciting rollercoaster ride you could imagine. The best part is, once you finish one rapid, you paddle through the calm waters until you reach some more!

My favorite rapid was called “Silverback”. A Silverback is another name for the dominant male gorilla of a clan. Our guide, Henry, told us the rapid got this name because when you reach the last wave, it feels like a gorilla crushing you. Our raft lurched and spun through the waves, until finally I felt the scary acceleration as we tipped over the edge. When I looked up, my entire field of vision was enveloped by a wall of water. It was angry and alive, rushing upward in a menacing V-shape, ready to devour us. I held the safety rope with all my might, and the next thing I knew we were on the other side, emerging from the rapid! It was incredible – we couldn’t believe we didn’t tip! We all screamed, laughed, and congratulated ourselves and Henry. It was an amazing high.

One thing I should mention is that the guides on our trip were spectacular. They made a video of our group, and I bought it – I will see if I can post some clips from it, but the connection here is very slow and I’m not too sure it will work. In any case, the guides are amazing – they joke around that it’s their first day on the job (but they’ve watched the training video many times!), but the truth is, they knew the river like the back of their paddles. Not to mention, they were spectacular entertainers. Sometimes, even if their whole raft made it through a difficult rapid, they would jump off the boat in celebration, just for fun! They had great skills with maneuvering the rafts safely, as well. For example, when you start out in the morning you go through training. You learn how to paddle, how to take directions, how to float through the rapids on your own if you get knocked out, how to get out from under the raft if it falls on you, you know, all the essentials. Well, one of the commands is, “Get down!!” after which you throw yourself into the belly of the raft, grab onto the safety rope with all you’ve got, and pray like hell you stay in the raft. Mind you, during all this the guide does not “get down” – he steers the raft!!

The last rapid was also a trip – it starts out as a level 6, which is the most dangerous level of rapid. Don’t worry, we disembarked from our rafts and walked around the level 6 stuff, until it was only considered level 4. We did, however, see some of the rescue-kayakers brave the waters, and it was intense! I was afraid they would drown, truly. One kayaker got torn clear out of his kayak, and dislocated his shoulder! However, at the section where we re-joined the water there were a few options – the chicken way, the medium way, and the hard way. My raft was going to take on the hard way, and I was all for it. We started out, entered the rapid, and held on for the ride of a lifetime. Henry yelled, “Get down!!” and I flung myself into the raft and grabbed the rope. We careened around sheets of frothing water when a felt myself being thrown from the raft. I tried to hold on, but I was being twisted and had no chance, so I let go of the raft and took my chances on the river. I was instantly submerged into a ravenous, thrashing cage of water. I tried to hold onto my paddle, but couldn’t swim well enough with it, so I cut my losses and let it go. I was helpless as a child, and without my trusty lifejacket would have stood no chance against the power of the Nile. I finally felt my head break the surface for an instant, and gasped for air before being crushed again under the unrelenting waves. Again I was tossed around and around, with no control. I broke the surface again and took another gasping breath, then had a split second to orient myself into the proper position – feet first, on my back, facing the water in the direction of the current. It was no use – I was instantly enveloped again, and I began to wonder if this fight for survival would ever end. At last I emerged at the end of the most violent waves, and I saw a rescue kayaker paddling furiously towards me. Out of breath, I grabbed onto the handles and was paddled safely to shore. My whole body was exhausted, and I was absolutely humbled by the Nile. The next thoughts I could muster…

That was awesome!!!!

The First Week

How can I summarize a week in another world?

I don't have any experience in hospital pharmacy in the USA, so this has truly been an incredible learning experience for me. I spent the week doing many things - meeting doctors, pharmacists and pharmacy technologists, learning my way around the hospital, working in the many satellite pharmacies, and going on rounds with the medical teams.

The first pharmacy I worked in was Main Pharmacy, which serves mostly out-patients and staff. The women in this pharmacy were friendly and boisterous - they loved to hear me try to speak Swahili! I would counsel a patient, "Mara mbili kwa siku: moja asubuhi, na moja jioni." ("Twice a day - one in the morning and one in the evening") and after the patient walked away they would erupt into giggles. "You did great!" they would tell me, "You're learning fast!" Their laughter was shared with me, not mocking me - they were genuine in their encouragement. The people here are so warm and generous - they have so little, and yet have an enchanting way of making a lot of what they have. Relationships, time, each other. Kenyans take strength from these things. I haven't seen the women in Main Pharmacy for a while - I will have to go and visit them! Amy, Jackie, and Patricia were the key people who helped me. We had a good time!

I also worked in Memorial Pharmacy for a short while and met Joel, Michael, Tom, and Agnes. Samuel is the pharmacist in the "Casualty" pharmacy (the emergency department), and I met Rose, there, too. Tony is the pharmacist in the Nyayo Wards, which are the wards for the Adult and Pediatric inpatients. He works there with Bilhac, Veronica, Beatrice, and Naomi. I'm trying to put down all these names and visualize faces so I can remember them better later! As you can see, there's a lot to keep track of without even getting started on the medicine and the patients!

Speaking of patients, I rounded a couple of times this past week, as well. It was very good to get more experience, and I benefitted very much from rounding with Sonak, my preceptor. He is brilliant, and works very hard for his patients. He makes a great role model. The doctors from the University of Utah are great to round with, as well. They are brilliant, knowledgeable, and do a good job of keeping the group focused on patient care. Sometimes the rounding team is so large that can be difficult! I'm starting to learn where I can make a difference in the hospital - making sure patients get the medicines they need, asking questions, checking doses, etc. With more practice I'm sure I will improve.

Now with the week almost at a close, I am looking forward to the safari we will take on the weekend! Who needs sleep!

Lake Nakuru - the 1st Safari

So for our first weekend adventure, we decided to head out to Lake Nakuru... a moderate-sized Kenyan National Park. We were advised that the park was about 2.5 hours away. I have since learned that Keyan people have a different perspective on time. We left at about 3pm. After 2 hours in the car and no road signs indicating we were anywhere near Nakuru, we asked our driver, Paul, how much longer the trip would be. He told us we were about 2 hours away. True to form, at about 7pm we arrived at Midland Hotel.

We spent all morning Sunday on safari - the matatu has a roof that can be raised for wildlife viewing. We met up with a group of students from the University of Utah, and continued to tour through the park with them. Lake Nakuru is famous for its flamingos, and rightly so - there were millions of them throughout the lake and on the lakeshore. They made a mildly amusing, low honking sound as our matatu approached and we stepped out. We also saw monkeys, warthogs, impala, gazelles, baboons, water buffalo, and zebras. We got up close to some giraffes, and later some white rhinos. I have some great pictures of the wildlife, and if I can figure out how to post them, I will!

After the park, we went to a prehistoric site - Hyrax Hill. Human remains dating back 5000 years were found on the site. There was a small museum with some artifacts and replicas of the skulls. The real skulls are in Nairobi National Museum. We climbed the hill, and soaked in the great view of the Lake and Nakuru.

We ate lunch at a local restaurant, then packed up and headed home! Safari 1 was a great success - now I'm looking forward to white water rafting on the Nile in Uganda next weekend!

Lake Nakuru is famous for its countless flamingoes. They are in the water, on the shore, and in the sky. Our matatu was able to drop us off at the shoreline, where the flamingoes reluctantly made way for us. They also made an amusing din of low-pitched honking.

Thursday and Friday we Toured the Hospital

The hospital we work at is called MTRH - Moi Teaching and Referral Hospital. It is much larger than I thought it would be. There are several wings, and many different units, including Adult wards, Pediatric wards, Hem/Onc Ward, OB/GYN Ward, Newborn Ward, Psychiatric ward, "Casualty" (the Emergency Department), and a few others I am forgetting. The wards are connected by long, outdoor hallways that are lined with beautiful flowering bushes and other lovely landscaping. The outside of the hospital is beautiful, fresh, and welcoming. This is in stark contrast to the inside, as the wards are somewhat dank and foreboding. The Adult wards are called the Nyayo wards. Men and women are in separate wards. Each ward is made up of six large rooms, or "Cubes", three Cubes on each side of the hallway. All three Cubes on one side make up a "Firm". Each rounding team rounds on one Firm within the hospital. The rounding team is made up of Kenyan interns, American doctors, Kenyan medical students, and Purdue pharmacy students. The rounding teams can become very large, and Kenyan people speak unusually softly, like a murmur. Within the hospital, there is so much hustle and bustle, with cacophonous noise interrupting from every direction, that it can be almost impossible to follow the rounds sometimes! Even still, we persevere and do our best.

In our preparatory Kenya class last semester, they warned us about the smells within the hospital. They advised that many times people feel faint and need to stop rounding and rest, since the smells, sights, and cultural differences can be overwhelming. I am glad they prepared us in this way, because I was expecting the worst. The smell is unpleasant, but not overpowering. The most difficult part for me has been dealing with the suffering of the people. Some patients are so sick, it is unlike anything I have seen. One patient was like a skeleton. I was surprised he could move at all, it looked like there was not a strand of muscle in his body. It is heart-wrenching to see the dire needs of these patients and not be able to treat them with the technology and medicines we are so accustomed to having in the US. I have learned about how much we take for granted.

Within each Cube, there are 8 beds - four on each side of the Cube. There is no privacy whatsoever. When necessary, patients are two to one bed. If they are both very ill, they lie head to foot. If one patient is stronger, they will sit on the bed while the other lays. Many times family members or caretakers are in the wards with their loved ones. There are many people cramped into small spaces. Also, if a patient is discharged from the hospital but cannot pay their bill, they must stay in the ward until they or their family can pay. This means that while we are rounding, sometimes we skip over patients. They are not ill, but they cannot go home.

Food for the patients is another issue altogether. There is no breakfast that I know of. Lunch is a thick slice of bread and some gruel. Dinner is not much better. My colleagues and I wonder how patients can gain strength when they are malnourished even in the hospital.

The last thing I will write about is the mops. Kenya is a land of rain and red mud-clay. This red mud-clay necessitates the unending efforts of a fleet of moppers. The moppers shut down half of a hallway to mop mop mop, only to have their efforts ruined when they must switch sides and the traffic takes its toll on their fresh handiwork. In the morning, there are men with buckets full of soapy water who simply throw the water down the outdoor walkways, and then use bristle sweepers to scrub the hallways down. It would be a whimsical sight for a bystander to see so many white coats on their tiptoes trying not to slip in the suds.

Purdue Pharmacy is back! We've just arrived to the IU Complex. Our driver, Daniel, is with us.

The Arrival

The next morning, now Wednesday morning, we got up early and came down for breakfast. It reminded me of breakfasts in Europe - I had an egg, sausage, and a "pancake", which was a slightly sweetened, slightly thickened tortilla. We hopped in the matatu (van) with Daniel again, and set off for Eldoret. Little did we know, it was a 7 hour trip! In the beginning, the ride was fine and the roads were smooth. However, after we got out of the city, we hit the "rough" roads. According to Daniel, when the main roads need repair, they build these rough roads and divert the traffic so the construction can occur. Unfortunately, these rough roads are barely roads at all - they're more like blobs of asphalt between jagged rocks and treacherously deep potholes. Daniel was unfazed, and ploughed through. Another thing about driving in Kenya - there's no right of way. Or, more accurately, the right of way is given to the most aggressive driver! Traffic here is oriented in the opposite way from the US - you drive in the left lane and the driver is on the left side of the car, just like in Ireland. However, since the roads are such a mess, traveling is a free-for-all. That means that if the road has fewer potholes or looks more manageable on the other side of the road, then that's where you drive! Until, of course, the honking oncoming traffic forces the driver to swerve into his own lane at the last minute. It was amazing! We were being rattled around like popcorn, weaving back and forth across the road, and dodging cars and cargo trucks left and right! Add to this that Kenyan people and bicyclists travel along the roadside, and you'll have an idea of what our 7 hour matatu ride was like. There is no shoulder, so the matatus whiz by people's heads! More often than not, the pedestrians and bnicyclists would be carrying large loads of vegetables or firewood, or other goods for the market. I was amazed that we never clipped anyone, and to date I have only seen one truck stuck in the mud and one banged-up matatu. It seems like despite the apparent chaos, it works just fine in Kenya!

We finally arrived at the IU House, and were shown to our rooms. There are several townhouses in the complex, and my room is in the house with the computer lab and the kitchen! Needless to say, I see people quite a bit, because they are usually somewhere in my house! After we got our stuff into our rooms, we went out to dinner (the Wednesday night tradition here) to a wonderful Indian restaurant. They just kept bringing more food! I guess the costs of food and living are much different here, so you can get an incredible spread of food for just a few dollars. We dug in, and really enjoyed the meal. After dinner we went back to our rooms and got settled in before heading to bed!

The Flights

All I can say here is, Loooooooooooooooooooooooooooooooooong. We flew from Chicago to London, and London to Nairobi. While in Chicago, Gosia, Jeff, and I enjoyed our last deep dish pizza for a couple of months! Its strange being in a plane for that long. Each flight was about 8 hours, but it felt like an eternity. You can't move around very well, the bathrooms are eensy weensy, and the food, is well, airplane food. By the time we arrived in Nairobi on Tuesday night, we were pretty tired. We got our bags (all of our luggage came, but 2 trunks carrying supplies for the school were delayed), met our driver, Daniel, and were brought to a lovely bed and breakfast called the Heron Hotel. Feeling totally disoriented as to the time, we crashed in our rooms and tried to get some sleep!

Trip of a Lifetime

Jambo, na Karibu! (Hello, and Welcome!)

Let me start with a quick intro to this site. My name is Amy, and I am a pharmacy student in my last year of school. Right now, I am on an 8-week rotation in Eldoret, Kenya! My school has sent pharmacy students to Eldoret for several years. Last year, it became necessary to take a break in the program. Now, the program is up and running again, and myself and my colleagues are the first group of students to return to Kenya since the break! We are extremely excited about the opportunities that lie ahead of us!

I hope you enjoy the blogs!