Sunday, October 31, 2010

and then it was over...

Ready to go.....

21 at 48....

The three of us ran a 1/2 Marathon as part of the Nairobi Marathon today...21 kilometers! It is my 48th birthday...and this is what I wanted to do?? John was's birthday request, what could he say?
As many of you who know me know...I have always said I wouldn't do longer races, trying to have longevity in my running life...over years, not with miles at one time. Something about being in Kenya...just felt like it was the right thing to do??!
Running here in Kijabe is a challenge. So our "training" consisted of running at elevation, but never going more than our 4 mile distance. 13 miles is a big increase!?!?
Some of you also know of our pedometer addiction. Warren is currently contemplating walking to the gas station for a phone card...He needs only another 2000 steps and he will have 40000!! for the day. His last record was in Rome with Erika...27000 in one day. The thought of walking another 2000 steps sounds incredibly horrible to me. The way Warren looked at the end of the race...maybe he should call it good as well!
As I read over what I have just written I am wondering if we have totally lost our minds...or brain cells to living up too high in the sky!

Thursday, October 28, 2010

out of africa...

Today I finished reading Out of Africa. I think I read it a long time ago, and I love the movie, although the movie is not much like the book. But it is so different reading the book here… an amazing and accurate recollection of this place!

Isak Dinesen basically lived right here, within a few miles of where we are spending our year. Her weather was the same, her views were the same, and the people groups around her were the same.

She starts, In the day-time you felt that you had got high up, near to the sun, but the early mornings and evenings were limpid and restful and the nights were cold.


As she finishes the book she describes her goodbyes, including the grief of saying goodbye to the Kikuyu women on her farm. (Kikuyu are the dominant tribe in Kenya …a very tribally divided place!!...and they are the dominant tribe and language here in Kijabe.) I have also found myself intrigued by the women.

The old Kikuyu women have had a hard life, and have themselves become flint-hard under it.…They were more difficult for any disease to kill off than their men…and they were wilder than the men……They had borne a number of children and had seen many of them die; they were afraid of nothing. They carried loads of firewood---with a rein round their foreheads to steady them---of three hundred pounds, tottering below them, but unsubdued; they worked in the hard ground of their shambas, standing on their heads from the early morning till late in the evening…..And they had a stock of energy in them still; they radiated vitality. The old women took a keen interest in everything…This strength, and love of life in them, to me seemed not only highly respectable, but glorious and bewitching.

Last night Warren was out working on the piki as our neighbor’s helper Aidah walked by, headed home after working all day. I love her. When I need something for my kitchen she happily helps me, when I need to communicate within the local “network” she does it for me, when I look for the strawberry lady she appears because Aidah calls her???...It is like magic, but really it is Aidah. She works so hard but she genuinely feels bad for me when one of us is sick, when we don’t have water, when anything is off…I do think she sees us as more fragile than she is. Which we are! Anyway, Warren offered her a ride home. She already had her arms full, but she asked for a few minutes to cut some grass in a nearby field…with her machete! When Warren met up with her they tied this big load of burlap wrapped grass to the back of the piki , Aidah and her bags got on the back of the bike, and off they went. Warren was gone so long that I was starting to get concerned. When he got home he could not believe how far he had gone…straight up! She walks to the top of the escarpment, loaded like I described, for at least 40 minutes…both directions…every day…6 days/week.

And this morning as she half walked, half jogged by my kitchen window, she purposefully looked for me…and gave the biggest smile and wave…as she always does…

and the game played on????

from a local online news source...

Kenyan Prime Minister Raila Odinga on Sunday sent a message of condolences to relatives and friends of the seven soccer fans who were trampled to death during Saturday night's Kenya Premier League match in Nairobi.

The impatient fans broke into the stadium moments after the match pitting archrivals Gor Mahia and the AFC leopard football clubs began.

Football lovers in the thousands had braved the rainy evening to watch the match between the two teams whose encounters in the local premiership league has historically attracted fanatical supporters to the stadium.

Police and Kenya Red Cross officials said six of the victims were trampled to death as thousands of fans tried to force their way into the Nyayo National Stadium.

The seventh person died at the Kenyatta National Hospital where 11 other fans were undergoing treatment for injuries. AND WE KNOW HOW THIS GOES!

"Our emergency rescue teams are on the ground and they have been able to confirm the deaths of six people whose bodies have been found outside the stadium. They are five males and a female," Kenya Red Cross spokesman Titus Mung'ou said.

"We can also confirm that another person has succumbed to injuries at the Kenyatta National Hospital. That is what we at the Red Cross can say for now because there are several other emergency rescue teams from other organizations involved."

Kenya Football Federation (KFF) chairman Sam Nyamweya says Football Kenya Limited, Kenya Premier league management and the Stadia management board are to blame for being casual about the preparations for the match.

"KFF strongly condemns the mayhem that characterized the otherwise classic match between Kenya's premier soccer clubs (AFC Leopards and Gor Mahia) on Saturday," Nyamweya said in a statement on Sunday.

He called on the government to launch an inquiry to establish what may have caused the stampede during the match between AFC Leopards and Gor Mahia, alleging that tickets for the match were over-printed beyond the capacity of the Nyayo stadium hence the tragedy was inevitable. INEVITABLE??

Earlier this year, football's Word governing body FIFA banned the stadium due to safety and security concerns. Gor Mahia eventually won the game 1-0 following an 87th minute penalty that was converted by Collins Okoth. GAME PLAYED ON??? GOOD TO KNOW THE SCORE!? THE FOOTBALL SCORE AT LEAST, CROWD -7, GAME ON THE FIELD 1-0

A fortnight ago, the Africa Cup of Nations qualifier match between Kenya and Uganda, surging crowds broke the gate to the VIP section of the Nyayo National Stadium but no injuries were reported. WOW...THERE WAS EVEN A TRIAL RUN THAT HADN'T GONE WELL!

Another fan reportedly died in 2005 in another Africa Cup of Nations-cum-2006 World Cup qualifying match between Kenya and Morocco, prompting world football governing body, Fifa, to order the stadium capacity at Nyayo reduced to 26,000 from its 30,000 capacity. OH, A FEW TRIAL RUNS!

BOLD IS MINE OF COURSE...WOW. Life in Kenya....

Wednesday, October 20, 2010

Some Thoughts on Ankles

This last week was interesting in that I relocated two completely dislocated ankles. Two in one week seemed surprising since I relocate an ankle at Northwest about every year or so. The first young man had been in a car accident around three in the morning and friends took him to a nearby hospital. He brought an x-ray that showed a completely laterally dislocated left ankle. The hospital had also fashioned a posterior plaster ankle splint that did a fine job of keeping his leg firmly dislocated. We wouldn’t want the ankle flopping around. He shows up outside the ER around noon in a friend’s car with a referral note from the other hospital. The distal tibia is completely exposed as the skin over the medial malleolus has torn open. I track down a vial of 500mic fentanyl and after 350mics he tolerates me pulling his ankle back into place. He can even wiggle his toes afterwards, and has a good DP pulse. He then went off to the OR for a thorough washout and an ex-fix.
A day or two later another young man shows up straight from a walking injury to his right ankle. He has fallen and suffered a complete medial dislocation with the distal tib/fib exposed and a large skin tear over his lateral malleolus. I find more fentanyl and after giving him 650mics he is still talking on his cell phone but he doesn’t seem to mind when I pull the ankle back into place.
People here are very pain tolerant. They don’t do a lot of screaming/writhing around like I would if I had the same ailment.

Saturday, October 16, 2010

Samuel and family...

Our Maasai friend, Samuel, brought his wife and baby to meet us tonight. They had just been to a staff banquet at the school, where he is a guard, so they were dressed in Western clothing. We had so much fun. Samuel is very interested in all things new and modern...He wanted a Facebook account. So...we set him up. He comes to our house to check his email once in awhile and I am sure it will be Facebook now! He said he knows two other Maasai with Facebook so he was trying to find them.
We took a few pictures to load onto his site...Quite a fun and funny project...
His wife speaks much less English, but she was obviously amused by the whole process.

Wednesday, October 13, 2010

a day in the life...

I was feeling a little down this morning…an email that I read before starting into my day?? The return to our “routine” after a few days away?? The fact that the nursing matron wasn’t there at our “appointed” meeting time…Who knows…
After doing a few errands at the school I headed toward the “dukas” (shops in Swahili and the common name for our shopping area, such as it is!
On my way I ran into Samuel, our Maasai friend who works as a guard for the school. He always greets us with friendly eagerness and openness to chat. We ended up in a conversation about family planning, educating his daughters, preventing early marriage for his children and the cultural challenges of his generation as they seek to help their children have more opportunities for their lives. An obvious privilege to get to be in this conversation!
Then I walked to the vegetable market where my friend Jean followed me out after I made my purchases. I sat on the ground with her where she was taking maize off the cob so it could dry on tarps on the ground…She told me about the different types of foods she cooks and I asked her a million questions. I have no idea what they do with many of the things that are for sale here! I hope we can arrange for her to come and teach me. We can.
After lunch our Swahili teacher, Edward, came. At the end of our lesson we ended up having a chat about differences between here and where we live… He is smart and well informed about many things. He had great questions.
Just before dinner Rachel came over. She was bringing me Samosas. I had fresh cookies so she sat down, ate a few and we had a little chat…about her children and mine, about her husband…who isn’t great, about her very elderly mom…and the funniest…about weight differences in our cultures. She could not believe that thin is considered so beautiful in America. I found a Vanity Fair that Alison gave me for the plane ride and announced…”we will not find one fat, or even chubby person in this magazine…even though America is full of larger people….” She could not believe it…and she did not think those thin people were attractive. She said, “you know, if a woman’s husband leaves her here, they will try to get fatter so he will feel bad and think he shouldn’t have left…” I burst out laughing telling her how we have the same syndrome…just the opposite. The world is crazy…
In the was a perfect day....

Monday, October 11, 2010

Thursday, October 7, 2010

ER thoughts...

The ER is a unique place in any institution and it is no different here at Kijabe Hospital.

There are truisms in ER Medicine that span continents, race, and money:
1. No one who doesn’t have the ER in their blood wants to be in the ER, and lots of people in medicine don’t have it in their blood.
2. There’s no place like the ER to strip away people’s facades and expose who is going to be there when you need them.
3. I’m convinced that the ER is unique in the way the environment encourages connection, dependence, equality of function amongst all the players in the drama, and a sense of “family”.
4. Like any good family, there are many devious subplots in the ER.

For good or bad I am realizing that my goofy personality is starting to come out in the ER here. It has been a month and a half and things have been so new and serious, but just today I noticed that the jokes were starting and people were laughing and situations in the ER were starting to look funny instead of sad and so serious…….I think I’m infecting this place the same way poor Northwest was infected with me. Beware Northwest……the infection will return, and it might be multi-drug resistant and terminal. I’ll Be Back!

we concluded that the petrol was empty!

look closely at labeling on side of truck, and this is with at least 100 people within 50 yards!

Wednesday, October 6, 2010

"Kenyans like everything..."

Today I spent the day in a large van/bus sort of thing with 26 nursing students. We made our way through tea plantations, coffee plantings, banana trees...until we found a very rural health clinic with 3 male community health workers keeping the doors open on a volunteer basis. Their commitment and resolve was amazing, while the attention I drew from the community children was quite humorous. Jane, one of the nursing instructors said to me, "you are like a white elephant that we brought to their town!"...I am just going to focus on the white part...;)
As we were driving along the old hymn "How Great Thou Art" came on the radio in Swahili. The entire bus load sang along.....very cool.
This was quickly followed by Michael Jackson's Beat It, immediately followed by Kenny Roger's and The Gambler...All loudly accompanied by the students...By this time I was incredulous! What kind of a station is this...and how does this work that these students know all of it? Jane,apparently seeing my expression,says, "We are Kenyans. Kenyans like everything..."

Saturday, October 2, 2010


Polepole...slowly in Swahili. (say the e's, like long a) That is a good summary of how things go. Our roof is back in place and the bathroom is usable, although still in progress. At least the tree crashing through led to a new paint job, which is a nice thing. The seemingly old oil based paint that was used for the job might have taken a few years off our lives, or at minimum stolen a few brain cells!, but it does look cleaner and brighter. The paint smelled horrible!! We are pretty sure that they aren't planning to cut down the entire eucalyptus forest behind our apartment, but I am still sort of wondering. The Kenyan habit of telling you what you would like to hear, as opposed to the actual facts, makes me unsure about the "assurance" I have been given regarding this tree cutting business. The chainsawing has been steady for 3 weeks now!!
All that aside...we had a great Piki ride to our friend's place at Mayer's Ranch last night, where we ate an amazing meal and spent the night so that we wouldn't be riding home in the dark. At 7:30 this morning we rode back so that Warren could take over call in the ICU for the weekend. By the time we got to our place at 8a we had seen many birds, a dik-dik darting across the road and a whole family of baboons. They had heard the neighborhood leapard the night before so we were hoping for a sighting, but the word is that you only see a leapard when it is already on you! They have actually seen it there, but not easily or often. It did run off with the smaller of their two dogs once, puncturing him in the throat just exactly in the place that stole his voice!, but their massive Great Dane, Zeus, chased them down and Elvis has been as good as new, although silent! ever since.
I was met with an enthusiastic response from the matron of the nursing school when I offered my services to them for the year. I am meeting with the faculty on Mon at 9a. John has a mid-term break coming up next weekend. He is brewing plans for Piki rides, camping and a climb up Mt Longonot. So he seems to be settling into life here. And I am sure another weekend of call will bring a few more vignettes from Warren.