Wednesday, July 13, 2011

our friend Hope...our immigration laws at work!

Copy and paste to watch this video about our little friend.

Monday, July 11, 2011


Our travels home were smooth and all the bags arrived with us back in Seattle at about 5pm today! 9 hours to London...9 hours in London walking, riding bikes and eating!, and then 9 hours to Seattle. July 10 has been a long we chased the sun around the globe!!

We are tired and really disoriented. But we were greated with so much love and attention!! Thank you to those of you who did amazing work on our yard...filling pots, trimming plants, weeding! Wow. It was amazing to come home to such obvious care and attention to detail. Thank you to those who brought food and flowers. Thank you to Mick and Carol for helping to pick us up and for bringing along food and treats. And to Alison and Myles!...amazing work and effort. The house looks so perfect and you made so many thoughtful preparations for us. You outdid yourselves. Thank you so much!

It is quite an odd feeling to be back. Thanks for making the landing softer...

Wednesday, July 6, 2011

kwaheri kenya...home sweet home seattle!

We really are down to the wire! Warren is in an almost giddy mood...bags all out, munching on dried cranberries, demanding that we bring out more clothes to use as padding around other things(Ali and Erika, you know the mood!) All cupboards are empty...contents on living room floor...chaos. John is in the midst of it all trying to study for finals??, but happily watching the progress that means he is on his way home! People are coming by to say goodbye, see what we are giving away, have tea one more time, leave contact info...

It feels surreal. The year has gone by so fast!!?

I notice that as the reality slowly sinks in and I can allow myself to believe that we will be there soon, I have some weird things coming into my mind...toasted rye bread, cake??(today I saw a US style bd cake while watching our nightly dose of House, and remembered that I LOVE them), Sonrisa Happy Hour!, Agua Verde, Varlamos, our bed!, our bathroom...Why these things? They seem so random. And this doesn’t count people, places and the fact that I get the sense that summer is really sort of showing up in Seattle now!?

Warren and I had a last hurrah sort of day in Nairobi on Tuesday. We had lunch with some Kenyan friends, shopped for a few more things to bring home, did a few errands...It felt sad...bittersweet. Nairobi is familiar and comfortable now and we have our favorite little haunts. I can picture how to make a great life here.

I love the concept of the “angle of repose”, that maximum slope where something will stay before it slides. There we were on Tuesday...Now we have started sliding!

See you soon!

Friday, July 1, 2011

stop making sense!

A friend of ours here in Kenya posted this on his Facebook wall today:

I discovered these new Kenyan laws today. Sitting on a flower pot in the CBD-5000/= Spitting on any footpath or blowing the nose aimlessly other than into a suitable cloth or tissue-10,000/= Making any kind of noise on the streets-10,000/=

As a reminder...10,000shillings is approximately $120! The average wage here in Kenya is not more than a few dollars/day.

A few days ago I was going through paperwork looking for an email address. I found some orientation papers we were given upon arrival here last August. Part of the information included some tips on avoiding fines in Nairobi. A few laws to be aware of:

Pedestrians crossing roads in Nairobi when traffic light is red: fine 10,000ksh (shillings)
Motorist moving on when the traffic light is red: fine 10,000ksh
Pedestrians crossing the road while talking on their mobile phones: fine 500ksh
Boarding/Alighting at non designated matatu stops: fine 10,000ksh (matatus are the local mini bus, main public transportation)
Unfastened seat belt: fine 500ksh
Worn out tires: fine 10,000ksh

Making any kind of noise on the streets!!?
If you stop at a red light here the cars stream around you and honk obsessively!? While this is happening people are darting between cars, talking on their phones, jumping on and off matatus while the matatu is moving, certainly not wearing seat belts! And tires?? Cars aren’t even aligned straight! And in all this chaos...beware not to sit on a flower pot, blow your nose or spit!

But no worries, the cops don’t have cars, making it hard to chase you down and they happily accept bribes if they do happen to catch you.

Despite all this craziness...I had lunch with a friend today and told her all that I love about this place. I feel kind of nauseous walking through the market knowing that it is one of my last visits and the end of my ability to say..."I know it doesn't cost that much, I live here." Earlier this week Warren and I took a spontaneous last visit to the animals on the Mara. We heard of a good deal and went for it. As we drove out of our camp it was like the animals had set up a finale and a farewell! There must have been 40 giraffes...beside us, behind us, in front of us...on the road, running ahead, popping up out of the trees! The zebra were running alongside us, an ostrich sort of raced us, there were wildebeests, lots of birds...It was almost like you could hear music...but it was made up of hooves, rutting noises of wildebeests, bird calls, breathing...Wow.

I had a moment when I thought that I should get the camera...then realized it just needed to be taken in. I won't forget.

Wrapping Up

It’s the last few weeks of our time in Africa. I continue to see patients in the Casualty/OPD/ICU. Interesting cases continue to come in

Case 1:
45 y/o male treated at outside clinic 3 days ago for malaria. Symptoms for malaria are sketchy and patient received IV quinine and coartem tablets. Patient c/o skin blistering past two days. On arrival the patient has what looks like deep second degree burns over more than 60% TBSA. The skin is friable and easily sloughed off with gentle pressure. Mucus membranes are involved as well. No early signs of infection are noted and the patient is treated like a burn patient and admitted to the ICU. The patient is aggressively managed with fluids and burn care. The patient develops some evidence of pneumonia and is intubated. After one week of care the patient dies in spite of ICU care. This is a case of drug induced TEN (Toxic Epidermal Necrolysis), and is a good reminder that the drugs we prescribe can be helpful. They can also be dangerous and actually lead to death.

Case 2:
30 y/o otherwise healthy male presents with severe dyspnea. History includes shortness of breath for approximately 10 days, with relatively acute onset of symptoms. Patient was admitted to a nearby hospital for the past week and discharged home on no medicines feeling poorly. Patient states he was treated for Tb while hospitalized but knows little about medical details. He comes with no charting/papers/meds on the back of a motorcycle. The driver, supposedly his brother, is nowhere to be found. VS on arrival= SBP59, HR 130, RR 50, afebrile, O2 sats on 15L mask maybe 83%. Patient c/o central chest pain and SOB. Patient can barely talk. PE significant for massive bilateral elevated JVP, symmetric wheezy lung sounds, soft abdomen, and no significant LE findings. Initial tests= CXR enlarged right heart shadow c/w right heart enlargement & increased haziness in area of central pulmonary vessels, EKG sinus tach with right axis deviation and right heart strain, quick look ultrasound shows massive right atrial enlargement and minimal pericardial fluid. Therapy so far includes fluids, intubation, lovenox, and dopamine. This is a case of massive PE with an initial week of mismanagement at nearby hospital for pneumonia. So far risk factors are unclear and the patient is fighting for his life in the ICU.