Housewarming week!

This was a really busy week for me. My boss wanted to launch our other two studies, so I spent the first half of the week running around trying to coordinate people and help them handle trying to run 3 separate studies at one time! Mostly my days are filled with sorting out e-mails, gathering supplies, helping organize patient files and data, and going to meetings. Sometimes it's interrupted with fun stuff - I did get to attend a surprise birthday party for the Director of the Clinic we work with :)

My team at a surprise party!

Just for the record, I'll tell you a little bit about our 3 projects:

1) "SToP Crypto" (Strategies to Prevent Cryptococcal Infections): this study is a clinical trial for HIV patients with early cryptococcal infections. Cryptococcus is a fungus that usually only infects people with suppressed immune systems. In HIV patients, cryptococcus can lead to serious brain infections, and we are working on comparing the standard treatment (fluconazole) to a combination of fluconazole and flucytozine.

2) SToP Crypto Environmental Sub-Study: this project involves patients from the clinical trial. If patients have cryptococcus growing in them, we ask for them to allow us to go to their homes and take samples. I'm really excited for this one, because it means I get to go out to rural villages and homestead and go into people homes and take samples of their dust, foliage, and other things around their house to see if we can get more information about where the fungus may be coming from in their environment.

Locks don't matter much to crowbars

3) THINK2 (The HIV Neurology In Kenya Study 2): this is a cool project looking at people with HIV associated cognitive defects and how they affect their social and economic welfare. My team will recruit 200 patients and perform neurological and psychological exams on them and then follow them for 2 years to assess if HIV infection is affecting their brains. We will be interested in seeing if we can observe socio-economic impacts from the HIV associated dementia and impairment many patients encounter.

Ana-Claire was supposed to arrive on Thursday to watch the team do a walk through of the procedures for the THINK2 study, but when I arrived to the office on Thursday morning I discovered that our office had been robbed. The thieves pried the locks off our outside doors and took all the cups and plates from out little kitchen. It appeared that they even had time to find all our file cabinet keys, unlock all the cabinets and rummage through them. 

The eggplant had a nose :P

Luckily, they were interrupted at this point (it's still unclear if the security guard caught the burglars or if it was just the neighbors who started shouting), but all of our computers, electronics and valuable items were still there!!!

We were REALLY lucky, but AC was a little shaken, so we moved ALL our expensive or difficult-to-attain scientific supplies to the main hospital to be kept under more locks-and-keys. It tool us most of the day on Thursday to get everything sorted out and moved, and to hire a new security company.

The rest of the week was just busy preparation for the launch next week, but I had planned some fun weekend activities! I invited about 50 people over to my house on Saturday afternoon for a Pool Party/BBQ/Housewarming party! I ran around throughout the week collecting food and supplies, but by Saturday had made burgers, hot dogs, 2 chickens, veggie kebabs, pasta salad, potatoes, and a peanut butter-banana-chocolate cake :) Oh and a lot of sangria :P

It turned out to be a great day, and a TON of people showed up and brought a bunch of great food! We lounged in the pool, ate a lot, played frisbee and water polo, and generally had a great day. The rain held off until almost dark, and when it finally moved in we hung out on the porch of my landlords house until it passed. 

Eventually, people packed up and went home, but we all agreed to meet up at the rooftop bar named The Duke of Breeze. A fun day merged into a fun evening, and I was out until the wee hours handing out with a pretty big crowd of mzungus.

I love my apartment complex, and it was great to do some entertaining. I haven't had a real chance to have people over since I lived in San Diego, so I was long overdue! :) All-things-considered, it was still a pretty productive week, and my housewarming actually marks one whole month of being here!! Time is flying by!

Housewarming Party by the Pool!

Fun observations about life in Kenya

Extended stays in a foreign land always come with some fun and sometimes not-so-fun peculiarities, idiosyncrasies, and interesting experiences. I like to write these down because they make me smile when I read them at the end of trips (once I'm accustomed to the things I first found odd or funny) and years after. Here are some for Kenya so far:

1) Having children shout at you when you walk by. This I find almost always adorable and endearing. Kids most often just stare at me with wide-eyed wonder like I am fluorescent purple or with the mesmerized expression of someone who is hypnotized by a flickering television. Once they realize I am a walking, breathing white person, they usually snap right into character and shout "Muzungu! Mzungu! Hi!!!! HOW ARE YOU?" Mzungu (pronounced mah-zoon-goo) means white person, and it is exactly the same from every child. It's like they take elementary school classes....maybe there is a Yelling At White Ladies On The Street 101.

When they are staring, I usually smile and wave to be friendly. When they shout, I answer "I'm doing great, how are you?!?" which about 90% of them are not prepared to answer, and they usually just giggle and hide their faces. A few brave ones will say "Fine" or actually run right up to me after that and keep repeating "Mzungu!" or "Buy me a soda" or "I'm hungry" or just touch my arms or try to shake my hand. Overall, I find it pretty cute, but I refuse to buy sodas or give out food because I would quickly have a pack of children following me where ever I go. But it has inspired me to look into volunteering while I'm here.

(The not-so-cute version of this is having grown men shout "mzungu" at you every 30 seconds on a busy road or in the market. Or walking up to you and trying to grab your hand before you realize what's happening....but I'm trying to just pretend it's like being a movie star which almost makes it less annoying/creepy)

Also, a lot of people randomly shout "BARACK OBABMA!" at me. I need to devise a clever reaction to this - any ideas?

2) Greeting everyone in the room, shaking their hand, but not introducing yourself. I find this one odd. Kenyans will walk in, shake your hand (while keeping their left hand gripped in their right elbow, like they have to support their right arm), say hello, but not say their name. I always respond with "Hi!! I'm Kristyn!!"....and am met with silence and a blank stare. I now just ask names....but I need to ask my team what the deal is with that.

3) British English. There are some interesting hold overs from the colonial days that have stuck around in the language here. Problems get "sorted." Supplies and meeting times get "organised" not purchased or made. You "liase" with people, you don't chat or meet. One of the questions we ask our patients: "Do you have any problems toileting on your own?".....is toilet a verb?? There are other quirks I'm not sure are British, like "Can you pick me at 8am?" - you do not say "Pick me up"....just "Pick me." Or instead of "She didn't answer her telephone" you say "She's not picking."

4) The biggest vehicle has the right of way. Driving or riding on any form of transportation here is NOT for the faint of heart. On any given road there are bicycle taxis (boda bodas), motorcycle taxis (piki pikis), motorcycles-with-a-backseat/carriage taxis (tuk tuks), mini buses/passenger vans (matatus), and private vehicles on every road. There are also chickens, goats and cows roaming free EVERYWHERE (see #5). They drive on the left here, and passing is an art form....basically if you want to pass, you just drive in the right lane with your blinker on while flashing your headlights. If a smaller vehicle is coming at you, they usually get all the way to their side of the road and yield for you to pass. On very narrow roads, the biggest truck has the right of way and you have to maneuver to the shoulder if there are any bits where only one vehicle can pass at a time. It's pretty harrowing.

My favorite tuk-tuk (left) and people riding boda-bodas (right)

Also, there are potholes the size of hippos just about everywhere, which make highway driving at night extremely inadvisable. And lots of random, perfectly camouflaged speed bumps....those are brutal.

5) Free range livestock...everywhere. I was sitting in my clinic in Suba, when a cow literally stuck it's nose in my office window. Since there is obviously no air conditioning anywhere, windows are always open unless there is a rainstorm....and there are cows, goats and chickens that just wander the grassy areas in between the hospital buildings. 

I don't understand how people know who's chickens are who's, how they find their wandering goats and cows at the end of the day, and what's to keep my from scooping up the adorable baby chicks and bringing them home with me. But overall I think it adds to the charm.

Wandering cows (left). The chickens that crow outside my office window daily (right).

6) Grown ups using the kiddie carts at the grocery store. When I've gone to the bigger grocery stores here I noticed that there are 2-3 different sized shopping carts. There are the normal, adult sized carts and small, child sized carts. For some reason, Kenyans seem to choose the small carts. They push these tiny things around and have to stoop over to reach the handle to direct the carts. I don't get it.

Why use the small carts???

That's all I've come up with so far, but I'm sure there will be many, many other funny things I discover over the next year!

My awesome Grandma

On Monday, I got some bad news. My grandma passed away rather unexpectedly. I had just visited her the weekend before I left the country and was pretty shocked and saddened by the news. Things like this are never easy....but being this far away and feeling so helpless and rather disconnected from my support network and my family is a extra tough. She was a fantastic woman with a huge heart, and was always incredibly supportive. The night before I left her house, my boss had emailed me about the terror attacks in Nairobi: she asked if I wanted to postpone my trip or rethink my plans. I sat on my grandma's porch and watched the rain with her and finally got up the courage to ask her opinion (not wanting to hear the sensible "You won't be safe, stay in America.").  She looked at me and said with total honestly, "It's where you want to go, and it's where you're supposed to be next. Don't let crazy people scare you from doing something good." I was very pleasantly surprised and felt so happy to know how excited she was for me and how proud she was that I was taking a risk to do something I thought might make a difference.

Now not only two weeks later, she's gone. I feel really lucky that I got to know her, because not everyone gets to spend this many years with their grandparents around. And in the last year she was just so encouraging - through some rough patches with guys, getting through my PhD, and moving to Africa, she always had a wise and kind word, sent me the most adorable e-mails, and every year sang Happy Birthday to my voicemail. I was lost all day on Monday trying to figure out how to cope from here. I sat in my office crying after I heard, and my Kenyan team looked so scared and kept bringing me tissues and food, but I didn't know how to respond. I left around lunch time and came home to my empty apartment to try to call my family, but at noon-time here its 5am on the East Coast....so I waited around, looked at plane ticket options to go home, and paced.

Eventually, I spoke to my family, cried with my sister, called a couple good friends to vent, and tried to think happy thoughts. By the end of the day, and not knowing what else to do to deal, I wandered around my compound. I had bought some vegetable seeds a few days earlier....my grandma always kept a lot of plants around, so to occupy myself I cut apart some empty plastic Coke bottles and found a shovel. It started to rain, but I walked around the walls of my complex until I found some decent soil, shoveled it into a shopping bag, and sat in my kitchen and planted a little garden on my windowsill.

It's not logistically or financially feasible for me to go home to be with my family for the memorial, but after this week of thinking it all over, I'm just so glad that I got to see her so much in the last couple years and that I knew she was proud of me. She was a really fantastic grandma, and I'll miss her.

Lions, cheetahs, and giraffes, oh my!

Early on Thursday morning, my boss let me sneak off and take our US visitor to the Kisumu Impala Sanctuary! Mark is a professor visiting from UCSF and was here to give us advice on the clinical trial. We got up super early and walked over to the park just after sunrise. It's a cool place that has both free ranging and cages animals.

From the website:

"The sanctuary has all the big five animals except the Elephant. Captive animals include the leopard, spotted hyena, blue monkey, patas monkeys, grey parrots, buffaloes, grey duikers, ostriches, hartebeest, cheetahs, lions, lionesses, white rhino, guinea fowls, tortoises and serval cats amongst others. The free ranging animals include hippos, impalas, zebras, monitor lizards, Sitatungas, red tailed mongoose etc."

The animals were mostly out and about, and we wandered through the cages. The place was pretty small, and the cages were made of chain link fence which you could practically walk right up to and stick your hands in if you were determined to. I thought that was neat because we were so close to the animals, but it would probably make more sensible people a bit nervous.

When we got to the lions, there was a lioness hanging out RIGHT next to the path. I could have definitely stuck my fingers in her mouth....but she seemed incredibly cranky, and sat there growling, hissing, and generally being very unhappy we were anywhere near her.

I stood there watching her be angry for a while. It was pretty amazing being nose to nose with a huge, angry predator.

Eventually our presence was too much for her, and she limped up to standing. We noticed her back legs had obvious claw and bite marks, and we talked to the groundskeeper who said she had been fighting with another lion and they were "working on it." I'm unaware how you counsel apex predators how not to fight each other when locked in a small cage, but maybe they've made advances in lion therapy here :P

The park was completely deserted, and we slowly made our way through the monkeys, birds, buffalo and gardens. Mark is super into bird watching, so we also strolled the shores of Lake Victoria and watched the birds going about their early morning routines.

The park had a baby giraffe that was barely held in by a thin electrified wire "fence." This fence would never fly in the US for about a million reasons, the first of which is that you could easily accidentally walk right into it...but being the animal lover that I am, I grabbed a few branches of a shrub and stuck my hand through the fence and fed the baby giraffe. He was so cool! he just paced along the fence and followed us around the enclosure. We both got to feed him, pet him, and help him with an itchy spot he had on the back of his neck :) He was really friendly!

Throughout the park, the impala are wandering free and grazing on the grass. They were really pretty, and it was neat watching the babies bounding all over the place after their moms. They were skittish, and scampered away every time we approached them on the path.

Mark wanted to do more birdwatching, and since that's not really my thing, I headed back to see if any of the big cats had woken up. On my first pass the leopard was sleeping, and the cheetahs were hiding in their den.

Boy was I in luck! The cheetahs were out and were pacing in their cage. When I walked up to stare at them, one of them rolled over on his back in the grass and started wiggling like my kitten does when she's using the carpet to scratch her back :)

They were rubbing up against the fence like they wanted me to pet them (which is how I feel all furry animals think...but people keep saying I shouldn't pet wild animals). One of the grounds keepers who was pulling weeds nearby walked up to me and started asking me about where I was from, how long I've been in Kenya, etc. We had a brief chat and he saw that I hadn't taken my eyes of the cheetah in front of us. He looked at my huge camera and asked, "Would you like me to go in there and take a picture so that you have a nice one without the fence in the way?" to which I obviously and overly enthusiastically responded in the affirmative.

I didn't hesitate in handing over my very expensive Nikon to the nice man, who proceed to WALK INTO A CHEETAH ENCLOSURE....he posed the cheetah by making him sit still, and snapped the awesome picture above (not bad, right?!).

Then after rubbing the cheetahs belly and watching me drool from outside the cage, he turned to me and asked, "Oh, would you like to meet the cheetah? Did you want to come and pet him? Come get a picture with him!" At this point, Mark walked up just in time to tell me he thought it was a BAD idea...but by the time he had started the sentence I had already thrown down my purse, scurried under the guardrail, and was at the door to the cheetah cage. With poor Mark looking on very worriedly, I got to pet both of the cheetahs!! They were purring and rolling around, and one was even play wrestling with the guy's shoe (which looked borderline painful/dangerous - even my kitten hurts when she gets her teeth and claws into my foot....and this was a cheetah gnawing on his sandals!).

Honestly, it was an amazing minute and a half. The cats were both really docile and super friendly, and it was hard to imagine them as wild animals. I was so giddy after that!! I was bouncing and skipping and looking at the pictures the whole way home...and Mark just kept repeating "I just didn't want to have to call and explain to your parents how you lost your arm." After the park, we headed to work. The rest of Mark's visit was full of official business and meetings, but I was so happy we got a quick break to go see the animals! And now I have met the lions who I can hear roaring when I lie in bed at night :)

As for work, I have started working with a few people at the CDC - oddly enough there is a branch here in Kisumu! I'm hoping to collaborate with them and get to use their huge, shiny lab in exchange for not much more than a smile and a handshake. We'll see how this goes! The people I have met that have agreed to help me seem incredibly nice and enthusiastic, so I'm hoping that once I have some patient samples, they will let me come use their brand new incubators and other machines. Their lab is about 10 kilometers out of Kisumu, but it would be worth it if the lab is as great as they claim it is!

On Saturday, I slept in, tidied the apartment after Mark's departure, and went out for another solo adventure...I walked from my house all the way into town, in a big loop down the main street and through the shopping areas, through a large open air market to buy a few vegetables, and all the way back home. All together, I figured out that I walked somewhere around 5 miles in a big loop.

Sunset on my roof deck :)

When I got home, I was wiped out from the heat, so I jumped in the pool! When I was getting out, two of my neighbors (who also happen to work at the CDC) were arriving and invited me to go to dinner with them and some other CDC people. I happily accepted, and we all went out for Indian food. It was a good meal despite it taking almost 2.5 hours from start to finish! After dinner, a few of us headed out to a rooftop bar called The Duke of Breeze. There was an insufferable DJ playing, and I heard some "classics" like the Macarena, She Drives Me Crazy (by the Fine Young Cannibals, but remixed) and a lot of others. We had a few beverages, danced in a little circle for a bit, but it never felt very happening or got very crowded, and sometime after midnight we called it a night.

On Sunday, two other girls and I went to the Kibuye Market. According to various websites, Kibuye is the largest open-air market in Kisumu, possibly the biggest in Kenya, with some websites even claiming it is one of the biggest in all of Africa. We were in a mission (well, the other girls) to find fabric for skirts...and one of them wanted to cover up her zebra print couch.

We arrived at the market in the late afternoon, which was definitely not prime time. The market is a giant, open-air maze. It consists of stalls, tin shacks, alleys, muddy paths, dusty trails, and lots and lots of vendors yelling. They sell EVERYTHING. Furniture, piles and piles of used clothes, fruits, veggies, hardware, electronics, dried fish, live fish, blankets, fabric, bags, shoes, soap, household goods...and its all very cramped, hot, and dusty.

Interesting character at the Kibuye Market

At one point we were even in a section where men were taking apart old oil drums and hammering them out into sheet metal and making things out of the sheet metal. They crafted grills, suitcases, lanterns, chicken feeders, watering cans, cooking pots, woks....pretty much anything you could think of made out of metal. All from a used oil drum! I remember asking Ana-Claire jokingly in my first week: "Do you recycle bottles and cans here?" and she said something like "If it ends up in the trash, someone will go through it and repurpose it..." I guess the oil drums are a good example of that.

This guy to the right was an interesting character...I had seen him the day before at the small market in town, and he had a bicycle with a weird, stuffed woman/puppet.mannequin on the back of his buke. He was just wandering around Kibuye buying onions on a Sunday afternoon.....

We lasted about 1.5 hours wandering around looking at the wares in the hot sun before we had to find a cold drink and shade. We found a small stall that had plastic lawnchairs and cold sodas, and tooks a break from the hectic yelling and shopping to sit and relax. The three of us were surprisingly exhausted, but I find haggling, getting yelled at (people are constantly shouting "Muzungu!!" [white person] at us) and shopping in general very tiring, so we regrouped, bought our vegetables for the week and headed home. The other two girls each came away with a used shirt, but I just ended up with some fruits and veggies. Overall it was a good shopping trip, and weekend!

More pictures: https://kristynspictures.shutterfly.com/9793

Cows on a Ferry...almost as scary as Snakes on a Plane?

I finally had my first solo adventure!

Ana-Claire, my boss, returned to Nairobi on Friday, so for the first time I was left to my own devices in Africa! I spent a long afternoon/evening at the office/lab on Friday preparing for our first patient who was supposed to come to our rural field site for treatment on the following Monday. On Saturday I broke my less-than-5-hours-of-sleep-for 2+ weeks streak by sleeping until almost 11, and then went for my first completely unchaperoned outing: apartment stocking/grocery shopping!

The field "shuttle"

While not exactly worth writing home about, I found most of the things I might need for the next few weeks, picked up a pretty sweet oscillating fan (for the rip-off price of $65 US dollars, yikes), and noted a lot of items that I couldn't find anywhere. Most convenience foods don't exist here, so I ended up making my own huge batch of pasta sauce and buying a lot of peanut butter, nutella, jelly and bread until I figure out a list of recipes I can make with the limited ingredients available in Kisumu.

But there were lots of fresh fruits and veggies, and enough rice and beans to last me decades, so I stocked up on a few essentials and came home to cook (in front of my new fan :)!

 I had a quiet evening at home, and packed up....I was headed back out to the rural clinic in Suba on Sunday evening so I would be there for our patient's arrival early Monday morning. On Sunday, I got up, got myself prepared for another long travel session, and headed to the clinic to meet up with my driver. I took a communal vehicle that goes from Kisumu to the neighboring district (Suba) every Sunday. Many of the local fieldworkers go out to rural communities all week, then come home to Kisumu to be with their families on the weekend. Because of this, there is basically a "shuttle" back and forth on Fridays and Sundays.

I hitched a ride with a bunch of very friendly fieldworkers who spent the 1.5 hour drive trying to teach me their language (Luo) and trying to come up with a Swahili or Luo name for me. By the end it was down to something that meant "Angel" and something else that meant "Born in the evening," but nobody could agree, so I'll have to try again next time :P

We arrived to the ferry as the sun was setting into Lake Victoria - this region really has some awesome sunsets! I spent a few minutes wandering down by the shore checking out the smaller canoes and fishing boats. All the fishermen were super friendly and kept clamoring for me to climb into their boats for a picture, so I finally caved and had a few taken.

The ferry ride over was uneventful....and I actually had headed out to the middle of nowhere without any solid sleeping arrangements. All my super-nice new fieldworker friends helped me find a place to stay, which actually ended up being at a huge Insect research facility located in Mbita. The International Centre of Insect Physiology and Ecology (icipe) has a few sleeping options, but I went the cheap route and stayed in their dorm-type rooms. My little room was rather cell-like, so I went down to the lobby, got the last serving from their dinner buffet, and ended up being the last person in the dining room at the late hour of 8:30 when the power went out....

Sunrise and Lake Victoria - the view from my room!

Luckily I had my iPhone on hand and I wandered back to the room with the built in flashlight. My second floor room was stifling, so I took a chance and opened up the windows even though the screen had a few sizeable holes. I made sure the mosquito nets were good, and went to sleep safe-and-sound in my net!

Monday was an incredibly long day - I woke up before sunrise, checked out of the room, and started coordinating the team by phone from a lawn chair on the shore of the lake :) I have 4 people on my team for each site, and everyone had questions since this was our first patient!!

My view from my "mobile office"

I spent until about 9:30 just calling around and making sure everyone was ready, where they were supposed to be, and doing everything in the right order. Ana-Claire was actually flying in from Nairobi to Kisumu, but upon her arrival was having car trouble getting out of Kisumu.

She eventually found a vehicle and made the 2.5 hour drive and made it in time to consent our patient and do a spinal tap! We were really lucky that our patient was super cooperative and agreed to all the parts of the study, so we had lots of samples to process.

My team outside the clinic in Suba

I spent the rest of the day in the lab - it was a little odd putting on gloves again! But I got all suited up, lab coat and all, and helped our lab tech process blood, urine, and spinal fluid from our HIV infected patient....all in 90 degree heat (and sandals, I totally forgot real shoes, whoops!). It was a very long afternoon in the very very warm lab, and we had enough time between procedures to scarf a quick roadside meal of flatbread, beans and a Coke and then get back to work.

Everything went really well, and at the end of the day Ana-Claire collected me from the lab and we headed out to Rusinga Island to sleep at the eco lodge again! I love the place, and it was perfect at the end of the day to be in the middle of nowhere with crickets chirping and millions of stars overhead.

The view from a rickety water tower next to my clinic in Suba

The lodge kitten trying
to come with us!

The woman who runs and owns the eco lodge is a really fun lady, and she and her staff make excellent food! We had another great meal of perfectly fried fish from the lake, rice, veggies, and even a ratatouille she baked in her solar oven! Dinner is served in a gazebo and it was cool to watch bats swoop in and snag the bugs above our heads that were attracted by our dinner candles.

The Suba Team!!

I was exhausted after the long day, a full meal and a beer. I took a very quick "shower" (the electricity was surprisingly working, but the water from the electric shower head was so scalding all I could accomplish was splashing a bit of water on me).

I was actually sharing a room with Ana-Claire - I'm relatively sure I would never have voluntarily agreed to ever sleep in the same place with any of my previous bosses, but AC is very easy-going and easy to get along with, and I was out like a light within about 30 seconds of crawling into my bed net.

Lake Victoria tilapia

The next day we did a team debriefing about the first patient enrollment, discussed where to improve next time, then had a celebratory lunch at Icipe (the insect research facility). We were offered the options of steak or fish, and we all chose fish....and about 1.5 hours later were all presented with individual, whole fried fish :)

Cows on a Ferry...

It was another really good meal, and after stuffing ourselves AC and I headed back to the ferry to get home to Kisumu before dark. I was very entertained by the herd of cattle that got loaded onto the ferry after our SUV: it looked like quite the effort to convince the stubborn cows up the ramp, but after a lot of yelling, cow-butt-slapping, and a few whippings, the herd was loaded onto the boat.

It was another beautiful ferry ride, and we made it to the Kisumu side as the sun was again sinking behind the lake. I thought it was a really great trip, and I felt pretty accomplished after my first solo 48 hours, getting a room without advanced arrangements, and our first successful patient enrollment!!

More pics: https://kristynspictures.shutterfly.com/9793

First whirlwind week in Kenya: part two!

My first week in Kenya continued:

So after my weekend in Nairobi, Ana-Claire and I packed up and headed out to my new home in Kisumu!! We took a 7am flight, and were on the ground in Kisumu after a quick 40 minutes in the air.

View Full Size Travel Map at Travellerspoint

We flew in over parts of Lake Victoria, which is the largest tropical lake in the world (and the second largest overall after Lake Superior). After collecting my small mountain of luggage, we actually headed straight to the office! I was introduced to my Kisumu-based team (who I had met over Skype, but finally got to meet in person!), and started in on the day's work.

First, I got a full tour of the office/clinic. It is a small, 3 room concrete block house. The first door on the left (see more pictures here: https://kristynspictures.shutterfly.com/9723) is the office, where our team of 4 (5 if you include me!) shares two small desks and a water cooler. The main door leads to a small reception area with a desk for speaking to the patients. The third room is our clinical room, with an exam table, a small supply cabinet, and a bucket for washing your hands. There is a small "kitchen"...which to my untrained/non-Kenya eye actually looks like a storage closet with a foot sink. There is also a very luxurious restroom.

Our clinic building

Our office bathroom

So the norm in a lot of foreign, developing nations is a squat toilet. If you want to get technical, I've read they are actually better for your systems than "Western" seated toilets, but let's just say it will take some getting used to!

My commute to Suba - amazing scenery!! And goats in the road :)

After spending Monday and Tuesday in Kisumu organizing with the team, doing mock patient enrollments, and trying to finalize future plans for the study, we woke up early on Wednesday and headed out to our other study site in rural Kenya. I've made a map and put it at the end of the blog to help orient everyone! But basically, the other site is in another district, the Suba district (Kisumu, my city, is in the Kisumu district).

To get to Suba, you either have to go over the lake or around the eastern side of it. On the way to Suba, we drove west, towards Uganda, and boarded a ferry (with our car!). The ferry travels south across the finger of lake that protrudes into Kenya, and lands in Suba, in the town named Mbita (pronounce Mah-bee-ta, but with a really abbreviated "mah").

Sunrise over Lake Victoria

There are two sites we work through in Suba: the first is the main Mbita hospital, located adjacent to the ferry landing, and the second is our clinic. The clinic is actually located in Sindo, which is a 45 minute drive away (down a pretty rough, rocky, dirt road). In the clinic, we meet the patients, draw blood, do exams, and dispense medication. Then the samples have to travel 45 minutes (on a motorcycle) to the lab in the Mbita hospital to be processed.

This is an interesting challenge out in the rural site that is adding extra stress to a tough study, but so far the Suba team is rocking it!

On day 1 with the Suba team, I pretended to be a study patient! I was given a full exam, had my blood drawn, had all lab tests preformed, and even was prepped for (but not actually given) a spinal tap! It was an interesting experience, since I learned the whole procedure our patients will endure. Also, the team confirmed I am in great health, with normal everything and HIV negative with no fungal infections :P

After a full day in the lab being poked, examined, and prodded by my team, Ana-Claire took me to Wayando Beach Club to spend the night. It was a rather stressful drive as a serious downpour started as we left the clinic, and I found myself gripping the handles in our SUV more than a few times as the car fishtailed and slid in the thick mud and we zoomed along the road back. But we made it safely to our destination: The Beach Club is an eco lodge in the Suba district on Rusinga Island (technically no longer an actual island since a causeway was created from the mainland in the 1990's).

Pulling in the nets at sunrise!

Nile perch

The lodge is a beautiful place!! There are little cottages for sleeping (again, more pictures here), a large pavilion for dinners and hanging out, and its right on the lake! It is definitely a bit rustic, and when we were there the electricity was out. There is hot water only when the electricity is on (and even then only in one of the 3 cottages!) and are no flushing toilets. Instead, there are buckets filled with sawdust...you bury your business in a layer of sawdust after each use. I can honestly say that was my first time with a sawdust potty....

Proud fishermen!

Anyway, after an amazing dinner of fresh fish from the lake and a well-earned beer, I passed out to the sound of crickets in my little cottage! I awoke just before sunrise - we arrived in the dark and I wanted to explore the place before we were off to work again. I wandered down to the lake shore and found the fishermen pulling in their nets they cast the evening before. I watched them pull and pull and pull and pull! I must have watched for about 30 minutes when they finally started getting excited and told me to get my camera ready....and as the net came in, I saw 3 fish flopping around, and they were quickly untangles from the mass of net.

Room 1 in my place!

The fishermen were very proud of their catch of a few small Nile Perch, which is actually and introduced species to the lake. These perch can grow to 300 hundred pounds and wiped out hundred of native fish!!

After thanking the fishermen for letting me observe, it was time for breakfast and to start the day. We had a whole day working with the team, and then left in the afternoon to return to Kisumu. Since the return ferry schedule is a bit random, we decided to take the "overland" route, and settled in for the 3 hour drive back to the city.

Room 2 in my place!

The scenery was really amazing, and we spent half the drive on bumpy, dirt roads through nowhere. I was glad that it wasn't raining until we hit the pavement road that leads into Kisumu. One day I'm sure I'll write a whole post on just the roads and driving here....

We made it back, and after a long day in the Kisumu lab on Friday trying to help them finish getting ready, we got news that we had our first patient scheduled in Suba for Monday!! This meant I had until Sunday afternoon to hang out in Kisumu before I had to drive-ferry-drive all the way back to our rural clinic.

My very African themed living room!

I spent Saturday sleeping and then finally took my first extended outing without Ana-Claire's supervision: I went to the grocery store! I went to a store called Nakumatt, which is kind of like a Super Wal Mart - I bought a pile of stuff, but most importantly I found an oscillating fan :) After my 3 hours wandering through the mega-mart, I finally organized my place and took some pictures! And that officially marked one week of being in Kenya!!

And finally, here is a map (with pictures if you click the markers!!) of all the sites I travel to around Kisumu so far!!

Kenya: the first whirlwind week! (Part One)

Hello from Kisumu!

Thanksgiving in September

Well, I left San Francisco headed east to Africa, but I made a 2-week pitstop in Florida to visit the family before shipping out for a year. During the two weeks my father seemed to make it his personal mission to fatten me up for the winter, and he dragged me to steakhouses, seafood places, mexican restaurants...and to top it all off, he offered to make me a meal for my last night in the US. I joked and told my sisters to tell him I wanted a full Thanksgiving feast (and then to take a picture of his face :P), but Dad was up for it and actually decided to cook me a whole turkey dinner!!

We had turkey, stuffing, mashed potatoes, green bean casserole, cranberry sauce, and funnel cakes for dessert!! It was a great way to celebrate my last evening in the US, and I was SO full by the end. I think we have a contender for Dad of the Year :)

It was great to see my family during the trip, and I had a blast in San Francisco all summer, but I had been living out of a suitcase for almost 6 weeks by the time departure day arrived, so I was pretty excited to get to my new home for a year. I packed up my bags for the last time for the next few months and loaded them all into my teeny, tiny rented Fiat. I really thought they weren't going to fit! But with the seats folded down, and no other passengers, I loaded them up and headed to the Orlando airport. I was borderline embarrased to have so much luggage....I'm used to traveling pretty light, but heading out for a year to sub-Saharan Africa gave me the excuse to give in to the temptation of being allowed to check 2 bags up to 50 pounds each. So with my bags stuffed full of bug spray and clothes, off I went!

I started my 35 hours of travel by driving myself to the airport, returning the rental car, and dumping 100 pounds of luggage ( and really hoping to see it 4 flights later...). I flew from Orlando, to Washington, DC. I only had a 1.5 hour layover in DC, so I dashed to my gate, had a glass of wine to encourage some shut eye on my red-eye flight, and got on a flight to Brussels, Belgium! The flight to Brussels was 7 hours long, and by the time I watched a movie, had semi-decent plane dinner, and took a long nap, we were in Europe and it was time for breakfast.

The route

I had a 4 hour layover in Brussels, so I grabbed a croissant, coffee and juice (even though it was midnight FL time) and then went and bought as much chocolate as I could stuff into my already bursting carry-ons! Whenever I travel I try to bring candy with me to give to people, so I bought big bags of Snickers and Milky Ways to make a good first impression on my new Kenyan co-workers :P

My first view of Africa!!! Over Egypt!

I eventually boarded my flight bound for Nairobi, but had totally forgotten the plane made another stop....we were scheduled to land in Kigali, Rwanda for an hour but not switch planes. I braced myself for the 11 hour journey, and watched bad movies for most of the flight. We flew over Greece then over the Mediterranean to Egypt - It was clear and sunny over the Sahara (big surprise!), and it was really cool to see the dunes for hours.

Eventually it clouded over and then got dark, so there wasn't much scenery after the desert. Our stopover in Rwanda was uneventful, and we landed in Nairobi with no problems around midnight local time! Since the International terminal basically burnt to the ground a few months ago, we had to get out and walk on the tarmac to a bus, which took us to a tent/garage to get our bags. My bags made it, customs was easy, and I found my driver!

I arrived at Ana-Claire's house (my boss) around 1am, checked in with the family, and crashed! After somewhere over 35 hours door-to-door I had safely made it to a new continent and my guest room for the weekend!!

Day One in Africa!!

Since I didn't get to bed until around 2am, I slept in until almost 10am - I wandered down from the guest room long after breakfast had been served, and I spent the whole day just hanging out at Ana-Claire's house playing with her two daughters. Kamilla is 6 and Arwa is 3, and they are adorable little bundles of energy! We chased the baby chicks that escaped from the chicken coop, had a yummy lunch, played in the yard, and lounged. Ana-Claire (AC) took me to the store to get my phone all set up, but besides our quick trip down the block for a SIM card, we just hung around the house all day....which was exactly what I needed!! Most ex-pats in Nairobi are pretty nervous at the moment, so besides being relaxing for me to just hang out, AC was being practical and cautious. We had a huge dinner of fresh chicken (I didn't ask if I had been chasing it earlier in the day or if it was store bought), cookies the girls made, and I crashed again.

Day Two in Africa!!

Sunday in Nairobi made up for my rather quiet Saturday - we were up, fed and out the door by 9:30 am to go horseback riding! Kamilla is a horse lover, and there is a stable only a 5 minute drive away. Arwa on the other hand is terrified of horses (and dogs I later found out), so Ana-Claire and Arwa chose to walk, and Kamilla and I donned riding helmets and picked out horses to ride through the local forested park :) We were lead through the park by two nice gentlemen who tried to give me a brief lesson in horse riding....I have ridden a horse a few times, but I've never had a lesson or learned how to trot! I was pretty hopeless until Kamilla's guide saw me, stopped, and lead her and her horse ahead of me and told me to stop doing whatever I was doing and just watch Kamilla and copy her - and it worked! 

Trotting!

I got the hang of it and we trotted a few times with the guides leading us, and eventually met up with AC and Arwa who were hiking through the forest on a parallel trail. After returning to the stable, we found a family of kittens hanging out in the office...and they even had a hutch full of tiny baby bunny rabbits that we got to hold! 

Sykes Monkeys!

Arwa being adorable :)

After leaving the stables, we went to visit a friend of Ana-Claire. The friend had a huge house with a giant trampoline in the backyard, so I played with Kamilla and Arwa, and while we were outside, a troop of monkeys came down from the trees and started playing in the neighbor's yard! They were chasing each other and doing somersaults - it was a blast to watch!!

Baby bunnies!

The last event for the day was an art gallery exhibition: AC knew the woman who ran the gallery and AC's husband is in a band (he's a musician) with her as well. So we all went to explore the gallery. I was beautiful, with a few small rooms but expansive, well landscaped grounds. After walking through the exhibition once (lots of wood carvings), I chased the kiddos through the gardens and they taught me about weaver birds. Weaver birds weave elaborate nests that look like cylindrical wicker baskets and they pick a tree and build big colonies together. We found a tree that had a bunch of weaver bird nests, and on the ground were dozens of nests that get knocked down by the wind.

After the gallery we went home and had a huge dinner and packed up to leave for Kisumu - Ana-Claire and I were headed out on a 7am flight on Monday, so we turned in early!

Week one, to be continued....

See my pictures here: https://kristynspictures.shutterfly.com/

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