Givan's Village

Today we went to Givan's house to learn the ways of the Maasai. A half-Maasai, half-Kikuyu man named Wilson stopped by our house early in the morning to pick us up. Givan was waiting for us along the side of the highway with his piki-piki. Jason and I were initially jealous that Isaac got to ride with him.


Too bad the bike got stuck in the sand. Givan's house was pretty far out there, so I'm glad we didn't do what Givan had initially suggested -- take a mutatu and then walk for a couple hours.


Givan first showed us his goats.


Then we released them for some grazing. It was nice -- ultimate job for chillers. Goats make annoying noises.


Younger brother Matthew, Givan, Isaac and I enjoying a cup of chai made with very fresh goat's milk. Probably not a great medical decision. Givan just got promoted to security manager at RVA, so our visit was his way of celebrating.


This is the kitchen for the families that live here. I'm glad I drank the chai before I looked inside.


Picking out lunch.


Ahh, the poor goat's final moments. We look a little too happy.


The way the guy on the left, one of Givan's friends, slit the goat's throat and bled him was amazing. Surgeon's hands. You can see two colorful bangles on the man's wrists, each of which signifies a wife. He has two -- polygamy is still pretty common among Maasai. That's why Givan doesn't know how many brothers he has (he says over ten).


Cutting out the kidneys for a quick snack. That's where we drew the line -- no raw organs filled with goat urine.


Matthew blowing up the lungs.


Our favorite of the day -- roasted goat ribs, nyama choma. So delicious.


When the meat is ready, one of the guys grabs it and throws it on the ground on top of some leaves. But after the fourth or fifth piece of meat, there are hundreds of flies swarming around the leaves, our food and the Maasai sword they used to cut it up. Sometimes you just can't think about things too much.


The men brought over a metal pot to boil some of the innards.


Organs with frothy green stomach contents -- delicious.


The stomach was definitely the single most disgusting thing we ate. This picture was taken after I had already scooped out most of the mushy green stuff. I felt like Bear Grylls.


Waiting for more meat. Now we understand why slaughtering a goat and eating it is a day-long affair.



Our goat fed around a dozen people. These two schoolboys even came to pick some up for their teacher. I was doubtful at first, but there was a lot of meat on our little goat.


The whole time the men were out in the field eating the goat, the kids and women were back by the houses eating chapati and potatoes.


We returned to Givan's house only to find that his wife Jackie had prepared another meal of chapati, cabbage, potatoes and more goat meat. Surprised none of us exploded in a cloud of goat parts.


The kids liked us. It's interesting -- in Maasai culture, kids have to ask for your blessing before they are allowed in your presence. So kids will walk up to you with their head bowed waiting for you to touch their head, which means that you allow them to be there.


Everywhere we go, the kids can't get enough of seeing themselves on our digital cameras. Note the flies, which were everywhere. They especially love the babies, which is kind of wack cause the babies are wrapped up and can't fight them off.


The one on the far right is one of Givan's twins, Lydia. The others are his younger brother's kids.


Givan laughs while Jason and I suffer from severe food coma on the way home.


What a great day. Tomorrow we go to Nairobi with one of the interns, Michael. We'll be taking a mutatu into Nairobi, so pray for our safety. The power went out fifteen minutes ago so I'm going to sleep.

Siyaipei

We just got back from dinner with a couple of the full-time missionaries here. They're from Taiwan and have been living here with their family for six years. It was nice to eat Chinese food and get lectured about how dangerous Kenya is -- Isaac and I agreed that they are typical Asian parents, except that they live in Africa. Awesome people.

We spent the day at a clinic in Siyaipei, a very small town in Maasai land. We barely had time to buy a couple ndazis (fried dough) from the cafeteria for breakfast before we were hurried into the ambulance to head out around 8am. This was the first time anything here has happened on time since we have been in Kenya.


Shortly after our hour and a half drive along the Rift Valley floor, it was already time for morning chai. Here we are in the clinic kitchen with Jeremiah, who oversees all the rural clinics, and Stephen, one of KH's nutritionists.


I kept on hearing a bell ringing the whole morning, which made more sense when I looked out the window of the exam room.


Below is a kid with all of the physical exam findings associated with rickets, like he came out of a textbook. Most of our patients were Maasai, who traditionally herd cattle and goats, and apparently when lunch time rolls around and they're thirsty they'll milk their cows for a quick drink. So brucellosis is pretty common here -- and is something I know nothing about. We saw a ton of kids today, which is understandable in a country where the average age is around twenty years.


The best part of rural clinic is always the food. Here we are with the amazing chefs.


Jason, Stephen, Dr. Swanson, me, Isaac and Jeremiah at the end of the day.


Most of today's trip ran on a new highway through Maai Mahiu and Suswa. So smooth that sleeping was actually possible.


A couple nights ago, a man wearing a blood-stained shirt ran into the casualty carrying an unconscious boy bleeding from a number of lacerations on his head. We later figured out that the man was the one who hit the boy with his motorcycle. Aside from the fact that the man runs into the casualty only to find me and Isaac, even more absurd is that after running through the ABCs a few times, there wasn't much more we could do other than watch and pray. He didn't die and it seems like he's improving in the ICU, but it makes you wonder how the boy would have done had he been brought into an ER in Chicago.

One of the new attendings has been encouraging me to take pictures of my patients who have weird pathology. It feels wrong, so I only did it once. This is a kid with Burkitt's lymphoma. It was huge. But the kid was up the next day running around the peds ward.


We're taking the next two days off. Looks like we'll be going to Givan's tomorrow (he says to bring a lot of sugar, I think it's a gift for the village) and then Nairobi to check out the Maasai market on Saturday. Should be awesome.

Cactus Tree

Alright guys, I found a tree that looks like Peter's hair:


Am I the only one who sees the resemblance?

These trees are pretty fascinating. The bottom looks like a tree and the top looks like a cactus. Anyone know what they're called? We see a lot of them when we travel down the mountain from the hospital to the rift valley. By the way, whenever we travel down the mountain I'm pretty sure that there's around a 50% chance that the car we're in is going to flip over. I'll have to upload a picture of the "road" that leads from Kijabe to the valley.

I should take this time to talk more about what we've learned about Peter's hair since coming to Kenya. The first time Peter's hair came up was when we went to the Nduriri mobile clinic. One of the school boys we met there randomly mentioned that Peter's hair was "beautiful." I have to admit, I was really taken aback by this. I just assumed though that the boy either was being very polite or had just learned the word beautiful and wasn't really quite sure how to use it yet.

A few days later, when Peter and I were on call, one of the male ER nurses randomly said, "Peter, your hair is so nice." I quickly asked the 3 other nurses, who happened to be female, if they felt the same way. Indeed, they also thought Peter's hair was "so nice." At this point, I was really confused. Later that evening we were paged to the ped's ward to see a baby who had spiked a temp. I took this opportunity to get more input about Peter's hair (as well as give the baby some paracetamol.) Maybe there was something weird about the nurses in the ER. Three female nurses ranging in age from 25-55, in my estimation, all agreed that Peter's hair was "very beautiful." I asked them why they thought that (?!?!). Apparently, they were attracted to the spikiness and uprightness of Peter's hair. I immediately looked around for someone else to verify what I was hearing from all these nurses. I spotted a boy who looked like he was around 14 years old. His name was John and his brother, Paul, was being treated in the hospital. After some brief introductions I asked, "John, do like Peter's hair?" He didn't give me a direct answer but instead said, "Peter, just tell me one thing: how can I make my hair stand up like that?" UNBELIEVABLE. To make a long story short, I've pretty much asked every local I've met what they think about Peter's hair. Everyone in Africa loves Peter's hair.

Lake Naivasha

I am on call today so I'm sitting at home praying my pager stays silent and no one rolls into the casualty.

Isaac and I both had a free afternoon yesterday so we decided to check out Crescent Island and Lake Naivasha. We recruited Jason, a college student who is spending a few months here, and headed to the mutatu stand to find a driver. As soon as he pulled up in his beat-up Corolla we knew the car wasn't going to make it. We were right. He sat down and the seat snapped, like the back of the seat was in Jason's lap. So we made a quick pit stop in a small town at the bottom of the Rift Valley where a man came out and welded the seat back into place.


Meanwhile kids kept coming up to us asking for bread.


We didn't give them any, but we took a picture with them.


We ate lunch at the Lake Naivasha Country Club, which apparently is where all the rich Kenyans hang out. We couldn't afford the baller lunch buffet so we ordered sausages and fries.


After lunch, we took a boat across Lake Naivasha to Crescent Island, which is no longer an island because a bunch of flower farms have been sapping all the water. It was also where they filmed "Out of Africa," some old movie none of us have seen before.


A hippo chilling in the lake.


We spent the afternoon walking around with animals. Giraffe families, zebra, impalas, gnu and a python we tracked forever but couldn't find. We each took turns chasing them.




Here we are admiring a gnu carcass that a group of vultures was feeding on.


Jason climbed into an aardvark hole and got stuck.


We should have paid attention to the gathering clouds, cause it started pouring just as we got back from the island.


It was good trip, and thank God for bringing us home safely. We spent the evening playing basketball up at Rift Valley Academy, the boarding school for missionary kids. It's weird how many Korean kids go to school there. Anyway, here's Mt. Longonot again. Kenya is beautiful.


On a side note, I had a couple Maasai parents bring their baby into the casualty while I was on call. They came from really far away, close to the Kenya-Tanzania border, cause their baby had this huge bump on her head that is probably a hemangioma. I learned that the traditional Maasai diet consists of cow meat and a mixture of milk and cow blood. Maybe we'll try some when we visit Givan.

Nduriri

We drove out to a rural clinic in Nduriri yesterday. We were scheduled to leave at 8:30am, but in typical African fashion we left about an hour late. Here's Isaac with Obonyo, one of the interns, in front of KH.


After more than an hour of bouncing around over rocks in an old-school Land Rover converted into an ambulance, we finally arrived in the small town of Nduriri. The clinic was a small concrete building covered in chipping paint with patients lining the hallways. The place is run by a few hard-working nurses who use dirty index cards taped together as patient charts. After a few hours of seeing patients, the nurses put together an amazing lunch with plenty of chai. Kenyan food is really really good.


Speaking of lunch, these aren't bottles of rubber bands...


After lunch, Isaac was wandering around outside taking pictures when he was spotted by a few of the kids at a nearby elementary school.


Seconds later, dozens of kids come streaming out of the school gate and mob Isaac.


I forced them to take a picture with me too.


We walked over to the school, where more kids came running out to meet us. They were fascinated by the muzungus -- and by Isaac's digital camera. We showed them pictures of themselves and they went CRAZY. It was hilarious. They also sang songs for us and had a blast giving us high-fives. The best was when you said "Habari!" they would respond with "Mzuri!" in unison. Even as we left and the kids were forced to return to the classrooms, they were piled on top of each other screaming and waving goodbye to us through the windows.


After getting back to KH, it was soon time for call. The call nights are so busy that now we both go on call together -- how is one intern and one M4 supposed to cover an entire 250-bed hospital!? We have to evaluate the truckloads of people coming into the casualty while checking up on seizing babies, dealing with drunk trauma victims and declaring people dead. It gets crazy.

Mt. Longonot

It has been a very busy few days here in Kijabe, and we both have a billion stories we want to tell. The place and the people have just been amazing.

First of all, Dr. Trotter drove us down to Mt. Longonot early Sunday morning. The place was incredible. Isaac and I are still recovering from the 5-hour climb with half of it under the scorching African sun. One hour climbing up the side, another three all the way around the rim of the volcano and one more back down. And a good amount of scrambling up rocks with sheer drops on either side. Wanting to get air-lifted out definitely crossed my mind a few times.




We saw a couple families of giraffes grazing and running around, a few water bucks, and a car that we thought was a zebra. And a bunch of huge hawk-like birds. There was also a mini-volcano along the side of Mt. Longonot.


The whole area was littered with these plants covered in berry-shaped ant houses protected by spikes. Pretty weird.


We went with a few family medicine residents who brought a pulse oximeter along and I was satting 90% with a HR of 136 at the summit. We also ran out of water with about two hours of hiking left, which was kind of scary.


Out necks and arms were pretty crispy but somehow we survived. Praise the Lord.


Anyway, Isaac and I have been making friends. One is Givan, a security guard at Rift Valley Academy. He’s this tall lanky guy who is a Maasai warrior. It isn’t hard getting hired as a guard when you killed a lion with a spear at the age of fourteen. He says, “Oh it’s easy. I can show you.” He also invited us to the house he built in a Maasai village where he lives with his family. Unfortunately, it involves a 1-hour mutatu ride (recklessly-driven van with twenty people shoved into seats for ten) and a walk he claims only takes one and a half hours (the doctors said it takes thirty minutes by car). And they were banned from killing lions after the 90’s, so now they kill hyenas to protect their goats and cattle. We’re thinking about going this weekend. He says that we can slaughter some goats in the evening.

One of the doctors told us that when he went to visit Givan, they were driving along and saw a bunch of giraffes. Givan yelled, “Let’s get them!” and jumped out of the car with a club in his hand. He threw the club and barely missed the fleeing giraffe’s head. Now that is a man.

We've been in the hospital a few days now and it's going to be tough explaining what that has been like. We'll write more about it in a later post. Call last night was definitely as busy and crazy as I thought it would be. It was my second day at Kijabe Hospital and I have already had a baby die in front of me as I did chest compressions. But despite the hospital's flaws (like the power going out pretty frequently during surgeries) and limited resources, it's been amazing how much the Kenyan interns, residents and staff have welcomed me and Isaac.

Tomorrow I take a break from pediatric surgery and Isaac from anesthesia to drive with a team to a remote clinic in a town called Nduriri. We'll try to update more often, depending on whether or not our dial-up internet decides to cooperate.

Kwaheri.