Malindi Day Trip.

July 23^rd: Today was our big Malindi excursion. We planned an 8:15 am departure and hit the road running. In our cozy van (we hired Bernard, the driver who brings us to and from the hospital) to be our private chauffeur. We stopped along the way at the Gede ruins but decided we could get more for our money elsewhere and headed for a neat little marine park.

The marine park was a nice little beach without vendors! Giving their level of harassment, this was much appreciated! We were able to lounge in peace!

Soon after we got hungry and met some of the Malindi crew at a local restaurant called The Old Man in the Sea from which I had the most amazing pasta I have ever had in my entire life (big statement…I know!)

I’m not sure why we continue to willingly put ourselves in contact with the nasty vendors, but then somebody had the idea to go to the Malindi tourist market and of course it sounded like a great idea at the time! I have their speech lines down:

“looking is free” “come to my shop, this is my shop” “promote me” “I make a good price” “this is ebony” “this is banana peal” “this is soapstone” “this is shark tooth” BLAH BLAH BLAH

We spent quite awhile stumbling around the market and most of us didn’t leave empty handed. (Luckily Whitney was there to talk me down from my crazy idea to walk away with a HUGE painting!) By the end we were exhausted and ready to head back for Mombasa. We all decided we were so happy to be in Mombasa; Malindi was nice but a day trip was enough to realize that culturally, the heart of a true African experience can be found in Mombasa.

On the ride back I decided that I wish I had invested in coca cola the day it ventured to Africa. There are stands and advertisements every which way. The bottles are still the old fashion glass variety and I haven’t completely figured out why.

Swahili lesson:

Nini = what

Lala salama = good night

First Cesarean Section

July 22^nd: Fridays are characteristically slow at Coast General. Additionally, the neuro team had departed so I headed to maternity for the day. They were prepping for the cesarean section. There was only one pair of scrubs left so I eagerly claimed them and changed. Little did I know it would be another 1.5 hours until the procedure. I passed the time talking to the nurses and doctors as we waited for the anesthesiologist and for the patient’s insurance to process. (I was surprised to hear that they had insurance!)

Then I met the patient and it was a neat experience to know her personal story. She was 40 years old and had been trying for years to get pregnant (most women here start having babies in their early 20s…if not sooner!) She said, “It’s a miracle, I’m going to have a little girl!” The doctor explained all the complications (fibroids, pre-eclampsia and hypertension), which is why she was having this procedure two weeks before the due date.

I had no idea caesarian sections were so quick and seemingly simple! It took less than 5 minutes to get the little bundle out!

This evening I got a productivity roll and worked on my application/personal statement and went to bed early in preparation for our Malindi trip tomorrow!

Too much tumor.

July 21^st: Another day in neuro surgery! The notable procedure today was another laminectomy. The patient was a 30 year old with a benign tumor spanning from his thoracic to his sacral vertebrae –all his lumbar = ~12 inches of tumor. Jose explained how at home removing it all it would be a 12-24 hour surgery. Therefore, the goal of today’s surgery was to only remove the top third (That chunk was causing paralysis…although the bottom was causing a little bit of a loss of control of bowel/bladder function. The paralysis was considered more urgent.)

This procedure called for:

1.     The Spaniard neurosurgeon

2.     Another Kenyan neurosurgeon

3.     A Kenyan orthopedic surgeon

Therefore there were MANY hands moving swiftly, effortlessly. We found it CRAZY how little communication was necessary; they just worked together like they had been a team for years.

At one point they called us over to come see the exposed spinal cord. Then they showed us a chunk of the tumor. They explained how they could tell by the pigmentation that the tumor was actually malignant and not benign. They showed how it was darker so it was melanoma that had metastasized.

This poor 30 year old… They removed as much as they could and closed him up, knowing his prognosis was pretty bleak.

That evening we went to white sands beach to play the tourist and buy some worthless knick-knacks. I’ve obtained quite the collection –look out roommates, our apartment will be having an African theme this year! ;)

Diagnosis

July 20^th: This morning we awoke with the same enthusiasm for a day watching neurosurgeries. The surgeries scheduled were pretty similar to the day before (several laminectomies). In addition, there was a shunt removal on a 4 month old scheduled.

This poor little boy had hydrocephalus and his frontal lobe was bulging outwards. I got to hold his little hand as the anesthesiologist set up for intubation and anesthetics. Jose explained that the tubing equipment that they have here in Kenya is not the best and this little guy’s was faulty. Therefore they were going to try to replace the faulty segment rather than removing the whole thing. Sure enough, once exploring they found the problem and were able to replace it.

After watching the surgeries of the day we were waiting in front of the hospital for our ride back to the compound when this man approached us but didn’t say anything right away. My first instinct was to reach for my pockets to protect the contents as I thought he was trying to pickpocket us. A minute later he found an opening in the conversation and began to ask for our help. (I hate those moments when you feel guilty for questioning a person’s intentions, for judging right away.)

This was my first taste of trying to determine a diagnosis on my own and it was SO GREAT! He described the strange symptoms his daughter was experiencing and he was so sweetly concerned. He was frustrated because they had come once before and the doctors just gave her headache relief meds but the symptoms were worsening. It was Whitney, Maggie (an Irish medical school student) and me. We unanimously concluded that it sounded an awful lot like epilepsy. We followed the man back to the waiting room where his daughter was seated and we had her describe her symptoms as well. More and more signs were pointing towards epilepsy (Maggie had a pocket-sized medical reference book that emphasized that we were on the right track). We all felt the satisfaction of being able to give her feedback. It may not have ended up being the correct diagnosis, but it will give them a discussion point with the doctor. To try and solidify the evidence/conclusions we made our very first (informal but equally exciting) dictation. We wrote the important symptoms, the symptoms that were missing, a potential course of treatment, potential tests to run and our tentative diagnosis. We gave it to the family. We probably had relatively no impact on that girl’s future but we were happy to give her even just a bit of our time and our feedback.

Later that night we went to the highly anticipated 9:15 pm 3D showing of the legendary Harry Potter. This was past our usual bedtime (I just may have dozed off for a bit :/)!

Neuro Surgery

July 19th: I woke up this morning with the intentions of spending my day in maternity but when one of my fellow pre-med-ers told me that a neuro surgery team from spain had arrived for the week! = instant change of plans! How many chances does a person get to spend a day watching professionals fix the intricate problems associated with the nervous system?

We arrived in main theater 4 to see the neuro team setting up shop and I was honestly giddy with excitement for the day to come! The neuro team was INSTANTLY so accommodating and welcoming to our little curious selves! We were busy making ourselves flys on the wall (so as not to get in the way) when the head honcho walks up to us "Hi my name is Jose"

From there we chatted with him about their mission. They are spending a total of three weeks away from Spain –their first week was spent in a big hospital in Nairobi, now they are in Mombasa for the week, and next week they will continue on for a week in Zanzabar.

I’ve always thought about ‘brain surgeons’ as the most respectable, brilliant kind of people. And I guess I expected that they’d have arrogance to them –and I would have granted them any degree of cockiness without an ounce of judgment. Jose was as down-to-earth as possible. He asked us about our lives and our experiences here in Kenya. He was very very genuine and it went a long way!

That’s what is so great about Elective Africa. I’ve gotten the opportunity for unmatched exposure. There may have been things that differed from my expectations but once I adjusted mentally to the way things were here in Kenya, it was so great! Regardless, I’ve been able to come in contact with doctors/nurses that make you think “I never ever want to have that trait as a physician.” A firsthand experience of the repercussions of different qualities is a very, very impactful experience! I have been completely frustrated by the lack of personal care. The standard here is to provide exclusively physical health care with no attention on the emotional or mental aspects of health coverage. 

Alternatively, I’ve met doctors like Jose! …He had arrived at the hospital, ready for action, before 8 am. He wasn’t actually able to begin until 10:15 am (this seems to be the norm around here; inefficiency). To keep a neuro team waiting on a simple blood transfusion, clean scrubs, equipment or the anesthesiologist is not exactly how I imagine things are done in the states. But here, it happens, time and time again.

The first patient was a gunshot wound patient. He had been shot through the anterior protion of the skull and the bullet was lodged nearly smack dab in the middle of his brain. The MRI scans were unbelievable. You could see all the lobes of the brain with a nice bullet shaped object hanging out right in the center of this intricate control center.

As they rolled the patient in, Jose explained to us how the superficial portion of the wound had become massively infected (the actual incident occurred over a week prior). Their goal, he explained, was to clean up/remove the infected tissue and remove the loose shards of skull. “we don’t even try to remove the bullet” he explained, “as it is too dangerous to poke and prod in those regions of the CNS.”

It would only seem natural that he would have severe loss of mental capacity, coordination, sensation, or ...something! -with that foreign piece of metal in his brain. “He got lucky” Jose said. He will most likely walk away with, at most, epilepsy. A condition that simple medication can treat! If ever put in a similar situation (heaven forbid), I’ll simply point my scalp towards the barrel and PRAY that the bullet will have the exact same location of impact. On second throught, I think I’ll spare the neuro team the inconvenience of traveling to my rescue and I’ll just pray for avoidence of that situation.

Regardless, the surgery was amazing but MUCH less intrusive than I had imagined. The next procedure was the implementation of a VP shunt. This was a patient with a brain tumor in an area that compromised the draining of the cerebral spinal fluid from the ventricles of the brain. The added volume within the non-expandable skull causes catastrophic pressure buildup. So the procedure involved:

1. Drilling a hole through the skull (no big deal)

2. Making an incision in the abdominal cavite

3. Threading the tubing under the skin from the inside of the skull down through the neck and into the peritoneal space

Simple as that. The fluid then had a path it could travel if the pressure built up (and we could instantly see the draining of the fluid through the tube. It was absolutely amazing.

During the surgery the neuro surgeon would motion for us to come get a closer look. Afterwards Jose happily answered any (and many) questions we had.

The last surgery was a laminectomy. The ‘lamina’ is a part of each vertebrae and ‘ectomy’ means to remove. A calcified tumor had grown on the vertebrae and into the spinal cord’s cavity, causing compression of the spinal cord (leading to paralysis). Jose told us that the procedure was about 20 years out of date and would never be administered in Spain or the US but this hospital lacks much in terms of chemotherapy or radiation so it’s the only option here.

By removing the tumor that clung to the lamina of a vertebrae (literally ripping out the bone protecting the spinal cord) they would remove the problem causing paralysis and the patient could walk again.

This was hands-down the most amazing day spent in the hospital –and we stayed past dinner time! We were given lunch and tea in the doctors lounge and got to interact with some amazing healthcare staff. (both Kenyan’s and Spanyards!)

Safari Days!

July 14th - July 18th: We were up bright, early, and excited for our 8:30 am departure! We had each packed a backpack full of the essentials necessary for roughing it in the Masai Mara and walked out in the Mombasa morning heat to find the private bus we had arranged for our journey. There were near 30 of us and this bus was classic for the adventure! It was a lovely cream color, (the shade that bright white things turn when days of direct sunshine leave it discolored), there was no air conditioning, the seats were as comfy as cement, and (regardless) we were gung-ho for the supposed 14 hour trek!

Only a supposed 8 hours were to be taken on this bus (turned out to be 9.5 due to traffic) and I actually really enjoyed it! It was neat to see the african countryside and see the transition from Mombasa (the second largest city) to Nairobi (the capitol). I had figured Mombasa was a fair representation of all of Kenya but as we shifted away from the humidity of the coast we also shifted to a cleaner overall atmosphere. I THOROUGHLY appreciated this detail. Mombasa is really great and you really get to experience a feel for the village life that many Kenyans come from, but with that comes the smells, the filth, the flys, the stray animals, etc. I've never really been one to make a scene at the smell of manure or other unpleasant aromas. But I've never experienced the smell of burning all contents of trash. The way it lingers in the Mombasa humidity is enough to provoke my gag reflex at times. I think it's worse for me because you can't differentiate what exactly you are smelling. Its quite the pooparie, if you ask me!

But Nairobi turned out to have a much cleaner appearance. When I wasn't enjoying the african scenery along the way, I had my nose in a novel I picked up from the Nakumatt -which made those 9.5 hrs fly by!

We arrived in Nairobi around dusk so we just had time for a quick dinner (at an excellent chinese restaurant, YUM!) and checked into our hotel. Whitney and I shared a room in a really clean and well kept hotel (with hot showers) for only ~$10 each! What a steal! We had hoped to hit the hay early but ended up chatting in the dark, from one mosquito net to the other!

We awoke to find the most INTENSE safari vehicles waiting to take us the last 6 hr leg of our journey. We each grabbed a seat and were OFF! The last three hours were on unkept dirt roads, with bumps so big that our vehicle was practically horizontal on its side at times. We'd bounce around in our seats, hitting our heads on the roof, smacking into each other. It was quite a bonding experience! ;) And I've never been so happy that I'm not prone to car/motion sickness.

We arrived at our Masai Mara (name of the park) camp/house site. It was actually quite luxurious, a cute little cabin housing Halley, Whitney and myself! We threw our bags down and jumped back into the safari vehicles for our very first evening safari!

Holy Bajeezes, I say this with complete enthusiasm: add African Safari to your bucket list. It is amazing. Literally, the next two days were spent with lions. We saw an unprecedentedly absurd number of lions, they'd weave in front of us (brushing up against our safari van once!) We saw several prides of lions every day, males, females and little pups. We saw them up and roaming (once trying to hunt!), laying in the sun, and playing around with each other.

Every safari driver has a radio and if one van finds a high priority animal within minutes the poor little creatures are flooded with vans and camera flashes! It looks pathetic at times, silly little homo sapiens at the heels of a cheetah, lion, elephant, zebra, etc and they barely give you a glance in return! They don't seem to be affected by the presence of idiots! ;)

The nights got QUITE cold, I honestly wore every article of clothing I brought when I crawled in bed for the night -which I think added to the overall experience!

On Saturday after our day safari we stopped for a tour of the Masai tribe life. Let me share with you some facts about their way of life:

1. They drink cow blood. (Which takes the cake as the most off-putting). I respectfully asked if the cows were spared in the process. No, they assured me, they have a technological device to abstract the delicious fluid without harming the cows.
2. They live in houses that the women make from cow dung. This textile, I learned, is a great insulator for those cold nights in the Masai Mara. -It also attracts many many flys.
3. The baby cows live in the house with them. As a matter of fact, the calfs territory in the house is over 1/2 of the entire square footage! The need to share residence with these animals so the lions don't take them as bait in the middle of the night.
4. They gage their ears if they don't finish school.
5. They have open fires inside their houses -HEAVY fumes!
6. Boys are circumcised at age 13 in front of the whole tribe (200 people) in their manhood ceremony. This ceremony includes a lion wrestling (and yes, people often die in this battle...I still didn't understand exactly how they lure the lion into their village or why they would want to encourage such things but nonetheless you need to be stronger than the lion in order to become a man.
7. At age 15 each of these new 'men' need to prove this to their tribal community so they are sent into the wilderness for 5 WHOLE YEARS!
8. Despite this primitive living, I saw numerous cell phones in the hands of these people. Not sure exactly how that works.
9. They have arranged marriages
10. The men can have up to seven wives.
11. They buy their wives with cows (the going rate is 10 cows per bride and if you can't afford it/don't have that many cows, there's a simple solution: you can trade your sister for your wife! At which point your lucky sis gets to transfer to the village from which the wife comes)
11. They really know how to sucker you into a pity-purchase. They end the tour with a convenient stop at their market where they sell authentic merchandise, 'just for you!' ...somehow I walked away with a necklace containing an elegant tooth pendent? Not sure the logic on that one...

Despite all these extreme and absurd differences in culture, you still find yourself intrigued and impressed with their lifestyles. It is such a community lifestyle, its admirable. And of course you wonder, "what if I was born a Masai?" I would drink cow blood. I would do their dances, wear their vibrant fabric, be married by the time I was fifteen to someone not my choosing. And that would be normal.

I'm not sure how to treat the feeling that I'm glad I was born into the culture I was. It makes me feel guilty somehow. -As if it's my fault that they live in dirty, poverty. But actually I think the guilt comes from the fact that I pity them. Internally, I mock their customs, their ways, their rituals, their way of life. But they are happy, contented -possibly even moreso than I! And yet I pity them. I realize that my way of thinking is twisted, tangled a bit. 'Normal' is such a relative term and it hinges on your culture. The whole nature vs. nurture debate...

I wonder what kind of world it would be if we stepped away from the 'norms' of our specific culture and focused ENTIRELY on what is important? I think both Americans and Masai could  grow from this mindset.

Anywho, we spent the next morning on safari and made the bumpy trek back to Nairobi. We spent the next night in the hotel and took the next bus back for Mombasa. (I have 50 pages left of my 656 page book!)

Safari was amazing, but it felt good to be back 'home!' Whitney and I made the realization that we had only 9 days left to be spent in the hospitals, so we went to bed early in hopes of spending a long day at the hospital the next day!

Patience can be hard to find.

July 13th: I woke up this morning hyped about spending the day in Peds. I got there in time to follow Dr. Sauud with her morning ward rounds where I saw endless cases of meningitis mixed with pneumonia, sickle cell disease, rhumatoid heart disease, nephrotic syndrome, rickets, and more. Meningitis is so absurdly prevalent. You'll often see three kids to a bed near the oxygen supply and two to a bed is not uncommon elsewhere. It is stuffy, smelly and hot to the point where I'm uncomfortable, but the kids seem to be in so much other discomfort that they don't seem to notice or mind. It's usually the mothers that keep watch on the children.

Most of the diagnoses have an additional "severe malnutrition" attached and yikes are some kids sickly looking. Its horrible. There was a five month old who honestly still looked like a preemie. She was completely unresponsive to touch, sound...anything. The doctor clapped in front of her face without a flinch or a blink. I always always want to hold little babies, but when they are so so helpless it makes me wish that could be enough. She was strapped to oxygen and was febrile (high temperature). The poor little thing.

We weren't half way through ward rounds when I saw this little bundle all alone on a bed (I never did find out exactly how old she was, but I'm guessing 9 mo to one year). No family member was there the whole time I'd been there and I was starting to get curious. I went over to a nurse and asked why she was all alone (and wanted to include "and why is she unattended by staff?" but knew my place). The nurse explained to me that she was abandoned by her mother. All alone. Sick and alone. I stepped over towards her and tried to get her to stop crying. Oh little did I know I would be spending the rest of my hospital time bonding with the little thing! She was crying and waving her arms (in each breath and each sob you could hear the mucus buildup causing her troubles). I tried to reach out for her and get her attention but her little arm pushed mine away. Little did she know she was dealing with persistent Ann Bergstrand. ;) I kept trying to smile at her and console her the best I could. To my delight, she eventually caved and let me in. Before she knew it she was snoozing with her little fist wrapped around my finger. I slipped it out without her waking and went to go continue watching ward rounds.

Soon she was up again, crying and waving her arms again. I saw a bottle set on the table beside her bed (keep in mind that I had not seen a single doctor or nurse attend to her all morning) so I decided that maybe she was hungry. I sat her up and helped her with the cup and realized that drinking would be a struggle for her, with all the mucus buildup. I tried to make her go slow but most of the milk ended up outside her mouth. I felt so helpless.

The icing on the cake was when I checked her diaper to see if that might be another factor making her fussy: she had been sitting in a dirty diaper most likely the whole morning. The rage started building inside me as I walked over to one of the nurses and asked where they keep the clean diapers. She looked at me with annoyed undertones and said "I'm too busy to do that right now" and I said "ok, but can you point me in the direction of them and I'll do it!" (changing diapers, after all, IS something I am capable of) and she responds with something I have trouble understanding entirely but I think she didn't want me into the chemical room? Either way I was frustrated beyond belief. It would take 30 seconds to go get a diaper for me. Every other child had a guardian of some sort to watch after them, feed them, change them, etc. But this little pumpkin didn't. And its like that puts a big sticker on her forehead saying "Not worth the time, effort, or emotion to care for me." Because nobody (other than me) even glanced her way. I wanted to break into the back 'chemical room,' (wherever it was?) and steal a diaper. Better yet, I wanted to wrap her up into a bundle and swing her right out the front door of the hospital. I seriously thought about this. I don't think anyone would have stopped me; I don't think anyone would have noticed. That made me even more frustrated.

I understand how overworked the doctors and nurses are here, and how much death and disease they see on a daily basis, so it's hard to blame them -they are just adapting. It becomes survival of the fittest. If someone can't make it with minimal care, then they certainly aren't going to become a priority. That's not the typical mindset you want in a healthcare setting, after all it's the ones who can't survive on their own that need the care the most... It keeps me all balled up with uneasy anger.

Coming back to the compound, knowing that little orphan was still laying alone and filthily unfed, was difficult for me today. But the crew went out to dinner and we were able to have a great time together! We came back and a few of us stayed up having heart-to-hearts, getting to know each other. It was really great, we have a good crew here in Mombasa! I'm meeting some amazing people!

And now, off to safari! :)

100% Better

July 12th: I woke up around 6:30 am this morning and was annoyingly still a bit off. With the safari only two days away (which begins with a 14 hour bumpy bus ride), I decided that it might be a wise choice to stay home from the hospital for the day. Whitney (who had been up throwing up during the night), Kitty, and Nicki (who's flight home was this evening) had all also decided to stay home. I had pringles for breakfast and spent most of the morning lounging around. But it seemed like I was taking steps in the right direction and getting better, step by step! By afternoon my waves of stomach pain were less and less frequent and I was able to join the others out by the pool!

Whitney and I grabbed a tuktuk to the Nakumatt and when I got there HOLY SMOKES all the food looked sooooo good! (Which I took as a good sign!) Interestingly enough, my choices were doughnuts, ice cream and apple juice -weird, I've never had much of a sweet tooth?? ;) But actually weird to be craving sugar after such a stretch of uneasiness! 

When I got back there was talk of a few people going to the local's market (where the people here shop for anything and everything). I waited a little bit to see how some food would settle with me and decided to join them! 

We pass this market every day on the way to the hospital. It is always crowded and this afternoon was no different. It is absurd to see fresh fruit and food being sold inches away (if not on a tarp on top of) rotting old garbage. Thats what they do everywhere here: the trash goes kaapuut where ever they please and they burn it, but it never burns it all up. Not to mention the smell of burning everyday trash is worse than you would think. And it lingers. Uf da. 

But the market was regardless really really neat to see! The clothes, shoes, kitchen utensils etc were all second-hand type and nothing was really that clean. This is poverty. One guy that was with us was on a mission to find some of the Kenyan soccer jerseys from the Kenya teams and was eagerly trying them on. I was much better off just looking around, taking it all in. Most of the surrounding conversations were in Swahili and I can't count how many times I heard "mzungu, mzungu" (white person, white person). It becomes our names here, especially in a setting like this one where we stick out soooo much!

As dinner time rolled around, you can bet your bottom dollar that I had not forgotten about my skippy peanut butter! It suited me just wonderfully! I was hyper from the fact that my stomach wasn't trying to self-destruct! 

A bunch of us decided to dish out the 300 shillings (~$3) to go see the movie X Men tonight! It was extremely intense and quite the film! The movie theater in town is seriously one of the nicest that I have ever been to! It almost seems a little out of its element! 

All in all it was a great day and I'm happy to say that I am fully back to 100%!

Pringles Therapy.

July 11th: I woke to see another day! ;) We caught the 8 am ride to the hospital where Whitney and I were to spend our first day in Pediatrics. We made it just in time for the 8:30 am ward rounds. Oh man it is tough to see these uncomfortable, sickly kids -sometimes two to a bed. There were two birds flying about inside the ward and nobody seemed to think it strange! We saw several meningitis patients, a malaria patient, one potential TB patient (not quarantined off at all!), one small child with some sort of heart problem and several other organs in rough shape. I made it my goal to try and ekk out a smile out of each one; some gave a bashful smile, some seemed too glazed over to express emotion. 

I wish I could say my little stomach bug had become a thing of the past but I ended up having to leave the hospital early. It's frustrating because i think my main symptom is just intense hunger, since food has been hard to keep down. And I think most of you know I don't do well when I'm hungry! But it is hard to know for sure, all the symptoms seem to run together. So I took a tuktuk home and instantly took a nap (falling asleep to The Proposal movie with Sandra Bullock). I would be a little concerned if I were the only one feeling this way, but several of us have been going through the same so we're all thinking its just a minor adjustment bug. (And the ones that had it at first are now feeling better so that gives me hope!)

After I arose from my slumber, I convinced Kitty and Halley to join me on a jaunt to the Nakumatt (superstore area that has the casino) with a goal of getting A. money from my debit card and B. foods that were familiar to me. After making a call to bremer only to find out that they couldn't give me an explanation for my problems, we entered the casino to give it a try. I was a bit frazzled all the way around at this point and anxious to find a place that could help me withdraw money so I was DELIGHTED when the transaction went through! 

Unfortunately, they had made a copy of my passport AND front side of my credit card and insisted on keeping it. We were not too pleased with this sketchy situation and insisted on walking out with the copy they had made. They told us it was "company policy" to keep it for their records and said that they would return it if they would be allowed to cancel the transaction. But they said that it would take two weeks for the 10,000 shillings to be put back on my card (over $100), and I didn't like the sound of that either. I felt like if I walked out with that copy, I would never see that money again. Kitty was brilliant and called Jevis to come assist us while I tried to debate with the employees/managers. Their story didn't make any sense and I tried to explain to them how frustrated/frightened I'd been with the thought of having no other access to money oh and soon the emotions came over me and lickidy split i got worked up and started to tear up a little bit. Oh goodness did they ring the alarms at this one! A manager/owner guy shuttled quickly over saying "don't cry don't cry...you can take your copy and your money" ...Why didn't they offer that in the first place? They tried to explain how this policy was for my (the customer's) benefit so that I wouldn't have to bring my passport for any further withdrawals, but I wasn't buying it. We hurried out of there before we caused any bigger scene and went on to try and find something edible.

I picked up: Pringles, Skippy peanut butter and Kelloggs Corn Flakes. Even that didn't sound good at the time and we got home and I went right up to my bunk for another nap session! I woke up in time to give dinner a go and stuck to my Pringles and they sat well with me! I was so pleased to get any sort of caloric intake at this point! 

After dinner we all stayed huddled in the living space and to candle light (the power went out -which happens frequently here) we did a form of hot seat where we just asked each other different get-to-know-you questions. 

Nikki brought a guitar and after our little heart-to-hearts Neil whipped it out to play us a song he wrote about the sickliness of the household, it was quite the comedy and very entertaining! 

Quick swahili lesson:

 mzungu = white person  

Thats all for today! Hoping I'll be able to tell more about my adventures and less about my struggles tomorrow! 

A warm welcome!

July 10th: I woke up this morning feeling still a bit off but I wanted to mentally step away from my stomach and get out and enjoy Mombasa!

Myself and a few others decided to check out a baptist church in the area! I was the only one from our compound, so I met the others around 10:15 am and we grabbed a sketchy cab to the 10:30 service! I was worried about how they would receive us (we've seen a few cases of racism since arriving) but I was pleasantly surprised! We got there a few minutes early and were greeted with smiles and "karibu!" (=welcome!). I was so energized the second I walked in! There was background soulful music playing before the service and people were flocking into the chapel! After the formal welcome and prayer they broke into dance and song! And I was sooooo excited when the first song was "Trading my Sorrows" and I knew every word and sang it like I meant it (just like everyone else)! haha A song in swahili came next and I tried my darn'dest to pronounce every syllable (the words were posted in the bulletin) but struggled a bit. It was neat to see every person genuinely inspired; even the little kids seemed to be having a blast and participating in the service! 

An interesting part was a prayer tucked somewhere in the service, lasting HONESTLY over 15 minutes. I wish I could claim to have stayed attentive the entire time but it got a slight bit repetitive, yet the individual giving the prayer was sooo enthusiastic! Not a single word spoken during the service was without energy, everything was with a rejuvenated spirit! It was refreshing (and reminded me of Mount Caramel!) :)

Then they gave a formal invitation to all the visitors -even as far as passing around a microphone so we could give our names and where we were from! Normally, I might have felt a little uncomfortable with this, but I really appreciated it in this setting! For the first time I really WAS a foreigner and I really DID feel out of my element, so to know that they appreciated our presence was so powerful! 

The sermon was wonderful and actually done by a visiting pastor from Chicago (but who lives in Nairobi now)! After the service ended we were on our way shuttling out of the chapel when some people snagged us and wanted to invite us to tea or juice. We didn't want to be rude so we sat down and chatted with a few Kenyans (although, my weary stomach avoided any foreign beverage). 

The rest of the crew from my compound had gone to explore a local market in Mombasa and I had hoped to catch a tuktuk so I could meet up with them. First I had to stop at a nearby development with banks/atms because I had some problems getting money off of my debit card (which has been a frightening headache!) The casinos actually have the best exchange rates, so I stepped in there to see if they would be able to give my useable currency (none of the atms have worked yet). As I was waiting at the counter, an intense wave of sickly uncomfort spread upon me and I abruptly asked for my card back and rushed for a tuktuk back to our compound (a distance normally walkable). 

I took a couple hour nap and woke up feeling still a little off kilter. The crew had all decided to go get dinner at a restaurant nearby. I initially decided that I should lay low and try to recoup as fast as possible, but I was convinced to give it a try. I was really glad I did and was happy to see some familiar types of food (and managed to stomach two pieces of pizza!) We had a great time and the restaurant was RIGHT up next to the ocean. When we returned back home it was a different story and that pizza began to not sit so well with me. So I put my good sleeping skills to work and hopped into bed. 

Inspiration and nausea.

July 9th: So far my favorite part of being here has been the instances when we were invited to share in on the culture, really feeling the extreme poverty. The first major experience was when we went to the orphanage. Today we went back! And we also visited an old folks home.

We left at 8:30 for the old folks home (one of its kind in Kenya apparently) and I wasn't sure what to expect. I had envisioned a dirty rundown place but my visions were quite far off. It was the cleanest place I have been to yet, speckled with enthusiastic nuns and employees. The people seem to be getting the care they need. They were very well attended to, which was VERY refreshing to see after our days in the hospital.

Sister Rose first gave us a tour of their home. We stopped to chat with their oldest (103 years old!!!!) who was exceptionally sharp! He could only talk in swahili but Dolas translated for us. He was very precious, saying "peace be upon you while you are here in Mombasa and when you return home" ...you could really tell we were a highlight of his morning and he was so happy to share is wisdom!

Next we ran into a 97 year old woman named Juliet. I have never been so blown away and impacted by a stranger. She was the kind of woman that made you want to spend the day learning her life story. She seemed extremely intelligent and religious. She recited (from memory!!!) this 5-7 minute long poem. It was nearly a motivational speech, she talked about being messengers of God and living in peace despite our good/bad choices/situations. She was amazing.

Following, we returned to Precious Vision Care Center. Jane greeted us at the entrance again and led us into the school. It is more of a school than an orphanage (with 250 students and only 50 of them are orphans) so she had to arrange for them to come in on a Saturday so it was a smaller crew. Oh my goodness gracious are they amazing little fireballs of inspiring energy. They are all so smiley and happy! They sang multiple songs (complete with dancing) and even included us into their dances! It was really fun! Then Jane took us on a shorter version of the tour of the village where they come from. This time she included showing us the home she is hoping to rent for herself and the orphans. -she is just waiting on some financial issues presently. She is also an inspiring woman, very focused on what is important.

My stomach has not been 100% since I got here, frequent stomach aches. I haven't let it bother me too much but today it seemed to be getting worse. Joann and Nikki were headed back to White Sands and I decided to tough it out and go with. I was slowing getting a little bit more miserable as the day went on and luckily some dark clouds started rolling in so we rushed on back. I instantly crawled into bed for a therapeutic nap and woke up feeling a bit better. Dolas had a wonderful dinner prepared (as usual) and I thought it might be a good idea to try and eat something (I had been having trouble with the thought of food all day). I ate and five minutes later regretted it.

Something has been going around our house all week. It started with the Irish dentists and now only 3 of us (out of 15) have NOT vomited since our arrival. Today I became another one to bite the dust. I feel much better presently but I am still crawled in bed at 7 pm for bedtime. -I just want to sleep this nasty puppy off! Hopefully tomorrow's blog will bring the good news of improvement!

Surgery Ward, White Sands and the Lion King

July 7th and 8th: I'm a little behind on my blogging since my days have been JAM PACKED with many exciting things that I am much too exhausted by the evenings! So I'll combine Thursday and Friday.

Both days were spent in the main theaters yet again. We found a doctor we really care for, an anesthesiologist named Dr. Seco. He has been excellent -answering any and all of our questions! He also has been great about quizzing us as well! He had me draw out the entire Krebs cycle and questioned me on other biochemical pathways! He explains everything he is doing and everything the surgeons are up to as well. There are medical school students in this program as well and it is always fun to listen to the questions they ask him and the questions he shoots at them! It gives Whitney and I plenty of topics to look up when we return to our compound in the afternoons (we keep a notebook on us and scribble different terms we would like to learn more about!)

The surgeries are really interesting...but the transition between them is often a bit slow and our time spent there doesn't exactly seem to fly by. On Thursday we decided to venture down to the maternity ward. We were hoping to see a birth but as we were walking by the 'cubicles' of delivery areas, I noticed a little nugget of a precious bundle on one of those heated newborn beds. I was with Phoung and Candice (Phoung just finished her first year of med school and Candice had spent the day in the maternity ward). We noticed a oxygen tube laying beside the little baby boy with a piece of tape attached.

The baby boy was blue -scalp, fingers, toes, everything. He was still covered in a layer of the afterbirth, all sticky and clammy. He had a blanket around him but he had wiggled free from it enough that it barely covered him. He wasn't crying, which was frightening. I got so riled up. Why wasn't anyone attending to this little child? I was so so so angry.

All three of us put on our gloves and tried to position the oxygen tube as best we could, rewrap him, and get him to show some sort of life. I didn't want to leave him. I stood beside him for quite awhile but finally had to leave because our ride home from the hospital doesn't wait for maternal instincts or emotional attachment. I've been wondering about that little boy ever since. I have no idea if he made it or not, I sincerely hope so. It's really REALLY aggravating to see such poor patient care. Nobody becomes an advocate for their patients. People die, young and old, and they are all so conditioned to it that it doesn't affect them. They just move forward. I guess I can't blame them, it must just be a defense mechanism. But it is so extremely hard to see firsthand. -to see a suffering baby put on the back burner because of his bad condition... Oh it breaks my little heart!

Throughout these little doses of horrific moments, it really brings me closer to God. I'm finally a step away from the easy street that I am accustomed to and starting to see some of the REAL hardships of the world. Even though I am powerless in the situations I have been exposed to here so far, I feel God's presence in the situation more than I ever thought possible. Strangely, it is amazingly inspiring. I hope that God will choose to work through me while I am here, giving me the strength to make a difference in His name.

It is enough to keep me awake at night. Thinking too many thoughts. Too many thoughts. Oh for Heaven's sake I just can't step away from the images of the day...But this quote brought me peace one night:

"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much" - Mother Teresa

Everyone here seems to experience so much during our mornings at the hospital. We all seem to come home in a lull, just in our own thoughts. Patients passing away in the ICU because they couldn't afford dialysis, violence/rape victims checking in to casualties (the emergency room). But we know it would be good for us to get out and see Mombasa to try to escape the heavy cloud of the day's experiences.

On Thursday we went to a beach/resort area called White Sands that is annoyingly populated with aggressive bartering vendors. We all came home with loads of souvenirs -myself carrying a heavy table all the way home. It just might have to become my carry-on item. Oops! ;)

On Friday we all went to a 7:00 showing of The Lion King! So so so so great! It was in 3D, go figure! We were all nearly brought to tears when Mufasa died in the stampede. And all laughed at "Asante sana, squashed banana!" from Grafiki the monkey! ('Asante sana' means 'thank you very much' in swahili). We all bonded for awhile back at the compound and some of the crew here went out to explore the nightlife, I opted for bed instead -emotionally and physically spent from my first full week here in Mombasa.

July 6th: Today was amazing. It all began in the main theater 2. Whitney and I got to sit in on two really impressive surgeries. We left the compound at 8 am yet surgery didn't begin until almost 10 am. -This is a part of the Kenyan culture I've begun to expect. Before the start of the surgery, we walked around to the 4 theaters to check out the day's schedules. We picked theater 2 which was the gynecology theater for the day.

The first surgery was a uterine tumor removal. So amazing. As we were waiting for the patient to be brought in, we were chatting with the doctors and nurses for awhile. They LOVE to tell about their heritage in the village where Obama's family's heritage comes from. Somehow everyone has some connection to Obama, but it is nice, it brings a common ground between us!

Then they rolled in the patient. She looked over 9 months pregnant! Whitney and I looked at each other questioningly but both decided to just observe before asking too many foolish questions. We knew her diagnosis was uterine cancer, but I think we were both thinking "I bet she's pregnant!" The surgery began and we watched attentively! The minute they made the incision she began gushing fluid. (by the end she lost 12 LITERS of fluid! holy man!) In addition, they removed a tumor the size of a basketball and did a whole hysterectomy. It was absolutely amazing! They weren't sure if the tumor was benign or malignant but they sent it down for a biopsy.

Its really unfortunate because most of the horrid conditions we see could be handled much better if the people sought treatment weeks/months earlier. They wait to seek medical help until its much too far gone and then their lifespan drops significantly. (The average life expectancy is around 60 yrs old here!)

Then we watched a fibroid removal. Every procedure is sooo neat. It is just crazy to see how resilient the body is (as they can pull organs outside the body!)

Our evening adventure was dinner on a floating restaurant! -it didn't feel like Africa at all! It was as if we were at a fancy resort in the states. Yet the view was nothing like I've seen before, very plush and jungle-like! About 15 of us went so we had good times spent together!

Progress in the Surgery Ward

Our coordinator had lined up a orientation through the hospital, so we got up early and went to the hospital for the tour. Two hospital employee's (Paul and Anthony) gave us the run down on the hospital first. They had a little powerpoint presentation with interesting Coast Provincial General Hospital (CPGH) facts. The most striking detail is that the ratio of nurses to patients is 1:50-70. Talk about under-staffed! They explained how that is their biggest obstacle in providing care for patients -manpower.

Then they gave us the tour of the whole hospital. It is a pretty big place, with over 700 beds total!  We went through each ward and met several people from each! It will be nice to know some familiar faces! I came to realize that some wards are better than others in terms of sanitation and contamination -and it seems the orthopedic ward from yesterday was easily one of the worst. That was relieving to know at least, I'm going to try to ease into that area from now on! I start pediatrics next week and I predict that I'll feel the biggest connection to medicine when I spend time there. Walking through it, I was instantly drawn to it. People always tell me that peds is so heartbreaking. So I've been trying to mentally prepare for my time there. I saw a few children in beds as we toured and some seemed to be in really really rough shape. I'm sure it will be eye opening to spend time there.

Easily the most powerful moment of the day was experienced in the Maternity ward, in the labor area. There are little cubicles for each woman in labor, with a sheet as a pseudo door/curtain for separation. They are all alone. There is bed for them and that is about it. No family, no nurses, no doctors...they are all by themselves as they are beginning to push their newborn into this new world. As I kept walking around the ward, with wide eyes, I saw a young young girl (probably 10-12 years old) laying on one of the beds. I tried to ask why there was such a young girl on the bed but sometimes people can't understand my questions so I just let it go. As I turned the corner I saw a little baby on a table. A nurse was wrapping it up and I stepped closer to get a look. The coloration of the skin looked like it still had afterbirth on its skin and I figured it must have just been born. Suddenly the nurse started to smother it as she wrapped the little thing up. I looked back at our 'tour-guide' and he said "still birth."

I now see how difficult working with sick children could be. I haven't been able to stop visualizing that little baby all day long. I wonder if it was the young pregnant mother's child? I don't know. Either way, I can't imagine getting to full term, seeing your child, and losing it instantly. How emotionally draining!

This was towards the end of the tour thankfully because I got a little detached for a while after I saw this. I stumbled around at the back of the pack but I really just wanted to go back and see that baby. Luckily, Whitney, Mark, Andrew, Simon and I went to get a bottle of water and take a little physical/mental break. Our legs were really tired as well from walking around all morning. (the tour/orientation ended up taking over 3 hours!)

After our refreshing cold bottled water, Whitney and I headed back up to the main theater to watch some surgeries. We only had 1.5 hours until we had to leave at this point, so we were anxious to catch something neat! And also eagerly waiting to see how we would feel at the sight! We scrubbed up (complete with borrowed boots.. kinda eww!) and walked in on a gyno surgery on some uterine fibroids. We only caught the tail end of it, but we got to see a blood transfusion because she had lost a lot of blood.

It's just a different setting overall. One time somebody dropped a needle and just picked it back up and put it back on the table. Towards the end, a nurse bumped over the surgical tray and it went flying everywhere, splattering bloody gauze and surgery tools in its path. Overall, the level of organization and order seems to be missing. People are walking in and out of the surgery room, talking on cell phones, laughing and joking and anything you could really think of. It seems to be pretty unprofessional as a whole.

Whitney found an interesting fact about Kenya: the gov't spends more in one MONTH on the interest on their debt than they do in a whole YEAR on health care. Holy bananas, can you imagine all the lives that could be saved if only they had proper health care? It blows my mind how crowded the waiting rooms are in this hospital. Paul and Anthony said that sometimes people show up at 7 in the morning and wait all day only to be told to come back the next day.

Although limited, I have found the staff at the hospital to be very accommodating and inviting! One lady named Cecilia from the casualties ward (emergency medicine) would say "we are not separate (white and black) we are all brothers! You are like my children and I am your mother of a different color!" I really enjoy seeing people with views like this. There is no need to think otherwise in my opinion. I jokingly called her 'Mama Cecilia' the rest of the day.

When we returned to the compound I was really tired and very hungry. Luckily Dolas was around to lend a helping hand! She made these noodles for me (like ramen noodles except they have more spice to them, african style) and they were exceptional! I took a 20 minute power nap and was dead set on getting my laundry done. It takes quite awhile to wash everything by hand and it almost wares your hands raw to squeeze each piece out individually! -How smug do I sound in saying that? It is crazy what we take for granted on a daily basis.

Tomorrow will be another day in the main theater watching surgeries! afterwards we plan on either eating on this floating restaurant that we heard about or going to see the Lion King in the cinema a few minutes away from our compound! I'm really looking forward to it!

SENSORY OVERLOAD!

July 4th: Firstly, happy independence day! I love that I can picture what everybody is up to back home; it almost feels like I'm there... boat rides, flags, watermelon and arrowwood fireworks! I miss you all! The Kenyan's didn't really blast "I'm proud to be an American" today. How odd right? ;)

One of the Irish gents (who's names are Mark, Andrew and Simon) asked me during one of our many culture comparisons, "What is it about that American pride? It just seems as though Americans are always loving their country and making it vocal!" Its true. And I didn't really know how to explain it other than its just a part of the culture, a part of the way we were raised? I tried to say that it is our way of bonding together despite our differences, especially in tough times. It's a tough idea to sum up, but it is a great part of the US in my opinion! It's heartwarming. :)

Now to the nitty gritty of my first day in the hospitals:

Today was our first day without Betty (our program coordinator -she went to lead to Malindi program for a couple of weeks) and we miss her already. She was EXCELLENT. I haven't a single negative thought or word to say about her! But we got to the hospital and had to pay our hospital fees (10000 shillings) and fill out some paperwork. It took about an hour just due to inorganization, a part of the Kenyan culture I've just begun to accept. Timeliness is not a priority and rushing is never necessary. People here just... live. No hustle and bustle like is the norm in the US; its refreshing at times but a little aggravating at times like these.

We got to pick 4 wards, I chose:

Surgery
Pediatrics
Maternity
Casualties (which is ER)

Following, an administrator shuttled me right on over to the surgery ward -ward 8 here at Coast General Hospital and lined me up with Mohammed, a intern physician (like a resident in the US, but does everything on their own).

Let me just set the scene here: Ward 8 is the orthopedics ward. It is basically just a long hallway with beds side by side by side by side. No curtains in between patients. No sanitary precautions. No air conditioning. It is the worst smelling place I have ever entered in my entire life. Many flys were buzzing about, floors were unswept. Looking around at the various patients (all with serious casts, external fixators, or gaping wounds) it became clear to me that today might be an interesting day. Toto, were not in Kansas anymore!

Mohammed was going to do surgery here today which was initially a little confusing to me, since it was basically just a warehouse of battered up patients -I didn't know where he would get his surgery supplies. All of a sudden a nurse rolls in a tray of scalpels, tweezers, gauze strips and the works. I was very excited to see how he was going to be resourceful in such horribly unsanitary conditions! The doctor unwrapped a patient's current gauze strips and began to examine this HUGE open wound on the calf of this man.

He also had two broken legs (one of which I would later see the bone). The man on the bed next to him (literally, side by side) had a similar situation. This neighbor had an open wound on his thigh and he also had a broken hip. All of these injuries seemed to be infected, unkept and painful! What was interesting is that nobody was groaning in pain or anything. I asked the doctor "do they give these patients a lot of pain medication?" only to find out all they seem to use is Ibuprofen! A high pain tolerance for these folks, holy kazoa!

Additionally, I came to learn that about 99% of the patients in this ward were here from car accidents. -a detail that does not surprise me in the slightest!

The doctor takes out the scalpel and begins to cut off a giant infected scab on the calf of this man. The man is squirming in pain. The layer of puss and blood is emerging underneath and I'm beginning to feel the heat of this room. I've realized lately that I am a bit squeemish at the sight of gory things like this, but had hoped it would improve (especially considering my medical aspirations!! :/...).

As i began to get nauseated by the sight, I tried telling myself: it's not that bad. it's not gross. this is a normal thing to see... but suddenly my vision began to get splotchy. I knew I didn't want to push it (for more reasons than one) but mainly because I would be eternally disgusted with myself if I were to faint and fall over onto the horribly unsanitary ground. I had been careful not to touch ANYTHING and the thought of my body touching the floor made my state of mind worse. The ward was open to the outside and I quickly stepped away towards the opening for a breeze. Tough luck finding anything other than humidity and stuffy conditions around here, but the wide open sky helped quite a bit.

I was so frustrated with myself at this point. My brain is thinking: this is so cool to see, what an experience! But my body decides to react to this intense 'sensory overload' (as Whitney called it later). So after I'm feeling about 50% better (vision returned) I walked back to the patients bed to watch. I instantly felt nauseous again but tried to tough it out a little bit longer. This time my forehead was sweating a Nile river and my vision was going faster. Poor choice to push it, miss Ann Bergstrand! As the last of my vision was fading to blackness (nooo exaggeration), I was lucky that I had just stepped out because my feet knew where to take me despite my lack of vision. I had to lean on the railing once I got outside to maintain my balance. I was very shaky and hot and thirsty and my stomach was knotted. It was horrible. (also notable that there were patient beds situated outside under the awning of the roof, on the sidewalk)

I regained my composure and told the doctor I just wasn't feeling well and that I needed to go get a bottle of water. He smiled and chuckled at me and said, "I felt uneasy about this stuff at first too, I'll see you later."

Whitney showed me on our way in where I could buy a bottle of water and I went to pick one up. She had texted me because she was getting a tour from an elective africa employee at the hospital. I told her where I was and she came and joined me for some water. She has been experiencing the same effects that I had (this was her second day) and so we could completely relate to each other. It is frightening, really, when you are hoping to go into this field. I love every second of the opportunity to see it in action, but my body wants to reject what I am seeing! I am praying that one of two things happens: 1. this goes away really fast, or 2. I find a new calling! haha I guess we'll see!

At this point I had pushed it, and my body continued to feel a bit 'off', just not quite right. Very queazy. I was debating going back to the compound to give myself a break from all of this sensory madness but instead...

I decided to go explore the main theater with Whitney, where MAJOR surgeries take place. Wise choice? maybe not, but I just didn't want to pass up the opportunity to see something amazing! I knew some tonsil surgeries were planned for the day so I figured I'd give them a go! (I scrubed up into scrubs that were probably less sanitary than my own!)

Instead, I stumbled into some other invasive surgery. A woman had a six inch DEEP incision made above her belly button. I'm still not sure what they had been doing because I walked in towards the end, but it did not effect me! I saw layers of adipose tissue, organs, the whole bit and it didn't make me queazy! I was ecstatic! it was really neat... and really different than I expect it would be like in the states: there were probably 15 people in the operating room (one reading the newspaper!). I watched for about 30 minutes and only began to feel a little sick towards the end when they were suturing her back together. The doctors all talk in Swahili so you don't really learn what is going on unless you ask and I was still a frightened little new-bee so I just watched!

I don't really understand why the superficial injury made me so much more uncomfortable than the deep incisions made in the main theater. The main theater was air conditioned, which may have helped, but it still doesn't make much sense. I'm hoping that each day I make some progress and leave here being able to stomach it all!

We had planned (with our new coordinator, Jevis) to leave the hospital around 1 pm on this first day and I was more ready than I thought I would be when that time rolled around! We waited for our tuktuk and the six of us went on home.

We decided that we would all try Haller Park again this afternoon since the feedings start around 3 pm. We got a quick lunch and hopped in another tuktuk to Haller Park. It was 800 shillings to get in which I thought was a bit steep at first, but it turned out to be worth every penny! The park itself is actually in an old quarry which they introduced wildlife into (plants and animals) with cute little sidewalks. The atmosphere is almost like a jungle, it was neat! We rushed to the giraffe area since they feed first and got there with plenty of time. They have little pellet things to feed them, just hold out your hand and they eat right out of it! Giraffe's have HUGE tongues. They are very slobbery, but very cute! I actually saw one use its tongue to clean out its nostrils! haha it was absurd! From then we got a tour guide and he led us to the Hippos and crocodiles, snakes and turtles, and MANY MANY monkeys! It was quite the place!

So many things happened today, I feel like a novel writer! but finally the rest of our Mombasa crew arrived! 4 more people from Ireland, two from Norway, one from England, and 2 more from the states. We had a full house and it was GREAT! I spent some time outside talking to Sylvanos, the maintenance man around the compound, and he is so precious. We talked politics. haha He explained about the current Kenyan president, the school systems here, the Ugandan leader and many other current hot topics in Kenya! It is so interesting!

Overall it was a good day in Kenya! I love love love Mombasa! Sylvanos said "why don't you just stay here?" haha I told him I wish I could but I thought there might be a few people who I would miss back home! I told him I'll come back to visit! anyone up for an African adventure in a few months? ;)

A day for rest and recoup...

June 3rd: Today was a down day for us. We spent most of the day doing this and that around the compound. We attempted to go to a place called Haller Park where you can feed giraffes and see hippos and crocodiles and many many monkeys, but we got there too late and had missed the feeding times! The Kenyans at the gate informed us that it would be a better idea to come back another time. We zipped back in our tuktuk to the Nakumat (which is a general term for the walmart stores I spoke of earlier).

After that we went and checked out the Ireland guys' compound. We will have a full house at our compound (with 15 people here) so they have another gated/guarded house about a 5 minute walk away. It is just as comfortable and cozy as ours and we sat there for awhile with many interesting conversations on health care in our various countries (Ireland, Canada and the US). By this time our stomaches were growling and Dolas' homecooked meal was desperately calling our names (Lillian cooks at the Ireland guys' compound)!

After we ate dinner we were all wiped for some reason (even though it was a down day) and I was snoring, drooling and mumbling in my sleep by 8:30 pm!

new language lesson:
ni ghali mno = that's too expensive (which comes in handy when dealing with tuktuk drivers or vendors)
jina langu ni... = my name is...

Diani Beach!

We all made a pact to never stay sitting in the compound during daylight hours. So today's goal was to try to eat dinner in a restaurant in a big cave along the coast! I saw a picture of it and it looked unbelievable! This restaurant is called Ali Barbours and is located in the Diani Beach area. There are several suburb-type areas in Mombasa; our compound is in Nyali (an upperclass development) and Diani is a little bit of a trek away. 

We got up early and took a tuktuk to the ferry. Mombasa is situated on a peninsula/island so we had to take a ferry to get to Diani. Along for the adventures were Whitney, Halley and three med school guys from Ireland. The tuktuk ride was so great, it took me for my first venture through downtown Mombasa. Throughout this whole adventure, it became clear to us that Nyali (where we're living) is a much more civilized region of Mombasa. Downtown was very crowded, dirty and rundown with a slew of specialty shops. It is always interesting to see a store (in a cloud of dust from the unkept roads) selling couches or jeans in such dirty conditions. Cleanliness doesn't seem to be a factor around here. We arrived at the ferry and paid 400 shillings ($4.00) for the 30 min ride (a ride which would have costed ten times that in the US). 

Being at the ferry was an experience similar to arriving at the Nairobi airport; I was out of my element entirely. It is nice to travel in a big pack like we were (6 of us) but it almost draws more attention to us; as if we're a crowd of two-headed squawking wildabeasts. Never in a way that makes me feel uneasy for my safety, there are guards heavily sprinkled all over this city (which is comforting) and the people want your possessions more than anything else. But its a very awkward thing to feel. The crowd to hop on the ferry was HUGE, easily more than 1,000 people. We were honestly the only white people on board. Holy dose of minority! Most of the people seemed to be quite poor as well, those are the ones that tend to stare excessively. I usually really like eye-contact, but in these situations I tend to avoid it. When I did glance upward for a split second, I instantly felt a minimum of 7 sets of wide-piercing-eyes on me. You just know they are really trying to figure you out, more than just a quick glance. The people in Nyali notice us more easily than other Kenyans obviously, but they don't stare like these people do; they are always very friendly saying "Jambo" as we pass by. 

But the crowd at the ferry was very intimidating. There were a few times when I would meet someone's glance and smile and say "Jambo" and they would always smile back at me, but initially it is hard to know how to react. I wish I knew exactly what they were thinking as they looked at me -probably 'how many shillings is she carrying' for many- but its more than that. The way we (as a human race) view skin color is astounding to me. Both white and black people have their stereotypes and they are often so far off. EVERY SINGLE worker here at elective africa is amazing. They are so kind and helpful, they laugh at our silly questions, and mother us through our culture shock! They accept us. They come from a much different background, but they are so happy to get to know us even just for a month! I will never forget them! I suppose the workers here are educated and pretty well off compared to the majority on the ferry, that could be the difference. 

We hopped off the ferry and walked up this little hill to the region where the Matatu's are in excess. Betty (who has taken on the role of mother duck and who is absolutely one of the most amazing people I have ever met) gave us detailed instructions on how to get to Diani Beach! We bargained our way down to 70 shillings ($0.70) for a 40 minute ride and all 6 of us scooted inside. 

The matatu's are one of my favorite parts so far, just because using them is a part of the culture. It's their mode of transportation. I'm sure that many people from home would not feel comfortable riding in them (they're stuffed, smelly and not exactly ideal in any sense of the term) but they are authentic and, to me, that is the neatest thing. At this point we don't necessarily stick out like sore thumbs either. I think they appreciate that we are living the way they do. People often help us too if we get confused or if we are getting ripped off (for instance one time we paid $0.50 when $0.20 was more reasonable -haha big difference right? one Kenyan thought so enough to tell us about it!) 

After accidently walking when we were supposed to hop on another matatu (they don't always bring you that close to your destination), asking for help from a private clinic along the walk, and hopping back in another matatu, we made it to the beach. The beach was really neat (and really tourist-y...we became less and less of a minority as we got further from the ferry). 

There were vendors along the fine white sand. They were fun my first day but holy smokes jiminy cricket they get super annoying. They don't leave you alone. You might say "no, I don't want that" and they say "looking is free" blah blah blah. So not to give them false hope, we stop being friendly from the get-go. One time this man approached us with his wad of keychains he sells (MANY people sell keychains) and he gave us his whole speal and we just ignored him, all six of us pretended we just didn't hear him. haha so then he proceeds to say "go back to your homeland" -this became a joke phrase for us. 

Another time a man approached us and we just kept walking by, he ended with "have a good day" and I (just out of habit at this point) responded with "no thank you" ...he laughed and laughed and said "no thank you, don't want a nice day" and he let us pass without too much hassle. 

We spent some time enjoying the view of the beach and Whitney and I went for a little swim in the Indian Ocean! It felt sooo good (as always) to remove the day's filth and cool off from the hot, sticky humidity. 

The goal of the day was to eat in this cave restaurant but we didn't want to travel back to Nyali in the dark, so the plan was to get an early dinner around 4:00 pm. We arrived at the area only to find out the restaurant doesn't open until 7:00 pm. We were REALLY bummed to miss out on such a cool experience but we found a restaurant called Forty Thieves at a resort instead (with really great pizza). With a re-boost of food, we began our journey home. With all the mishaps on the way there, it took us about 3 hrs to get all the way there, but we were MUCH more efficient on the way home and made it back in a little over an hour! 

Traffic is CRAZY here. Absolutely nuts. There are security guards all over the place, but nobody enforces any road laws. People pass into oncoming traffic, swerve in and out, and drive really really fast. On our way back from the ferry (which was in a tuktuk) we were at a standstill in traffic in downtown Mombasa. These two little boys approached the side of the tuktuk and put their hands out as if I had something I wanted to give them. I said "samahani" which means sorry and soon traffic started to go again. We were in an area with two lanes in each direction and we were on the inner lane. The little boys rushed away back to the edge of the street RIGHT as the traffic started up again with a screeching start. The image is burned into my memory, this little boy barely made it through without getting smoked by oncoming traffic. Holy smokes, I just about screamed! 

Edwin (the main owner/operator) of elective africa was at the complex when we returned and he took us out to a really neat hotspot in Mombasa (along with the other wonderful staffers Betty, Sylvanos and Jevis). There was a 'Mombasa's Got Talent' competition going on there. There were some really good dance routines and other talented acts. One Kenyan got all dressed in coyboy attire and sang to Shania Twain! I was so surprised to hear such things! haha

It was a long and busy day where we were really immersed in the culture! It was great, a very unique day! 

Jambo!

July 1: I was sure that the 6:30 am bright sun would wake me up and I was hoping to get my day started early to get on track with this Kenyan schedule! But man alive can I sleep! I kicked myself when I saw 10:00 am on my watch as I rolled over for the very first time! But I hopped out of bed/mosquito nets to find the commotion in the living area! Dolas (our wonderful chef) and Lillian (our sweet little cleaner) were active in the kitchen. Dolas taught me the tricks of the trade of mango consumption as she cut up my very first mango! It was delicious! Even though I have never tried them before, other people are saying they are the absolute best they've ever had! It's quite a treat!

Whitney, Halley and I took our breakfast outside to bask in the sun and chat. Through talking with Whitney I've been learning about all the differences between American culture and Canadian culture. Apparently I've been living under a rock, because they call the letter 'Z' as "zed." (A detail actually learned through a game of scrabble). We came back inside to find a group of people from Northern Ireland who had arrived. More extreme differences were found here! They go to medical school directly after high school and each year of medical school only costs them $5,000 equivalent US dollars! -for a WHOLE year! Most of the morning was spent chatting as a group! I had my nose in a swahili translator:

todays words:
wapi? = where?
samahani = sorry
tafadhali = please
kwaheri = goodbye
mzuri sana = very well
dio = yes
la = no

Another one of the grounds keepers, named Benson, chatted with us a bit as well. He is 32 years old and was married at 22 (to a 12 year old girl! ekk!). He explained how this is normal for Kenyans and we tried to hide our jaws dropping to the floor! He said "just you wait, when you see 8-10 year olds in the maternity ward" ...Yikes! He explained how in the last five years or so the gov't has tried to prevent the marriages of such young women (usually the women are really young and the men are a bit older when getting married) so that they can first receive a good education. I asked him if divorces were common in Kenya and he said yes yes yes. He talked about how Kenyans like Americans (which is good to know) whereas some of the Muslim population in the area are not as keen to us. I asked him to explain why people felt this way and he said that it is not the individual Americans that the Muslim's in the area dislike, but the fact that our government killed Saddam Hussein. The Kenyans are happy that Obama is our president, Benson said that Obama comes once in awhile to visit his fathers grave (somewhere in Kenya). Benson is a happy man, and loved to mock me for my Swahili pronunciation, but helped me learn words too! Whenever I see him about now, he gives me a quick quiz on my Swahili!

Around 2 in the afternoon we all gathered together in tuktuks (it took three of them to carry us all) with a big duffel bag full of toys, and headed to an orphanage/school! I was very much looking forward to seeing all of the cute smiley children! It turned out to be quite a sight!

We arrived to find children organized into different groups doing different things. One group was outside playing. As I lugged the big duffel bag out of the back of the tuktuk a little boy came, with a big smile, and offered to help me carry it! I was hesitant at first; my thoughts being 'I hope he shares!' but he ended up knowing the drill and leaded us back to the directors room where all the toys/books/supplies were located. Jane was the head honcho and she came back with us too and invited us all to sit! She explained the mission of the organization and had us sign in. Then she unloaded all the toys! Together, we brought a heaping pile of toys!

Then she told us she would give us a tour of the area of Mombasa from which the little pumpkins come from. Unbelievable. You know the commercials that say 'donate one dollar a month and you can buy so and so shoes'? I had always thought that those are a little fabricated, but this region was absolute, complete uncivilized poverty. As we walked around following Jane, all the people we passed were friendly. We exchanged "JAMBO!" (hi in swahili) hundreds of times as we passed small groups of people. There were little candy stores, a movie theater (crazy looking!), a barber shop, people out cooking food; there was plenty to see! Stray dogs here and there, chickens, roosters, goats etc! We walked past a couple of really deep holes in the ground. I decided at that moment that I wouldn't ask to use the ladies room! ;) They had a field for trash where all the animals were grazing. Little precious children were milling about too... with and without shoes. It was interesting to see: some of them wearing ratty old clothes, some wearing really nice looking garments like dresses and things (a product of donations I would assume). Regardless, they were covered head to toe in soot/dirt/flies and it was heart breaking. Some had teeth, some didn't. Most of their bellies stuck wayyy out from malnutrition. I just wanted to pick one up and RUN straight for the hills with him/her, wash them off, give them good food and hugs! That wasn't even the start of it...

The tour of the area took about 30 minutes. Jane explained to me that this region of Mombasa is called "Shauri yako" which means "you decide who you become'' or "it's up to you'' The people all seem happy and content, which is strange to accept. You can see the family dynamics just by casually observing and they are all very friendly! If only they had 1/2 the resources to allow them to "become who they want to be" because I feel as if they have the internal goods, the happy souls, to make a positive impact on the world.

Then we returned to the school, called the Precious Vision Care Center. Jane arranged all of us visitors on a ledge overlooking the playing grounds. All 250 children (lots!) were called out to the area (age 1.5 - 14 yrs old) and I was impressed by how good of listeners they were! It was absurd! They stood still in straight rows when asked to, they sung their little songs when prompted and most were so smiley and energetic about it! They sang and clapped to their songs in Swahili, and I heard Jesus' name throughout one of them! Jane was so precious, it was neat to see someone so on fire for what they do. She has quite a calling! There are several helpers from all over the country through a program called GVI -a bunch of wonderful wonderful people!

Then we brought out all the toys. There were a lot lot of toys, but not quite enough for all and they were the sweetest little sharers! The minute that Jane told them (in Swahili) to bring the toys back to the front, without hesitation, they all promptly listened!

We got to intermingle with the kids at the end (the best part of all!). I gravitated towards a little 1.5 year old. She was beautiful...but she showed absolutely no emotion. I tried to become as animated as I could to encourage her to smile back, even just a little. Nothing. But as I held her, she wrapped her arm around mine. She was comfortable with me and she just watched me as I made a baboon of myself trying to get her to smirk (talking in a foreign language to her too -the youngest children did not know any english). Finally, I gave her a little tickle and she smiled. It sounds silly, but it was amazingly rewarding! I got to hold her for quite awhile and when we had to leave she didn't want me to put her down. I wish I could have brought her back to our complex and made her clean and cozy. Some of the children at the school were not orphans, but this one was so young that I'm sure she was. I'd smuggle her back to the states if I could! All the kids were really active and animated! One little girl LOVED my watch. she would press a button to hear it beep and laugh and laugh. I would pretend like the beep scared me and she would laugh and laugh even harder! Even the little 1.5 year old gave a little smile at this!

I wonder what these kids would do if they saw my world. I try to imagine what it would be like to grow up how they do. The roughest of the rough. Yet how much energy they all seem to have! I wonder if this little 1.5 year old (I never did find out her name) will develop a same spirit, I wonder what her story is, what kinds of things her eyes have seen...

We left the orphanage/school and instantly talked about coming back. I can't wait to spend more time with the kids! We plan to go back again some evening after our work in the hospital begins! It's crazy, I've already seen so much and I haven't even yet been to the hospital!

We took the 25 min walk back into the walmart-type store to buy a few things and spent the rest of the evening bonding with one another and the elective africa employees. Edwin, the founder and man in control came today. He usually lives in the states, but he's moving back to Kenya after 15 years in the US! He has one baby daughter of 15 months and she and his wife are moving back with him. He seems really excited about it. It was neat to talk with him about the program!

I hadn't planned on writing until tomorrow, but falling asleep is not coming easy to me yet again, so here I am! Tomorrow we are taking a ferry to a beach area and shopping area and will get dinner at a restaurant that is INSIDE (literally INSIDE) a cave. It sounds beautiful! I can't wait!

I wish everyone of you could have the opportunity to see what I saw today. It is life changing. These kids are amazing! I wonder what percentage of the kids are HIV positive? I hope to ask eventually... I wish I had a better way with my words, so I could give a better description! Moral of the story: We are all so so so blessed!