Happy to be home

We're very happy to say that the Duke Neurosurgery team made it safely to Eldoret...and has now made it safely back to North Carolina!  I'm sorry that I haven't posted for a while now, but the last week and a half has been extremely hectic.  We calculated that we spent about 2 hours on a plane, at least 10 hours on a bus, and about 20+ hours in a safari van.  Steve has promised to talk more about the surgeries, so stay tuned for a guest blog!

We started the adventure last Friday, September 2nd when Steve, Ellana, and I flew to Nairobi to pick up the group.  We had a fabulous day exploring the city as we had not spent much time there previously.  We enjoyed our time at the Village Mall that had everything from a gourmet meat and cheese shop to one of the largest toy stores I have ever seen.  Nairobi is definitely an interesting place as it harbors one of the largest slum areas in the world but also has completely modern, upscale areas.  I often have a difficult time wrapping my head around the enormous disparity between the rich and the poor in East Africa, and Nairobi is one of the places where that disparity is most evident.

We were very pleased that the group had no problems with their flights and arrived on time in Nairobi.  Once they arrived at the hotel, we had a late dinner and enjoyed seeing everyone for the first time in months.  Most of the group had been to either Uganda or Rwanda with Dr. Haglund (the head Neurosurgeon) in the past, but this was the first time for the Duke Neurosurgery program to be in Kenya and to not be going to a capital city.  At dinner that night, we were all pleased to be sharing the hotel with the actress Olivia Wilde as she was sitting just a few tables away from us!

On Saturday morning we attempted to cram all of the luggage into the Moi Teaching and Referral Hospital 25 seat bus.  We had decided to drive back to Eldoret because we couldn't get enough plane tickets for the group, and we thought that it would be easier with all of the luggage.  We had also been told that the trip would take around 4.5 to 6 hours at the most.  In order to give the group a feel for the city, we took them to a giraffe sanctuary and had lunch at a beautiful restaurant in one of the suburbs outside of the city.  Then we headed to Eldoret only to arrive about 7.5 hours later!  An exhausted and hungry group sat down to dinner around 9 pm that night at one of our favorite spots, Mamma Mia.

On Sunday the group divided up so that one half could attend church and the other half started unpacking the 4 tons of supplies that had been shipped by DHL.  Yes, everything made it to Eldoret!  The total value of the supplies was about $400,000.  The team set up the operating rooms and prepared for the first operations on Monday, and also saw patients that would be operated on through the course of the week.  One of the more interesting cases was a young man who had been shot by a barbed arrow a day or two prior.  The removal of the arrow was set for Monday morning.

On Sunday afternoon, we took the group to a restaurant at the top of the Rift Valley so that everyone could see some of the amazing views of Kenya.  The restaurant is located in Iten, which is where many of Kenya's most talented long distance runners are trained because of the altitude and the incredible hills.  We have learned that on important training days, the runners are driven down the bottom of one of the enormous hills twice a day, and they run up the marathon distance both times!

On Monday, the team held a teaching conference on neurological trauma for the doctors, residents, nurses, and medical students of MTRH, and as well as some visitors from Nairobi.  Everything went well both at the conference and in the OR, as the team was able to remove the arrow successfully.  After a long day, we ate dinner at an Indian restaurant and had a brief Kiswahili tutorial given by our teacher, Wycliff.

Tuesday, Wednesday, and Thursday pretty much followed in the same fashion with me taking many of the members on small excursions around Eldoret including numerous trips to Imani.  I think that the Imani artisans enjoyed having many of the members tour their facility and do lots of shopping!  The team ended the time in Eldoret with a wonderful celebratory dinner at the Eldoret country club on Thursday evening.  We were treated to traditional Kenyan fare, lots of thank you speeches,  some traditional Kenyan music and dancing, as well as amazing gifts.  Duke Neurosurgery's contributions to MTRH will hopefully be treasured for many years to come, and I know the team members will always remember their time at the hospital .

At 6 am Friday morning, we set off for our safari to the Masai Mara.  Although the trip took around 6 hours, the final two hours were on some of the worst roads I have ever traversed.  I'm not sure how Ellana slept for about an hour, and we were extremely happy to finally arrive at our home for the next two nights.  Steve and I weren't sure what to expect, but we were incredibly pleased with our accommodations at the Olasheiki Camp.  Olasheiki is in the style of a tented camp that is very popular in the Masai Mara.  The lodge was also entirely run by members of the Masai tribe who helped to guide us around the park.  We were able to see cheetahs and lions on the brief 1.5 hour trip we took on Friday, and then saw numerous animals on our day-long drive on Saturday.  Ellana's favorite were by far the giraffes or "twiga," which is the Kiswahili word that she uses for them.

Overall, I don't think we could have been any happier with what was accomplished by the Duke Neurosurgery group in Eldoret or by the fun times we were able to have with everyone in the Mara.  And despite all of the hours in some sort of transportation, Ellana was absolutely amazing and has already become a seasoned traveler.  Now we are just looking forward to my family members arriving in early October so we can see more "twiga" again soon!

Our Masai guides and the staff at Olasheiki

The bridge from the camp into the national park

Our beautiful breakfast area

Cell phones are everywhere!

Ellana and the "simba"

Ellana in search of "twiga"

Mara River

So glad she napped, but she would have loved the lion cubs!

Rain, rain go away

First of all, we are glad to hear that Irene has passed as we had been watching closely for our friends and family in the east and northeast.  So glad everyone is ok!  In terms of Eldoret, on Saturday we thought we had turned a corner as it was beautiful, sunny, and actually hot in the morning, but the happiness was short-lived as it rained most of the afternoon and evening on Saturday and Sunday, and was rainy and cold the entire day yesterday.  I know that rain is generally good and that given the drought in the other parts of Kenya rain sounds like it is needed, but the rainy season in this area as been changing rapidly over the past several years and as this isn't a normal time for the weather to be this rainy, the farmers are starting to get worried about this year's crops.  We had heard that it should get less rainy and warmer in September, but now I'm hearing October.  All I can say is that I am missing central heat tremendously and will never take it or a hot shower with lots of water pressure for granted again.  I'm also really excited about moving to Florida in January as I am definitely not a cold weather person!

We are currently suffering through Ellana's first ear infection, but at least we have lots of pediatricians around to make sure she is ok.  Although having a sick toddler is no fun, we have really appreciated the numerous "house calls" we have received from the doctors living on the IU House compound.  If there is any place to get sick, I guess this is it!  Our only major concern is that we are supposed to fly to Nairobi on Friday morning to meet the Duke team, so hopefully she'll feel better by then.  As I right this post she is sleeping on my lap and has been the most cuddly she has ever been.  I was supposed to work at Imani today but didn't feel that leaving her with our babysitter was a good idea.

This past weekend we had a relaxing couple of days.  On Saturday we celebrated Ellana's friend Gavin's first birthday.  Ellana loved the balloons, pizza (one of her new favorite words), and cake as well as the bucket swing that Gavin received as a gift.  Ellana would have been in the swing for hours if we had let her.  Someone commented that it was the happiest they had seen her!  For dinner we went to a potluck hosted by one of long-term ex-pat couples living in Eldoret .  All of the people working for the hospital and AMPATH who are living here for more than a few weeks were invited, and we enjoyed the amazing combination of food including Ethiopian dishes, macaroni and cheese, and cake and ice cream.  The food was quite an eclectic combination!

Ellana and Andy in the kiddie pool

Ellana has a great "zombie" walk!

Chrissie, Gavin, and his adorable monkey cake

Eden and Ellana helping Gavin open his gifts

Before church

Fun in the swing

Happy girl

On Sunday we tried a new church with Gavin's parents, Chrissie and Geren.  Ellana enjoyed the music for a few minutes, but then we retreated to the nursery.  She liked playing with the other kids and the toys, although I had to laugh a little when the kids started saying yangu or "mine" in Kiswahili when trying to get or keep a toy.  I guess the word works well in any language!

We can't believe how quickly the time is flying and that the Duke team is arriving this weekend.  Hopefully next week will lead to lots of effective surgeries as well as good training sessions for the people here.  Keep your fingers crossed that our huge DHL shipment with the equipment arrives on time!

Ugandan Fun

We just returned from a fabulous trip to Uganda.  I don't think we could have asked for a better weekend or a better group of people to share the experience.  Along with our amazing driver Javan, our friends Matt (a medical student who we met in Eldoret two years ago), and Erin and Kurt (Erin is also completing a global health residency at Duke) came along for the weekend.  Ellana was absolutely amazing, and despite a steady cough, she showed little signs of her illness from last week.

I should preface the trip by saying that Steve and I have been to Kampala numerous times and spent over a month there in 2008 working at Mulago Hospital through the Duke Neurosurgery in Uganda program.  I also was fortunate enough to work with a fair trade, handcraft organization called Uganda Crafts 2000. Uganda Crafts was started by an incredible woman named Betty Kinene, who is disabled and needed to support not only 10 biological children, but 10 additional adopted children after her husband was shot and killed during the oppressive Obote regime in Uganda.  Uganda Crafts now supports around 200 artisans who are either disabled, orphaned, widowed, or HIV positive.  One of the most amazing moments in my life was when the daughter and assistant director of Uganda Crafts, Ninah Kinene, actually visited Durham about a year and a half ago and stayed at our house.  I was really looking forward to going back to Uganda Crafts and seeing Ninah again.

Daddy and Ellana at the Ugandan border

We arrived in Kampala on Friday early evening and had a wonderful dinner at one of our favorite Indian restaurants, Khana Kazana.  We have a few good Indian restaurants in Eldoret, but in our opinion, none of them really compare to the Indian food in Kampala.  Ninah and two of her sisters met us at the restaurant, and then we went back to our hotel, the Golf Course Apartments, to chat.  I really enjoyed seeing Ninah, and I think she especially enjoyed meeting Ellana as I was several months pregnant when she was in Durham.  We were also pleasantly surprised with how nice the hotel turned out to be, and our view of the Kampala Golf Course was amazing.

View of the Golf Course from our room

Ninah and I

Saturday morning we started walking around the city in order to show Matt, Erin, and Kurt some of the main sites of the downtown.  They were all impressed with how safe the city is as well as how easy it is to walk around.  Steve and I were also impressed with the brand new shopping mall called the Nakumatt Oasis, as it has even more selection than our new Nakumatt in Eldoret.  We took everyone to Uganda Crafts, and then ate lunch at a really cute outdoor restaurant.  Matt and I were really excited to have milkshakes as we have been trying to find them for weeks in Eldoret!

Ellana shopping for baskets

Kurt and Matt shopping for ties

For dinner we hit a local Korean restaurant that Steve and I had tried a few times.  Luckily Matt, Erin, and Kurt were all relatively knowledgeable on Korean fare, so we had a wonderful family style meal.  I couldn't tell you most of the names of the dishes, but it was definitely delicious (although it felt a little strange to be eating Korean in Uganda).  I think that our driver, Javan, enjoyed the experience, even though he thought it a little odd, as well.

Ellana eating noodles at the Korean restaurant

Outside of the main part of the lodge in Jinja

Sunday morning we left for Jinja where Matt, Erin, Kurt, and Steve rafted the Nile.  Steve and I rafted three years ago, and as I had a pretty rough experience (I still have scars on my knees from one of the class 5 rapids), I decided that rafting was not a good idea for me.  Ellana and I enjoyed hanging out at the lodge and watching all of the monkeys right outside our door.  She makes a great monkey sound that is kind-of like "ooh-eeee," and I didn't think she was ever going to get tired of watching them.  The lodge has a combination of tents, dorms, and chalets, and we stayed in one of the chalets.  Of course I was so ready for Ellana to walk, but considering that our chalet was basically on top of the Nile, it definitely made me nervous for her to be out of my sight for even half a second.  Everyone enjoyed the day, and although the rafting experience has changed due to a dam being put in the Nile a couple years ago, Steve was glad to have gone again.

Javan, Steve, and Kurt after rafting

Monkeys outside of our chalet

Erin, Ellana, and I

We woke up to monkeys running around on top of our chalet this morning, ate breakfast, and then drove home.  Ellana had a great car ride home despite only napping for a grand total of 45 minutes the entire trip.  Once again, I think we're all hoping to make it back to Uganda as soon as possible!

Ready for another weekend getaway

Steve, Ellana, and I are so excited to be taking another short trip this weekend to Uganda.  The past couple of weeks have been really cold and rainy, so we are hoping for some warmth and sun in Kampala and Jinja.  We are going with some of our friends here at the IU house, so hopefully Ellana will be on her best behavior!

Ellana has finally decided that walking will be her most common form of getting around, so we had our first experience with a truly walking toddler in the grocery store earlier today.  Her favorite things were all, of course, at her level, so she enjoyed stacking some soap containers and touching the bags of powdered sugar.  I'm also a little embarrassed to admit that her current favorite foods are Pringles (or as she calls them "Gingles") as well as some pop-sickles that we found that are kind-of like Flavor-Ice.  She doesn't understand that Pringles are not breakfast food as they are the first thing she wants in the morning and typically the last thing she wants at night.  She loves them so much that she throws a fit if I don't let her eat them while we are in the grocery store, and she doesn't even want the cashier to take them from her when its time to pay.  She shouted "Gingle" to the cashier the other day until he gave them back to her, much to my horror, but everyone in Nakumatt seemed to think it was hilarious!

Ellana also recovered today from her first real illness in Kenya.  She started coughing early Wednesday morning and could not keep anything down yesterday until dinner.  By that time she was finally acting like herself and woke up acting completely fine this morning.  We were so glad as we were nervous about having a sick toddler in Kenya!

We also have successfully found a second babysitter as Sylvia ended up not working out last week.  For some reason she stopped returning phone calls and showing up, so her cousin, Sharon, has taken over.  So far, Sharon has been amazing, but we are a little sad that she will be leaving for school in Nairobi in a couple weeks.  Her sister will be taking over at that point, and if she's anything like Sharon, I'm sure everything will be fine.

Steve's OR frustrations have continued the past couple of weeks as last Wednesday the hospital was out of oxygen, and this week they neglected to tell him that the medical students had exams that physicians had to proctor meaning that none of the difficult surgeries could be completed.  Thank goodness the Duke team arrives in less than two weeks!

I will be writing more as soon as we return from Uganda.  Have a wonderful weekend!

Our "unique" way of serving fondue

Ellana playing in bamboo curtains at a friend's house

Dinner Party

Ellana fell asleep on our walk home

Outside of Moi Teaching and Referral Hospital

MTRH sign

A little piece of Heaven at Kiboko Bay

We just made it back from a near perfect weekend in Kisumu that was only slightly tarnished in the last five minutes of the trip home when Ellana got really carsick.  She acted completely fine afterwards and greatly enjoyed taking a bath with her friends the two duckies and tiger, so we weren't too worried and just attributed her sickness to the car ride home.  The weather was absolutely terrific in Kisumu, and we really couldn't have asked for a better couple of days.

I cannot express how excited I was to arrive in Kisumu and to feel warmer temperatures.  We got to Kiboko Bay resort late Friday afternoon and Steve and Ellana had just enough time to sneak in a quick dip in the pool.  Ellana loved the kiddie pool so much that she started saying pool constantly, and we had to be careful about saying that word too long before we were planning to go swimming.  Friday evening we watched a beautiful sunset over Lake Victoria and had appetizers of guacamole and cheese samosas, and then had our favorite fish masala (or fish curry) for dinner.  As I said in the last post, the resort has eight tented camps which are basically tents situated on permanent foundations.  In general resorts of this nature are actually quite nice, and are a very popular type of lodging in East Africa.  We had a king-size, four-poster bed that was amazingly comfortable, and I wish that we could have the same down comforter in cold Eldoret, as it was really too warm in Kisumu to fully appreciate it.  The bathroom was once again large enough for Ellana's pack and play, and we were very excited to have a shower with not only warm water, but also good water pressure.  Amazing what we are thankful for these days!

The pools at Kiboko Bay

After some guacamole

At Sunset

Saturday morning we took an hour-long boat ride on Lake Victoria.  We were able to see lots of birds, a few  hippos, and hear the history of Kisumu and Lake Victoria.  Kisumu has traditionally been a port city on the huge lake, but there has been a decrease in the amount of products being shipped across the lake over the past several years.  The Kenya side of the lake also tends to be dirtier than the Uganda or Tanzanian sides, but our guide couldn't explain exactly why.  The boat ride was very enjoyable, and Ellana particularly enjoyed it when we were going faster, although she did not want to wear her life jacket at any point.

She loved it when we were moving quickly!

Fishing and restaurant area of Kisumu

Once we got back from the boat ride, Ellana took a long nap, we ate lunch, and then spent several hours at her new favorite place.  She enjoyed playing with the other kids for the most part, and she enjoyed making her ducks "quack" in the kiddie pool.  Kiboko Bay is very popular with the local community, and we saw some beautiful wedding pictures being taken.  As if the day could get any better, we were told about and invited to the first ever "Nyanza Wine Carnival" that was going to take place that night at the resort.  Basically, all of the Kenyan alcohol companies were showcasing their most popular wines, and the whole wine tasting was completely free of charge.  We actually really liked a white wine that is made in Kenya.  In addition to the tasting, the resort was providing lots of free appetizers to go along with the wine.  I don't think I've seen Steve so happy since we got here, and he was like a kid in a candy store running around to all of the booths!  Ellana finally had enough of the fanfare around 7, so we retreated to our tent to watch our current favorite family movie "The Lion King."  We all crashed really early as the sun and pool  (and wine) had worn out all of us!

A delicious Kenyan wine

Our tent at Kiboko Bay

Daddy and Ellana eating masala chips

After the pool

Sunset at Kiboko Bay

During wine tasting

Nyanza wine carnival

This morning we ate breakfast, sat by the pool, and then left Kisumu around noon.  I think we're all hoping to go back to Kiboko Bay as soon as possible!

No surgical gauze?

Steve has promised to do a guest blog sometime soon, but as I stated earlier, his biggest difficulties in operating have all revolved around a lack of equipment.  When he arrived at the hospital yesterday morning, he was informed that there was no surgical gauze meaning no operations in the hospital could be started.  I asked him if this hadn't been noticed the day before, and he said that OR crew had responded, "well, we had some yesterday."  Ultimately someone had to run into Eldoret to buy some which meant that the cases were delayed even more than usual.  As I have said multiple times, Steve is really looking forward to getting some more supplies when the Duke team arrives!

Other than his OR day yesterday, Steve, Ellana, and I are enjoying settling into our daily schedules and routines.  This six months for us in Kenya will be the longest we've spent in Africa for one trip, and it is nice to know that we can actually feel like we are living here, rather than knowing it will be for a very short time frame.  Our longest previous trip was to Tanzania several years ago, and two months there was just long enough to feel settled, and then we had to leave.

My current schedule is normally the following:  on Monday, Wednesday, and Friday I have been going to Imani.  Sylvia arrives about 8:30 and I try to sneak away without being seen.  On my walk to Imani, I've discovered an amazing bakery that has the best vegetable pies that I have ever tasted.  The bakery also offers a chicken, meat, and cheese option, but the vegetable ones have just the right combination of potato, carrot, bell pepper, and spice, and two of them makes a perfect lunch (although I'm sure not the healthiest).  I pick them up normally on my walk through Eldoret to Imani, and I justify the calories because my walk there and back is over 1.5 hours.  I'm still working on the operations aspect of Imani, and instead of getting frustrated with the systems, I'm trying to learn as much as possible so that I can make some incremental changes (although I'm finding not getting frustrated to be extremely difficult).  On Tuesday and Thursday, I stay home with Ellana, but the days are broken up with my bi-weekly Kiswahili lessons.  I'm really glad that I took Kiswahili classes at UNC this past year, as I feel as though I can often at least understand the context of a conversation.  Kenyans tend to insert lots of English and slang into their Kiswahili, so actually speaking is still quite intimidating!

We're also enjoying getting to know many of the ex-pats who live and work here on more full-time basis.  Last Saturday we had a fantastic meal of shepherd's pie made by one of the ladies who helps place orphaned or abandoned kids in the various orphanages in the area.  Elizabeth actually took us to one of the orphanages on Tuesday, and we were amazed at how well the organization is run.  At that same dinner, Ellana loved hanging out with one our friend's puppies, Miwa, as they are about exactly the same size.

Ellana and Miwa

This coming weekend, we're going to take a short trip to Kisumu, which is located on Lake Victoria and is about 2 hours from Eldoret.  One of our favorite little resorts, called Kiboko Bay (kiboko means hippo in Kiswahili), has about eight "tented" or permanent camp sites, a wonderful restaurant (I can't wait for the fish curry), and a small pool.  Kisumu is much warmer than Eldoret, so we are looking forward to some warmer temperatures as I'm a little tried of the cold mornings and evenings.  I know I have to be careful saying that with extreme heatwaves happening all over the US!  Needless to say, we're really ready to get out of Eldoret for a couple days.

Nakumatt- our of our favorite shopping spots

Outside of Nakumatt

Ellana and Andy with their favorite guard, Silas

Ellana after a bath

Ellana and Silas