We're in Lamu!

We have arrived safely on Lamu Island just off the Kenyan coast and have been here for two days. We have spent our two days relaxing, playing in waves, enjoying seafood and getting sunburnt. (Not too much though, we have been applying sunscreen. The person(s) who this comment is address to shall remain nameless but let's just say they know who they are.) :)

This is the beach here. It has not been this sunny yet so not this blue. But oh so warm.

Our first day in Lamu did not get off to a good start. We started the day in Nairobi and made our way to the airport for our 11:00 flight which landed at 1:00. I was envisioning the day laying on the beach (even for a small amount of time) and exploring the town. Unfortunately none of this happened. We arrived at the airport only to be told that this airline was no longer flying to Lamu with the airline we had booked with because they had not been flying to Lamu for a week. When we asked why she said that the runway was in need of repair and for safety reasons they were no longer flying there. They did however book us on a 1:00 flight from another airport. We got a ride there and after a flight delay we were on our way.

We arrived OVER Lamu in about an hour and after circling three times and seeing the landing gear go up and down three times we figured we probably weren't landing. The pilot came on and told us that due to the weather we could not land and we would be heading for Malindi to refuel and then head back to Lamu. On our way to Malindi the pilot came on and said that we would not be landing in Malindi due to weather as well as the fact that they were out of fuel. OKAY! We were now headed for Mombassa. After an extremely bumpy landing we were in Mombassa for about an hour and then off to Lamu again but only if the weather was better, if it was not we would be headed back to Nairobi. Thankfully all was fine and we landed at about 6:30. After a very long day we were happy to find a great house! It has an absolutely amazing terrace that over looks the water! Ahhhhhh lamu.

One of the many very cool doors here. Although very nice they are quite difficult to open!

Okay I am seeing that I have an extra picture at the top but I cannot figure out how to delete it for the life of me and the window that I have opened here is in spanish. So I guess you have two pictures to double your viewing enjoyment!

Well I am just noticing that internet here is quite expensive so I should wrap this up. Happy Thanksgiving all! (Or is that next weekend?) Kylie


and they're off!

well, it is almost 2am, i am on call tonight and i cant sleep. i am not sure if it is b/c i am expecting the phone to ring or if i am just excited about our trip tomorrow. it is crazy that carlynne has been here almost 5 weeks already. today she toured the wards giving out sparkly maple leaf pencils to the nurses. on my advice she distributed standard see through bic pens upon her arrival (a huge hit - honestly... i had noticed previously that the nurses would often look covetously at my bic pens and drop broad hints about how nice they were and how you just couldnt get pens like that in kenya) and ensured herself a good first impression, but the sparkly maple leaf pencils were all her. i am sure that she will go down in legend in kapsowar hospital.

tomorrow we are hoping to get on a matatu before 700 and make our slow bumpy way to nairobi. perhaps if i stay up all night i can sleep for part of this grueling journey. on friday morning we hop a plane (whit whoo!) to lamu island on kenya's northern coast. i am most excited about this leg of our journey as lamu island is known for its relaxed island atmosphere, budget guesthouses ($10 for all 3 of us), complete lack of motor vehicles, relatively pure swahili coast culture and amazing snorkeling. oh yeah, and kick ass beaches on the indian ocean. my parents brought us some frisbees and our friend steve n. sent us a sweet aerobee, so we will be having a good time. i have heard that there is good windsurfing there as well.

after lamu we will hop a boat or a matatu to watamu, where my parents have graciously booked us a week at a slightly more upscale hotel. the type of hotel that has a pool even though it is 200m from the beach. my mom has been getting quite canny at using her timeshare to its fullest and she got a smokin deal. watamu is a bit more of a tourist town, but this is b/c it is sandwiched between ancient arab ruins stuck in the middle of coastal rain forest and a coral reef marine park. oh, and there's also kick ass beaches!

finally we will make our way to mombasa, kenya's second largest city, where i plan to eat large amounts of indian food after getting lost in various markets and haggling with gregarious merchants. i am not sure what kylie and carlynne are excited about here, but i have heard there is great shopping if they are in to that sort of thing.

after mombasa we hop another plane back to nairobi ($50! - take that westjet!) where we will see carlynne to the airport (sob) and then make our way overland (boo!) back to beautiful kapsowar (yay!). after a few more weeks of work we hope to head to the sudan to visit our friend josh, but that is still up in the air.

there, now you know... the rest of the story (or at least a bit more)


Ants in My Pants

This is Carlynne contributing to Marc and Kylie’s blog again because I will be leaving Kapsowar in a few days. I have enjoyed five educational, adventuresome, and often ridiculous weeks so far. I am Marc and Kylie’s guest of longest duration. And their favourite.

I will share a few things that I have appreciated while being here.

First on the list, my new cardiovascular activity of choice. Dancersizing.

Since running is a spectator sport in these parts, I have had to come up with creative ways of getting exercise in the morning. At first I would jump rope in the back yard. Then I started listening to my ipod and kind of running on the spot and around in circles. As you can imagine, that sort of thing gets quite silly, quite quickly. It didn’t take me long to realize that my shadow is a top notch funk dancer.

I have also learned to love the gorgeous walk to the hospital. These are eucalyptus trees.
However, it is not nearly so pleasant when called in the middle of the night. Thank you for letting me bring your headlamp Daniel. But I have stopped actually wearing it and I just hold it in my hand instead. It was much too amusing for the Kenyans. “You are wearing your torch on your head!”

I have also enjoyed all the children that play around the hospital. Some of the young ones run away from me and cry. Its my freaky white skin and blonde hair I suppose. I never get that kind of reaction in Canada, I swear. But in general, it is very satisfying to greet a group of kids in Swahili and get a chorus of Swahili responses. Often with a few “Assist me cakes” thrown in. Sorry children. No cake in my pocket today.

My last three weeks here I have been working on the men and women’s medical wards. I especially enjoyed the women’s ward (see picture bellow). The nurses are very cheerful and do a great job translating for me most of the time. All of the staff enjoy chai (very sweet tea) and two pieces of white bread (very gross bread) in the chapel at ten O’clock each morning. I’ll miss them forcing me to go, even when rounds aren’t close to done and there is so much work to do I would rather not take a break. If they catch me yawning, it’s game over. Sometimes they’ll even bring a mug to me on the ward.

I will also miss all the amazing preceptors! Its not every hospital where all of the doctors are super nice missionaries…or related to you…or both.

It has also been really wonderful staying with Marc and Kylie. I haven’t lived in the same city as them for seven years and living in the same house is a special treat. It has been a lot of fun. Here we are having an icecream party with homemade icecream.

And yesterday we went for another beautiful hike.
At one point we took the wrong trail and ended up in someone’s backyard. Whoops! But the residents of this little mud hut spoke surprisingly good English and were very neighbourly. They helped us back on track.

Another wonderful thing about being here is that, despite being on call every four days, there has been quite a bit of free time for reading (four novels so far) and watching Veronica Mars. I have even had time to get out my watercolours. Here is a picture I painted of a boy at the gate to the hospital.

I think it is quite obvious that I have had a wonderful time here in Kapsowar.

And now I have ants in my pants. Literally. I actually have that a lot here. Perhaps this is part of the reason Kenyan women don’t wear pants? There are these nasty Safari ants that invade your home by the hundreds. They crawl up your leg and bite you all over. In Canada, ants seem so small and harmless. In Kenya they are neither.

But I also have ants in my pants for two other reasons. I am speaking figuratively now. In just a few short days Marc and Kylie and I are leaving for two weeks of snorkeling and beach adventuring along the Indian Ocean. Lamu Island here we come! And after that, it’s home sweet home. I can’t wait to see my friends and family again. Especially Daniel☺.


kasi mingi

it has been really nice to have carlynne here living with us for a few weeks. it is always fun to have new people around to get excited about things that have grown mundane to us, thus renewing our own enthusiasm. in addition to the obvious cultural phenomenon and reappreciation of our beautiful surroundings, kylie is quite excited that carlynne is getting into the first season of veronica mars.

carlynne being around also means that we suddenly have a plethora of pictures around the hospital. until my family came, i dont think we had any pictures of me at work or wearing a clinical jacket, or of kylie in her secretary's office. thanks to carlynne, this newly available memorable medical mosaic has inspired me to write another post about our work in the hospital.

carlynne has been looking after a very nice lady in the female ward who took a "harmless" little antiobiotic called septrim (septra in canada) which gets given out like candy in the rural dispensaries in kenya (and some walk in clinics back home). basically she had a cold, was given this unnecessary medication and her immune system flew out of control attacking her own skin and mucous membranes. i hope this makes you parents out there thing twice about demanding antibiotics from your family doctor for your kids' ear infections and coughs. she is now doing much better and was discharged home today.

i am including this picture mainly b/c i really like this lady. she had an internal fixation of a femoral (upper thigh bone) fracture and has been sitting in bed for over 3 weeks in traction. when i was on call last week i asked the nurses to move her bed outside but they said it was impossible b/c the bed didnt have wheels. being crazy busy i didnt push the issue, so i was quite happy to see her this week outside in the sunshine (perhaps we recently hired stronger nurses). apparently, so was she.

on saturday i was called to the hospital to see a lady with intestinal prolapse. she came to the hospital with a large portion of her small intestine hanging out of her anus. fortunately i do not have any pictures of this. unfortunately it was my job to bring her to the OR and slowly and steadily stuff them all back in where they belonged. unfortunately i just got a call from paul asking for advice b/c they have fallen out again (i fashioned a sumo like g-string support sling out of gauze which held for 2 days at least). i told him it was like juggling a bag of worms. as mentioned previously, our surgeon is currently out of town, so we are trying to help her though until she can receive definitive surgical management.

here are some pictures carlynne took of me in the course of a working day. both involve holding an xray into the sun and both involve consultations, each of which happen a lot in any given day. the first picture is a classic window consult.
as i am walking by the window of the female ward on my way to the OR or outpatients i am often stopped... "hey, can you look at this xray for me and tell me what you think?" this one was a barium followthrough, which are notoriously difficult to read, so i pretty much just made some stuff up.

this picture is of me consulting our medical director steve while my friend daniel, a sudanese intern, looks on. i am showing him a picture of a broken arm (supracondylar fracture) in a 5 year old after i had partially reduced it (read me hanging off the poor kid's elbow and squeezing the forearm while 2 strong men pulled on his wrist with all their might). i really wanted him to say "yeah, that's probably acceptable" b/c i had just borrowed his ortho textbook which explicitly stated "supracondylar fractures are extremely prone to neurovascular complications and thus must always be handled by an experienced orthopedic surgeon". unfortunately he agreed with my gut feeling that it just wasnt good enough and thus i am going to torture this kid again tomorrow morning.

in carlynne's peter parker tour of the hospital she managed to capture the elusive hospital secretary in her native environment, so i have included this picture for the enlightenment of all occupational ethologists engrossed with ethnic organizational environments (note the neat stacks, thoroughly amazing to passing kenyans and anyone who knew kylie growing up).

finally i will include a picture of our culinary adventures sans electricity. when i arrived home from work this week i encountered carlynne mixing up a big batch of granola. being unsure of carlynne's granola making skills (and being addicted to kylie's grand version of the same) i discretely enquired as to kylie's involvement in the granola making process. it was difficult for me to hide my dismay when i was informed that she was not involved at all (granola ingredients being quite scarce in kapsowar and granola being so close to my heart (separated by the diaphragm, pleura and a touch of lung to be precise)) and i am afraid that carlynne was a tad hurt by my lack of confidence in her granolabilities. fortunately it turns out that as a team (with carlynne doing most of the work) carlynne and i can also make an excellent batch of granola.


Rondo Rondo R-R-R-Rondo

We have just returned from a weekend in Kakamega Forest with Marc’s parents. You may remember if you are savvy, dedicated blog reader that we went to Rondo before when my mom came to visit. It is a wonderful retreat centre surrounded by beautiful gardens and a lovely veranda. As before, we spent the weekend walking (a bit), eating (quite a bit) and relaxing (A LOT!) It was so nice to unwind for the weekend and not have to worry about dishes and cleaning and cooking. Unfortunately Carlynne was on call this weekend and so was unable to join us and instead was stuck with all the dishes and cleaning and cooking. (We will make it up to her in two weeks when we head to the coast for a lot of beach laying and coral snorkeling and just general chillaxin. Is that really a word or just a word people in Chilliwack use? Or maybe I just associate it with Chilliwack because it starts with chill mmmmm)
We went for a walk again through the jungle, up to a viewpoint and then back to the bat cave we went to before. This time I knew what to expect and was quite wary of the bats flying over my head (my imagination was running wild with icky bats getting caught in my curly hair) so I spent most of the time in the cave hunched over and the other part gripping Marc's leg.
On top of the hill:

Dans le jungle
With the very large umbrellas we quite enjoyed. We need to get one of these puppies for Chilliwack rain.

Looking for the southern cross on our nightly walk. Pete was blocking out the light from the cottages. OR is he just acting a bit weird? ;)
Enjoying our chocolate mousse.

Well we are now back in Kapsowar and back to work but on the bright side, we found an ice cream maker here and are making OREO ICE CREAM tonight!!! Do you want to come over?


expatriate arrival

This is Carlynne, contributing to Marc and Kylie's blog to announce our safe arrival in Kenya. Thanks for all of your thoughts and prayers! We survived the trip splendidly (as did all of our luggage) and even adventured for a few hours in London. This is mom and dad in front of Buckingham Palace:
Here we are waiting to meet Marc and Kylie after on eight hour bus ride from Nairobi to Eldoret. Not the most enjoyable drive (we were airborne 50% of the time) but we saw lots of zebras. Note the happy anticipation. That is because we have not seen Marc and Kylie for almost a year!
Yippee!! Marc and Kylie arrive..and after the beginning of a tropical rainstorm no less. We are waiting for the driver from Kapsowar Hospital to pick us up.
We arrived in Kapsowar in the dark but in the morning we had this gorgeous landscape to wake up to! The hospital and missionary houses are perched on a waterless peninsula surrounded by rolling hills covered in lush green fields and pastures. To the east is the Rift Valley and you can see mount Kenya on a clear morning. This picture is the view from Marc and Kylie's backyard. I am sure that this is one of the most beautiful places on earth. Not only does the high altitude allow for a fabulous view, it also makes the weather cool and comfortable and keeps bugs and common African diseases (such as malaria) at bay.
Dad and I began working in the hospital our first day. Dad will be helping with outpatients for two weeks. I will be doing a five week international elective as part of my fourth year of medical school. My first few weeks will be spent in the pediatric ward. Kapsowar hospital has four wards and 120 beds. Marc and a Kenyan physician are the only doctors working right now. This is the Greidanus team intensely interpreting an x-ray of one of my patients. It is great to be able to walk up the hill and consult my own dad and brother!
Kylie is often busy doing secretarial work for the hospital or teaching, but she has also been home with mom cooking delectable things for us. Mom's African culinary training while my parents were missionaries in Nigeria is being put to good use. Here we are enjoying a lunch break in the back yard.

After some sustenance, we are back to work for the afternoon. I am working with one of the Sudanese interns. (You can read one of Marc's precious posts to learn about their amazing story.) We round on the patients with the very helpful Kenyan nurses and then review with Marc.

As anticipated, the practice of medicine is very different here. We have cases of malaria, typhoid, HIV, and TB. All diseases I have not seen much of in Canada and need to read up on. The medical director, Dr. Steve Lee, has started a lecture series which has been very helpful.

The lab tests, medications, and available equipment are impressive for Africa but limited by North American standards. My second day at work a little premature baby named Cynthia stopped breathing. We tried very hard to resuscitate by hand with a bag and mask, but without a ventilator there was nothing more we could do. So far in my medical training I have only experienced the death of palliative patients. This was very different and difficult. When not working, there is time to relax . Here we are hanging out in Marc and Kylie's house. Note the spectacular view through the back door.

On our first weekend off we took a day hike along the ridge of the valley. Here I was temporarily joined by some local shepherds.This is mom and I in the village centre of Kapsowar. It is a vibrant place. Everyone is very friendly. Especially when we try a bit of the swahili we are learning. Marc and Kylie have made many friends here and they are all eager to meet us.

Sometimes all of the stares are uncomfortable. There is really no chance of blending in. Especially when Mom and Dad wear their safari gear which you can see a sample of in this picture:).

We have loved our first week here. Today we are headed to church. We have prepared a few songs to sing with Dad's guitar. This is a beautiful land with wonderful people. Working with them and serving them is an amazing opportunity. We are looking forward to the weeks ahead!