A walk on the wild side

Even after frantically swatting at them, desperately hoping that they would sustain some kind of insect concussion, they re-emerge, faster, stronger and louder than ever.

The worst part is the auditory hallucinations I suffer even if I manage to kill one of the little (blood)suckers. There are fewer mosquitoes in the East African highlands (and hence less malaria), but I still find myself without a good night’s rest.

 buzzzzzzzzzZZZZZZZZZz-SWAT! (3 sec of silence.) buzzzzzzzZZZZZZZZZZZZZZTHWACK!. 

So have gone my nights here in Eldoret, Kenya.

 I left Mbarara just over a week ago. I spent my last night there hurling pints of undigested foodstuff from days prior. (Just one uncooked tomato with my last cheese sandwich likely did me in. It could have also been the one meal of “fried Fish” I had when treating my data management colleagues out to dinner…but the tomato seemed the more likely culprit given the rapid onset of symptoms.)

 I spent the following day riding for hours in a Toyota Corona sedan (automatic shift), through rugged dirt roads to reach Kibale.

“So what happens if this car gets stuck?” I asked Deo, my driver, as we trolled through mud and small pools of water. “No, we won’t get stuck!”

"Chimps' Nest"

 I was less than pleased with my initial accommodations, a tiny “bungalow” in the middle of the jungle without any lights outside. Perhaps romantic for the adventure couple (of which there were a few, including one older one from Oakland)…but not so great for the solo traveler. Or, I should say, not so great for this solo traveler.

 The trip was well-worth it for the amazing tour of the jungle on foot. Even though I had only seen two chimps, I learned so much about their behavior. And just hearing them call out to each other was amazing. We spotted our first one high up in the trees…when the ground is wetter than usual, the chimps like to stay high up. “Magezi” was the 30-40 year old “alpha male”- ie the leader of the 120 chimps that were habituated for tourists. We waited about 45 minutes for him to come down, and he finally did…and I literally “tracked” less than 20 feet behind him! He kept looking back at me, but moved too quickly for me to get a good shot. And then he called out and banged his fist against the root of a tree (which emitted a drum-like sound) to signal to his peers his presence before scrambling up another tree. The best shot I could get with my i-phone was of this shy, big-bellied adolescent, Ebitooke (“Banana”).

Ebitooke. My kind of chimp.

I can’t think of any other word than AMAZING. Maybe awesome.

We drove to Fort Portal that afternoon which is a pretty little town in the foothills of the Rwenzori mountains. I was told that the Rwenzori is a favorite spot among avid mountaineers, given its technical difficulty. I decided to create my own itinerary and asked to go see the Amabere caves, which was well worth it. (The thought of Marburg virus did cross my mind…as did bats and Rabies…but I quickly got over it.) The caves were known for their “nipples” which were thought to be the breasts of a mythical princess, Nyinanmwiru, who, known for her unparalleled beauty, was banished by her father when a soothsayer revealed that her son would kill him and take over the throne. He also cut off her breasts to “make her less beautiful.” The princess managed to find a lover and gave birth to a son regardless. Amabere means breasts and the “nipples” which “leaked milk” were actually new stalagmite and stalagcite formations.

waterfall near the caves

 We then proceeded to walk to several crater lakes, including one that was more like “quickmud” than a lake. (I had been warned several times not to step in this mud, lest I get pulled down to the center of the earth.)

 


I spent a lot of quality time with my guides and driver and learned much of their families and personal histories. Two, including Deo, were orphaned at very young ages…not from AIDS, which was my first guess, but from car accidents and other illnesses. It was humbling to realize what it meant to be in a country where the life expectancy was 48 years for a man.

 I took a plane to Nairobi and spent Sunday evening in a hotel before flying out to Eldoret early Monday morning. The Eldoret plane stopped off in Kisumu before traveling for 10 minutes to Eldoret…a road trip which would have taken several hours, undoubtedly, so I was grateful for the quick ride. Eldoret is home the many a marathon trainee. It is about 2000m above sea-level (or 7000 feet). Though I fancied myself a runner at one point in my life, I have not attempted a run yet here.

 The moment I landed in Kenya I was aware of the marked difference in economies. The Kenyan shilling is 80 to $1; the Ugandan shilling is 2500 to $1. Even so, an average government doctor here makes $1000/month....and has to also pay to go through residency. Though medical school is largely free, this is not easy for many doctors who work multiple jobs.

My current accomodation is at the Noble Guest House which is set on a lovely piece of property, with many a garden. The rooms are very nice and the staff is kind. (They are already getting used to this Mzungu's habit of peanut butter on toast with bananas every morning....one of the staff even fetched a banana from the kitchen when the table ran out just for me :)) There are many other Mzungus residing here as well, including a large Missionary family from Texas.

 “God, we thank you for this meal and for allowing us to come to Africa…” Heard on my first night in Eldoret, in a twang that was as foreign and novel to me as the East African cluck.

“Missionaries!” Dave exclaimed when I told him. “What do Kenyans need Missionaries for? Everyone I met there was already Christian!”

 True. What is striking about Eldoret is the number of NGOs- religious and otherwise- that there are around here.

Note the Swami Narayan Temple in the back

My days here were similar to my days in Mbarara- trying hard to capture the process of TB care among patients with HIV, understanding what measurements we already have of this process and what we need to further capture in order to describe the gaps in care. For example, determining how long it takes from the time that a patient is diagnosed with TB to the time that they receive the results is an important middle step to measure- many individuals live far away and trying to contact them may be a challenge. Some, I was told, even come from as far as South Sudan. The ultimate goal for these individuals is to not only start them on TB meds, but also start them on HIV meds if they have not already started them. We have good studies that have proved that earlier initiation of antiretroviral medication saves lives.

So went my last week. It seemed a bit slow at times, and all the driving made me want to stay around Eldoret for the weekend…even though there are few things to see around here. I am hungry for good (bourgie) food and am really looking forward to my return home.