Some more thoughts generated during my trip

Jambo!

Yes, that's how they say "hello" in Kiswahili, the Kenyan dialect of Swahili. So now you're ready to visit, or at least more ready than I was when I arrived. This may be repetition for some of you, and I intend to upload pics and stuff, but so far I haven't gotten a good enough connection for that. Hopefully soon I will have a real internet connection, but I have learned not to hold my breath. Lots of delays everywhere.

Getting to Kenya takes about two days. The route I chose was a red-eye to Amsterdam on KLM, which was very nice overall, and then I wandered around Amsterdam and gazed at the canals for a while. I stopped twice for coffee which was very necessary, and tried to shop for a watch. I wasn't really willing to shell out 100 euros for that, so I left empty-handed. I did manage to snag some of those great Dutch wafers with syrup inside at the airport, and I'm still working my way through them. Other comfort food I got there included some Cote D'Or dark and milk chocolate bars with hazelnuts. I love those. Anyway.

Next was a new red-eye from Amsterdam to Nairobi on Kenya Airways. Not quite as nice, but I slept. The individual screens (which KLM did not have) didn't work. Like the flat-screen TV's at the Nairobi airport. I will soon show you the picture of the Nairobi domestic terminal. About the size of my apartment, packed with plastic chairs. I had all day to wait there as well, but decided not to wander the streets of Nairobi on my own.

So then a short flight to Kisumu. Kisumu is Kenya's 3rd-largest city, but it feels like the slum of a larger city. The downtown is one unbelievably crowded road, with street sellers and shops. Everyone sells prepaid cards to one of Kenya's two main cell phone operators. Turns out everyone in Kenya has two cell phones, since it's expensive to call between companies. I used to think cell phones were for rich people, but no. And a lot of really nice cell phones too. Kisumu is mostly paved, though a lot of dirt roads as well, which is a problem now because of the rainy season. I oriented a bit in the clinic there after a long sleep, and then took a nap, and then slept some more. After that I felt great, and I haven't been feeling jet-lagged since. I guess if you fuck up your sleep schedule enough with two red-eye flights in a row, your body will take what it can get. Or at least mine will.

The clinic in Kisumu is this concrete building, and the patients overflow. Most of them are there getting enrolled in anti-retroviral treatment (HAART), or are there to see docs due to side effects, new illnesses, or treatment failures. There are probably 20 anti-HIV drugs on the market, and here they have about 8 or so. So that's not so bad, but it means that they only have about two therapeutic options (since you have to be on at least 3 drugs) with a bit of room to play. If those don't work, and they sometimes don't, that's sort of about it. There are many of the diseases that go with HIV, like fungal infections of various body parts, TB (I saw one 13-year old who probably is going through his 4th bout of TB), weight loss, etc. But also some people doing well with their treatment, going on with their lives.

After a couple of days the clinic closed for four days for Easter, so I went with a Nurse Practitioner student, Karen, to the Masai Mara. This is the big wildlife reserve in Kenya, bordering the Serengeti reserve in Tanzania. Apparently this is where Out Of Africa was filmed. Not sure if I saw that movie, but the reserve was amazing. Huge expanses of savannah, zebras and giraffes and lions and elephants. I didn't see any rhinos or cheetahs or leopards, but that's OK. It would have been better if you weren't stuck in a "pop-top" ( http://www.footprint-adventures.co.uk/info/Toyota%20minibus%20pop-top%208%20seats%20.JPG ) all day. So including the flights, I spent a lot of time my first week sitting. So then it was time to go for a run, and I made the mistake of running on two of Kisumu's big streets. Lots of stares and good-natured yells. And lots of cows, cow shit, and ditches full of garbage. Oh well.

Finally, on Tuesday, I went to Suba. Suba is a region of the province of Nyanzaa (in which Kisumu is located). The apartment I live in is in the town of Mbita, which is reached by car and then ferry from Kisumu. The main regional health centre is in Sindo, 20 km away, which usually takes 15 min but due to rain, it takes a lot longer. No paved roads, just horrendous dirt roads which have ridiculous amounts of mud. It got a (probably badly driven) Toyota Land Cruiser stuck for a while. Not to mention the semi-trailer bringing bread from somewhere. I'm still not sure if there's a store to buy supplies around here but apparently there's a fruit/veg market, so I won't die of hunger. I brought stuff from Kisumu, like pasta which I had last night. And a chocolate bar.

So, this is long and just a series of events, but I wanted to catch you up. I'll see about posting this soon, maybe with pics, as soon as I have a good connection.

lots of love,

Allon