Saturday, March 12, 2011

Lake Naivasha and Hell’s Gate NP: Trip 4 out of Kisumu

I thought Lake Naivasha was half-way between Kisumu and Nairobi—like a three hour bus ride. It’s sort of a suburb of Nairobi and takes 6-7 hours to get to from Kisumu by big fancy bus. By crappy matatu it takes 6-7 hours but it feels so much longer as every three minutes you see your life flash before your eyes.
Lake Naivasha is the ancestral home of the Masai tribe—one of the few tribes in East Africa which has attempted to hold on to its culture in the face of globalization and nation building. Sadly, they lost most of the ground around Lake Naivasha to flower plantations. Lonely P told me that a flower could be harvested in Lake Naivasha in the morning and in your European lovely’s bouquet in the evening. Pretty impressive and gives you a thought for the scope of these operations. There are literally hundreds of very large greenhouses surrounding this fresh water lake in the heart of Kenya. And scattered in-between all these giant farms / communities are little campgrounds.

Entrance to Hell's Gate NP

I went with Steph (another Hubert Fellow) and Aaron, and we chose from the LP to stay at Connelley’s Camp. Expecting Irish, after some ridiculous back and forth with the moto-taxi drivers, we realize the camp is actually called Carnelley’s Camp and costs twice as much as LP claimed. Still, it is a stunning campsite with hippos in the lake—right there.  Actually, the hippos could be a little too close at times and at night, the lovely Carnelley family places an electric fence to dissuade the hippos from entering the camp grounds and eating the campers. I never got around to touching the fence, but I was curious as to how powerful an electric shock needed to be to stop a hippo.

The next morning, wake-up early and head for breakfast (four maandazi—fried dough, and three cups of tea, shared among three people—what the hell were we thinking for a full day of bike safari?). As we sit enjoying our meal, the gentleman who is serving us (and we’ve gotten to know pretty well from multiple meals) goes and finds an entrepreneurial soul who is willing to rent us mountain bikes for 500KES, 400KES, 300KES per bike—it was impressive how quickly the price went down and I credit this with the incredulous look on my face because LP had said the cost should be 50KES at the park to rent a bike—I think someone never quite made it to Lake Naivasha and chose to phone in this chapter. The correct price is actually 500KES at the gate to the national park, so we got a deal except for the fact most of our brakes worked marginally (“it’s very flat in the park”—except for the giant mountain if you go left) and the seats sucked.



Quality of bike aside, you enter the park and are greeted by rugged, dry, beauty. It was simply stunning. You bike for a bit and there are some gazelle, a little further and a warthog family, to the left a giraffe and to the right a zebra and damn, I almost hit an ostrich. A few times during the day we pulled off the road, stashed the bikes and walked into the park and the fields of giraffe and zebra. The only animal that could be a little dangerous was the warthog, and we gave full clearance to him and his kind but all the others are relatively passive and somewhat skittish. That was the day, biking and walking safari.

Saturday, March 5, 2011

Shout-outs

Erin -- I spent the better part of two nights trying to record the sound of the lion from my window. All I ever got was a very weak sound which if I posted would not be impressive and would make you think I was lying about the lion. I wasn't but I have no proof. I did try.

Eric / Tom / Nick -- I have a new appreciation for all the work you do on Excel. One of these days you are going to get a phone call from me at some un-Godly hour and I will be asking you how to use the logic functions of Excel. I know that Excel possess functions that would probably make me cry for how simply it would replace hours of my time manually manipulating data.

Nick -- I already sent you the email, but...ONE MONTH til Serengeti / Zanzibar -- can't wait to show you around

Marisa / Tony / Michelle / Jen -- Can't wait to have our reunion in the Deep South, just a little more than a month away. Hard to believe its been four years.

John William -- I think I have written more blog entries in my one month aboard than you in your 8 months...I like reading what you're up to, keep 'em coming, that last one was especially good.
http://vermont2peru.blogspot.com/

Mom -- Hi. I know you will be the first person to check on this blog, so I'll pass that along.

Jessica -- You get the one and a half month warning, you're gonna travel like a local and see all my favorite places and people. It will be a true experience and it will be great to share it with you.

Everyone -- I currently have readers in six countries and I am hoping to improve upon this, so if you can get me a new country, it'll make me happy. And I really think that's only five countries since the Kenya hits are probably just me.

Thursday, March 3, 2011

Work Update

I spend a lot of time on the computer. You may have noticed this, considering my frequent blog updates or faster than US email replies. But most of the time I am not messing around, but actually working. I am going to be at time vague in my description of the work, unlike my other blogs where I tell you the color of bananas I ate or exact greeting my host used, because some of this information is not mine to share. That said, I hope it's still sort of interesting.

My first week was field work, understanding the work flow of the system I was going to be modifying.

My next week was projecting numbers for the algorithm / case definition for TB which has been developed by experts throughout the world.

My next week was convincing myself that the numbers I was projecting were real, and much bigger than expectations.

My next week was coming up with my PI and colleagues, novel ways to address the issues I had uncovered and do our work as best as we possibly can, inside of the limits set by finances, culture and reality.

Remember the 25,000 kind souls who answer questions weekly about their health status? Well, our plan was to add a few more questions to the survey and see what the prevalence and incidence of TB in the community. Furthermore, we wanted to trial an "intervention" of TB screening done through a combination of clinical diagnosis, CXR and a fancy new polymerase chain reaction (PCR) machine which would then function as a point of care test (POCT) for the clinic. It is a nice idea, however, logistically very challenging. My work is to figure out how to plan for all this to take place, and ideally, be around to set the stage for the kick-off to take place.

The actual day to day of my work involves a lot of excel. If this sounds familiar to my medical school readers, it feels familiar to me. Instead of sitting in my seat in the library where I am hoping to get a plaque, I am sitting on the second floor of a sweltering office complex in East Africa, sweating (a lot) and putting in numbers and formulas instead of medical facts and disgusting pictures.

Those 25,000 people, have generated a lot of data, and what I am doing is taking the data which seems appropriate from their answers and extrapolating it to the algorithms for our diagnostic chart. And trying to think through all of the steps along the way. Some of the data is readily available from years past--HIV prevalence rate in the community; cough / fever complaints; population demographics. Some of the data is based on expert estimate: how many people will refuse an HIV test, how many people will have a CXR which will rule in for TB and require further testing. And then some of it is based on pure guess: how many people will be willing to walk to a mobile field site for a sample?

So I take all this data: real, estimates and guesses and put it together into an excel spreadsheet. Actually, many spreadsheets, although I am working on making it into one big spreadsheet with a bunch of different workbooks. Is my terminology correct here? I don't know.

And once I have those projections for our community, I have to estimate on a budget. This is interesting, because I always wondered approximately how much people make in places like this, and now I know. I have to try to accommodate for everyone and everything which may cost a penny. My working philosophy is that whatever I can run the budget up to on Excel, I should add between 10-20% because that gives me cushion. I haven't done that, but that's in my head. And this research ain't cheap.

I did this all for my community, Lwak. And the reason I have down time right now, is I am waiting for data from the other site in Nairobi to give it the same treatment. Presuming all of my formulas are right, which is definitely a presumption, but I think a correct one, it is all clerical at this point and things should just fill themselves in. We'll see.

Wednesday, March 2, 2011

"The sun sets at 6:20": Trip 3 out of Kisumu

David moved into the place where I was staying at, the Pabari's Paradise out-house; he is a candidate for a PhD in soil science from Cornell. A very nice guy and slowly becoming a very respectable Kisumu local, considering he spent extended periods of time in Kisumu often throughout the past few years. He also has wheels, and he invited me, along with another of his friends from Cornell, to visit the village where the families of several of his friends live. I took him up on this generous offer and we had two great visits.

It took about 90 minutes to get to Mumias, a town built around the production of sugar and the agribusiness Mumias Sugar Company. Travelling in a car is nicer than travelling in a matatu--its also much quicker, and depending upon your driver, you do not feel as though you are going to die--David was a very good driver.

We then stopped for tea because David's friend who was going to guide us down the maze of back roads to their home, was still on his way to find us. I remembered that more than two chapati (especially if it hasn't been freshly cooked and has just been absorbing the grease from its neighboring chapati) is more than enough chapati for anyone.

Once we were all together, we stopped by the market to pick up two chickens as gifts and some other insundry kitchen supplies to deliver to the family we would be visiting.


Entrance to the family compound

We got to the first compound in the middle of the sugar fields and were greeted by the entire extended family dressed in their finest clothes. We were welcomed into the head of the compound (Mzee)'s hut first for introductions and to deliver our gifts. We were then shuttled to the hut of the eldest son who is still living on the compound for our meal.


Mzee's house

EVERYTHING--I can't stress that enough--EVERYTHING that we ate was harvested from the immediate farm and a result of the hardwork of the people who shared it with us. The meal started with a few bowls of peanuts and seasame seeds laid out on the table in front of us with milk tea (the tea leaves were probably not from the farm, but they could have been). And after filling up on these snacks, the meal was brought out--plantains, arrowroot potatoes, sweet potatoes and cassava--more than I could ever eat. And after I had eaten as much as I could, and there was plenty more left, they brought out sweet bananas for desert. It was a beautiful spread of food and the company was great.



Most of the younger generation spoke some English, but the Mzee and some of the women did not speak English but could understand Swahili so I was able to communicate with everyone, which was particularly special. It was also pretty funny, how after me speaking with the Mzee for a little while, one of the older sons began to translate our conversation into English for David and his friend.

We finished eating, heard a small bit of history on the lands from the Mzee and walked around to see the grounds. It is just (inshallah) the start of the rainy season so there wasn't too much growing but it was still special to see where they lived and where our meal had come from.


Mzee and his family
As we packed up to leave and say our goodbyes, we were handed some gifts including a huge bag of roasted seasame seeds and peanuts, as well as two chickens--different from the ones we gave, but of the same type. We jumped into the car, and off we went to travel to the next (and last) compound.

When we arrived at this compound we were greeted by the elder mother and spent time in her house. We gave her the chickens we had received (Pabari's Paradise frowns on raising chickens--as well as many other things) and entered her house for introductions. Here we learned that our hostess was one of two wives for the late Mzee of the household. She had twelve children (only 3 sons) and the Mzee had taken another wife in hopes of getting more sons (she had three children, two sons). Fortunately for our stomachs, this visit was the reverse of the last visit and her sons grabbed us and showed us around the property first and then we sat and talked, and then we ate--again the food was copious.

One special meal we got was "Aliya" which is a special Lou food of slow roasted / dehydrated beef. It was delicious and its a genuine treat as beef is expensive and the labor is great to cook it. We had fresh fruit, multiple types of ugali, chicken, local greens and much more. Another beautiful meal to remember.


As 6:20 was approaching and the sun was setting, we said our goodbyes, piled into the car and gifts of peanuts in hand, we left happy and having had a true day to remember.

Sunday, February 27, 2011

Mbita Island: Trip 2 out from Kisumu

Approaching to greet
Mbita was great. The drive to the ferry was wonderful, until the last few kilometers which were terrifying. The matatu was late (as we had been sitting in the bus stand for well over two hours) and it needs to meet the ferry at the dock in order for us to get on the ferry, and them to pick-up ferry passengers and take them to Kisumu. The entire trip, the conductor had been hurrying people on and off the matatu (“fanya fasta fasta”) was what he kept saying to the passengers as the driver took off before both feet of the new passenger had left terra firma. And by the time we were just outside of the ferry, the driver was being motivated by other matatu conductors who were coming back from the ferry who were gesticulating that the ferry was leaving. Each matatu we passed made the driver accelerate harder and check his speed less. And there we were barreling at who-knows the speed (because the speedometer is either broken or disconnected) towards the lake, downhill and around curves without ever really breaking. We made it—on the ferry and to the island.
I arrive at the island and everyone wants to know if I want a taxi—no I don’t because I don’t really know where I would go. So I walk. And I just walk around and people greet me friendly and little children run to me and say hello. People ask me to take their picture—and I oblige and have some cute pics of little kids. I just walked and talked and took in the environment. It was really hot, very dry and dusty and quite beautiful.

Piga picha


I ate lunch at a small shack on the “causeway,” which links together Mbita and Rusinga islands. I got a big old fried fish with ugali and cabbage and sat and ate for about an hour listening to the guys next to me babble back and forth in a mixture of English, Swahili and a tribal language I don’t know. I paid and I left and slowly walked back checking out the stalls along the way.

Sandals made from old tire

The entire time I was on the island I was greeted so warmly and I was never asked for anything, at all. Except for one situation—I passed a group of young men sitting under an open air shelter and they approached me with a notebook and asked for a contribution (mchango). This is a really common thing to do for sports teams, schools or other community efforts—everyone around donates what they can and maybe something happens.
The boy, the youngest of the group, approaches me and asks me to contribute and shows me the book. This is an old school book with a list of names ~100 long who have donated anywhere from 10 to 200 KES (0.10 - $2.50). But there’s a picture on the front of this notebook, and the boy says that it was his brother and that he passed recently. This is another common tradition is for the community to contribute to the expenses of the funeral as well as the well-being and future of the family. So I looked at the guys one more time, always in the back of my mind wondering if I am about to be taken, but I went on my gut and I had been so well received and so comfortable in my visit that I pulled out 50 KES and gave it to them. I always look at the contributions and at the one that appears most often and go a denomination or so above.
As I pull out the money, and sign my name in the book, I see the guys behind my young friend smiling and welcoming me to the town and Kenya, thanking me for the gift and wishing me good luck with my journey.

Picasa Update--

https://picasaweb.google.com/MatthewJMeyer/KakamegaForest?authkey=Gv1sRgCLW647rOqs65wAE#

https://picasaweb.google.com/MatthewJMeyer/MbitaIsland?authkey=Gv1sRgCLug_ribyrLRqgE#

https://picasaweb.google.com/MatthewJMeyer/AroundMumias?authkey=Gv1sRgCMC829nPtYOEGg

Three albums worth of photos--not too many, but you need to link through these to get there.

Saturday, February 26, 2011

Bus Standi

Main bus stand in Kisumu

I got Friday off from work. The bosses were gone to a "retreat," whatever that means, and I had finished my work for the week, and maybe longer (interesting story, call for details). So I decided to see what the world had to offer me around Kisumu. Since I don't have access to a car myself, this meant a "matatu" ride. For those of my readers who are related to me, which is many, a matatu is a little, little gentler version of a "daladala." And the only reason they are a little better is they seem to be newer, I think they send the broken down matatus to Tanzania and breathe life into them and then call them daladalas. I really do.

I got to the stand early, because if you're going to travel anywhere by an over-stuffed mini-van you want to start early because these things move slow. I got there at 7AM which is earlier than I arrive for my transport to work--I was motivated, amped and ready to go. And you know where this goes, I was the only one. The Kisumu bus stand is timid as far as my experience in East Africa goes. I got there and had to find someone to ask where my bus was located--usually, I can't get within 100m of a bus stand without being offered transport to the far reaches of the planet. But here, I had to find someone, and basically rouse him from his stupor of collecting $0.50 from each bus that exited the stand. He pointed in a vague direction, which was really all that I wanted, and off I went.

I find the bus and the driver says, get in-- I look in, and its empty. Not a good sign if you want to leave soon, because it ain't leaving until its packed. So I look at him and say I'm off to get chai (breakfast) and he says, I'll join you. And then says I should leave my bag in the front seat to reserve my spot. I'm trusting, but seriously, I could just hand my stuff out to people because then I would at least get to choose who made off with my goods. I told him I would take it with me and get whatever seat was remaining. Honestly, the front seat is the choice seat, as long as the person between you and the driver (you didn't think we wouldn't use the "seat" where the stick shift was) isn't fat. The other issue with the front seat is you can actually see what is on the road and the ridiculous / dangerous driving choices your driver has opted for--passing on a curve, passing on a hill, passing on a hill and a curve, passing into oncoming traffic, nearly hitting a person / motorcycle / goat, driving too fast, pulling off to pick up a passenger when there is no shoulder, etc.

Chai came and went, and back to the matatu. My seat still remaining, along with most of the other ones, I hopped in and sat, for two more hours. Fortunately the bus stand is pure entertainment. I would say 90% of the people (and this is probably a dramatic underestimation) at the stand have no intention of getting on a bus, maybe ever. They make their living at the bus stand (making a living may also be a bit of a stretch, but it's their source of money). This includes all sorts of employment or mischief: bus drivers, conductors (guys who cram themselves into the matatus and collect the fare from you, and cram more people on the matatu), police officers, transportation officials, people hawking ALL sorts of goods (including, but certainly not limited to, bananas, CDs, DVDs, socks, pad locks, sunglasses, hanker-chiefs, wallets, underwear, water, biscuits, gum, candy, hot-dogs without the bun, buns without hot-dogs, newspapers, phone cards, toys, chains, rope, and soda), pick-pockets, prostitutes, drunks, beggars, people selling meals, people selling produce and dry goods, bicycle-taxi drivers, regular taxi drivers and touts.

I want to focus on the touts, because they are my favorite. These people will do anything for any sum of money. You name, they'll do it. As soon as a bus pulls into the station the touts flock to it and usually there will be two or three on top of the roof (because that's where all the goods are stored that travel with the bus, obviously) starting to unload before the bus has parked. Usually these guys (and they're always guys) are between the ages of 15 - 30 and they just "hang-out" at the stand hoping to get a little change here and there for assisting.

Once the goods have been unloaded from the top of the bus, they usually are handed down to another tout on the ground who packs them on his cart--I don't have a picture of the cart but I hopefully will get one so you can see how impressive these things are sometimes. They are home-made at a welder's shop or constructed out of wood and they load these things like you absolutely wouldn't believe. And then they hop in front of the cart and just start dragging. Seriously, world's strongest man ain't got nothing on the huge amounts of weird things these people will pull places--and all for much less than a dollar.

Other touts work for the bus companies, and I think work is way to generous, I'm not even sure if they are associated with the buses in any fashion other than they try to bring people to buses and ask either the person to pay something for the help or the conductor to throw some shillings their way for helping them get a person to ride. And these people will try anything to get someone on board.

They'll shout at you, they'll block your way to the other bus, they'll grab your hand, they'll promise you the world just to get you on the bus they want you to be riding. I even saw a young tout trying to talk the conductor of another matatu to get on our matatu. Now this would be like if an apprentice for a store clerk at Hudson News in JFK Airport tried to talk the co-pilot, flying the Delta shuttle to Detroit, into paying for a flight on United to Durham.

After getting so bored that I actually purchased some CDs through the window, I took off for Mbita.