Safari to the Maasai mara

Hey everybody,

Well, I have just returned from one of the most amazing weekends of my life! Six of my friends from Kijabe and I spent three days treking through the Maasai mara game park. We left early Friday morning, taking 5 hours to travel there, and then on our arrival spent the afternoon and evening on a game drive. Here is the group...

Unfortunately we just missed the mass Wildebeast migration, but were lucky to see the last remnants on their way to Tanzania.

The tallest land mammal on earth and probably my favourite for the weekend.

One of the most amazing experiences of the weekend was being in the middle of a herd of elephants on the move. They are so graceful for such huge animals.

We made a quick trip to Tanzania for lunch (well, the tanzanian side of the Mara river), and were lucky enough to see Hippos fighting in the water.

And finally, early sunday morning we were lucky enough to witness a pride of lions making a kill. This is one of the young males trying to drag the remains of the water buffalo into the shade and away from the vultures.

The elder male of the group (yes we were this close).

One of the lionesses. Okay, I did use my zoom a wee bit.

This is a picture of the tented village we stayed in. Very authentic :)

And thats me. It was a entirely wonderful and exhausting weekend, and so now I intend to fall into bed. I'm looking forward to my last two weeks in Kenya, which I am spending in adult paeds (as opposed to baby paeds where I've been). Love you all and see you soon!

Post Holiday Update

Habari gani rafiki, long time no speak! I’m sorry I have failed to post an update in the last two weeks. Unfortunately my trip to the Masai Mara game park was cancelled two weekends ago due to torrential rains and so I have been waiting for more exciting news before I wrote again. I have just arrived back at Kijabe after a week long holiday, and am now feeling well rested and ready to enjoy my final four weeks on the mission station.

Well, I was sad to leave the wonderful Obstetrics and Gynaecology team after three full-on weeks with them. I think I’ve mentioned in a previous update the 6am starts, so it won’t surprise you that I was ready for a holiday when my time was over. But I have to say, I miss the ladies, the babies and especially the team very much now that I’ve moved on. Most of all I’m missing the chai and samosa breaks that became the highlight of my weeks :)

But before I go any further, I better tell you about our wonderful holiday! On Sunday morning, Juliette and I were lucky enough to fly to Mombasa for a few days of r&r. We arrived in the city and took a drive around the sights before settling into the hotel. This is a view of the beach from the hotel.

We spent our time enjoying the hot African sun, swimming, reading and walking on the beach. The absolute highlight of our stay was a trip out to the reef for some snorkeling. I can never get over the amazing beauty and variety hiding just beneath the surface of the water. We were even lucky enough to see one of the very rare Lion fish, along with the full cast of Finding Nemo :)

Unfortunately, the beach life cannot last forever, and so we spent the rest of the week in Nairobi, sorting Juliette out before she heads to Cardiff to begin her Masters degree. After a few issues with her visa, she will fly out to the UK on Tuesday morning, only three days late.

So now, its back to business. I’ll spend my last four weeks doing a mixture of paediatrics, neonatology and paediatric surgery. We are looking forward to the arrival of two new American students and a bunch of Kenyan medical students to join the team. I’ll write to you with more news as it unfolds. Hope you are all well!

My African Birthday

Well, as of the 5th of September, I am officially 24 years old! Can I start by saying a huge thank you to all those who sent me birthday wishes, I was so blessed to open my inbox to a huge number of emails from home! It is honestly the only time I have ever been pleased that facebook emails you every time a message is left on your wall because the hospital have just banned facebook on our internet and so I was able to read all the birthday messages even though I could not access the website!

My birthday morning began with a 6am ward round. It seems there is no rest for the wicked, even on your birthday! Later in the morning I had time for a chai and ndazi break with the lovely obs and gynae team (Chai is taken with an abundance of sugar and ndazis are African deep fried doughnuts).

Frank and I



Munge and Joshua

We then went on with our busy day. A gynae clinic and an emergency caesarean section later, the girls Emily (Wales) and Gail (Northern Ireland) found me in casualty and took me away for a traditional African lunch in the sun.

Later on in the evening we had a few friends over for dinner, including the two new recruits, Matthew and Chris who are medical students from Bristol. We made pizza and chips and were just sitting down to eat, when Juliette and her boyfriend Richard arrived bearing gifts. My main present was a Masai blanket, and a box of chocolates covered in flamingos, but they also brought a huge bunch of lilies and roses. This is me pretending to be a real masai… I just had to.

And then the best part, my birthday cake!

So it was a great night for everyone and I was extremely spoilt. Today I’m on call for the weekend, ie. The whole 48 hours until Monday morning ward round. Unfortunately it means I have to hang around close to a phone, but I guess I get to enjoy my beautiful flowers :) I hope you are all well and enjoying the beginning of spring. Kwaheri!

Mini-safari at Lake Nakuru

Hello my friends, I am just back from my weekend of fun with Juliette and Emily (a fellow medical student at Kijabe). We had a great time, I feel like we had a real holiday, but as usual I have come home exhausted.

So it was Alisa the american's last day on Friday, and we made a big dinner of spaghetti bolognaise and then had ice cream with real chocolate sauce. It was very special and a nice way to send her off. She left the following morning for a weekend in Nairobi before she flew out on Sunday. So now we are down to four!

Juliette drove up to meet me in Kijabe on Saturday morning and we got on the road to Nakuru by about 9am. We drove through a wee town called Naivasha on the way and stopped for some photos, then headed for Lake Nakuru National park. You pay about $40 US to get into the park, and then can drive freely around checking out animals to your heart's delight. Lake Nakuru is famous for it's flamingos, but unfortunately it's hard to get close enough for good photos. They are so beautiful though, lining the lake with bright pink feathers.




Lake Nakuru lined by Flamingos



We also saw Zebra, warthogs, wildebeast, water buffalos, rhinos, antelope, impala, grouse and gazelles. Unfortunately we missed out on seeing Giraffe and lions, so I guess I'll have to wait for the Masai Mara. A picture is worth a thousand words they say, so here are a few...




Mama and baby rhino




Zebra




Zebra and Pelicans at the water hole




Gazelles on the plains





Emily and I at Mwabira Waterfall





Water Buffalo covered in mud




Lake Nakuru from Lion Hill lookout



We caught up with Juliette's family in the evening and ended up staying at this guest house near Lake Elementaita. On sunday morning we enjoyed a lavish sleep in, a long hot shower and a late breakfast, and then we set off for a more relaxed day. We drove back into Lake Naivasha Country club, and had lunch in the sun. It is such a gorgeous place,with a big lawn covered in Acacia trees, Juliette wants to get married there. We went for a walk down to the lakeside where we saw a couple of hippos playing around, and then went for a swim (in the pool, not the lake!).





Hippos on Lake Naivasha





Juliette and I at Lake Naivasha




After whiling the day away in the sun, we made our way back to Kijabe and here I am! Today I had a good start to Obstetrics and Gynae with an emergency caesarean section within the first hour. I think I'm gonna enjoy myself, although the 6am starts are a killer! Hope you are all doing very well back home, and just before I leave, I have to gloat... My little sister just informed me that WGC won the National Stage Challenge! WGC is number one, don't mess with number one!


Okay, enough now, love to you all,
Chlo




PS. Tiki my travelling mascot. Just so you know I brought I piece of New Zealand with me! Shout out to Lisa Bathgate.

In the hospital, the busy hospital...

Hi again, I hope you are all keeping well and that winter is slowly retreating. I am pleased to say that the weather here is also becoming more friendly, with sunny days most of this week. I always thought of Kenya as an extremely hot country, given its position right on the equator, however I was surprised to learn the climate is very temperate. It tends to sit between 20-30 degrees. Kijabe (meaning ‘place of the winds’ in Maasai) is even cooler, with a breeze picking up every evening. Aah, just like home :)

As I promised last episode, I thought I’d give you a look at the medical side of my life in Kenya. This week is my last in general medicine and was particularly challenging. Disclaimer: the following stories may be too graphic for those without strong ‘tumbos’.

On Tuesday night, I was on call and was paged to see a patient in Casualty (ED). I went down and found a 41 year old man, who complained of lesions on his hand and in his groin. I was struck first by the awful smell coming from his general area, and then as he showed me his right hand this is what I saw…

He had several hundred purple-black lesions covering his right hand and extending up his forearm. The smell intensified (as did my nausea) as he revealed that his groin was also covered with similar lesions, which appeared to be infected. Having never seen anything like it, I assumed these were warts. I ordered a few tests, gave him some antibiotics for the infection and organised his admission. In a half an hour or so I received his blood results which revealed he was HIV positive. In the light of this I took another look at his hand, realized that these were not common warts, but Kaposi’s sarcoma, a type of cancer that occurs commonly in HIV.

A couple of days later, on morning ward round, we were given a new patient who had been admitted with heart failure over night. She had been treated in the past, but over the last four years had not had the money for her medicines and had resorted to traditional witch doctor treatment. As we were assessing her, we realized we had not yet seen her Chest X-ray. This is what we saw…

I’m not sure if you are used to looking at X-rays, but basically the globular opacity in the centre is her heart. Normally the heart takes up about a third of the thoracic cage, as you can see, hers is on the large side. On listening to her heart sounds, it was difficult to make anything from what you heard. It was basically just once big murmur. In a third world community such as this, we assume that she has suffered from severe Rheumatic heart disease. We prescribed her some treatment, but unfortunately there is not much you can do for a heart like this (other than transplant). While we were visiting our next patient, we were called to a cardiac arrest (my recently gained resus certificate came in handy). Unfortunately, we were unable to resuscitate the patient. Only seconds after, shaking from the adrenaline of the last arrest, we were called back to this lady who had also gone into arrest. I am unhappy to say that we were similarly unsuccessful in our resus. I could not believe it. Two in ten minutes!

SO… that was my week. Today I am pleased to say, none of my patients have died. I am learning to treat many conditions that are much more severe than you would see at home. Although interesting and exciting, this experience can be emotionally draining. On that note, I’m happy to say that Juliette, Emily (another med student) and I are heading to Lake Nakuru national park for a weekend Safari (meaning journey) and some relaxation. Hopefully I will have some happier photos for you next time!

A typical week in Kenya continued...

When the weekend rolls around we are always ready for some fun, so this Saturday after rounds (yes I said Saturday rounds!) Juliette picked me up and we went back to Nairobi. We turned up at her friends house for a traditional 'bride price' negotiating ceremony. Can you imagine their surprise when a mzungu (white girl) like me walks in? This is part of the preparation for being married. Basically they cover 10 girls up completely and the groom has to pick which one is his bride. If he fails he can be fined money or told to come back and try again in a few years, but if he succeeds, the negotiations begin! The elders of each family fight it out to see how much of a dowry has to be paid. Traditionally 100 goats was offered, but now they tend to pay in kenyan shillings. It was hilarious and long, and the poor bride is locked in her room until the families agree. Luckily for Juliette's friends, the families did agree. According to Kikuyu custom, the couple are now officially married (not according to Kenyan law though). What do you think about that Daniel? Am I worth 100 goats?

On Sunday morning Juliette and I attended her church, called Mavuno. The music is incredible, if you can imagine a full band and gospel choir you will know what I mean. I feel awkwardly white, especially when they dance during worship, but I'm getting used to it slowly.

After church we visited the Nairobi Museum and took a drive through the city centre. Although Nairobi is home to more than the population of New Zealand, it has a small town feel to it. The CBD is compact and only has a few high rise buildings. The other thing immediately apparent is that the Kenyans really take pride in their national identity, especially given their recent olympic success, and thus have flags blazing wherever possible.

Just before we left Nairobi we had the pleasure of meeting up with Gael, a friend from Dunedin. We had ice cream together and caught up on the amazing time Gale is having working with African Impact, before she heads to Zimbabwe to complete an internship at a Law firm there. She is enjoying Kenya heaps, and spend her time working with kids in orphanages.

On our way back to Kijabe, we dropped Gael at her house in Limuru, an absolutely stunning town half an hour from Nairobi. The area is known for its lush landscape and rolling tea fields. She lives in a cute wee cottage there with her boss and his wife, and Doug's brother Adrian (Doug is another friend from Dunedin).

Finally we made it back on the road again. The drive to Kijabe is stunningly beautiful (have I said that already?) especially as you pass by the Great Rift Valley. I am trying to catch a sufficiently representative photo. Here is the valley at sunset tonight.

And now I am home, writing to you and wondering what the next week will bring. I will endeavor to include some photos of my work in the hospital next time. Sawa, it's time for bed.

Good night and god bless!

A typical week in Kenya

Sasa my friends, another action packed week has passed! I hope you are all keeping well. I thought I would write a little of what I get up to over a week in Kenya.

My week begins with an early start on Monday morning, trudging down the hill for a 7am continued education meeting ie. a lecture. This is the main entrance to Kijabe hospital, and those are med students in the stunning white coats!

Following the lecture we begin our morning rounds. I am on a general medical team with the lovely Dr. Peter Mwaka, a kenyan 'family physician' or in other words, a GP who can do surgery (C-sections, appendectomies etc.). We visit each of our patients, taking time to make sure they are being looked after well, and often praying with them or their family members on the way. This usually takes til about midday.

Every day at 1am we have traditional kenyan lunch (usually rice, stew and chappatis) and listen to another lecture (continuing education is big over here). After a wee catch up with the rest of the colleagues, I spend my afternoons finishing jobs and seeing patients in the Casualty department (ED).

We finish at 5pm and wander back to the house for a light dinner (I'm honestly always stuffed from lunch) and a relaxing evening. UNLESS.... you are on call. Call begins at 5pm and finishes at 7am the following morning. As a medical student, you are first on call, meaning you respond to the pager when it goes, and call the junior doctor if you need help. It is terrifying and exciting and tiring all at once. But at least I know I'll be ready to be a junior doctor when the time comes!