02 February 2011

Kenya: The Kakamega Forest + Democracy Now?

So, apparently almost the entire Arab world has decided in the last few weeks, that after an average of 25 - 30 years of autocratic rule, they want democracy.  Now.  In the three weeks leading up to my first trip to Morocco.  What timing!  How selfish.  With uprisings spreading to Yemen, Jordan, Algeria, and now rumors of Libya and even Nigeria being next, I figured it would be smart to change my vacation plans.  With the help of God (it could only be) and Nikki the kind Delta agent, my flight from Nairobi will now head to Lisbon, and then home after nine days of Portuguese espresso, nightlife, and port.  

But we are still one long week from being done here in Kenya.  My time with Dr. Allibhoy came to an end today, after a busy set of rounds.  We continue to see cases that are only seen in textbooks back home.  Today, a patient with cryptococcal meningitis was readmitted, our patient status post thoracentesis is still improving, and a post-MI patient appears to be doing well on day 1.  Dr. Allibhoy gave an excellent talk today on the latest in Acute STEMI management.  Here in Kisumu there is no cath lab, so no PCI can take place - thus, they use fibrinolytics.  I don't think I've seen fibrinolytics used for MI in my training in the U.S., so it's interesting to see that used here, and safely.  I've only seen it given in suspected embolic stroke.  Dr. Allibhoy does an excellent job of keeping up with the latest in Cardiology, collecting journal articles and attending annual meetings in Europe.  

I'm continually referred to as "Dr. Travis from U.S.," but out in the village I answer to Giles, Charles, Jarvis, or Trevor.  The "Tr" sound doesn't mesh well with native Kiswahili tongues, but I appreciate the efforts.

Yesterday's visit to Kakamega was beautiful and a refreshing break from the polluted air and busy streets of the city.  Mom's details will be below, and will hopefully include the amazing 8 - 10-foot python that had wandered into the local village and was beaten to death by a swarm of villagers, and then taken to be skinned by the Kenyan Wildlife folks.  It was the only snake, dead or alive, we saw yesterday, even though the forest has 27 species of snakes (25? poisonous per the guide).  We saw plenty of red-tail and Colobus monkeys swinging from the trees, and great views of the falls and land surrounding.

I'll leave you with a quick commentary on top of all this pro-Democracy anti-autocratic unrest in northern Africa and the middle East.  The sentiment down here is of course the same as the U.S. - Democracy = good.  No other way about it.  But how about when Democracy elects leaders that will not be friendly to the U.S?  This is what will likely happen in Egypt.  Then what?  Will the country then be unfriendly to tourists from the West?  From what I hear, the Muslim Brotherhood (majority in Egypt) is not similar to the majority of other Muslims around the world, and continue to represent an extremist view.  But they are who will ascend to power in Egypt.  At first, President Obama wanted to have "talks" with Egypt, but now the word from the State Department is for a transition to begin "now."  How is our country's leadership handling this?  Shall we bomb the hell out of northern Sudan to set them straight?  Or hold diplomatic talks with Egypt?  What's the course?  Is President Obama being too weak, or being smart?  In all honesty, the main thing about an Obama presidency that made me hopeful was his anticipated ability to work with international leaders and bolster the view of Americans around the globe.  Is he doing enough right now?  Of course, it depends who you read, and it's fascinating:

You can either read the caution-provoking article about Obama being the one who will be remembered as "the one who lost Turkey, Lebanon and Egypt."   Or, you may want to read support of Obama supporting Democracy, and practicing what he preaches.
  
Oh, and Josh still doesn't have the truck.
The better version from Mom:

Hello all!  Yesterday we took a trek through the Kakamega Forrest.  It's about 1.5 hours each way and our driver, Mark, had to drive like he was on an obstacle course on some of the journey as the pot holes are deep, wide and plentiful.  We made it and boy was it spectacular!  We began our 3.5 hour trek (about 10 miles) with our guide, Rachel, who was wearing sturdy leather-soled flip flops.  Our lst stop was to look at a 10 ft. dead python the villagers were skinning.  OMG!  I could not get close but Trav took a couple of pictures.  As we entered the forest, we saw a troop of blue-tailed, red-tailed, and white-tailed monkeys which was quite exciting.  It's the lst time I've seen monkeys in their natural habitat.  Rachel then told us of all the animals/reptiles there--27 species of snakes, 10 of them being poisonous (I went blank after that--ha).  Thankfully, we didn't see any.  We did see lots of monkeys as well as a breathtaking, beyond words overlook of the whole valley and some waterfalls.  Pictures can't capture the awesome beauty of this part of Kenya. We had the perfect day as it was overcast and nice and cool. There were fewer people around and I noticed that the whole area (forest and villages) was pristine with hardly any litter.  They seemed dedicated to caring for the area which was heartening. The kids were excited to see the mzungus and to have their picture taken.

We returned and boy were our feet tired.  After a lovely dinner of spaghetti and garden salad at the mzungu hangout, the Green Garden, we made our way home via tuk tuk since it was after dark.  Trav then began to try and change his trip plans. Instead of Morocco (with politcal unrest nearby), he will go to Portugal.  The communication system here is archaic and extremely slow.  After about 2 hours of trying to communicate with KLM about his desire to change his flights, the call was disconnected and we were about out of phone time.  So very frustrating to say the least.  We decided to call it a night and try again today.  I'm happy to announce that he was able to work out all the changes! And, we'll be on the same flight to Amsterdam so I'm pleased about that.

Today, I took it easy while Trav did hospital rounds.  I began to talk with Dan, the on-site manager of the hotel about differences in here and the U.S. Here people are very connected to family.  If a brother has a financial need, the family (which is usually large) helps thus making it near impossible to save for the future.  On the other hand, the family is a built-in safety net.  Dan has several other businesses so that he can earn extra.  He has driven us a couple of times into town and has helped Trav get some music CDs (which excites T).

It has rained a little bit and there are thunderclouds in the area so we may get more.  We're heading back to the clinic tomorrow even though the truck is still at the police dept.  I guess Josh will find another vehicle.  We only have 2 more days in Kisumu and are trying to fit in many things.  Sat. we leave for safari.  Awesome.

Love to you all!

----
Asante sana.

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