Saturday, May 26, 2007

Kisumu … and actually starting the study!

I’m starting to feel like Kisumu is a “home away from home”. I know my way around town, know a lot of people, and feel pretty comfortable. This time was even better, because after a week in the hotel, the malaria branch chief left for the US for a month, and invited me to stay at her house while she’s gone. I pay the housekeeper’s salary (yes, housekeeper!). It’s a great house with a nice yard, they have 24 hour security guards, and it’s so wonderful to be able to leave a note with instructions in the morning and find it done. I never have a lot for her to do, but it’s great to have my laundry done and have fresh fruit and vegetables. I have been eating my weight in fruit salad and avocado. They have giant avocados here that are incredible! There is also a good internet connection, so I’ve been getting work done.

The first weekend I was here, I made a day trip with a bunch of other gals here doing research with various institutions to the Kakamega rainforest, the only shard left in Kenya of the vast rainforest that once stretched all the way across Africa.

We saw a lot of monkeys, but my camera doesn’t take reasonable pictures of monkeys in tree tops (believe me, I tried). The old trees were amazing. Here’s me inside one:
We climbed a hill to the highest spot in the forest (1700m) and stopped for a rest and a snack.
On the side of the hill is a small cave that shelters three species of bats.
Gratuitous close up flower shot:And yes, I actually did come here to work! Monday, May 14, we officially started our study, loading up a minivan with supplies and heading out to Bondo, which is an hour away on pretty good roads.Here are our two clinical officers (essentially physician’s assistants – function much like doctors here) and two nurses hanging out in our clinic. They have been great to get to know and work with. And here is the very first patient we enrolled, looking on while the clinical officer finishes up the paperwork. Poor sad sick kiddo eyes. It has been fun to see her back for follow up visits looking much better. We’ve been enrolling for two weeks now, and ironing out bumps as they arise, but things are going pretty smoothly. I really enjoy being in a clinic again. As the room we have is in the maternal and child health clinic, and there are about 250 patients per day that pass through the doors, we sometimes help out with the other patients and I’m enjoying being called to assist with interesting cases. I also very much enjoy the ride out and back every day. The country side is beautiful. Kenya also has great birds, and I go “telephone pole bird watching”. There is a bird sitting on just about every stretch of wire or pole. There are lots of starlings, doves, fierce looking shrikes, large brown hawks called black kites, kingfishers, crows, great black crested eagles with a long crests that curl over there foreheads, hammerkops (brown stork-like birds that have feathers at the backs of their heads that makes their head look like the head of a hammer), ibis, grey plantain eaters…

The other fun thing about being back is getting to know Kisumu. I get dropped off in town most evenings, do an errand or two, and walk the mile or so to my house. I found a tailor who makes beautiful suits, so I’m having a suit tailored. It was a lot of fun to sit down with the tailor and discuss the details. I think it will be gorgeous, and at a fraction of the cost that I’d pay in the US. I also found a salon that caters to “musungus” – foreigners. They do great pedicures, massages, waxing, etc. The other day, I had a one hour pedicure for $5. My feet were exfoliated and massaged to within an inch of their lives. J I got my arms waxed (just for the heck of it) for another $5 – not nearly as painful as I thought it would be! I’m going to go to church with Chris Odero, my study coordinator – I was supposed to go last weekend, but he was called out of town at the last minute.

There are several other EIS officers here on various projects.
I’ll be here until June 10, so I’ve got so more time to enjoy it!


When I arrived in Nairobi, I realized I had 8 hours before my flight to Kisumu, so I hired a taxi for the day. We went to the national park that borders Nairobi. I didn’t see a whole lot, though we did see some giraffe and impala very close.

My driver decided I needed to see more, so he took me to a place called Giraffe Center, where there is a population of rare Rothschild giraffes. They have built a raised pavilion, and the giraffes will come over and eat out of your hand.

They’ve also trained them to take a pellet that you have placed between your lips for a “giraffe kiss”. Now, giraffes have incredibly long, black tongues….

Fortunately, they are not slobbery…..
Are fairly dextrous about it…..
And have reasonably good breath!
And a kiss from a baby!
Sorry, the food is all gone!

Friday, May 25, 2007

Lemurs!!! (and other beasties)

This time I was strategic – I went a weekend early and arranged a trip with a travel agent to Andasibe, a national park about three hours from Antananarivo. The next weekend I went with one of my teammates to a nearby “Lemur Park” for a few hours.
The countryside is beautiful – Malagasy architecture is unlike any other I’ve seen in Africa, there is a lot of rice farming, and they farm on terraces, as in Asia.

On the way, we stopped at a reptile park, where they have lots of chameleons and some other critters. Chameleons are much fun to watch, especially darting out that long tongue for a juicy grasshopper or crawling on your arm, and range from the sublimely beautiful….
to… well, ugly is a harsh word, but… let’s just say I didn’t want him on my shoulder. This fellow is a member of the largest chameleon species. It turns out geckoes are not just those tiny lizards on your ceiling (or that little green guy that sells car insurance). Some of them are fairly large and look quite outlandish! Many have camouflage patterns that are incredible and look exactly like dry foliage
Madagascar is also known for its spectacular butterflies
Well, I have been promising lemurs, so here we go!
Andasibe is home to the indri indri, the largest lemur. It that has an estimated life span of 50 years, but absolutely refuses to eat in captivity, so the only place you can see it is its natural habitat in Madagascar. It has a haunting call that carries several miles.

The brown lemurs are a lot of fun to watch climb around. These are very bold!

The sifaka is a lemur that travels on its hind legs, both in the trees and on the ground, but it doesn’t walk, it jumps. Watching them bound along in great leaps, with their little white paws flapping in the air beside their heads, is one of the funniest sights I’ve ever seen. I wish I could post a video on this!

And finally, the aptly named bamboo lemur – these guys are so cute!


I spent almost two weeks in Madagascar, again with a CDC/USAID team, this time to decide how to spend the $17 million that has been allotted by the US government, based on the results of our assessment visit in March. It was great fun to see the rest of the team again, and meet some new faces as well. We had a fair number of meetings, although fewer than last visit, but spent most of the time doing this…..

Meeting in a conference room at USAID debating (more or less vociferously) where and how to use the funds and drafting the planning document. We frequently worked till after dark, and had plenty of opportunities to watch the sunset and moonrise over Antananarivo from the conference room window, which was a spectacular sight.
We also did some going out to eat afterwards: this is most of the CDC/USAID team, with the WHO malaria rep -
Once again, haute French cuisine nearly every night means extra pounds you need to shed when you get to Kenya!

Short stint in Atlanta

I had about 2 ½ weeks in Atlanta, most of which was taken up by the EIS Conference. The EIS Conference is a large CDC-wide conference, where all the new little EIS recruits (like myself a year ago) try to meet as many people as possible and figure out what they want to do with the next two years, and go about trying to impress the supervisors of the positions they’re interested in, all under the guise of being at a scientific meeting. The EIS officers (including myself this year) present the results of some of their work. And pretty good chunk of CDC is there. It’s a great time – I enjoyed last year a lot. As an incoming EIS officer, everyone wants to talk to you, because there are more positions than officers. As an extrovert, I had a blast. As a current EIS officer, it’s a chance to catch up with your classmates and all sorts of people you haven’t seen since last year. I gave a presentation on the work I did in Niger. EIS presentations are ten minutes long, and incredibly highly practiced and scripted. I gave it to my branch three times before the conference, getting 2 ½ hours of feedback the first time and down to 45 minutes the last! I actually really enjoyed giving the talk, and especially enjoyed fielding the questions afterward. (And I actually didn’t take any pictures all week! Go figure!) Oh, and we got a really great incoming EIS officer for the malaria position – she’ll do a terrific job!

I did manage to get down to Florida for a little less than 24 hours to my friend Lee’s house to meet up with my roommate from medical school, Hilary Ann, and her husband Shawn. We had a delightful time chatting, cycling around Watercolor (a beach side town), and walking on the beach. Trying to take the kayaks out in rough surf resulted only in some nasty bruises, but we quit before we sustained any concussions! This is me and Hilary Ann.