Leaving Detroit

We scored exit row seats for our flight to Amsterdam. Legroom!

Entertainment plan

You've got to have a plan for passing the time when you'll spend the next 24 hours on planes... And especially if you don't really sleep on a plane. Our plan is to watch movies on the last long flight (Amsterdam --> Nairobi) when we're too tired to read. On the earlier flights we'll catch up on our magazine reading and shed carry-on weight in doing so before moving on to books. We will start with "This Old House" because we both read it. Then she'll read her fashion mags while I look at "Bon Appetit". I'll tear out some recipes hoping to try them. Some day...

Indy airport, Harry & Izzy's

Here's our traveling group: Susan, Donna, Ed, Mike, Aaron, & Betsy. And I'm hidden behind the camera...

Kenya February 2011

Tomorrow we depart for Kenya.  The hardest part about leaving, as always, is leaving Kido behind.  Thankfully, she will be in good hands at home with our housesitter/petsitter.  And as on our last trip, we will be able to spy on her via "kidocam" on our iPhones.

There will be 10 of us on this trip:

Susan Cordes (ENT)

Ed Weisberger (ENT)

Mike Moore (ENT)

*Aaron Moberly (ENT Resident)

Diana Sullivan (nurse)

Heather Cain (nurse)

*Leslie Helfert (Anaesthesiologist Resident, wife of Mike)

*Betsy Moberly (ER Physician, wife of Aaron)

Donna Weisberger (former teacher, wife of Ed)

Kyle Cordes (travel agent, mr. fixit, phone guy, blogger, husband of Susan)

(*) represents Kenya rookie status

The surgeons and nurses will be working with counterparts at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya.  The focus of this trip is to work with the Kenyan ENTs to screen and operate on thyroid patients (goiters) and to help train medical students.  The Kenyan ENT's have been pre-screening patients and scheduling them for surgery in the coming days.

Leslie is on a training rotation and arrived a couple weeks ago.  Diana left a week ago as she wanted more time to observe and teach before the big group arrives.  The rest of us depart tomorrow (Friday) and will arrive in Nairobi Saturday night.  We will spend the night in Nairobi and then fly up to Eldoret on Sunday morning.  The surgeons will go to clinic at noon to screen/review the patients scheduled for surgery on Monday.  And it will be game on!

Susan and Heather have been making requests for equipment and supplies from various medical supply companies, mostly with pretty good success.  (See previous entry on Olympus.)  They have also been saving unused supplies from home that otherwise would have been discarded.  Susan and I have packed an extra 50 pound suitcase for each traveler to take, since we each are allowed two such bags on international flights.  When we get to Nairobi, we are restricted to one bag for our flight to Eldoret, so we are having our excess luggage trucked to Eldoret.  It should arrive sometime Sunday afternoon.

Stay tuned for regular updates and more info...

Olympus donation

Olympus donated a flexible endoscope with light source, video processor, and HD monitor. The ENT clinic at MTRH (Moi Teaching and Referral Hospital) will love this! We just have to get it there... Thanks Olympus, you're awesome!

Getting ready for next trip to Kenya

Susan's office is a mess. It's time to start packing supplies and equipment to take to Kenya. Olympus is donating a flexible nasopharyngo endoscope for the ENT clinic in Eldoret. We seem to have a mismatch of components and hope we can get things straightened out with the Olympus rep before our trip! The clinic will really benefit from having this equipment. And we can't do the rest of our packing until this is figured out as this is the most important thing we are taking. We will be there in three weeks. Just the usual pre-trip stress...

Welcome Home Card

From our neighbors!

Back home again...

Good to be home!

Detroit

We've made it to Detroit. One more flight then home!

Amsterdam

Not ready for this.

We have arrived in Amsterdam. This marks the half-way point. Our flight to Detroit leaves in an hour.

Nairobi

We have arrived at Nairobi. On the way, we flew over this inactive volcano.

Time to go

Time for the taxi to the airport.

Africa dust/dirt

I've mentioned in a posting long ago, and here's a reminder... The brown-red Africa dust/fine dirt is pervasive. Thus the countless shoe guys...

Siam

Third and last time at Siam Chinese restaurant.

Last day in Eldoret

It's a cool 72 degrees this morning. Thus the coat...

Happy Thanksgiving

We had a great feast this evening... No, the dogs didn't get the turkey. They aren't supposed to be in the houses, but the doors are usually wide open and tonight they couldn't resist coming inside with all the food. This one is "Zawadi" which means "gift".

Victoria

Victoria was a patient from our February trip (upper picture). She had an extremely large goiter removed. Yesterday, Susan was asking about some of the patients from February who had major surgeries. Victoria was one that the clinic nurse, Sophia, didn't know about off the top of her head. And because Susan asked about her, Sophia tracked her down and asked her to come back to clinic. So today, there was Victoria, all healed up and doing great (lower picture). Also worth noting, she had her daughter traveling with her to help her get here and to clinic and to interpret. Victoria only speaks her tribal language and not English or Swahili. Through her eyes, smile, and interpreter, she was very thankful.

Corn on the cob

There are a number of street vendors that sell grilled corn. This guy built a stand for his grill out of stones so he can work at standing height. I'm told it's not sweet corn, though. I've never tried it because I'm also told to avoid it because it may not be clean enough for a sensitive mzungu intestinal system. There are pieces of corn cobs in various degrees of disintegration along the streets. It smells good...

Guard dogs

Every neighborhood or compound is surrounded by walls and fences. Vehicle gates are manned by security guards (typically unarmed). And most also have guard dogs. Indiana House is no exception. There are four dogs here. They live outside and hang out mostly at the gate with the guards. At night, they will bark at anything. Often we'll hear dogs barking in the distance and then our dogs start barking in a chain reaction. Dr. Sisenda says the IU dogs are intimidating and bark like crazy when you're outside the gate and then are friendly when inside the gate. They've never barked at us. Inside the gate they are and act like pets. Susan is with Chai, the youngest of the bunch. Chai likes to play but stops (with tennis ball in mouth) for a tummy rub.

"duka"

A duka is a small shop. They usually sell coke products, maybe fruits or snacks, and prepaid phone cards. These photos are of my friends Henry and Francis and of a duka.

The duka is a nice one. Coke painted it. Zain, a cell company also paints a lot of the dukas. This duka has electricity, which is rare, and it has a refrigerated case inside. We actually had COLD cokes from this place. A nice cold glass bottle of coke for about 30 cents. A warm coke at another duka may only be 25 cents. For us the extra nickel was worth it!

Warm shower / Nakumat

Of course Americans are spoiled. We like to take a daily hot bath or shower. Most Kenyans don't bathe like we do. It's just a difference between cultures. Besides, I would guess that across the country, most Kenyans don't have running water in their homes let alone electricity. In a city like Eldoret, the chances are better. Houses that do have water have single-pipe water. There is no hot and cold. Just water. IF you are wealthy enough to have water and electricity in your home then you may splurge and buy an electric shower head instant water heater. We have these on the showers at Indiana House. They are like a big plastic shower head with an electric line running into it to power the heater. As water fills the shower head you can hear a little switch click on and the water coming out gets warm. Although this is FAR better than a cold shower, it's not perfect. Water pressure at IU House isn't that great. But with this thing, it doesn't matter because if you turn the water up very much, the volume is too much for the heater and your warm shower gets colder. You have a tradeoff between temperature and volume/pressure. I choose lower pressure and more heat.

These are for sale at Nakumat. Nakumat is like a miniature Wal*Mart. They sell all kinds of different things. It's a great store. And since it is a modern store with set prices and checkout scanners, there is no negotiating and no "mzungu" vs African price. All pay the same.

Water at Indiana House

We don't drink tap water in Kenya as our "systems" aren't used to the local bacterias. (or whatever. I'm no doctor!) Anyway, IU House always has a lot of residents and a great need for drinkable water. This photo shows their setup. The employees fill this big tub with tap water and boil it with a large propane burner (next to the OPEN window). The water is then poured into the large metal urns. Then the urn spigots are used to fill old wine bottles (that are cleaned daily.). There might be a hundred wine bottles here. You can see some in the corner on the table. The bottles are then used in the dining room for meals and they are also available to take to the rooms for drinking and for brushing teeth. Also, you can fill used, cleaned plastic water bottles from the urns and have drinking water "to go". To the left, not in this picture, are a couple of refrigerators. One is full of wine water bottles and the other has sodas and Tusker beer for sale on an honor system. This room is adjacent to the dining room.

Nivea For Men

I had read that Nivea believes there is a lot of potential in marketing men's personal care products and that they were going to increase their advertising. Well, they didn't leave out Africa! I've seen signs in shops and billboards and now I see that they've found a way to advertise on the roads on personal vehicles!

Audiology Booth

You may recall that Susan sent a retired sound-proof audiology booth and three audiometers on the recent shipping container. These were unused items that she commandeered from Wishard Hospital.

The booth and equipment had already made their way to the ENT clinic before we got here (thankfully!). The two audiologists, Eric and Richard, had already sorted things out and knew what they had and what they didn't have. They had everything except a step-down transformer (to convert the local 220V to the USA 110V standard that the equipment is wired for) AND audio patch cords to connect the audiometer to the booth. Who knows what happened to the patch cords since the booth was last used at Wishard...

Needing a step-down transformer is standard procedure here. The hospital techs easily came up with one. The trickier thing was the 1/4" plug mono audio patch cords.

At home, when I want to try to find something that may be a little unique or specific to a problem, I search the Internet. My first site to search is often eBay as it seems that if something exists, someone is selling it on eBay. So I searched eBay and with a little refinement, I found such patch cords. The interesting thing I noted is that the seller was targeting musicians and these were advertised for connecting an electric guitar or microphone to an amplifier. I mentioned this to the local guys I was with and they said "of course!" and that there were a couple music stores in town.

So we went to "Vineyard Sounds" which is a doorway behind the gas pumps in the upper picture and I was able to buy the patch cords we needed.

Back in the clinic everything is now working great. In the lower picture, Eric is in the booth wearing headphones and Richard is working the audiometer while another looks on. They may now have the best audiology setup in the country. It is amazing to pack up such large things back in Indy, and like magic, they appear in Eldoret.

Shipping container

The shipping container that was shipped from the IU med center in July that arrived at Moi a couple weeks ago is in the foreground of this picture. Note that it is with three other containers. All four are next to the Riley Mother-Baby Hospital. Since the flow of equipment is one-way, they don't get sent back. These containers get used for storage or other things when empty. I'm told that a couple of containers have gone to villages to be used as clinic buildings for the AMPATH program that works with AIDS patients. Africans don't let things go to waste.

Pineapple anyone?

There are many roaming (and stationary) street vendors in town. This one has a wheelbarrow full of fresh pineapples. He slices off the exterior and then cuts the pineapple into slices. He sells the slices to passerby's in the area and then moves on. This would be great if I liked pineapple...

road construction, continued

Additional rock was delivered for the road construction. The workers are breaking it into reasonable sized chunks using sledge hammers. Unemployment is high and labor is cheap, so there is very little investment in machinery. You will rarely see a backhoe or jackhammer or anything powered at a construction project. Labor is cheap and plentiful and what's the hurry?

Swahili lesson

Every morning in Eldoret, Susan heads to the hospital. I stay behind for an hour-long Swahili lesson with "mimi mwalimu" (my teacher), Wycliffe.

Monday evening

At lunch on Monday I met Carlos (top photo, right) and Louis (bottom photo left). They are from Spain. Carlos is an ENT that specializes in nose jobs and sinuses. Louis is a nurse. Carlos has been here once before. They came to do sinus cases and training but their timing is bad because the ENT's here are tied up with exams. Carlos seemed to be saying that he came now because of when he received approvals from the foundation he is working for. I don't know if he asked if this week was a good time to come. If he did, the Kenyans probably told him "fine" as they don't say "no" to any offers of help. He will still give some lectures to the OR staff and will operate on Friday but that's about it. Carlos is interesting. He closes his private practice (but still works at the university) every summer so he can kite-surf and do other extreme water-sports on the Mediterranean every day.

Monday evening Dr Sisenda took us to the Eldoret Club, the country club, for dinner. It was a little odd traveling down a dirt road and going through a gate, and wow, a really nice looking golf course and building. The building is their clubhouse/restaurant/bar/hotel. It looked really nice.

We had dinner with the Spaniards and also an ENT who recently joined the local staff. Dr Moustafa is in the upper photo on the left and his wife is in the lower photo on the right. They are from Egypt. There is a glut of doctors in Egypt so when he reached retirement age, he was forced out. He came to Kenya so he could keep practicing.

Webcam aka "Kidocam"

It is nice to be able to "look in" at Kido's favorite pillow at home. Here is a screen shot from my iPhone.

road constructon

The roads in the subdivision (or compound) that the IU residences are part of are being reconstructed. They were made of chunky rocks as a base and then just packed with the red Kenyan dirt that is everywhere. Now the rocks have been dug up and the dirt has been tamped with a steam roller (dry, without steam). The rocks have been re-set on one lane and now smaller gravel has been dumped and spread on the large rocks and the roller has packed it all in. Soon traffic will drive on this side while the same work proceeds on the opposite side. The guards tell me that it will all get topped with a layer of asphalt. Hopefully I can report in February that it is complete. Heck, maybe by February the fiber optic cables will be installed on the main road, too...

Dodging Ngombe (Cows)

Interesting juxtaposition here. I'm walking from IU House towards downtown and the hospital and I have to get out of the way of herd walking down the street. At the same time, on the left side of the road, you can see something coiled coming out of the ground. What you see is called "innerduct" which is a semi-ridged plastic pipe within which you install the latest and greatest fiber-optic telecommunications cables. So you're seeing the old culture and the world together in this picture. But one more thing... They've been working on that innerduct since before I was last here in Feb. Back home this project would take a couple weeks if the weather was good... And did I mention the weather here? Oh well, TIA, this is Africa, and these things happen at their own pace.

Weather report

Even I could be a meteorologist here. I could report every day, "Abundant sunshine today with highs in the upper 70's. Clear tonight with lows in the mid 50's."

Dr Sisenda did say it was cold and rainy a couple weeks ago (but what is "cold" here?) and now everything is very green."

We do see some Kenyans wearing what we might consider winter coats in the mornings. Temps are all relative I suppose.

Sunday evening

Had dinner at IU House this evening and sat with a family from San Francisco. Husband is an orthopedic surgeon and wife is an OBGYN. They are here with their 9 year old son and 11 year old daughter for one month as part of their 10 month trip around the world doing medical work. They worked on trip plans for two years, rented out their house, turned in their leased cars, got qualified for "home school" for the kids, etc. They have worked in Israel and Kenya, (maybe Germany? I forget) and have plans for South Africa, Hong Kong, Japan, and China. Very interesting...

So back in the USA, it is time for the 1:00pm football games to start. Since the Colts play at 4:15pm, that would be "Monday morning football" for us, starting just after midnight. We have no tv so no temptation to stay up and watch... Especially since the Colts are so short-handed and playing at New England.

Sent from Kyle's iPhone

Sunday

Doing some laundry. Think we will walk to town and find some lunch. Relaxing Sunday...

Uganda-Nairobi Road

Just a bit of video on the way back to Eldoret from Lugulu on Saturday. This snippet is from the outskirts of Eldoret.

Church

Sunday morning the Sisendas took us to Catholic mass at the cathedral in Eldoret. They offer many services on Sunday with options of English and Swahili. We went to the 9:00 English mass. Mass is mass across the globe, but there were little differences here and there. As seems to be the case whenever and wherever a large group of Africans sing, the sound is amazing. The church seemed full and sat approximately 500.

Saturday evening

Our friend Lucy came to Eldoret from Uganda to visit us. We met Lucy the last time we were here and spent time with her when she visited us in the US this past summer. She is a law student in Kampala.

Joe and Sarah Ellen Mamlin took the three of us plus a few others to dinner. We went to "Mamma Mia's" which serves a varied menu. The name sounds Italian, and they do have a number of Italian dishes, but the also serve a lot of Indian dishes.

Anyway, we all had an enjoyable evening. Lucy then took a bus back to Kampala that was scheduled to leave Eldoret at 1:00 AM. And it's at least a six hour trip depending on how long it takes to get clearance for everyone at the border. She texted around 9:00 AM that she made it back.

Lugulu

We had a nice trip to Lugulu and the "Friends Lugulu Mission Hospital" and received a tour from the current doctor. Much has changed in 17 years!