Hell's gate

We actually took this hike the first weekend but are just getting around to posting now.  Posting somewhat problematic between internet connection and having to downsize photos.  Nadia has taken on task of photo choosing/downsizing and Rochelle taks of writing... so blame her for any spelling errors. 

Internet is interesting actually.  For 1000 Kenya shillings (about $12) we bought a sim card which one loads via a phone, then puts into a small modem which the gives internet access via cell phone service.  It works pretty well.... most of the time.  Though connection can be slow; it won't allow downloading or uploading of videos.

Hell's gate is a slot canyan about an hour drive over pothole filled roads from Kijabe down into rift valley, past Mt. Longonant and into park.   On entering the park we say herds of Zebra, Impala, some other kind of antelope and tons of warthogs, baby warthogs and baboons.

On the way.  Beautiful scenery heading down into rift valley.

 Antelope and Impala.

Impala

Notice the bike on the rock.  I don't know why I can't get these pictures to load rotated.  I give up!

Mom's becoming quite the climber!  Unfortunately still can't rotate the photos.  Philip (our guide and driver) was QUITE encouraging.  And of course at one point told us we couldn't turn back now!

There's hot water on them thar rocks!  A hot spring above drains onto the rocks.  Good thing.  It was quite a scramble getting down to that area and at the first hot springs Rochelle had to stand under the draining water for a while.  Got camera and hair wet (and kind of gross!)

Washing our hands.  We didn't drink this water, but have been drinking the water in the house without any trouble.  So far anyway.

Philip insisted Nadia climb the tree

Babboons

Got through that climb!



 

 





At the top of the ridge





We made it!  Hot, dusty and tired (and still have Crescent lake to go).  Notice Mom's injury.  She fell towards the end; too relaxed after having made it through all the hard parts!

Lunch was at a nice
"country club" on the edge of the lake.  All you can eat buffet, dining on the lawn with Wildebeasts roaming around.



Rift Valley Run

Sat we ran/walked in the rift valley run. 

Thanks for taking photos Nadia Giannakopoulos

Kijabe Rift Fun Run (and walk!)

Thanks everybody for your support! Because of the generosity of our friends, family and colleagues, we raised 71000 KSH ($825), which is enough for 90 fine needle aspirates, 73 inpatient days, 3.5 major surgeries or 16 days in the ICU. When the average yearly income of someone in Kenya is $750, you can imagine what a difference this makes!

 

Actually by the time we finished, we had raised $950! 

 

The run was STRAIGHT UP for about 5 km from Kijabe hospital to the "freeway" - road from Nairobi to Navaisha and Nakuru, and I'm not sure where.  Rochelle made it to the top where whe met Panina (secretary).  She and Panina walked/ran about another KM then turned around and headed back.  Run/walk down was just about as bad - easier on the breathing but hard on the legs!

 

I think the link will work to go to FB photos; if not will try to post more....  keeping up with FB and blogs is a little overwhelming, especially since photos are too big to post directly to the blog site!

 

End of week 2 and photos from work

We've gotten into a nice routine by the end of our second week (well almost end).  Ginger rises at 4:30 AM, Rochelle at around 5.  Nadia between 5 and 6.  Day starts with coffee and computer shenanagans (trying to get Safaricom to connect - Safaricom is an ingeneous modem that connects using cell phone networks - it is faster ane more reliable then the hospital wireless service which requires that Nadia stand at the kitchen counter to get reception).  Rochelle then attempts to run in the howling wind.  Wind blows like crazy every night and usually dies down around 8.  After breakfast we all take the 3 minutes trek to the hospital.

To the left is the view of the back of the hosptial.  probably about halfway between hornbill house and the hospital!  It's so nice to be able to walk 'home' for lunch or a can of pop or bottle of water.
There is a phone system between hospital and various houses which is 3 digit phone numbers!

We also got cheap phones to use.  Calling the US is about 50 cents for 30 minutes!   Of course vise-versa costs a fortune!

To the right is the door to pathology department and the sign (CHOO) pointing to the bathroom.  Not sure how appropriate that is! 
Luckily we have our own bathroom because the CHOO is nasty.

Ours is in the gross room... well the door is through the gross room.


Dr. and Mrs. Barnes are the couple who have been coming to Kijabe for 16 years.  They are both in their late 70s (he is 79) but still active.  He was relieved to see us.  Still comes in to help with the blood smears though!

To the left is the gross room.  Ventilationis the open window.  We haven't been able to find soap or other cleaning agents (although Mom managed to clean with water so the counters cleaner then since we arrived!  she got many thanks from techs!).  Water runs - some of the time - .  There is a compouter and Dragon voice recognition that does soso.  The view out the window is a partial mountain view, so that helps!

Nadia and Ancent.  Ancent is a kenyan trained pathologist about 1 1/2 years out of training.  He is now based at Kijabe fulltime (his hours are 10 -4 acutally).  It is wonderful to have some consistency.  Course he already has to spend much of his time in meetings.

Specimen arrived in a leaking container.  Guilty specimen below   Was a uterus with an MMMT (bad cancer) which was stuffed into a jar in such a way it was almost impossible to remove!

 Specimens come in pill bottles, film cartriges, milk containers, blood draw containers, some taped up so much one can't get the tape off, others leaking....  Some have been stuffed into the container in such a way they have to be cut up to remove them.



There is one cutting machine.  Two techs and one secretary to do all needed to process 6000 surgicals and I'm not sure how many cytologies every year.  They actually do very good work considering the resources and state specimens come in!  Only special stains are PAS and AFB.  Frozens are done as touch preps!  Thank god for cytology experience!!

Microscope room.  Has decent library, 2 computers, 3 microscopes all stuffed into a pretty small room.
Now it's time for dinner!

Our home away from home -Hornbill house

Hornbill house is our home away from home.  It is a nice duplex with beautiful flowers in front yard (which someone else takes care of!), Rosemary bush, parsely and clothes line.  From the small front porch and living room window is a beautiful partial view of the Rift valley, including the sunset.  Neighbors in adjoining duplex are an MD (internist) and PA with 18 month old; they are here for 6 months. 

Front door of hornbill house.  We were told by some we would need mosquitoe nets and to boil or filter water.  Nadia and Mom put up nets.  Rochelle tried and gave up.  Mom took hers down.  Nadia is still using hers.  Mom and Rochelle started out taking anti-malarials...  Rochelle quit after a few days.  We filtered water the first day and then quit.  We HAVE been bleaching all vegetables and fruit that we don't peel.  We have running HOT water (well, most of the time), a washing machine (but clothes must dry on line), 1 1/2 baths.... no TV, but none of us care about that.  It is all very comfortable. 

View of house above.  Nadia in living room, complete with fireplace.

Kitchen - came with welcoming flowers.  We were supplied with dinner of meat and beans, rice, bread, fruit salad and dessert.

Kitchen is well stocked with Gas stove and oven (thankfully since electricity frequently goes out).  Microwave (for when the gas runs out), lots of dishes of various types, full refridgerator that keeps items cold (!), toaster, blender, utensils and coffee maker (but we haven't found filters -luckily we brought french presses)





Road to SUPER DUCA and to small market below.  Super duca is small store which has an amazing amount of items including frozen meat (chicken, sort of bacon, forget what else), ice cream, PB, breat, toiletries, crackers, pop corn, pop (not TAB and not diet).  Little market has many women selling fresh (mostly) vegies and fruit.  More on the superduca and market later!



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Pile of toys and other items we brought to donate.

Work has been interesting.  Practicing pathology with minimal resources.  Walk from home to hospital takes about 2 minutes.

After 9 AM hallways are full of patient’s waiting to be seen, some on crutches, some obviously ill, dressed in a multitude of different clothing items.  After passing by the theater (aka operating room) and radiology, we turn down the hall to enter pathology.

We must be the quietist place in the hospital. 

The gross room is about is a small closet, well maybe 6x6 feet, or so.  The ventilation is a window that opens to the sunshine and a partial mountain view.  There is a fan, no hood, no soap, a weak stream of running water, no paper towels, no blue towels.    There is DRAGON recognition software (which can be quite frustrating) and a filthy keyboard.  A plastic apron and gloves are the only protective gear.  Steve would be horrified!

Specimens come in various pill bottles, vacutainers, sometimes taped shut, sometimes leaking.

Variety of specimens is incredible.  Mastectomies stuffed in jars, tons of thyroids (due to iodine deficiency), derm, neuro, pediactric, pediactric neruo, sarcomas, lymphomas, at least 2 TB cases per day.  It’s been a week and we’ve seen an unbelievable variety.  

Arriving

We are here in Kijabe.   The flight here was long, but not bad.  10 hours from Seattle to Amsterdam , a 2 hour layover then 8 hour flight to Nairobi.  Customs was almost non existent, including agent asked “did you give me the $50?”.

In Mennonite guest house our greeting

committee – one cochroach was not too disturbing. 

Main guesthouse

 Nadia had single room without bath or toilet.  Mom and I had a suite consisting of one bedroom with bunkbeds and second bedroom with double bed, toilet, sink and shower.   Shower took at least 10 minutes to get lukewarm,  but at least was clean.  After little sleep, attempted jog around and around the grounds and simple breakfast we left for Kijabe.

Mennonite guest house

We grocery shopped in Nairobi attempting to buy a months supply of items not available in Kijabe.  Don’t know if we succeeded but we left laden with various items from the grocery story, market (fruits and veggies were plentiful, inexpensive and fresh) and butcher (also surprisingly inexpensive).  Unlike what we had been told, pretty much anything we wanted (except TAB) is available in the Nairobi grocery store including all kinds of cheeses, good bread, meat, pb, honey, jam, spices of all kinds (and vanilla), beans, salad dressing, vinegar, etc, etc. 

Drive to Kijabe was mostly along relatively smooth freeway.  Roadside attractions of markets, drying skins, donkeys pulling carts, many people walking along carrying various loads.  Maniac drivers pretty much avoided hitting each other.  Last half mile was down deeply  pothole, barely paved, narrow road to the hospital and grounds.

View of rift valley along the way.

Sign for warning on Kijabe road.  No need for sign, it is IMPOSSIBLE to drive fast!

Hornbill house – our home away from home – is a pleasant duplex with pretty front yard and partial view of rift valley.  Living, dining, kitchen, bath and bedroom on first floor.  2 additional bedrooms and upper floor.  It has a washer but no dryer – clothesline is in front yard.  Kitchen is well stocked with dishes.

First night  we dined with the Barnes (Asa aka Ace is a semi retired pathologist who spends 3 months a year at Kijabe - he was relieved to have us arrive to give him a break!

Sunset taken from Pathology House deck (our view is almost the same but obscured a little)