Running From Elephants

This weekend was an adventure! We began on Friday with a 26km drive to our cabin on Mount Kenya, elevation 2900 meters. It took four hours.

We were picked up at noon by our guide (Tony Mugambi), our cook (Mark), and our porter/guide (Lloyd), in a Land Rover from 1972.  This was the hardiest vehicle we have seen. Three squeezed into the front seat, Roger sitting with the stick shift between his legs.  Four of us were in the middle, and the guide and porter sat in the back holding the door shut.  The one seat belt available was used as a hand hold for those of us in the second row. Once we began the trip, we understood the need for this beast. To call the road a road would be misleading. It was like nothing we have driven on before, which is saying something given the roads we have traversed around the world.  On the 26k trip, we had to vacate the vehicle numerous times, to lighten the load in order to get unstuck from the mud and deep grooves in the road.  At times this required the three Kenyans aboard to get out with their machetes to cut down branches to lay in front of the Land Rover.  This would create enough friction for the tires to grip and pull out of the mud. -Marjie

As we drove up the mud-slicked, rock covered, mountain-road to the basecamp we noticed that we had gained enough elevation that we entered bamboo forests. It was beautiful. Near one kilometer from the top, after being catapulted from rut to rut and over rocks we were again asked to vacate the vehicle. “This is the last time,” our driver promised. He and the porter and cook worked away on the truck and eventually got it unstuck, then he drove past and told us to meet the truck at the top. So we walked. I (nate) was a little ahead of the Gerstle band and was the first to meet up with our driver near the top. He’d left the vehicle at the top and walked back toward us. He motioned to look to my right, and about that time we all heard what sounded like thunderous applause. Bamboo cracked and snapped.  Instantly, our feet froze to the ground, “Elephant” Tony whispered. He pointed to a bamboo thicket just off the road and motioned to move in closer. Holding my iPhone in front of me like a policeman with his badge I took small steps, hoping that the video camera on the phone was catching what I was seeing and hearing. Then I saw him, the boulder-like gray rump, and massive gray head with yellow tusks jutting out from that muscular trunk. The elephant wasn’t more than 30 yards off the road, engulfed in the bamboo thicket. I looked at my camera and couldn’t tell if the beast was visible on the screen or not. At about the same time I felt a hand grab my arm, I heard bamboo cracking and saw the massive gray beast start moving our way. “RUN!” Tony yelled, “He wants to come onto the road”. All of a sudden, our lungs no longer noticed the lower oxygen with the higher altitude and we ran as fast as we could. Marjie called out for Roger, but he was worried about the girls and ran past her to protect them, (She now says she loved him for it, but at the moment she didn’t sound convincingJ). We covered about 40 yards of incline, when we stopped and looked back, our minds trying to determine if we were still in danger of being trampled. We saw nothing but fog. After further inspection it appeared that the elephant was simply toying with us and after taking a few steps in our direction decided to remain in the thick cover of the bamboo. It was dusky out, and when I replayed my iPhone video all that could be seen was bamboo and a dark gray shadow and then violent shaking and some shrieks as we ran from the elephant.  We laughed and it was then that altitude caught up to me, and I thought I might wheeze up my spleen. I’ve run from a lot of things, but that day we ran from an elephant and it was spectacular. -Nate

That evening we had the first of many amazing meals, cooked over a propane stove and fire in the tiny kitchen in the small cabin at the base of Mt Kenya.  The cabins are owned by the county government and are charming.  No electricity, light comes from kerosene lamps, hot water comes from a wood fire-heated tank outside. 

The next morning we headed up the mountain.  The bamboo gave way to a temperate rain forest, the trees covered with “bear hair”.  The landscape and fauna kept changing.  Zoe and I (Roger) continued on with the porter to Mogi (meaning pointy) Hill.   It was a mountain to us.  From there to an alpine lake, and back home.  Absolutely serene.

The last day we headed up the same path, then veered left to see the caves and Nithi Falls (at least 50 meters). Oh my gosh, the landscape and views were stunning, with the 15,000 foot peaks looming above.  The fog slowly rolls in over the course of the day, you can see it coming from the east, so mornings are best.  It takes 5 days to get to the top and back, more time and gumption than we had.

-Roger

 Stuck in the mud...

 The waterfall!

 Notice to Visitors: Dangerous Animals at Night

A day in the life of Marjie

July 25, 2013

Marjie here!

We’re coming to the end of our second week here.  I find myself surprised that half our stay in Chogoria is over already, yet looking forward to our travels at the end of our trip.

Did we mention yet how cold it is here??  Yep, it’s July on the equator, and I completely advised the family incorrectly on packing.  Our first day here, we went out and bought used American fleece jackets at the small market stalls.  Today, I bought everyone hats, scarves, and more fleece!  It’s probably been in the low-50’s at night, and maybe the low 60’s during the day.  But of course, there’s no indoor heating, and many of our house windows are broken, so the cold comes right in.  The silver lining to the weather is that there are few mosquitos, so though we continue to take our malaria meds, and sleep under mosquito nets, we might not really need to. 

Having settled the kids in school (more or less) last week, I spent much of my time this week trying to put some of my skills to use.  I’ve been volunteering at the local community health clinic in their family planning, immunization and prenatal clinics.  I’m not sure I’ve contributed anything to the clinic, but it’s been fascinating to see how things are done.  Great care is paid to cleanliness, though at first glance, the place looks old and run down.  There are six nurses that run the place, and about 15 nursing students from the nearby college that work alongside.  As interesting as my observations are, it’s even more interesting to spend downtime just speaking with the nurses and students.   We’ve discussed adoption (unheard of here), marriage, family structure, homosexuality (doesn’t exist), religion (very religious Christians), teen pregnancy, etc…  These are interesting women, well educated, and curious about the US.

In addition to my work at the clinic, I have also been volunteering at the local primary school (grades pre-K through 8).  Lena attends this school, and this week, Talia and Zoe have been volunteering as well.  (Zoe hasn’t attended school this week because her classmates have been taking exams all week.)  Volunteering at Chogoria Complex has been a complete pleasure!  The children are incredibly well-behaved, adorable, and fascinated with us.  They cheer when we enter the classroom, and chase us around the soccer field nearby.  I have read to the kids, helped with math lessons, and gave a social studies lesson on how to go to school safely (i.e. stranger danger), as I had been instructed.  One of my favorite parts of the day is “taking tea” with the teaching staff at 3:15 each day.  They spend much of this time grading papers, but we will sometimes have conversations on education differences in our countries.

I met this week with the local school board to discuss developing a sister school arrangement between Traverse City and the primary school in Chogoria.  We brought several donated laptop computers from our school district, as a goodwill gesture.  They were most appreciative, and have already used them with the students.  The school board is interested in exploring this further, including such activities as skyping, pen-pals, etc…

The past two days we spent at a Music Competition nearby. This was an extravaganza with over 1000 primary school students from around the country.  There were numerous competitions including: choir, traditional African dancing, poetry performance, speech writing, etc…  It was amazing to see little 5 year olds reciting poetry and exquisite dances performed by the students.  I think as much as we enjoyed the performances, the students enjoyed watching our girls.  They were quite the spectacle among the students, and were often swallowed up in crowds of students touching their hair, asking them questions, rubbing their skin! 

Signing off for now!  Happy birthday, from afar, to my mom!

Our life in photos

Our house

The kitchen

 Lena getting her hair done

Ready for work!

 Our safari in Samburu

 The hospital

 A street scene- there are little shops everywhere

 Lena's school

 A traditional Samburu nomadic tribe

More safari!

 At the equator!

Life in Chogoria Hospital

Thrown in.  How else to describe it?  Nate and I have been functioning as the attendings on the medicine and peds services, and what a ride it is.

To begin with, the environment is foreign.  The beds are packed together in one big room (the adults are divided by gender into two rooms).  The beds are so close that sometimes the mom of one peds patient sits on the bed of the neighboring patient.  The charting is scanty and hard to follow.  The xrays are kept between the mattress and springs, and held to the window to read.  Rounding is done at bedside with nary a nod to patient confidentiality. 

The diseases.  This is a prosperous area by Kenyan standards, and those prospering tend to adopt a more Western diet, bringing the high blood pressure, diabetes, and high cholesterol complications (stroke, heart attack, etc) that we see every day in TC.  Alongside this though is the wild array of tropical diseases—most prominently, TB, malaria, and AIDS.  TB is thriving with the AIDS epidemic; there are more people infected with TB than at any other time in history.  AIDS weakens the immune system and many bizarre infections show up, and the usual infections present differently than normally.  Xrays and labs even are different.  Malaria weakens the immune system as well, though not as profoundly as HIV, and this confuses the picture often as well.  Mix in some mental health issues which look different in a different culture, and 20 years of experience no longer count for as much!

It is intense, and like many people I think, I get more serious at such times.  But I am finding that humor and even goofiness go a long way.  Whether it is a cross-cultural bridge (the smile, the laugh) or they are just finding me bizarre, I don’t always know, but it doesn’t seem to matter.  I introduce myself to patients in a way I am comfortable being.  In the end, being yourself (while hopefully being culturally sensitive) is the key.

--Roger

Elephants, Lions, Gerstles and Kenya

At the age of 29, married, and a father myself, I never figured on being adopted. There are no papers to prove it, but I’ve shared enough water bottles, coffee cups, many meals, and almost a hotel room with Roger so I think it’s nearly official. I always knew I liked the Rich-Gerstle family, but this trip has given me even more reasons to enjoy their company. From day one, they made me feel very welcome, and we have laughed a lot together.

Traveling abroad can be very straining on relationships. It’s always risky to keep close quarters with friends while abroad, but the Gerstle’s adventurous spirit, desire to meld with the culture, and relaxed attitude has made living here fun and our relationship has deepened. In the evening when we sit around the table, talking and processing the day it is always interesting to hear the perspectives of everyone here and how they perceive the people, culture and traditions. Everyone seems to be adjusting well, and I’m even getting used to picking the stray blonde hairs out of my food, off my white coat, and off pretty much any horizontal surfaceJ

A little bit about me, my name is Nate Sailor, I am married to Trinet, who is my heartthrob and foxy lady ;) We have two handsome little boys; Hudson (3 ½) and Benaiah (2) and another boy due December 1^ST (Marji has suggested “Roger” as a namesake, but I’m just not sure the world is ready for more “Roger”s). I am in my final year of residency at the Munson Family Medicine Residency Program in Traverse City, Michigan. “Rogers” (as they call him here) or “Dr. Gerstle” as I am so used to calling him, is one of the faculty preceptors/attending physicians for the program and thus the connection to traveling together. We are working together and also independently in Chogoria on a few different projects from implementation of treatment protocols for the hospital, to working on an electronic medical record to augmenting the training of the interns. I couldn’t have asked for a better partner and mentor to do a trip with. We have had a lot of fun times and it is exciting to compare notes and discuss what we saw and learned from a medical perspective. My learning is doubled by him being here too.

Most of my days…ok pretty much all of them are spent in the hospital internal medicine wards. I have had the privilege of working alongside the Kenyan interns. We have very different knowledge bases, and it is great to share in the patients. I have seen more malaria, HIV (here it is called ISS “Immune Suppressive Syndrome” to prevent patient embarrassment.), tuberculosis, meningitis, and cryptococcal infections in one week here than I have in my entire medical school and residency combined. Then again we round on 40-60 patients every morning and then are in clinics in the afternoon so seeing “a lot” is not difficult here. The intern’s knowledge of infectious diseases exceeds mine, and it is fun to broaden my knowledge base. However, I am able to have some input when it comes to treating hypertension, heart failure, pneumonia and general medicine and emergency medicine topics.

The interns here have been so welcoming, they even invited me to travel with them on a trip to a town about 40 kilometers from here (Meru) for a dinner and lecture, and some shopping. (The prices seem to be much lower when I am with interns then when I am alone). At night we decompress with bad-mitten, some light jogging and lots of laughter.

During the day we deal with some pretty serious cases, last week we had a case of an 8 year old boy who was struck by a car causing a severe head injury. Despite hours of management and even having the general surgeon perform a craniotomy to relieve the pressure from the bleeding on the brain, the child did not survive the surgery. It is one thing to deal with adults who die because of trauma or illness but it is always tough to deal with the death of children. As a parent, my heart just breaks for the parents and families of those children. However, despite feeling quite melancholy after that case, I was called back to the operating room about an hour later (“Theater” as they call it here) for a pregnant mother in labor with twins. In Kenya having a multiple gestation pregnancy is an indication for cesarean section so I was able to take part in the birth of two beautiful, brown, pudgy African boys. Both boys came out crying and healthy, and it was just such good medicine for our hearts. In fact the same OR team that previously worked on the boy with the brain bleed, was present for the delivery and the male surgical tech sang and danced with the babies in his arms while some traditional African music played from a nearby radio. The interns here see a lot of death and end stage diseases and they are so strong because of it, so it was fun to celebrate life and vitality in light of the sad cases we dealt with during the day.

At the end of the week we drove to Samburo National Park for a car safari. We saw the lions, elephants, a zebra, crocodiles and even 2 lions chasing a giraffe. We were amazed at how the giraffe ran so gracefully. The lions never had a chance. I think the real reason the Gerstles wanted me to come on safari with them was because they knew I’m a slow runner, and if it came down to a chase I’d be much easier lion bait, and probably more of a “meaty meal”;) as those Gerstles are all so lean and sinewy;). Ok well I’ve yammered on long enough, “Asante Sena” or “thanks very much” for reading.  Signing off for now, 

 -Nate

Lena's First Days of School

Note: I wrote this on Friday but we forgot to post it until now!

After a four week teacher’s strike all across Kenya, my school restarted yesterday.  Even though it’s a public school (Chogoria Complex) we have to wear uniforms, and I call it “My Dorothy Costume” because it looks just like Dorothy from the Wizard of Oz. 

My school starts at 8am, and classes end at 3:45pm.  There are clubs and games, cleaning the school, and “personal studying” (homework) until 5:30.  But I just leave at 3:45.  I also go home for lunch. 

At 11am and around 3pm, everyone “takes tea” in reusable plastic cups from the school.  The cook scoops tea (with milk and sugar) from a giant bucket into your cup.  The cups are sometimes dirty, so you have to clean them out with your fingers.  There’s also a bucket of bread and you must take it.  When I hadn’t taken it, my teacher called me over and said “Take bread!”.  When I told him I wasn’t hungry, he told me again “Take bread!”. I did, and by that time EVERYONE was staring at me. The other students eat the bread in literally a minute.  Because I hadn’t finished mine, and everyone was leaving, I threw out half of the bread.  Then a girl came up to me, and she asked why I threw away my bread.  I told her I wasn’t hungry and was it bad to throw it out?  She said “yes”.   I was so embarrassed.

For the first two hours of school on both days, there was no teacher and kids led the class in checking their previous work.  Throughout the day, teachers just leave and don’t come back.  Then sometimes 10 minutes or an hour later, another teacher will come strolling in and start the next class.

Every morning at 8am, we have assembly outside for the whole school.  Today, a couple of the teachers gave little speeches about working hard because of the strike.  Then they sing the national anthem, and one student marches to the flagpole and raises the flag.  For the assembly the students stand in a specific order, with the oldest group (my class of 8^th graders) in the back and the youngest group (preschoolers) in the front. 

In my English class, my teacher started talking about awful situations.  She had us think about “you and your friend walking into a house and then the people in the house make you start doing what they’re doing, or think about walking alone down the street and being kidnapped”.  Then she told us to write a story about this, and she walked out of the classroom. 

The first day at school, I was stared at the whole day!  Today, I was ignored by my peers.  I’m pretty sure they just don’t know what to do with me. 

Chogoria Girls High School

Today, I (Zoe) went to the Chogoria Girls Boarding School. I arrived at 7:30 but the rest of the girls had been up since 4:30 doing homework and chores, mostly maintaining the grounds. I got a tour yesterday and was supposed to meet with the principal so she could show me where to go and what to do. However, when I got there she wasn’t at her office so I found some girls who were in my grade (they call it Form 2) and asked them to take me with them wherever they were going. They did but a few minutes later the principal found me (probably not too hard because I was the only white student in a school of 950 Kenyan girls). The principal introduced me to a Form 2 student, Sharon and said I would stick with her for the rest of the day. We first went to her dorm’s meeting where I stood in the middle of a circle of about 60 girls and introduced myself. A little nerve-wracking!

Classes began at 8 and ended at 4 with one 10-minute break for tea and a 15-minute lunch. The classes were similar to those in the U.S. in terms of rigor and subject but differed a little on how they were taught. In addition to our “normal” classes, they also took Christian Religion Education, CRE. In several of the classes, a student would start the class acting as the teacher; leading the class in review and going over homework. Sometimes the student would lead the entire class, other times the teacher would take over after 10-15 minutes. The classes were very interactive and I could tell the teachers and students had good relationships- they laughed a lot! I left at 4:30 after tea but everyone else had activities in the afternoon, followed by many hours of studying, then bed.

            Since a white girl had never been to this school, at least as long as these students had been there, they were VERY curious, which made me happy. J Throughout the day, I was asked:

What is your school like?

Do you wear uniforms?

Do you know Obama? As in, personally.

Who is your best friend?

Is Beyonce divorced?

Are you eating our lunch? When I said yes, they all laughed hysterically- not sure why…

Why don’t you speak Swahili?

Can I touch your hair?

And on and on and on.

It was rapid-fire all day. They all have great vocabularies but very heavy accents so every time there was a question, I had to ask them to repeat it and then I had to repeat the answer. I am curious as to whether the excitement will last the whole month I am attending… J Anyway, it was a very good experience and I am heading back there tomorrow at 7 am!

One final thought- This spring I went to a conference for sophomores and all weekend long they told us to get outside of our comfort zones. I found that it can be really hard to force oneself outside the comfort zone, especially when there are some many comfortable things to do. In Kenya, unless I stayed home all day, it would be impossible for me to remain inside my comfort zone. Although at the time getting pushed out of my comfort zone is, well, uncomfortable, looking back on each day, I am usually glad it happened.