Only Mountains Can’t Meet, People Can ~ Africa proverb
“You can say very many words without repeating yourself” – Dr. Ronoh after I explained the American healthcare system to the Public Health Officer who asked about it.
Ian, my friend at the restaurant next door, has a great laugh. His head goes back, his tongue sticks out and he cackles like a gleeful kid who just stole your candy, but you like too much to be mad at. He’s from Eldoret, but has lived in Lodwar for a few years, working as a waiter. He loves his job, and he’s good at it. Ian knows most customers by name, he’s always joking and laughing with people in spare moments, but your food always arrives quickly and it’s exactly what you wanted. Most of the time, Ian will see me and put in my order without me having to say a word. Fried fish and ugale, or goat stew and chapati; always greens on the side and kikombe, pronounced “key-comb-bay,” cha chai (a cup of tea) for an after dinner snack. He exposed me to a chapati and egg omelette. He even bought the Saturday paper for me when I was gone all weekend and gave it to me on Monday, because he knows how much I like reading the paper.
My normal routine after work has involved eating a relaxed dinner next door and then hanging out with Ian over a nice kikombe cha chai. A few days ago, I started sitting with Michael, another one of Ian’s friends. He was a teacher, but now he works for the county assembly. There are two things I especially like about Michael: one, he’s always reading a book – a man after my own heart, and two, he’s not afraid of the big questions or discussion that follow. In fact, I always have extremely stimulating conversations with Michael that revolve around One Health, education, economics, history, religion, science and technology or any other topic that comes up. For example, we’ve talked a lot about education, and how the current model in Turkana isn’t working. As a former teacher, Michael has strong thoughts on this topic. As I’ve mentioned previously, pastoralists move based on where the pasture and water is for their livestock. This results in the following situation: a child is in school for a few months during the year near Kakuma. Then, the dry season comes and the whole family (including livestock) heads across the border to Uganda where the pasture is; pasture, but no school. So children rarely finish a whole year of school due to this challenge, among others.
Matrix Scoring – A participatory epidemiology methodology
The Africana Guest House, Lodwar, Turkana County, Kenya
August 11th, 2018
~As told to me by a sub-county vet during lunch one day~
Emurons are wise men, seers. Some people call them witch doctors. In the Turkana culture, and among other groups in the Karamoja cluster, they’re powerful, the leaders. Because they can see the future, they dictate when the migration of people and animals happens. And some say they can stop an animal in its tracks just by looking at it. I’ve seen the power of Emurons in person, in two instances. Once, I saw an Emuron sitting near the kraal, eating some meat. All of a sudden, a large eagle flew down and picked up a piece of meat. It started to fly straight up, very high until you could barely see it. The Emuron started talking to the eagle. He said, “that’s my meat. You must bring it down because I was eating it.” All of a sudden, the dark speck in the sky started to grow. The eagle was falling straight down to the ground, dead. It hit the ground in a burst of feathers and dust. The Emuron walked over to the eagle, retrieved his meat, wiped it off on his sleeve and continued to eat.
Another time, we were in a remote part of the sub-county, near the border. The Emuron had stated that no goats or sheep were to leave the area past a certain hill. After completing our vaccinations one of the pastoralists gave us a goat to thank us. He said we did a very good job. I thought about the Emuron’s decree, but their power is waining with modern times. It didn’t seem very important. We put this goat in the back of our truck and started to head back. To leave the area, we had to cross a dry riverbed. Someone had dug a hole in the riverbed to get water and our truck go stuck because of that hole. All of a sudden, without warming, water started rushing down the riverbed – a flash flood. We had to leave the truck there, with the goat tied in the back. We spent the night in the village and the next morning walked downstream to where the truck was after being swept away by the waters. The goat was nowhere to be seen. We never found it. Continue reading
Alale, West Pokot County
Getting to Alale was certainly worthy of a story. I decided to take public transport, only 600 shillings (about $6 USD) each way. The day before, I went down to where the ticket office is in Makutano and reserved my seat. They told me the van would leave around 10 or 11 am, but what they meant was the van will leave when it’s full; that’s the norm for public transport. I showed up around 10 am, just to be on the safe side, and ended up waiting until 2pm (saa mbili mchana) to leave. Interestingly, a lot of the passengers where children. I think they were heading home for the summer holidays, school just got out. As we were heading down the escarpment towards Kacheliba, the car started having issues and eventually broke down. So there we were, stuck on the side of the road as the huge trucks carrying sand for construction rolled past, covering us in dust, followed by a brief but fierce thunder storm and torrential rain. A few hours later, another van from the same company showed up and we continued our journey. The road to Alale is bad: dry river beds to forge (this time of year they’re not full at least), rocks, dips, bumps, washboard, holes, and everything else. Being the relative newcomer to public transport that I am, I chose a seat next to the window. It took 5+ hours to make it to Alale. I kept drifting off to sleep when it got dark and would be jolted awake every time I slammed into the side of the van. When we arrived at 10pm my right shoulder and arm were bruised, but I was very happy to have made it! Continue reading
The driver showed up at the Kalya at 7 am, but Paul, the community animal health worker coming up from Kitale, didn’t make it until 8. We headed down the escarpment, the same way Maurice and I went to Kacheliba, pronounced “Kach-a-Leeba”, for our birding adventure. I’ll never get sick of driving down the escarpment, going from rocky outcrops to the dry, dusty lowlands, from 7000 feet to 4000 feet above sea level in a matter of a few kilometers. The acacia scrubland and desert succulents become more prominent as you descend. Once you make it past the escarpment, the road becomes a lot better (for a few kilometers at least). It’s currently being redone by, as Paul described it, the “Chinese.” According to Paul and what I’ve read, Chinese influence is increasingly prevalent in Kenya, and Africa in general. Paul asked why America stopped coming to Africa. Now, he said, it’s all the Chinese. According to him, it was better when the Americans and the British (post-colonialism) were investing in Africa, especially in the 90s and 2000s (even George W Bush did a lot for Africa), because they would “share their skills with Africans.” The Chinese companies, according to him, mostly bring their own laborers over and “don’t want Africans to have skills.” I don’t know enough about the situation to make a broad generalization, but it’s not the first time I’ve heard the Chinese referred to as the new colonizers; attitudes concerning them haven’t been extremely high among the people I’ve spoken with. Also, there’s a current scandal I’ve read about in the newspaper, a Chinese company that’s building a railroad has been accused of acting in a discriminatory way towards its African employees. It’s safe to say that the world order is shifting, with Americans becoming less present in Kenya. According to Paul, that’s bad, but I wonder if it’s just a matter of the new reality being different. Looking no further than the U.S., it’s easy to see how demographic changes produce prejudice and unease. Continue reading
Thursday July 26th, 2018
The Kalya Hotel, Makutano, Kenya
It took a long time, but I was finally able to start my project! The University of Nairobi (UoN) still hasn’t given their official approval, that’s suppose to happen tomorrow. However, Dr. M (the county director of veterinary services in West Pokot) said if the Director of Veterinary Services (DVS) in Nairobi told him it was ok to start then he would be fine with it. So Dr. Abuom got on the phone with the DVS office and got conditional approval: It’s fine for me to start but I still need to get approval from UoN. It was such a relief to finally be able to do something that’s relate to my project. I’ve been enjoying birding and visiting friends, see in future posts, but ultimately I’m here for my study. I conducted an interview today and it was really encouraging. I talked with Dr. M and a sub-county veterinarian. We had a wide ranging discussion, over 90 minutes long, about a whole range of topics including: the main players in animal health, the hierarchical structure of veterinary medicine at the national, county, and local level, previous and ongoing vaccination programs, logistical capacity, challenges with vaccination services, previous or ongoing collaboration with human health, thoughts and perceptions of integrated vaccination, the potential benefits of integrated vaccination, and how challenges to integrated vaccination can be overcome. The recorder worked perfectly – I saved the audio file to my computer ASAP after the interview – and the whole experience gave me a really good feeling going forward. Continue reading
I don’t think it’s an unusual experience to be perceived as a “rich American” and find that people want something from you. Comparatively, I am “rich” compared to the average person in West Pokot (and in many other places). Although my personal bank account doesn’t have much in it and I’m saturated with student debt, I have a strong safety net because of my family. If all my funds disappeared overnight I have not doubt I would be just fine. The people here aren’t afforded that type of security. Ta-Nehisi Coates writes eloquently about this topic for African American families in the US: “Effectively, the black family in America is working without a safety net. When financial calamity strikes—a medical emergency, divorce, job loss—the fall is precipitous.”
Last week, I was connected with a Kenyan National Team running coach who wanted $500 USD every two weeks to train me like a Kenyan. He also wanted to be introduced to universities in the U.S. that maybe needed a coach. At our last meeting, I explained that although I once dreamed about a career as a professional runner and poured everything into my athletic career in college, I wasn’t in Kenya to run. I was here to conduct a research project that I believed deeply in and was fully committed to. Sometimes a dream dies, and in it’s place is the realization that all the activities you were doing along with running can fulfill you to the same extent even without it. I’ve had a harder time coming to that realization than some of my teammates at Grinnell, I think. But physically, serious running isn’t in the cards for me. I’m still trying to learn how to do it as a hobby, not a calling. Continue reading
July 16th, 2018
The Kalya Hotel – Makutano, Kenya
I had mandazi for the first time recently, which is basically an African donut and is often served with tea aka “chai” for breakfast in the morning. On the way to Saiwa we stopped at a hotel for breakfast. It always gets cold overnight, into the 50s, so we needed something to warm up with. Biting into the mandazi was like eating a warm donut without any toppings, crisp on the outside and soft and doughy on the inside. It was delicious. If Dunkin’ Donuts served mandazi I would be there every morning.
So I probably should have done this earlier (thanks for the idea dad), but here’s a map of Western Kenya. I flew into Kitale, am staying in Makutano/Kapenguria, and will be flying from Eldoret to Lodwar near Lake Turkana in a couple of weeks.
Uganda is to the west and Ethiopia to the southwest (can’t see in this image)
Saiwa Swamp National Park is one of the smallest national parks in Kenya and is located near Kitale, only about 20 minutes from my hotel. It’s also one of the few parks in Kenya that you can walk around unescorted and is famous for the Sitatunga, a semi-aquatic antelope, and the De Brazza’s monkey. My friend in Kitale, Ajay, told me to call Richard Barnley, who’s family started Sirikwa Safaris with the goal of making Western Kenya a birder’s destination. They certainly succeeded! Visitors can stay at The Barnley’s Guesthouse and travel all over Western Kenya on birding, fishing, and sightseeing expeditions. Richard put me in touch with Maurice, the bird guide who takes their clients out, and Maurice suggested that we go to Saiwa. I got up at 5 am, excited to do some birding, and met Maurice and Dan (our driver for the day) outside the hotel. We headed off in the morning darkness, and as I mentioned in the intro, stopped a few kilometers outside of the park for a delicious breakfast of chai and mandazi. When we got to the park Maurice got his bird book out and we were off! Continue reading
Friday July 13th, 2018
Makutano, West Pokot County, Rift Valley Province, Kenya
The handshake is an important cultural greeting in Kenya. Every time you see someone in the street you know, you walk over and say “hujambo,” or “habari gani” and shake hands while maintaining eye contact. This ceremony is maintained when being introduced to strangers as well, and often occurs when two people happen to be in the same place for a short amount of time (e.g. walking through the hallway in the hotel). Sometimes, among close friends, the greeting starts with slapping hands, which then turns into an extended handshake and expressions of joy. It’s impossible not to feel like people are happy to meet you; each new person I meet here greets me like a long lost friend. I’ve shaken more hands in the past few days than in the previous 2 years.
After another short night of sleep, I got up at 5 am to get to the airport. This time I was going to Wilson, which handles regional flights. Interestingly, there are about 20 different terminals all spread out over a few miles, which turned out to pose a challenge. The 3rd party I had booked my ticket through didn’t mention what Kenyan airline it contracted with. I went to the wrong terminal initially, but with help I found my way to SarfariLink with plenty of time to spare.
The flight was about an hour long. As we descended below the clouds Kitale came into view. I first noticed the grid-like fields; later I learned that the area around Kitale and much of West Pokot is known for its agriculture and food production.
A view of Kitale from the rooftop restaurant at my hotel
Nairobi is chaotic traffic: vans blasting music, buses with men hanging out of the sides, old cars belching black smoke, motorbikes speeding between vehicles, their drivers wearing bright green fluorescent vets, incessant honking, and pedestrians leaking onto the road. Once a large enough crowd (5-10) people builds up, everyone crosses the street in a mass, dodging the cars that slow down just enough not to run you over as they navigate the traffic circles. Men wearing business suits hurry past, women in brightly colored dresses – Maasai red, blues, and yellows – stand out in the crowd. School kids in uniforms joke and talk loudly on their way to class. Venders sell roasted corn on the sidewalk and some homeless people burn trash. Smells fill the air, mostly diesel and gasoline, cooking meat and trash – the heavy smell of the city seeps into your nostrils and sits there until you don’t notice it. In the city center, shops line the streets, buildings jostling for space like trees competing for sunlight. Clothing stores, convenience stores, cell phone services, internet cafes, banks and hotels – you can buy anything.
I woke up at 4:30 am sharp, the sounds of traffic coming through my window. A few hours later and after a delicious breakfast buffet and 3 small cups of coffee (I think I needed more), I headed out from my hotel to explore the city center. I stumbled across John Michuki Memorial Park where there’s a market every Tuesday. Because I was there so early, the venders were just unpacking their wares. I talked with almost everyone and was told many times that “being the first customer is lucky, I will give you a good price.” They were selling ornamental masks, Maasai blankets, brightly colored, beaded earrings, carved can openers, wood statues of wildlife, bracelets, necklaces, paintings, and a lot of other things. Safe to say I got my gift purchases out of the way! Continue reading
One Health aka Conservation Medicine aka Ecosystem Health aka Planetary Health are all different names for a similar concept. In short, these frameworks focus on health relationships occurring at the interfaces of the environment, animals, and humans. Or as I like to say, One Health looks at human, animal, and environmental health together instead of in isolation; they all interact and depend on each other. Examples of One Health issues include: emerging infectious diseases, biodiversity loss, ecosystem function degradation, and habitat use conflicts, among many others. Last year I received my Master’s degree in Conservation Medicine (MCM) from the Cummings School of Veterinary Medicine at Tufts University and as I told someone recently, it was the best academic decision of my career. I love looking at challenging conservation and health problems from every angle and working in an interdisciplinary manner, which brings me to my current project this summer. Continue reading