Obamaland

Elections...

If there is anywhere I'd want to be outside of the US for a presidential election involving Barack Obama, it would definitely be Kenya. Since our arrival, people have been asking us about Obama. Will he win? Will Americans really vote for a black president? What do I think he'll bring to Kenya if he's elected? Will I be voting for him? Etc, etc, etc....

As most of you probably know, Obama's father (who was actually kind of a deadbeat dad, as far as I know--he only met him for one month when he was 10 years old) was a Kenyan. In Kenya, all identifications begin with tribal affliliations (this was the major source of the violence that erupted after one tribe allegedly stole the national elections from another tribe last December). In a way, it's like being at DePauw for undergrad, where someone's description is always [name] and then [greek house], i.e., "You know Matt Jones? That Delta Upsilon we met the other weekend?" It goes the same here, except with tribes. Obama's father was a Luo, a tribe which is based in Kisumu, the third largest city in Kenya, which sits on Lake Victoria. His grandmother raised his father in a small village not far from the city, near where Nadine and I went to a rural clinic last week (more below on that). Anyway, the Luos are the second largest tribe in Kenya, and they're the ones who had the presidential election "stolen" from them last year. So it's my belief that they feel particularly vindicated that one of their brethren has now ascended to the most powerful job in the world. Interestingly, their reputation in Kenya is that they produce intellectuals, leaders, and innovators. (They also party heavily and have the one of the highest HIV rates in the country.)

All of that above is to explain that on election day, the only topic of conversation here in Kenya was the US. In the week preceding the election, we watched various news stations (BBC international, CNN, Al Jazeera) devote 90% of the coverage to the US elections. Being in a foreign country for such an event definitely gives you a deep appreciation of how much the world follows, is invested in, and cares about the doings of American democracy.

So the night of the election (or the day of, in the US) we all gathered at Sonak Pastakia's place. He's the pharmacy director here, and he has a big screen with satellite TV in his place. We watched speeches he'd DVR'd, including the convention speeches, the notorious Palin interviews, and some of the SNL skits making fun of the candidates. Then, we turned to the live coverage of voting across the US. Some of the group members stayed up most of the night watching. I went back to the student hostel and returned at 645 am (1045 pm EST in the US) the next morning to a room packed with med students, pharm students, and a couple of Kenyans, waiting for the West coast polls close. As 7 am rolled around and Wolf Blitzer announced that Obama was the predicted winner, a cheer went up in the largely Obama-leaning crowd. We stayed to watch McCain's withdrawal speech and Obama's acceptance speech, and then we headed off to work. Needless to say, all of the employees at the hospital were elated. There was much cheering, high fives, and handshakes. As Monty Python would say, "And the people rejoiced." Later in the morning, Kenya's president declared the following day a national holiday to celebrate the victory of a Son of Kenya, as they like to call him here. Smart political move, too, as the president is the guy who allegedly stole the election from Obama's tribe.

Last night (the night after the results came out, and the night before the national holiday) we went out to one of the clubs in Eldoret to see what the scene would be like. The bar, called Spree, is typically a quiet place with pool tables, a dance floor, and very tasty snacks (best samosas in Eldoret). The last time we went, we walked in, grabbed one of many open tables, and chatted for several hours. This time, the place was jam-packed full of Kenyans out celebrating. There was nowhere to sit, and we could barely hear each other over the din of shouting and American rap mixed with (of all things) 80s. The Kenyans went out of their way to ask each of us what country we were from, if we had voted for Obama, and if they could shake our hands and congratulate us. Quite a feeling!

There may be a downside to all of this ebullience, though. Don and I have often talked about what we see as a problem with the general enthusiasm for Obama. We have been trying to ask around about what the average Kenyan thinks will happen when Obama takes the presidency. Answers have varied from, "America will be like a brother country," to "it will be much easier for me to go to the US and work," to "other countries in Africa will respect us more because they know we have US backing now." We're a bit worried, obviously, at how exaggerated and unrealistic these expectations are, and whether or not there will be any backlash when they realize that Obama is not, in fact, a Kenyan, but an American whose responsibilities are to America.

We'll see....

Lake Naivasha and Hell's Gate....

This past weekend, we hit the road again. We all piled into a matatu and cruised the 6-7 hour drive to Lake Naivasha, which is a large, freshwater, high altitude lake. On the way, we passed over the equator!

0 degrees, and about a mile up.

Shortly after arriving, we took a boat out on the lake. The edges of the water were ringed by large clumps of vegetation that served has homes for many species of fishing bird. Near these areas, in the shallow waters, hippopotami tend to lounge around, waiting for the sun to go down so they can come ashore and feed. The water was warm, although cloudy and muddy. We cruised along to a peninsula and got out for an afternoon hike.

Our transportation

On the hike, we came very close to a herd of giraffes. We also saw buffalos (scary!) up close, some gazelles, an eland (largest and tastiest of the gazelles), zebras, more giraffes, and lots and lots of birds.

Keith and Nadine, photographing a giraffe from about 30 ft

It was a great walk around, and then on the way back in the boat, we whistled at some fish eagles and threw fish to them in the water. The way they swooped in from the trees ringing the lake, hovered, and dove for the fish reminded me of watching the War Eagle at the Auburn/LSU game with Laura shortly before I left to come here.

Fish eagle, swooping up our bait

After the fun day, we went back to the campsite and had a big tasty dinner. I ate some fresh lake tilapia with fries. Then we went back to the bandas, had a Tusker, and got ready for sleep. Unfortunately, for some reason, this place had no mosquito nets, and the mosquitos were out in force. I tucked myself in so only my mouth was exposed, but I could still hear them buzzing around and occasionally trying to land on my mouth. Sooooooo terrible. Andy and I both lied there in our room for hours tossing and turning and trying to find a way to breathe without suffocating or sweating to death (the comforter was really hot). I finally got to sleep around 2 am (after going to bed at 10) and Andy didn't sleep at all. To add insult to injury, I was sharing a bed with Kelvin, who both snores and has untreated allergies. Didn't help. I had a line of mosquito bites on my arm the next morning when I awoke. Hooray for malaria prophylaxis.

Giraffe!

Anyway, we got up again a couple of hours later, around 545, to get ready for the big day. We had a huge breakfast down at the main camp (English-style, as the place we stayed at is run by Brits), then rented cross bikes to head into the gorge. This was one of the best parts of Africa so far. With my Camelbak strapped up and filled with water, I mounted the bike and headed out with the rest of the crew.

Crystal, Don, and Emily, biking through the canyons

We biked about 5K over to the entrance to the park, called Hell's Gate. Once inside, we were biking down a dirt road next to giraffes, zebras, warthogs, baboons, marshall birds, ostriches, and all kinds of other wildlife. SOOOO much fun. Then, when we finally got to the gorge, we got off our bikes and walked down through the canyon ringed by hot springs.

Melissa, climbing down next to a near-scalding hot spring spilling into the gorge. Kelvin points the way.

Needless to say, it was a great day. Fresh air, wild African animals, exercise, and camaraderie.

The group, at the top of the climb back out of the gorge

Rural AMPATH clinics....

I should also comment briefly on the experience Nadine and I had last week. We had the opportunity to travel out to one of the rural AMPATH clinics. We traveled to Kisumu (the area of the country where Barack Obama's grandmother still resides) to work for two days at one of the rural clinics outside of town. It's these extension clinics that do all of the patient recruitment and on-the-ground treatment. It was refreshing to see a clinic dealing mostly with healthy patients. (Our patients on the wards at MTRH, given its cachement in the millions, are typically the sickest of the sick, having already been treated at and then referred from the outlying clinics.) We observed the breadth of the AMPATH approach to treatment by spending time with the nutritionist, the food delivery servicemen, the social workers, the registration officers, the pharmacists, the clinical officers (like physician assistants or nurse practitioners in the US), and then finally the MD we traveled with. We got to see lots of first-time HIV+ enrollees, as well as patients who had been on antiretrovirals for months and years. It was encouraging to see the progress that these clinics are making. There is currently a door-to-door testing initiative that is trying to test everyone within the domain of each of the rural clinic sites for HIV. Part of this initiative is to provide counseling and encouragement against the stigma that HIV used to carry. Slowly but surely, these efforts are taking hold, as people are allowed to stay in their villages, rather than be cast out and left for dead.

In sum, it was a fantastic look into how the AMPATH machine operates here.

Pediatrics....

So I started this week on pediatrics. I'll write more about it next week, but it promises to be a much happier experience than working in the adult side. Kids' resilience is a universal, even in places with few resources and with all of the odds stacked against them.

Hope all's well with you, and regardless of your party, I hope you enjoyed seeing democracy at work last week. Being here makes you appreciate an election without physical violence associated with it!