My Heart Will Go On ...

and on and on and on! What I really mean is that Kenyans have this unending love of Celine Dion! Can't really explain it but all I know is that I heard pretty much an entire Celine Dion album at full volume on the streets of Nakuru at about 2 in the morning and continue to hear her songs at regular intervals. Who knew?

Will update more soon (internet access has been a little tricky lately).

Remember fording the river on Oregon Trail?

We drove yesterday through the countryside to spend the day and night at Lake Baringo in the Rift Valley. Lake Baringo is a fresh-water lake known for its population of hippopotamuses (hippopotami?). We were staying at a sort of camping resort where there were tents set up on an island for visitors to come use. Really, it was more like a hotel. Yesterday we got a ton of rain at Lake Baringo which was a little disappointing but had a nice relaxing day anyways. Interestingly, the Rift Valley has a river that winds through it and it routinely floods and dries up as it drains into Lake Baringo. On the way to the resort, we had to drive our van through this area of flooding on the road where the water was moving fast and was probably 1-2 feet deep. The above was taken by me reaching my camera out of the passenger side window (steering wheels are on the right in Kenya) However today, since we had gotten so much rain throughout the day before, we were questioning if we may even be trapped! We were in communication with our driver who was watching the level of the water earlier in the day and matatus (Kenyan word for big passenger vans) were not able to make it across. Finally mid afternoon, the driver said, let’s just give it a chance to see if we can make it, otherwise we’d probably be trapped for a few more days especially if it continued to rain! So, we were all pretty nervous about this wondering if our matatu may get washed away in the current with us in it. Some of my fellow passengers even went so far as to get out their utility knives in case we needed to crack the windows to escape. The back of a ten passenger van is not the easiest thing to get out of even in good circumstances. Needless to say since I’m posting this, I made it without too much difficulty and I think we entertained the 30 or so Kenyans loitering around this crossing watching people attempt to get across. We even got a round of applause at the end :)

I am always amazed in 3rd world countries at the intersection of poverty and the modern world (globalization as some of the other people I’m with seem to call it). We drove past huts made of plywood or mud probably about the size of my living room or smaller with no glass in their windows, certainly with no indoor plumbing and their inhabitants standing outside watching us drive by while talking on their cell phones. Practically every other commercial building is painted lime green (for safari.com) or hot pink (for zain) representing competing cell phone companies in the area despite that they also don’t have the basic things we would expect to be able to run a business. We drove through the mountains and tiny villages and would still see Coke machines. Many times children would be walking down the side of the road up in the mountains wearing dirty, battered sweatshirts displaying American brand names such as GAP or MUDD jeans. I can only imagine these were acquired as people back in the U.S. cast them off as donations and somehow, these ended up in rural western Kenya. We also drove past a training center where many of the Kenyan runners train to compete professionally. These areas look no less impoverished and no more modern than anything else I’ve seen here yet turns out some of the best athletes in the world. One of the best things about running is that it really doesn’t take any special equipment. The Kenyans happen to have the unique combination of a temperate climate, a high altitude and some inborn talent and they are world-class athletes.

I am particularly struck here by the weird divide that I feel between my experience here and what Kenya is actually like. Indiana University has carved out its own little piece of the world here. Its built a compound where things are very comfortable with modern amenities including wireless internet! The buildings themselves are maintained by a full staff. They have a host of people hired to clean bathrooms, prepare meals, make sure we always have safe drinking water available and even transport us around town if we need it. When you factor in that my mom is accessing my bank account and actually paying my bills for me (thanks mom!) in the U.S, my life is even easier here than in the U.S., since most of my basic needs are taken care. It certainly hasn’t been anything close to “roughing” it. And so the existence I live here is one more akin to a boarding school or my freshman year at college. And is completely unlike the way the average Kenyan lives. I have this strange feeling I’m cheating or something. Though I have to say it is a little bit of a relief. I was worried that it would be so unlike my normal life that I might be miserable. I just feel so rich being here. Since I’m a pretty economical person I don’t like wasting money and have been known to pinch pennies on a regular basis. For instance, I haven’t been letting people help me with my luggage here because I don’t want to have to tip them. But then I see how people live here and start feeling maybe I should just do it because I obviously have so much more than they do.

Greetings from the Sausage Tree

Well , made it to Kenya with relatively few problems. We missed our flight to Eldoret because we went to the wrong airport in Nairobi but caught the next one later in the day without any issues other than spending a long boring day in the Nairobi airport. We arrived in Eldoret yesterday pretty tired. We’re staying at a compound here called the IU House which is like a pretty nice dorm actually. Jen and I are sharing a medium sized room (named the “Sausage Tree” and have our own bathroom right outside the door (hot shower and everything though the water pressure is low). We had our initial orientation and spent the morning at the hospital today but then have had the afternoon off to get ourselves settled. Honestly, even just the morning made me exhausted. I think it’s a combination of the jet lag, the altitude and being in a new place and situation.

One thing I’ve been struck by here is the rampant discussion of Obama. As the election happened last night (Kenya time) multiple people stayed up through the night to watch the election results come in on CNN. I asked one of the Kenyans watching the election results what would be the benefit for Kenyans if Obama was elected and he answered, “we’d get a national holiday.” And he was right, Kenyans today are so happy that they have actually declared tomorrow a national holiday. That’s right, election of someone not actually from Kenya, not in their country has had that effect. One of the other Kenyans thought that it would be easier for Kenyans to get VISAs into the U.S. I’m not so sure that will be the case but I didn’t tell him that. People are so excited, there is even a reggae type song getting a lot of radio play called “Barack Obama.” If you’re into that sort of thing, you should google it and check it out, it’s pretty funny. The irony of this whole situation is the people of this country seem to be so proud that both a Kenyan and an African American is going to be president of the united states. However, if you look at the record, you see that Obama’s Kenyan father abandoned his family leaving a single white American lady and her white parents to raise him in the United States. So essentially, other than some sperm donation, how much did Kenya really have to do with him??? Just some thoughts (that I’ve kept to myself while here) …

Today at the hospital was interesting to say the least … there are about 48-60 Pediatric patients in 8 bed wards with beds being about 2 feet apart. There are no monitors, minimal medical equipment and disorganized or absent charting. The intern and the resident pretty much run things with attending physicians showing up a day at a time or not at all. I’ve been assigned to a team with a Kenyan intern (someone who’s had 6 years of medical school after highschool), a Kenyan Resident (someone who’s had training up through Intern year, then practiced for a number of years but is back to specialize), and a 4th year medical student from IU who seems vastly more knowledgeable than the Kenyan Intern. I did feel like the Kenyan resident was pretty competent, however. We cover 12-15 patients on our team. After we were done rounding today, one of the babies on the other unit stopped breathing and required some basic resuscitation. As we watched the infant required bag mask ventilation, became minimally responsive and started having some extensor posturing. The infant started breathing on her own again but with shallow breaths. They have minimal ICU beds here and really only intubate people that they feel very confident will be able to come off the ventilator because, culturally, they don’t withdraw support once they’ve given it. I believe this infant probably is septic, if not encephalitic (blood stream infection and infection in the brain) but so little was able to be done for her. We left her in a state such that I will be surprised if she lives until tomorrow. Its just such a different system and I’ve been encouraged by both people who have gone and people who work here currently to watch and observe initially and then try to contribute as I understand the system better. But ultimately, this system functions with or without us and there are many, many limitation which will not change by my presence here. I have to look at it as anything I can contribute with my limited knowledge is a bonus but not get too involved in taking ultimate responsibility. I sure have a lot of thinking and learning to do and will try to update this once per week to tell you what I’ve seen!

Floods, concert

To all the people who have asked, I appreciate your concern, but my area of Indianapolis is fine. I haven't personally experienced any flooding which is more on the south side of Indianapolis. There have, however been some patients transferred to our hospitals because there hospitals have been flooded. Actually, though I'm mostly saddened by all the flooding that's going on in Eastern Iowa and have a hard time seeing all the places I went to college and med school experiencing so much damage. Some of the pictures have been really unbelievable!

Tonight I went to see Jack Johnson, one of my favorite singers, in concert. I've seen him once before about 5 years ago and he lived up to everything I remembered. It's just a really laid back show and he sounds every bit as good in person as he does on CDs only he added in some new music and some fun improvisation. It reminded me of the concert I saw years ago with all my friends from med school and I wish they could have been there to see him again! One very cool part at the end was that he announced that all proceeds of the concert were being donated to the Red Cross because of all the flooding in Indianapolis.

Storm

There was a severe storm with some high winds, hails, and apparently some tornadoes the other night. I was at the hospital which wasn't really affected during the storm but the next day I was trying to drive home and found this tree blocking my way home. It's amazing to me that this gi-normous tree managed to split in two and fall over where just a block away, yard signs were still in place. Fortunately, there wasn't much damage in general but I thought this was pretty impressive!

Travels

It's been a great month for traveling for me! After a busy Neonatal Intensive Care month in April (hence, no blogging) I'm now on my elective in Dermatology which includes a week of vacation. Additionally, earlier in the month, I was able to attend the Pediatric Academic Societies conference in Hawaii where I presented a poster of a project I completed earlier this year. I spent a couple days at the conference and ... a couple days not at the conference :) Those days I spent snorkeling, relaxing on the beach, hiking up Diamond Head and not really working too hard.

Then, this past week I spent 6 days in New York City where my friend Cari got married in Manhattan. It was the first time in NYC for me and it was a busy few days since I was in the wedding but I did happen across some of the famous things and places such as the Statue of Liberty, Times Square, Herald Square, Empire State Building, Central Park, Madison Square Garden among other things. One of the neat things for me since I read a lot and have seen a lot of shows and movies based in New York City, I now have at least a basic knowledge of the geography and layout of the city and neighborhoods. Otherwise, I spent the time with about 6 friend from med school, many of whom I haven't seen since I graduated so that was great too.

I'm going to try a new thing where I upload my pictures to some web albums and I'll include a link here so you can take a look if you'd like. Most of the pictures of people, less of the sites ...

New York: http://picasaweb.google.com/njlohr/NewYorkCityMay2008?authkey=vC3JajR8FWs

Hawaii: http://picasaweb.google.com/njlohr/HawaiiMay2008?authkey=wIAAK0OwUxk

St. Lucia

It's been a long time since I updated this but I think maybe I was just waiting for something fun to report. Well, I found it! My friend Karla got married in St. Lucia the weekend before last and I was lucky enough to get to go! It was one of the most fun 3 days I've had in a long while. Some highlights included the amazing villa I shared with a few others at the top of one of the Piton mountains, the rehearsal dinner that was really a "cruise" on the pirate ship from the Pirates of Caribbean, and of course the beautiful wedding and reception on the beach. It was a small group and everyone was so welcoming including all of her husband's family who I hadn't met before so that made it really amazing too. Above pictures are the view from the balcony of my villa including a plunge/infinity pool, the group picture on the beach after the wedding including a rainbow in the upper left part of the picture over the resort and finally a little goofing off during the dance at the reception.

Otherwise I'm on a month in the ER which explains the few days off I had since we do mostly shift work. It's going fine and I'm liking it better than I did last year. Not too much else new to report but I'm eagerly awaiting spring and more importantly spring-like weather.