the big circle has been closed!

i'm home now! what a great trip! this will probably be the last post for quite some time. i'll be coming back and reading this blog when my life gets boring.

so in the immediate present my life is revolving around medical school applications, after which i will start hauling assphalt as a truck driver for a road contruction company here in northern alberta. then its back to college for one more semester.

thanks for reading this, if you have been, and God bless!

seoul

my last stop was a day long layover in seoul, south korea. took a train into the city from the award winning incheon airport - which was built on a reclaimed island out in the ocean. then i took the seoul metro to a random place, and walked around looking for some breakfast, which i finally found at a dunkin donuts (they're everyhwhere in korea!). then i spent the rest of the morning walking toward and trying to find my way up a large mountain in the middle of the city that has a tower on it that i went up to get an amazing view. by some measures seoul is the second largest urban agglomeragtion in the world. it was a very nice city, although seemed a little drab to be honest after the glitz and glamor of bangkok. i then wandered some more, found a cheap korean buffet which could not have been better, and then found my way back to the airport, only falling asleep on the metro a couple times on the way.

bangkok makes swift recovery from ravages of civil war

bangkok! flew there on kingfisher airlines, one of the best in the world. if you're ever heading to/from india. you may recall that downtown bangkok had a little bit of a civil war ragin' very recently - mere days before i got there in fact. i would have never guessed from being there though. well, except for the centrally located, massive burned out carcass of centralworld - what was the biggest mall in south asia. and a few other malls around it. but thankfully there are hundreds of undamaged malls still left in bangkok! i am absolutely amazing at the level of consumerism that exists there, and how nice everything is. bangkok would be one of the nicest and glitziest cities in america. there is always at least one well-stocked 7-11 within sight at all times. and they stock milk! i haven't had some good milk for 5 months! and a pretty amazing fermented milk product too. i went to this one mall - the siam paragon - and it just has to be the nicest mall in the world. it might be the first time in my life where i just wandered around for 4 hours: dazed, and completely in awe. and i was amazed at the relative lack of disparity in bangkok (although its a very different story in rural thailand). even the people doing the most menial jobs are doing it while listening to their brand new ipods and while wearing their designer fashions. impressive, especially after the squalor of india. in between the mall wandering, i went to some famous buddhist temples - one with a huge gold reclining buddha and also the biggest and most famous one in thailand, as well as the grand palace of thailand (tourist trap, but it was still cool). i stayed on khao san road - southeast asia's traveller's mecca - which was supposed to be dirty, sketchy and cheap - but was one of the nicest streets i've ever seen.

i also took a day trip down to pattaya, a beach town 2 hours south of bangkok (on really nice air conditioned busses and an elevated, 10 lane toll expressway). it also happens to be the self proclaimed sex tourism capital of the world. (but don't worry, i went there solely for the beach). wow though, there were an unbelievable number of prostitutes. and surprisingly to me a lot of them were ageing thai women (with kids trailing along even), sipping their favorite sugary iced coffee drink bought for them at one of the starbucks that populate every corner of town by a old, fat, ugly, or all of the above caucasian male, before he took them back to his $400/night luxury hotel room. not really how i would have (if hypothetically i would have) imagined thai sex tourism. just a sad situation all around though. pattaya also had a flippin amazing new mall, right on the beach, one of the nicest in asia. it was here that i went to one of those all you can eat sushi places with the conveyor belt of raw meat coming by! well, i learned that the raw meat on the belt was to be cooked in a little soup bowl, and the sushi was over in the corner. but this was after i had sat down and eaten about 5 plates of raw beef, chicken, and who knows what else. tasty though. also, as has become the custom, i found my way onto the premises of a luxury property - pattaya's hard rock resort, where once inside i was treated as a guest. so all in all, my 4 days in thailand were pretty funtastic!

it can't be normal to have had diarrhea for this long

kolkata! its the new indian name for calcutta. the city of poverty. its true, there are a lot of desperately poor people here. it doesn't help that every year during the monsoon the entire city has to swim through 5 feet of water. i've been doing things like being mauled after giving homeless kids under overpasses 1 rupee coins. and getting attacked by a deranged crow that attacked me from behind, drawing blood. so if i come down with some rabies-like schitzo bird flu in the near future y'all know where it came from. and trying to avoid being suckered in to buying powered milk for "needy" mother's "starving" babies - they sell it back to the shopowners as soon as we leave. as if i'm the first person to wrestle with the issue - its really tough to know how to deal with the poverty as a mere passer-through without just perpetuating it by breeding dependance.

kolkata surprised us, though. although there are way too many millions of the world's bottom billion here, there are also millions living well above the poverty line. kolkata is the cultural capital of india. there are more well-versed english speakers, expensive coffee and confectionary shops, and well-stocked bookstores here than anywhere else in india. yes, you read that right!

we are staying at the couple-hundred-years old calcutta ywca - because our friends are staying there and also because they have an atrium with a dirt tennis court. we've had some pretty intense games. we've also been eating some amazing food. if north indian food is savory and spicy (actually most of the time its pretty bland), then bengali food is sweet and tangyyyy. i have embraced eating with the right hand (that is - exclusively the hand). i'm going to miss that part about india. i won't miss the stuff necessity sometimes forces you to do here with your left hand.

yesterday we went to mother theresa's house/grave. there are now thousands of nuns following in her footsteps all around the world. devin is going to volunteer at the missionaries of charity home for the dying - really wish i could too but unfortunately i leave tommorow so there isn't enough time. did some soul searching while reading about her life in a little museum - while right above us a bunch of nuns were making vows committing the rest of their lives to the service of the poor.

cold!, tea at every turn, running through clouds, political martyrdom

darjeeling! the place has it going on. it might be the most beautiful locale i have ever seen. perched along the crest of a hill just in front of the himalayas, it reminds me of a swiss town high in the alps, except with a lot more tibetan and bhutanese people, poverty, $7 hotel rooms, and monastaries. although it still has its fair share of cathedrals too! and because its in india, its culturally appropriate and even encouraged to throw your garbage on the ground instead of finding somewhere else to put it! and also to urinate wherever and whenever in public, in whatever direction you feel led! not that i would ever do these things, except of course as a gracious attempt to be culturally sensitive. the best tea in the world is grown here, and you can sip it while sitting in wicker chairs at colonial establishments that have been here since the british era. even though its the warmest time of the year here, it always stays below room temperature. the town is cloaked in clouds - apparently if they were to disappear it is possible to view mt. everest from just down the road, but it doesn't look like the clouds are going anywhere soon. we took a jeep up here, but its possible to take an 8 hour toy train ride up from the sweltering lowlands that chugs (with steam) along a tiny narrow gauge train track. we've been eating meals with but 3 of devin's unlimited supply of female friends. they happened to be in darjeeling and later kolkata at the same time as us.

although darjeeling is technically in the indian state of west bengal, on the street it is part of independant gorkhaland. there is an intense independance movement that basically controls everything, including whether businesses are allowed to be open, which they frequently aren't because of political strikes. proposed gorkhaland would occupy a strip of northern northeast india. this is one of the biggest and established movements of its kind in india, although there are numerous others as well. like every problem the developing world has ever known, why don't we blame this one on the british. they created the awkwardly shaped state of west bengal that grouped a few mountain dwelling nepalis in darjeeling with tens of millions of bengalis living in kolkata. by the way, there used to be an east bengal too, but now its bangledesh. speaking of the british, check out last week's economist for great post-election analysis!

now that i've successfully lost your attention, i'll get to the juicy news! on our last day in darjeeling an opposition gorkha leader was brutally hacked to death with a traditional nepali knife at a political rally just down the street from where we were staying. the front page of the local papers had a huge picture of him bleeding out on the ground. no sensitivity from the press here. so the entire town went into lockdown mode. we went to visit the girls at this ywam house they were staying at, and we had to stay there for the rest of the day because apparently it was too dangerous to be on the streets. although later that night we wandered the streets for adrenaline's sake and it was fine. the next day we managed to find a jeep out of town although it was tough to do because all the jeeps were parked - their owners presumably inside their houses mourning. we had purchased a train ticket, but of course we were to pick it up the day everything shut down, so we couldn't. so when we got to the bottom of the hill (after a little too much reverse stomach and esophogeal paristalsis [if you're catching my drift] from one of the guys stuffed into the back of the jeep with us) and found our way to the train station everything was sold out for the next 3 days. so we ended up taking a night and the next day too "sleeper" bus to kolkata. i'll just skip describing that journey so i can avoid reliving it.

kathmandu!

we had a super duper time in kathmandu! my good nepali friend and apartment-mate from school, prajjwal, grew up there, so we stayed with his family. i had no idea that his father was a gordon-conwell educated pastor who started from scratch what is now a massive church there that has planted 60 other churches. he is also the country director for about every agency doing good things in nepal, as well as a university architecture professor. they have a really nice house with mosquito nets over the beds (which saved our lives), and we got amazing home-cooked american breakfasts (cooked just for us - apparently nepalis don't eat breakfast) and nepali dinners along with lots of good discussions in the evenings. as if that wasn't enough, prajj's brother ujjwal and some of his friends took us on a tour of kathmandu on sunday. all the tourist sites were rather expensive, but they insisted on paying for everything. wow. we went to a couple durbar squares - groups of ancient temples. also went to a museum devoted to a late king (since recently there is no longer a monarchy in nepal), and a "monkey" temple complex on top of a big hill with a great view of kathmandu. its an interesting city (although what city isn't) - all the houses are 3 to 8 stories tall, and very distinctively nepali. the streets are all very narrow, except for one big ring road. during the recent maoist strikes tens of thousands of maoists joined hands on the ring road - completely excircling the city so no one could get in or leave unless they were desperate enough to run people over. after our tour i got to go on a long run around prajjwal's house! it was the best feeling ever! in india it has been too hot to even think about running, so i've really missed it.

the next day, we got to deal with some more of the stupid, arbitrary bureauracy of the indian government. they just decided to implement this rule that if you leave the country, even though you have a multiple entry visa, you can't come back for 2 months. unless you get a special stamp that costs a lot of money and, as we found out, takes a full day of waiting to get. and the rules go on, but this is already probably boring you. you would think that they would understand that making tourists jump through randomly placed hoops of stress will only translate into less tourists; money. i haven't even finished college yet and i can figure that out. anyways, this caused us to miss our bus to the far eastern end of nepal but luckily there was another one later. we took it, arriving 17 hours later in kakhadvitta, nepal, from where we walked across a river into india and caught a bus to silguri, from where we caught a crowded jeep to take us up an infinitey switchbacking road way up into the himalayan hills to an epic best-tea-in-the-world-growing/british hill station/remarkably exotic town called darjeeling!

himalayan adventures

we are in nepal now, and it is wonderful. people actually have a concept of personal space here! and we need blankets to sleep at night - its that cool! we didn't think we'd even be able to come, as there was a week long, rather intense maoist (d*** communists) strike that shut down the entire country. the maoists were out in the streets to beat any shop owner or taxi driver who was working. so the whole country was brought to a complete standstill. thankfully they called it off, because they realized that the people actually cared more about survival than communst ideology (who would have guessed?). as soon as we heard it was over we headed in.

we took the bumpiest all day ride possible from varanasi to the nepali border at sunauli - a ride that got started moderately late by indian standards because they were under the bus hitting something with a piece of rock for 2 hours. the bus had this cute horn that played a little song every time it was engaged - about every 5 seconds for 14 hours. next day we took another all day bus from the border to the town of pokhara. we got to stay with an uber cool nepali guy named neeraj, who is a friend of some of my cousins. the first night we had a delicious nepali dinner with him and his parents and family members. his father is the director of the international nepali fellowship - one of the biggest christian ngos in nepal! they have some sort of rule that foreign ngos can't do anything here, so that basically means that we had dinner with a very important man. and they gave us a room that was the nicest i have slept in for many a month.

pokhara is right on the edge of the annapurna range in the himalayas, probably one of the most famous trekking areas in the world. on the first day we headed out for a 2 day trek. haha, it sounds a lot more intense than it was. the first day involved a 2 hour hike up to a little village called dhampus at neeraj's suggestion. it was just outside the annapurna conservation area - so we didn't have to pay the large permit fee. the village was idyllic, and we didn't do anything for the rest of the day, except for eat some more nepali food and watch the odd cow go by. basically the place was deserted. we got up the next morning at 5 am and there was the huge annapurna mountain range right outside our window! (during the day the mountains are shrouded in clouds.) very beautiful. we then climbed another 2 hours (after a while on the wrong path) to a village called pothana where the views were even better. had breakfast, and then came all the way down. that night we had a fine dining experience in pokhara. the place is amazing. we had to search for a place we could afford. its like a tourist town in north america. rather impressive.

the next day was today. it was a truly epic day, soiled by only one little thing. actually, when i write the word soiled, more than one thing, but i won't get into that whole issue this time. when we got up after sleeping in, neeraj cooked us a satiating breakfast of buffalo burgers complete with fresh lettuce washed with clean water and coca cola to wash it all down. we then checked into a hotel because neeraj is heading up to dhampus himself for a romantic weekend. we then rented scooters!!!! $3.50 for the day! didn't realize gas was going to be so expensive though.... anyways, on these scooters we had more fun than one knew was imaginable. we found a waterfall and a cave with a river and a temple in it. then we went out into the countryside to a river with rapids that we swam in. but then it started to rain.

as we were grabbing our stuff, my "friend" devin dropped my camera onto a rock, from which it bounced into the river, ruining it. i miss it already. the last parts of my trip will be pictureless. but i forgave him, because he's my friend, and thats what friends do. even if he wasn't my friend, as per the words of Christ. plus it was in no way his fault. even if it would have been he more than made up for it by being the best scooter partner. after that, it started raining very heavily, so we went swimming more because it was warmer in the water than out. it started hailing huge half inch hail balls. when, after at least an hour, that finally ended, we headed back, but the rain/hail started again, along with intense wind that threatened to blow our bikes off the road and was rather painfull when combined with the hail on our tender, north american skin. it was exhilerating. tonight we cruised around pokhara in the dark on our scooters. the only thing better than unexpectedly hitting a speedbump on a scooter during the day is hitting one in the dark! we got lost, which added to the fun. tommorow we're heading for kathmandu....

veg thali and varanasi

varanasi is the holiest city in hinduism. rumor has it that if your body is cremated here and the ashes deposited in the ganges river your soul goes straight to nirvana. (that means no chance of being a tapeworm in the next life!). we are staying in a really great guesthouse right above the main burning ghat, where this cremation happens on big pyres of wood. there's a funeral procession through the narrow, winding streets down to the river every few minutes. dead people are flown here from all over india and around the world. most of the time the bodies are wrapped up elaborately, but sometimes they're not - which is pretty gnarly when they burn the person right there in front of you. the people doing this work are the dalit, or the "untouchables" - but its lucrative so some of them have become the richest people in town. there's a list of kinds of people who can't be burned - they are tied to rocks and deposited in the ganges. of course, this being india, most of the time the rope breaks. so there's all kinds of dead bodies floating in the river and washing up on the shores. along with all the feces from the city. and thousands of cows and buffaloes trying to escape the heat (aside - there are people who spend all day in the water scrubbing down the cows, perhaps for karma). all this in the water that everyone here seems to love to drink.

the first day we were here we fell for a scam about a hospice for dying people right beside the burning ghat. we went up to this "hospice" with a guy, and of course it wasn't one and they demanded money. then some young guys started physically accosting me and i may have almost lost my temper again. moral of the story: stay away from the burning ghat. varanasi has dozens of ghats though (these are stairs leading down to the river). they are quite nice to walk along, and brilliantly photogenic. behind these is an intense old city with kilometer after kilometer of narrow streets filled with cows, their excrement, flies, temples and people selling stuff. on some of the ghats there are fire pujas every night, which are ceremonies performed by elaborately dressed young brahmins (the highest caste) involving lots of fire, flowers, what seems like some sort of interpretive dance and continuous noise (some of it provided by automated machines that power mallets that bang cymbals, drums and bells). after one little one of these they handed out this delicious pudding desert that may have been the only free thing i've ever recieved in india. oh, except for some partial body massages. the massagers come up to you and start massaging you without your permission - and you've got to literally beat them off before they have a chance to get their possy to surround you to ensure you pay for your massage. but we'd always let it go for at least a little while, because they sure did feel good!

on our second day here devin, lauren and i found a shopping mall and indulged ourselves in american style buttery corn and ice cream. then we went to a hindi bollywood movie at the cinema, in large part because it was air conditioned. it could not have been more entertaining. it was a romantic comedy that had about 10 different basically unrelated storylines. wonderful. we also went on a couple boat rides on the ganges - one at night when people set afloat little floaties with flowers and a candle on it, and one very early in the morning when everyone in the city and their dirty laundry come down to the ganges for their bath and their swimming/yoga lessons.

today we went to a "christian ashram". it was quite interesting. a typical ashram is a hindu communal retreat center that focusses on attainment of spiritual enlightenment through the teachings of a guru. so i don't really know what we were expecting from a christian ashram - i suppose some sort of fushion of hindu practice and faith in Christ. basically we were curious. well, turns out the place was less of an ashram and more of a chill hangout with christian hippies. we had a communal meal, and then, being hippies, they passed a guitar around the circle for any of the 10 people there to play. and a guy put in a good effort trying to play an indian flute thing that he is in india long term to apparently become proficient at playing. there is a soft spoken aussie guy with a head full of dreads and a rather sparse beard and his - you guessed it - musically inclined, artsy, and even more soft spoken wife and their child that have established this place to show Jesus to all the backpackers coming through seeking spiritual enlightenment. we had some interesting light-hearted discussions about such things as spiritual contextualization and different ways of interpreting the great commission: it was good. i appreciated them because you could tell that their hippyness was extraneous to their genuine desire to be missionaries without calling themselves or even necessarily considering themselves said, which in a way was rather refreshing. its all about the love man, not about the colonialism. don't worry though mom - i'm holding off on the dreads. and by the way, happy mother's day!!

the taj with devin!

sorry, i've gotten a little behind on the blogging, let me try to catch up a little! went to the airport and met my friend devin. he finally came out a little over 2 hours after his flight landed.... indian immigration. we hung out in delhi for 2 days - one day in old delhi which is a walled maze of little chaotic shopping streets. went to a very golden sikh temple where they give out free food and sing beautiful sounding sikh songs. also more hindu temples and a jain temple that had a bird "hospital" - more like a couple thousand birds being held in a cage. tried to get into the jama masjid - the largest mosque in india - but even though it was supposed to be free they wouldn't let us in unless we payed a lot of rupees. may have almost lost my temper. but i'll stop writing about it now because its a bit of a sore spot. the second day we walked around new delhi - refused about a million determined salesmen beneath the shadow of the india arch, decided not to go into the indian national museum because of the exorbinant admission fee, and saw the president's house. a punjabi chap named mr. singh gave us a ride in his rickshaw. that's also the prime minister's name - what a coincidence. the smog in delhi is so bad that the sun never directly shines - i can't imagine hot it would be if it did. then we hung out around connought place, the main shopping circle in delhi, before catching an evening train to agra.

agra is the home of the taj mahal. it truly is beautiful. there were thousands of indian tourists there. rather unexpectedly, almost every single one of them wanted to get their pictures taken with us. so all morning we posed in pictures. definitely the most popular i have or ever will be in my life. some don't even ask - they just put their arm around you while their friend takes the photo. and oddly its not cool for an indian to smile in a picture. it was outrageous and, needless to say, got a little old after a while. so we sat on a spatially isolated ledge under one of the minarets for a good while where only one indian tourist could gain access to talk to us at a time. later devin got violently ill, which was rather unfortunate. we then took the night/most of the next day too train to varanasi. we met a girl named lauren from new york where we were staying in agra, with whom we've been hanging out with ever since. varanasi is a remarkable place, but i think that will have to wait for the next post because i'm getting tired and we have to get up realllllly early tomorrow.....

it was inevitable, i guess

i got really, really, really sick. basically i had every symptom in the book, short of hair loss. i thought i might die. ok, i didn't really think i would, but it was scary. maybe it was the "aquafina" water that definitely tasted like it had come straight out of the ganges, or worse yet, the yamuna river. who knows. i prayed a lot and took some miracle drug, ciprofloxacin. thankfully now i'm doing much better, although i'm still nowhere near 100%. i was staying at this place in jaipur that was 20 degrees hotter than it was outside during the day, which was already pretty darn hot. so i foolishly decided to take a rickshaw to this fort nearby in amber. it was a climb and a half to get to the fort, and at the top i was basically delusional and completely messed up. i had to lay down in this shady area with the guards for a couple hours to get myself together for the trip back. then i just stayed in my hotel room. but the fort was pretty cool. i think.

the day before that i explored the old walled city of jaipur, the capital of rajasthan and home to 3 million people desperate to rip off a tourist. can't blame them, there's nothing else to do in town. its a pretty crazy place - the bazaar area is absolutely huge and there is a separate street for every imaginable thing to purchase. also any camels, cows, monkeys... wandered around all morning looking for something to eat - remarkably not a single establishment around opened until 11 am. climbed this huge free-standing minaret in the middle of the city for a great view. and i went to this amazing structure called the palace of the winds that is a huge facade that women used to hide behind to watch the world go by back in the dark ages when they weren't allowed to be seen in public. beautiful building. a rickshaw driver promised me a great rate for an extensive tour (20 cents). i now know that any time something sounds too good to be true in india it most certainly is. i knew that before but i must not have been thinking straight. it turns out the rate was contingent upon him taking me to all these overcharging textile factories where they pressure you to buy things and he as the driver who brought the tourist there gets a kickback. i don't have room in my backpack for textiles. so we argued, and we argued, and we argued, and i ended up walking.

"all" the trains from jaipur to delhi were "booked" - hard to believe considering i inquired 2 days in advance and there's a train leaving for delhi every 10 minutes, but whatever. so i took the bus. call me shallow, but my first day in delhi i was magnetically drawn to a shopping mall. i just felt this need to get away from the heat, incessant touts, beggars, bicycles trying to hit me, etc. and to eat something other than veg thali, masala dosas, and puri, as tasty as those foods are. "the great india place" is apparently the best mall in india. it was really nice - for india. don't let the hype and the gdp growth figures fool you though - india is very much "developing", and will be for a long, long time. a month ago i would have imagined the nicest mall in india to be a lot more amazing than it was.

after saying that, delhi has an amazing new metro system, being built in preparation for the commonwealth games that are going to be here this fall. the best thing is that you don't have to barter for how much the trip is going to cost. although that sort of takes the fun out of it i guess. anyways, after taking it to the mall in the suburb of noida, i took it to the largest hindu temple in the world. today (sunday), i went to the international church here (after searching for quite some time to find it. rickshaw drivers sometimes say they know where something is and it turns out they have no idea). it was so nice. first "normal" church service (i'm not really counting the rift valley academy church that was aimed at the middle school crowd - although that was pretty good too) in maybe over 4 months - it was absolutely refreshing. i love church. had a sit down chat with the pastor after the service, at his request. he was the man. there aren't many churches here, to say the least. then i went to a museum devoted to gandhi on the site where he was shot, then humayun's tomb, perhaps india's most impressive piece of mughal architecture. apparently there was a serious delhi-specific terrorist alert issued this weekend. so the military is absolutely everywhere right now, doing pat downs and waving their ak-47s around. they even had a little bunker set up in a shiny new metro station - completely surrounded by sandbags. i'm not going to say its overkill or they might arrest me - after all i had to give up my passport and every piece of personal data imaginable just to use this computer. personal liberties............ i digress.

tonight i head down to indira gandhi international airport to embrace my good friend devin from home, whom i will be joining as wingman on his indian adventures. he was supposed to get here last night but the toilet on the plane broke or something, so its 3:15 am tonight. yay! it will be really nice to have someone sleeping next to me every night.

pushkar/ajmer rajasthan

got on the 22 hour "express" train from mumbai to jaipur. the air conditioned one was fully booked (tried the suggested bribing, to no avail), so it was the excessively hot cage-like sleeper class. actually it was very doable though. they put all the white people on the (very long) train together in the same six person cage - in mine were an aging austrain surfer dude/chronic traveler who came to india for the women, a he-didn't-divulge-his-sexual-orientation-but-i'm-going-to-go-ahead-and-guess-gay irish guy, and a chubby english-as-a-second-language french canadian law student on a decidedly unspiritual pilgrimage to an obscure temple devoted to rats. also an indian family with about 7 kids on the floor. naturally you become friends with the folks when you are sitting around/trying to sleep in a 50 degree steel oven. goodbyes were tough, but life goes on. trains in india are great. there's a chai guy who comes by every 3 minutes with tea for 10 cents. and you can order a pretty tasty meal for 50 cents. did i mention the trip (1000 km) cost $7! garbage goes straight out the window, and if you use the toilet it plops out the bottom of the train onto the railroad tracks. i decided at the last moment to jump off at a place called ajmer. its close to a little hindu holy town called pushkar, famous for its annual (largest in the world) camel fair and its one of a kind temple to brahma (not that i care about the stupid "god", but yeah). shared a cab-thingy to pushkar with the aging austrian surfer dude/chronic traveler.

pushkar is a nice little temple town that is supposed to be centered around a beautifully serene lake. its in rajasthan, india's desert state. got there and discovered that the lake was completely dried up. but there were literally thousands of little temples all over the place that are painted light blue around what should have been the lake, and a big red one for brahma that apparently is the only temple of the world of its kind. the crowds in front of it were insane. all these "priests" try to shove flowers into your hands (to release onto the lake that should be there) and then demand money. i know what you're thinking - "people in india demanding money? that can't happen very often." actually it happens every single moment of every day from every angle to every white person on the subcontinent, and it is really, really annoying. back to pushkar - there is no meat, alcohol, or eggs allowed in the town. yes, they have a stringent checkpoint on the way in. they also charge a 20 cent toll to get into the town. hundreds of cows wandering the sreets. i had no idea, but the place is basically hippy central. thus, one day was enough for me. the vegetarian food was great though. the highlight was climbing a huge 1000m high mountain on the edge of town in the 40c (115f?) plus heat of the day to a little temple at the peak with amazing views and lots of cute little monkeys.

the next day i took the bus back to ajmer, which is just over a mountain range from pushkar. its india's biggest pilgrimage hotspot for muslims, as there is a huge mosque complex devoted to some sufi saint. first they wouldn't let me in because i was wearing shorts, so i found a sheet to wear as a dress. then because i wasn't wearing a hat, so i bought a little muslim cappy from a kid for 10 rupees (20 cents). then because i had a bag with me, so i followed another kid down a number of back alley ways to some sketch guy who would "hold" my bag for me. then they wouldn't let me in because i had my valuables on my person. at that point i decided the place wasn't worth my time. so i just wandered around the chaotic town for a while, visiting some other places, and then bought a train ticket to jaipur. the bureaucracy is crazy - i waited in line for over 2 hours to have a lady take 5 minutes to fill out a $1 train ticket. that's what machines are for. and for supposedly being a relatively english speaking country india sure doesn't seem to have very many people who speak english. figured out the lady had sold me a ticket for a train that had already left. so i hopped on a random one and sat with a huge group of ladies who were arguing at the top of their lungs in hindi for the entire 3 hours to jaipur. wandered around until i found a hotel that i could barter down. ah, the joys of life.

"london on acid" - mumbai!!

oh my word. india is chaos. all the rumors you've ever heard are true. got to the mumbai airport at 3 am and immediately started dropping water weight. its 37 degrees and 100% humidity. wandered around outside for a while looking for this guy who was supposed to pick me up. i am very lucky to be staying here in mumbai with the mother of a friend of my dad, or something like that. well, eventually the guy showed up, and took me to this elderly lady's house. its nice - i get a little apartment to myself and she insists on cooking meals for me and she even did my laundry. she is rather overprotective - she gave me a cell phone to carry around and she keeps calling me to see if i am ok and to remind me of all the bad things that could happen to me. the first night i told her that i hung out the door of the commuter train to catch the breeze and she basically had a heart attack. truth is i did do that, because riding the commuter train here is insane and thats the only way to stay sane. its actually pretty fun. the train doors stay open, because they physically couldn't close - there are 20 times more people on the train than there should be. when it comes to a stop at a station everyone is so desperate to get on that they just charge in - grunting and knocking people over. its impossible to get off when you want to unless you're hanging out the door to begin with. "my house" is about 45 minutes from downtown on this train, in the "nicer" part of mumbai. nicer is relative, as no one in the area has probably ever heard of or experienced an air conditioner and there are still goats and garbage in the streets.

first day i went downtown and saw the gateway to india, a huge archway erected by the british just before they left. across the street is the taj mahal hotel, site of the terrrist attcks a few years ago. i ducked in there for some ac. they call mumbai "london on acid". i presume the acid relates to the frenetic traffic patterns. or the urgency with which people are trying to sell things. but its actually a lot like london. there are countless impressive colonial buildings throughout downtown mumbai. there is a clocktower that is at least as big as big ben. and a massive colonial era train station (the busiest in asia) that was initially named after queen victoria (now it has some marathi [thats the language here] name thats about 200 letters long) i walked around all day, as i did the next day, when i went to a huge open air laundry facility where all mumbai's clothes go to get washed by hand. amazing. i also went to the haji ali mosque which is out in the ocean, connected to land by a long cement bridge that is lined with beggars. close by is a huge hindu temple devoted to the hindu goddess of wealth, where everyone buys flowers and reverently goes through all kinds of motions all along the km long street leading up to the temple. then once one gets inside, an obese and hairy shirtless guy irreverently grabs the ornate flower decorations and coconuts and whatnot and tosses them into a trough in front of the idol while the devotees cross themselves. crazyness. also crazy was the restroom situation there- i really needed to go, but shoes had come off at the entrance- and like all indian restrooms there was a half inch of urine on the ground. but i really needed to go.

wandered through the slums, got completely lost, took a random bus that i thought was going the right direction but it wasn't- i love it. eventually found my way to a pennisula called malabar where mumbai's movers and shakers live (like its bollywood movie stars). went into a huge jain temple. the jain symbol is the swastika. to be fair, they had it first. but its rather wierd being in a building full of elephant statues and mystical preist weirdo guys and scented candles that is adorned with swastikas. also, at the end of this peninsula is a pedestrian only area called banganga tank. it is full of hundreds of little hindu shrines, and the tank is a pool of water surrounded by ghats (steps into the water) where little kids are swimming and rituals with flowers are going on and whatnot. according to hinduism its the center of the world. and here i thought that distinction belonged to boston. on second thought i guess the center of the world and the hub of the universe could be at different places. anyways, it was a cool place. also went down to where the slums meet the ocean there - the water is horridly foul and there is garbage and sewer washing into it. and there were mentally deranged old men swimming in the sewer and they started coming after me so i left. this is india.

almost done. then i went to chowpatty beach which is the hangout of choice for young lovers. wish i had a girlfriend to walk along the beach with (is crying to himself). i drowned my feelings by eating. these little crispy balls of fried goodness called puri that the break a hole in and put lentils, chutney, lemon juice, wonderful paste, yoghurt etc. you eat it and then they make you another. its fantastic. basically everything here is fantastic except for the extreme heat and the horrible chaffing that results from the sweat and multiple days of walking all day. but i won't go into detail on that.

srilankan airline's successful attempt to fatten me up

fly sri lankan airlines! they served a meal as we flew from kuwait to dubai. then another as we flew from dubai to colombo, sri lanka. and this was by far the cheapest leg of my trip so far. i was planning to spend the day in colombo looking at buddhist temples and whatnot, as my flight got there at 4:30 am and didn't leave until midnight. (by the way, i planned this all this way). but i remembered something from the the airline's website about them providing a free hotel if your layover was long enough, so i decided to ask them because i was sooooo tired (from not sleeping). the reason i was tired was because i had not gotten enough sleep in the recent past. the lack of sleep had me feeling fatigued (i was tired). anyway, turns out they would provide a free hotel, and before i knew it i was being whicked away by private taxi (at their expense) to what turned out to be a luxurious beachside resort, replete with multiple pools, and unlimited food!!! and it was amazing, gourmet food. might i say that it was the best day of food i have ever had in my life. also unlimited locally grown ceylon tea (ceylon is what you might think of sri lanka as if you're advanced in years). so i decided not to even go to colombo, especially after finding out how much it would cost to get a ride there (the resort was an hour in the opposite direction). turns out sri lanka is turning into quite the tourist hotspot. i was half expecting the customs guys to ask me if i was a tamil and shoot me and leave me to starve if i didn't respond in the negative fast enough (as per recent civil war related events. although i'd still probably have that done by the government than try dealing with the tamils). but that didn't happen thankfully. back to the resort, there were huge ocean waves that i frolicked in between pool, lounging and eating sessions. they were large enough that when one hit you you lost track of which way was up and by the time you figured it out you were washed 30 feet up onto the shore. and then it was time to run back in the catch the next one. it was a lot of fun. then srilankan flew me in the middle of the next night to mumbai, india, and who would have guessed - served another fabulous meal!

americana in the desert - KUWAIT!

at 2 am i was woken up by the fight attendant - everyone else had already gotten off the plane. i was sooooo tired, having not slept at all the night before. dazed, i made my way through the amazingly nice airport, and when it got light out hopped on a random bus into the city. eventually found myself the hotel i had booked (apparently the cheapest accomodation in kuwait but still more than enough for me), where i could drop my huge bag and explore without 40 pounds on my back (which, in kuwait temperatures, causes extreme sweat loss!) kuwait is impressive to say the least. very much like dubai, except without the tourists. amazing architectural masterpieces rising out of the sand on every street corner. went to the famous kuwait towers to get a good view. inside are pictures of how they looked after the iraqi invasion in the early 90s, along with colorfully hateful descriptions of how bad iraqis are. i think the kuwaitis may hate the iraqis almost as much as they hate the israelis, and thats saying something in this part of the world.

but kuwait loves everything american. american cars, consumer culture - the bottom 3 floors of every building in the country is a beautiful mall. and they even love the concept of the ring road - there are about 9 of them! and there are dunkin donuts and krispy kreme outlets and gourmet coffee houses on literally every corner. there seriously must be thousands of starbucks locations in kuwait city. its amazing. walked through the huge national mosque. went to the kuwait stock exchange, which was really cool because you can walk right out unto the trading floor with all the traditionally dressed millionaires/billionaires?. no one asking me for money here, that's for sure! went to the fish market - probably the cleanest fish market on the face of the earth. spent the late afternoon exploring one of the nicest malls of all time, anywhere.

next day did some more of the same, along with lots of wandering and sweating while trying to figure out the public transportation system. then headed back to the airport.

a day in addis ababa

didn't sleep at the nairobi airport - too excited! flight left at 4:30 am, got to addis ababa, ethiopia at 6:30 am. after lots of waiting in lines finally got a visa. on the way out of the airport there was a huge traffic jam of people - turns out it was all caused by an ethiopian family who obviously had never experienced an escalator before and refused to get on it, so they were just standing at the top, debating what they should do next. all the banks were closed and the atm rejected me, so i decided to walk into addis. saw a huge orthodox church on the way in, so i walked in that direction. it was sunday morning, so there were thousands of worshipers there and spread out for about half a kilometer in front of the church - woman (all dressed in white cloths) on one side and men on the other. turns out this church is the largest in africa. ethiopia has a vibrant and very ancient orthodox tradition. found a better atm and got a ride to the huge meskel square, the center of addis ababa. started walking up the huge hill toward entoto mountain. many orthodox congregations were doing their thing, and they broadcast loud enough that everyone else has no choice but to follow along (although it would be easier if one spoke amharic). explored some fabulously nice hotels, like the sheraton addis. ethiopia's richest billionaire decided to build the most opulent hotel imaginable in the middle of a huge slum. walked all the way up the hill past many, many churches and slums (it took me all morning) before stopping in to a little random restaurant to get some njera for lunch. its a sour blanket of dough that is made out of a grain called tef that grows only in ethiopia that you use to grab tasty meat sauces with your fingers. washed it down with the best coffee ever - they like it wonderfully strong! they also love to smoke out their restaurants/houses out with powerfully pungent incense. i was trying to walk all the way up the mountain, but i soon realized that it would take me all day, so i caved and got a taxi. the oldest church in ethiopia is at the top - along with a tremendous vista of addis ababa, a spawling city of 5 million souls. took the taxi down again and eventually found out the "nice" guys driving it were actually liars and cheats - they demanded more money. we sat there and argued and for quite a while they wouldn't let me out of the vehicle. this is one huge problem with africa - unless you know someone you can't take them at their word. finally gave them all the money i had - it was a lot less than they wanted, and physically forced my way out of the vehicle (ethiopians are small people). browsed the national museum, which has bones from the oldest human. it started to pour - walked around downtown wet for what seemed like an infinity amongst the beggars and the goats to find a working atm so i could get a taxi back to the airport. a nice little boy (nice until he found out that his net worth wasn't going to go up very much after hanging out with me - then he got pretty ugly) permanently attached himself to me for the last few hours, as i was starting to get too tired to tell every single person who tried to talk with me (every 2 seconds in addis) to buzz off.

it was a good day. fell asleep at the gate as the plane was boarding - luckily a nice guy from iran woke me up so i didn't miss my plane. stopped in manama bahrain, then to kuwait.

good bye to kenya :(

spent the last week in kijabe on the men's ward. headed into nairobi on friday and made a stop at the nicest mall in kenya - westgate. good thing i didn't discover it sooner, or i would have gone there far too much! went to my aunt andrea's house who lives in nairobi - and got to hang out with my aunt sheila and cousin sonya who are on their way through to tanzania; it was a family reunion! there was even supposed to be another aunt and uncle around but unfortunately they are stuck because of the icelandic volcanic ash cloud. was supposed to leave early saturday, but the airline pushed the flight back to sunday. went out to lunch with my cousin sonya and did some more window shopping. had amazing ethiopian dinner with the family, and headed to the airport at around midnight.

i've really enjoyed my time in kenya, and learned a lot. the people at the hospital are amazing - they exemplify what it means to truly love people and to make personal sacrifices that translate that love into something tangible - no money involved. and it has definitely confirmed for me that i should be a doctor.

been to anarchist country - check!

56 bus riding hours and 12 passport stamps later, i'm back in kenya. what a great weekend. lets go back to saturday...

got up early to catch what was supposed to be a 3 hour bus ride from kigali to gisenyi, rwanda. like everything in africa, it took considerably longer. playing on the radio were recognizable gospel melodies in the vernacular, kinyarwanda, interspersed with french rap. gisenyi is a nice little town on the shores of lake kivu. apparently its where loaded rwandans go for holidays, although it has its share of poverty too. apparently lake kivu has compressed gas under the water, that one day will rise to the surface and kill everyone in the vicinity (sort of like los angeles falling into the ocean i guess). went to the market and climbed part way up a mountain where i made friends with some local children. then i took a taxi moto to the border with the democratic republic of congo (drc).

the drc is probably one of the most messed up countries ever. they've been embroiled in civil war for, well, basically forever, but especially the last few decades. apparently 5 and a half million people have been violently killed there in the last decade, making it the deadliest conflict globally since wwII. gdp per capita is dead last in the world. very recently the infamous lord's resistance army (lra) (brainwashed child soldiers on hard drugs) from northern uganda have been massacring entire villages in the drc. trying to get into the country was anarchy in itself - about 50 people pushing and shoving their way to one little immigration window. i was polite at first but soon realized that i'd be waiting there all day if i didn't get aggressive. the change in road quality crossing from rwanda to the drc was almost as bad as crossing from alberta to british columbia (haha) - it went from fantastic to absolutely terrible. no garbage (rwanda doesn't even allow plastic bags in their territory) to a virtual garbage dump. i walked the 1 km into the city of goma.

goma is half mud, half lava. there is a huge volcano that erupted a few years ago that buried half the city (including the airport), so that half is still digging out. i only saw one mzungu (white person) all day that wasn't inside an armored u.n. vehicle (we ended up having quite the discussion. he works in conflict resolution, in close collaboration with the upper leadership (like presidents) of the surrounding countries. i got the impression that he doesn't get to talk to mzungus very much. he seemed desperate to talk about american politics; i obliged). anyway, this guy told me where i could find the market, because literally no one spoke even one word of english. so i got a taxi moto bike to go to the market. no helmets in the drc. in fact, no rules whatsoever, haha. the market was great. it started pouring rain so i hung out there for a while. used up my extra drc currency before leaving by taking the taxi motos to the far end of town and back. at one point the guy started going the wrong way and when i indicated to turn around he did so very abruptly, and we lost control and crashed into a woman in a yellow dress, knocking her into a huge mud puddle. he kept driving. so that was my half day in the drc. took the late evening bus from gisenyi back to kigali.

next morning i got up extremely early to catch the bus to kampala, uganda (9 hours). decided to go just to kampala, and then get a ticket from there to nairobi later that night so i could hang out there a few hours. went to about 4 different bus companies before i found one that had a night bus. i liked kampala. i went to the market which, anywhere in africa, is always sufficient to supply enough chaos for one day. then i went to a shopping center where, after searching for forever to find someone to change some money for me (i couldn't use my debit card in uganda and all the forex places were closed) i had the most delectable indian food i have ever had in my life for dinner. even got to watch professional indian cricket on a big screen. made me seriously stoked to go to india soon, as if that wasn't already the case! there were tons of asians in kampala. evidently they all came back after idi amin made them all leave. then i caught the night bus back to nairobi.

africa's jewel - rwanda!

i successfully completed the bus ride from nairobi to kigali rwanda. it was supposed to take 24 hours; it took longer. took the kampala coach - it reeked with an unimaginably horrid stench that made me nauseous for the first time in a really long time. after taking about 45 minutes to move the first 100 meters (nairobi traffic), i could tell it was going to be a long trip. the bus remained about 20 degrees hotter than the outside air all day (the outside air was perfect) - every time i opened the window the people in front of me promptly closed it. the guy beside me wore a winter parka the entire time. we stopped in nakuru and eldoret for some much needed air. somewhere in western kenya one of the back tyres (that's how they spell it here - blame the british influence) started coming off. we stopped and, in true african fashion, it took about 2 hours to tighten it back up. i spent the time chatting with the only other mzungu on the bus - a british bloke with an afro who was about my age. at the ugandan border we got out and walked across a muddy no mans land before having to pay more than enough for a visa. got to kampala in the middle of the night for a short stop at kampala coach's squalid headquarters in the industrial area. got held up for no particular reason at the uganda/rwanda border for a few hours, and for some reason they decided all the luggage couldn't remain under the bus - it all had to be stacked in the aisles for the rest of the trip.

but the bus trip was more than worth it - kigali is an absolutely beautiful city! the roads are amazing (my cynical side suspects guilt money from the west for not stopping the genocide). there is a 24 hour nakumatt (african walmart) surrounded by a very pleasant mall downtown. for some reason i seem to gravitate toward the malls. i also gravitate toward the slums. the bus station is at the bottom of a huge hill, and when i got there it looked like the downtown was at the top of the hill, so i decided to hike up to it through the slums rather than the main road. the people's response indicated that i might have been the first mzungu to ever do that. i don't think i've ever felt as conspicuous. everyone just stops in their tracks and stares, and "mzungu", "mzungu", "mzungu" is the only word you hear. the kids yell it and run up to touch you which is great, but the hotshot young men say it angrily before spitting on the ground and the women mutter it under their breath. pure racism if you ask me. but no one asked me so i digress, that word only seems to exacerbate animosities. later i went back just to walk around, at least this time i knew which way to run if need be! anyways, at the top of the hill the aura completely changed. beautiful traffic circles with manicured gardens in the middle, numerous brand new glass skyscrapers, etc.. rather impressive. just explored for the rest of the day. one can take these taxi motorcycles anywhere in the city for about $1. they give you a helmet that is about 10 sizes bigger than anyone's head, and the straps are invariably broken, so you have to hold on with one hand to keep it there. it would be a lot safer if you could hold on to the back of the bike with both hands and forget the helmet! its wonderful. found a cheap motel, turns out it had a tiny television in the room! so i got to watch t.v. for the first time in 3 months! this morning i went to the genocide memorial centre, a very impressive museum that just opened a few years ago to commemorate the infamous 1994 genocide that killed 800,000 - 1,000,000 rwandans. over 250,000 of them are buried right there on site. very sad story. clearly still a very central theme in every single rwandan's life, as well as the national identity as a whole. also went to the hotel des mille collines - the impetus for the film hotel rwanda. if you haven't, see it. even most of the modern music videos playing in the restaurants are centered on the genocide. interestingly, rwanda remains the most densely populated country in africa even with all those people, as well as all the refugees who left, gone. a few other random facts about rwanda before i peace out - lusciously green. very mountainous. they love their beer - at least half of every store is devoted to it, as are the vast majority of billboards and roadside stalls. the main reason a tourist would come to rwanda is to see gorillas - but a one day permit to the national park where they live literally costs more than i have in my bank account. everyone speaks french, no one english. this makes buying a bus ticket (or anything you can't just point at) challenging for someone like myself. recently rwanda has become known as a model for the developing world. stellar economic growth. minimal corruption. effective government. its almost as if it doesn't belong in africa. wonderful place.

heading west....

i spent last week in wairegi, the men’s ward of the hospital. i learn a lot from the morning rounds. it is really nice of everyone here to let me join them for their rounds, and ask questions, etc. the ward is extremely crowded, with only about a foot between each bed and beds in the hallway and whatnot. also spent a night in casualty with my friend joel and watched a few too many people die. like one guy not much older than me who we had admitted to the ward that morning for very non life threatening things. a nice guy. he got out of bed and collapsed, and then we got called and tried to revive him but he died. then about 5 minutes later the same thing happened with a little baby in the nursery. spent the easter weekend at home with the b.s. there was a very nice sunrise service on sunday morning, followed by a potluck breakfast attended by all the kijabe mzungus. thank God for easter!

a couple weeks ago i swallowed a doxycycline tablet before bed (its malaria prophylaxis). long story short, it stayed in my esophagus and basically burned a hole in it. the pain has been almost unbearable, especially when swallowing. thankfully now its getting a bit better.

the b.s left on vacation to mombasa yesterday. because mrs. b. is not here to cook i eat my dinners at mama chiku’s hotel (around here, hotel means restaurant). i just tell the mama that i want a good meal, because i have no idea what’s on the menu. actually i don’t even think they have a menu. usually what comes out is something like rice, beans, meat and chapattis, for the equivalent of less than $2. yesterday i went to the cure hospital, a separate hospital right beside kijabe hospital that specializes in pediatric orthopedics. i watched some fascinating surgeries, like a club hand repair. and lots of casting of broken bones. monday i went into nairobi to buy a bus ticket for an epic trip that i’m leaving on very shortly. lets just say that if you never see another post here again its probably because i’ve been kidnapped by rebels somewhere deep in the rainforest on the other side of lake victoria…..

mzungus in mombasa

i had a funtastic weekend in mombasa! caught the night bus (8 hours) down on thursday night with a guy named kevan that i met last weekend and kent, his kiwi roommate from the orphanage they volunteer at. wandered around the river road area of nairobi a bit before we left - i can see why some people are scared to go out at night in nairobi! we missed (through no fault of our own) the bus we were supposed to take at 9:30pm, so we had to buy new tickets for a bus at 12:30am. but we got there, and after a great ferry and a little more matatu riding than it turns out was necessary, found the idyllic diani beach and the girls, sonja and ali. found a hotel room a matatu ride from the beach for $12 a night, and us 3 guys shared a room by putting the mattresses together on the floor. basically spent 3 days on the beach which was glorious. 3 study abroad students from the midwest came for a couple days too, as did a couple peace corp volunteers and some christian law student volunteers from the uk. good times. also lots of male bonding in our room because it was very necessary to have someone else thoroughly rub aloe into our sunburned backs. one day we went snorkeling out on the reef. eventually found out that kent was a christian too so that was cool! then on monday we headed into mombasa town and got a bit of a tour from the friendly peace core workers who live in the area, and then just wandered around. its a very interesting city - very muslim, always very hot and humid, rich history, etc.. where else would you find a fort jesus, pentacostal churches, mosques, animists, and jain and hindu temples within extremely close proximity? i liked it. we went to a coffee shop in the old city where they serve coffee with all kinds of delectable spices in it. a few different times.

barely caught another night bus back on monday night, and then went to the boy's orphanage tuesday morning in a suburb of nairobi called waithaka, just to see where they spend their time. they hang out with preschoolers all day - who are really cute. all in all, i don't see how the weekend could have been any better! back to the hospital tomorrow!

from kibera to githunguri

i have spent this week with the aidsrelief team, who are a special medical unit fighting valiantly to fight hiv/aids in the kijabe catchment area. they provide free antiretroviral therapy (arvs) and various symptomatic treatment free of charge to all hiv positive people who want it - courtesy of pepfar- the president(of the united states)'s emergency plan for aids relief. so i have been learning a lot about cd4 count trends, viral loads, the various antiretroviral regimens, protocol for switching to second line therapy, etc. etc. 2 days i spent in their clinic in the hospital - doing rounds of the aids patients who are in the hospital at the time and then clinics. and then i went to 2 rural clinics in places called gilgil and githunguri, where the clinicians go to the people's towns for their follow up appointments. because one of the worst things that can happen is that people will start taking arvs and then be inconsistent - and the virus easily develops mutations to the drugs - and they spread it - and next thing you know the drugs won't work on anyone anymore. so the biggest challenge is keeping people adherent to their regimens. its such a big deal that there are people hired to go around to patients homes and make sure they are taking their meds. remarkably, even though the drugs are the cheaper ones available, many people can live their entire lives on them and never come down with aids.

last weekend, i got to go into nairobi and stay with my aunt who lives there for a couple nights. it was a lot of fun. on sunday we went to nairobi baptist church (huge and basically western despite the lack of mzungus [white people]) and then got some chinese food. and on saturday i hung out with some fellow canadians! two nurses who are volunteering at an internally displaced people (idp) camp, and a guy who is working at an orphanage. we went to the famous kibera, the second largest slum in the world after soweto south africa, and got a tour from a really cool kenyan guy who lives there. he is spearheading a large number of development projects there, and earns his money by organizing the filming of various documentaries and films such as the constant gardener. it was very interesting just to walk around in the slum - the kids in there certainly weren't suffering for lack of happiness! conditions were pretty bad though, as you can probably imagine. the worst problem is the lack of garbage and sewage disposal, so those 2 things in particular tend to pile up all over the place. then we went to the giraffe centre - a place where one can get up close and personal with a special breed of giraffe that is almost extinct. if you put some grass in your mouth the giraffe will kiss you! it was fun. then we went to a japanese restaurant for some pretty good sushi. this weekend i am going with the same peeps to mombasa on the coast (indian ocean), so it should be a great weekend!

outpatients; more joy at joytown

this week i have been in the outpatient and casualty departments shadowing a really cool american doctor who speaks fluent somali, arabic, and about 7 other languages. and when he's not there a family practice resident who's in the u.s. airforce. and when he's not there a very goofy clinical officer (kenyan equivalent of a physician's assistant) who wants to emmigrate to canada. i think that this is my favorite kind of medicine because there is lots of interaction with patients (and their families), there's lots of variety, and you never know what's going to happen next. sometimes the doctor has to do things that they aren't trained to do. like the other day a lady came in who we finally found out had aids even though she told us she didn't tell us at first. (it directly related to the nature and urgency of her problem). but her husband didn't know she was positive, and she refused to tell him (in the west someone could be and has been charged with attempted murder for such stubbornness). anyway, she finally agreed that the only way she would accept treatment (and if she didn't get treatment she would probably die the next day because she had meningitis) was if the doctor called her husband in and "nonchalantly suggested" that they both be tested for hiv, so that the truth could come out without the husband knowing the wife had previously known about her status. well, when the husband was told this it did not go over well - he gritted his teeth and got a look on his face that suggested he was going to strangle his wife the minute they left the office, if not the doctor before that. it was kinda intense. speaking of aids, there was this woman who came in who was negative but has a positive husband who she really wants to have a child with. she wanted to know the best days of her cycle for conception. what should the doctor say to that? in other news, there was a radiologist here from montana that i got to hang out with a bit. he ultrasounded me for about 2 hours one day, demonstrating to the ultrasound techs how to find every organ possible. turns out i have a large spleen.

i also got to go back to joytown, the home for disabled kids. this time dr. b. was giving a tour to a group that is going on a medical missions trip to sudan. thats the main reason he goes there, but whenever we are there he sits down with the therapists for a couple hours and brings in child after child to try to figure out what is wrong with them. there are only a couple therapists there, taking care of 300 kids who in the west would probably have 1-on-1 care. unfortunately one of the byproducts of this is that a lot of the kids with paralysis die needlessly from kidney failure because their bladders aren't being managed properly. these kids (some as young as 5) are being taught to catheterize themselves on a regular basis. imagine trying to learn to catheterize yourself at age 5. i've also been making some cushions out of old foam mattresses, plastic shopping bags and tape to put on the hard schoolroom chairs so these kids don't get sores that get infected and then kill them. perhaps the craziest thing about the whole setup is that its a pediatric neurosurgeon who goes there every now and then to give tours that has to notice something obvious like that before anything gets done.

mentally compromised kids and tumor resections

last week was a busy one. i spent most of it in the operating room. dr. b. operated late into the night a couple times, and all day saturday too. there are just so many kids coming in with spina bifida and hydrocephalus. i got to "scrub in", which means i put on the sterile gown and gloves and passed instruments, suctioned oozing blood, etc. etc. i also watched a couple other neat surgeries, like the resection of a huge (like 1 foot long huge) testicular tumor. one night i stayed up almost until the sun came up watching about the most epic sugery ever. this somali guy had come in with a tumor about the size of a football in the middle of his head and neck. so the kenyan plastic surgeon here decided to take er out. he had to peel back the guy's entire face, and dissect everything below it down around the carotid artery (it was suspended in mid air) all the way to the spinal bones in the back of the guy's neck. it basically took all day and all night. that was definitely one of those "wow" moments - to see basically everything between the neck and brain completely gone, and then put back together again. the surgeon kept sending me up to the reference room to find out what artery he was likely come upon next! there was also an ear nose and throat team here repairing cleft lips, so i got to watch them do those surgeries for a day, which was really interesting too.

one day i went to a home for disabled children in a place called thika with dr. b. and a group of visiting american southern ladies. its called joytown, and it was alot of fun. i argued with some of the ladies about politics (they started it). joytown is run by an ngo that dr. b. started. there are hundreds of children there who have all kinds of severe physical and mental problems; its quite the place. actually a lot of the kids with problems resulting from hydrocephalus and spina bifida here at the hospital end up there, so it was interesting to see the track that life takes for many of them. to be honest, normally i'm not all that inclined to spend time with mentally challenged kids, but i had about the most fun i've had in a long time with them there. i sat down in a wheelchair and started wheeling around with them, and then a bunch of them decided to push me around the entire place in my wheelchair, and next thing i knew an hour had gone by!

ob/gyn!

dr. and mrs. b. have been gone to the usa to receive an award from the ama (american medical association) entitled “excellence in international medicine”. yes, that is very impressive. only one physician receives this award each year. if anyone deserves it, it would be dr. b. another doctor and his wife moved in to the house to keep the 2 junior b.s and myself company. they like very much to cook elaborate meals, which is fantastic. the man is an ob/gyn, and i have been shadowing him all week at the hospital - i’ve been learning a lot. gynecology involves a lot of clinic time inspecting a lot of… you guessed it. also a lot of counseling women on how to get pregnant. also, we have spent a lot of time in the operating room - laparoscopies, tumor and fibroid removals, hysterectomies, and an ectopic pregnancy removal (read blood, blood and more blood. the fetus implanted itself in the fallopian tube and the placenta vigorously attached itself to every organ within reach). also things like the results of female genital mutilation and spontaneous abortions that are happening right then and there. it gets pretty intense sometimes. it can be really rough being a woman in kenya. for example, there is a girl here who was forced into marriage when she was 14. she immediately got pregnant, but when she gave birth the baby died and she got a fistula (urine and stool were coming out the wrong hole). thus her husband abandoned her. so she went to live with her brother, who decided that she wasn’t worth feeding, so she became extremely malnourished. to top it all off, when she came in to have her issue repaired (which it turns out was far easier said than done) it was found that her husband had given her hiv. she’s not even 18 yet. very sad.

the other day i got to watch a baby get delivered for the first time! it was extremely exhilarating, and i was just watching! i’m just glad i’m not a woman so i don’t have to dread the experience, especially since that first baby had a huge head and left a trail of destruction on its way out that required many stitches to repair. by now i’ve had the chance to see more deliveries - in fact in one 1 hour stretch there were no less than 5! in other news, i got really sick but thankfully recovered in about a day, took a matatu into nairobi and got lost for most of the day (but it was the good kind of lost), and got the most terrible back pain i have ever had from twisting it playing basketball as well as bouncing around in the matatu. the trip back from nairobi was so crowded that this elderly man who had clearly been smoking far too much pot in the recent past had to legit sit on my lap the whole trip home. i think he enjoyed his “trip” a little more than i did mine. not to complain though - the babies definitely made this week one of the best yet!

safari!

it was a luxurious safari weekend! peter, isaac and I spent 2 nights in the maasai mara, a famous game reserve about 5 hours down the dirt path from here. it was fantastic - we saw most of the animals possible to see - including a leopard, cheetahs, lions (and babies), water buffalo, giraffes, elephants (and babies), etc.! we stayed in a tented camp - but they were luxury tents that had toilets and showers! the food was delectably gourmet, although the portions were a bit small and they wouldn’t give us any more. overall though the safari was definitely worth it despite the price tag. it was just the 3 of us to a huge land cruiser with openings in the roof so we got to stand in the open air the whole time! on friday, which was actually the day we were supposed to leave on safari but didn’t because we didn’t plan things out in advance well enough, we went into nairobi to a western style shopping mall called village market, and I was reminded anew of my appreciation of american consumer culture. I am definitely going to go back there just for the warm fuzzy feeling one gets when looking upon aisle upon aisle of any item one could wish to buy (it’s a rarity in africa).

last week i did rounds with dr. b. (the doctor [aka superman] I am staying with) in the early mornings, which I have been doing every week, and then rounds with peter and the pediatrics team, and worked on my research. we also learned a lot about diabetes in africa. the director of a major international diabetes organization came and gave a lecture on that topic. it is becoming a lot more common because more and more people are switching to a western style diet. there is also an obesity epidemic looming in africa, because for many it is culturally desirable to be large (it means your husband is capable of providing). in this culture it is also considered completely strange to be seen exercising, a fact that I am constantly reminded of by the quizzical stares everyone gives me when I go on my daily run. interestingly, non-caucasians are actually more prone to obesity and diabetes than are caucasians when all other factors are constant. the diabetes expert suggested this was because caucasians were the first in history to begin consuming lactose/dairy products, allowing them to consume more calories. this allowed for a gradual selection of genes that made them less calorie efficient. interestingly there is a third form of diabetes in the developing world which has been (creatively) named type III diabetes. it is caused by malnourishment. in other health news, they found some e-coli in the kijabe water source. someone came rushing into the house to tell us not to drink the water - immediately after i had just chugged about a liter of it after a long run. we all felt a little sick for a few days.

other highlights have included a visit from my cousin who i shall not name, who lives in a country which i shall not name, lest government officials from said country google "name of said country" "and" "jesus", find that both exist in this blog, and hunt my cousin down. i wouldn't want that. i also had a harvard and oxford educated doctor roommate one night in the b.’s loft where i sleep. i hoped some of his intelligence would emanate in my direction as we slept, but the fact that I am writing this sentence right now probably proves that it didn’t. the hospital has also been hosting weekly seminars on islam, and it has been very interesting to compare the african-christian perspectives on islam with the arab-muslim and other perspectives we got in the middle east when I was studying there. this week peter and isaac left. they were the medical students that I spent basically every waking hour of the the last month with - in casualty, pediatrics, various trips to maasailand and nairobi, and playing copious amounts of settlers of catan and basketball with. i’m going to miss you guys.

research

i thought i’d write a little bit about the research I’m doing, as some of you might be interested. only read if you are. we are looking at the incidence of post-operative infection in children who have had a shunt inserted for the treatment of hydrocephalus. hydrocephalus is caused by a blockage of the normal circulation of the cerebrospinal fluid (csf; the clear fluid that bathes your brain and spinal cord) - it causes increased pressure on the brain which must be relieved. a hole is drilled in the skull, and another one made into the peritoneum (the cavity in which all your organs reside). a tube is then shoved under the skin, with the help of a blunt metal stick, from hole to hole. one end of the tube ends up in a ventricle of the brain, while the other end drains the excess csf into the peritoneum, where it is resorbed by the body. this is called a ventriculoperitoneal shunt (vps). a doctor who was here before me compiled a bunch of information into a spreadsheet, so we thought it would be rather easy to just figure out how many of the patients had developed shunt infections after their surgery. we decided to define shunt infections as csf infections exclusively, because other infections such as wound infections can be caused by a number of factors other than surgery. we also decided not to include patients who have had spina bifida as well, because these patients all would have had another surgery to close the meningocele (neural sack) on their back, which greatly exposes the csf, leading to much greater chance of infection. normally there wouldn’t be very many cases of spina bifida in relation to hydrocephalus, but because kijabe is a pediatric neural referral center, about half of the hydrocephalus cases here also have had spina bifida. most kids with spina bifida end up getting hydrocephalus - this could be because they have were born with (congenital) central nervous system issues, or because their csf is exposed to infection (because of the defect on their back), which can cause hydrocephalus.

the study includes about 300 cases. what we didn’t realize until after I had written up the paper and everything was that about half of the patients had insufficient follow-up, which we decided should be at least 9 months after their surgery. you can’t really say that you have an infection rate of x% if you don’t even have any information for half of the patients. any critic would just say that it is possible that all the patients that were unaccounted for had shunt infections. this is probably more likely to be the case in africa than in the west. in the west someone would take their child to the hospital if they got sick after an operation. but because many of the children here live sometimes days journeys from the hospital and often have no means of transportation or financial resources, combined with the fact that there are large families living at home who would have to be neglected if the parents had to make the long trip to the hospital, if the child gets an infection they often die and are forgotten. of course, probably most of the patients who don’t come back for follow-up are doing fine, but we have no way of definitively knowing that. there can also be a stigma associated with hydrocephalus here that causes parents to neglect these kids - there are even stories of communities burying alive children with hydrocephalus during times of drought to try to appease their animist gods.

so i had to go about trying to gather more information on these patients. I searched an electronic database that the hospital has, and found some extra information. then I had to pull the charts from the medical records room of the ones who still had insufficient follow-up and look through those for more information that may have been missed. then, i made up a little questionnaire form with some questions about the patient and their phone number, if i could find it, and had nurses call the family to see if the child is still alive and if they have ever gotten a shunt infection. everything seems to be a logistical challenge in africa though. for some reason that I do not understand many of the kids don’t share their parent’s last name. a lot of the patient’s records didn’t have phone numbers. many of the ones that did didn’t work, because most people in kenya just use cell phones, and there is a lot of number turnover. also, there was post-election violence here a few years ago and many people were displaced from their homes so are not able to be contacted because they still live in internally displaced people (idp) camps or have resettled somewhere else. additionally, many of the people who come to the kijabe hospital are somali refugees and don’t speak kiswahili, or have moved back to somalia where they can’t be reached. many of the kenyans are from remote areas and belong to tribes that don’t speak kiswahili. i probably would have called it quits there, but dr. bransford wanted to find more of the patients. the more we find the more viable the results will be. so, we split up all the files of the ones we couldn’t get ahold of into tribes and towns throughout the country, and are trying to get a loose coalition of chaplains throughout the country who are associated with the hospital to go out into their communities and find these people. hopefully this works, although you can probably imagine the difficulties inherent in trying to get someone to get someone else to conscript some other people to go find some other people and ask them some questions… in africa. we’ll see how it goes.

maasailand and matatu rides

on thursday we went to another mobile clinic an hour and a half away in maasailand. the maasai are a tribe that raise livestock and essentially subsist exclusively off meat, blood and milk. apparently this diet contains everything needed for good health, as they consistently live to be over 100 years old. they live in makeshift homes of sticks and mud that they pack up and move around when their livestock need some fresh grass. they also stretch their earlobes out as far as possible with progressively larger loops - some have earlobes that dangle so low that they hang them over the top of their ears to keep them from getting in the way! they also always wear a lot of red. the boss on the clinic trip was a dr. thor - a large, very high decibel, door slamming (not because he’s angry, but because that’s just the way he is) kind of guy. he also falls asleep at every opportunity. he is really cool. we saw some interesting cases; a lot of malnourished kids and some with rampant iss (medical code in kenya for hiv/aids). i also got to inject an elderly lady in the buttock with some pain medication (i know that probably doesn‘t sound too appealing, but it was my first injection and it got my adrenaline going!), and I learned how to find someone’s blood pressure the old-fashioned way - with a stethoscope, hand pump and stopwatch.

the next day I went with peter and isaac (the medical students from chicago) to the home of a really nice maasai guy named givan to kill and eat a goat. after arguing for about an hour on the way there with the sneaky but persuasive car driver about how much the trip should cost, we finally reached an impass and he offered to let me drive, maybe just to try to appease us. it was great fun, heading out across the savannah, shifting with the left hand, not allowed to slow down because the dust on the ground was so deep that we would get stuck if we drove too slow. when we got to the “village” (3 houses), the maasai folks let all their goats out of the pens, and we watched/”herded” them for a while. then we drank some chai (tea) that was made from the fresh goats milk. almost as good as chai with cows milk. we then selected a goat. when they kill it they hold it down, basically dissect its entire neck while its still alive, and then cut its corotid artery and collect the blood (to drink fresh). then they hang it from a tree and open er up. when they found the kidneys the little children got all excited and immediately ate them raw! we roasted the meat over a tiny little fire (some of it got cooked) and ate it in its entirety. well, us and the millions of flies, and all the random maasai folks that showed up after they must have smelled the dead goat. either that or someone called them on their cell phones, which they all remarkably seem to have tucked under their robes somewhere. needless to say, we ingested a lot of protein, and undoubtedly a lot of other random creepy crawlers that live in raw meat too. what couldn’t be roasted, like the lungs and stomach (including far more than necessary of its partially digested contents), were thrown into a pot to be boiled and then we ate that too. this meat eating saga lasted the entire day, and it was truly epic. and considering that the only side effect was above average toilet paper use for the next few days, it was definitely worth it!

next day we took a matatu (small van that serves as public transportation) into nairobi. they are extremely overcrowded - people sitting on laps, in the 8 inch wide "isles", etc.. and hanging off the back bumper too. each matatu has a name - like "jawbreaker", "the last ride you'll ever take" and "jesus of nazareth is the king of kings and lord of lords". they are known for being almost entirely responsible for kenya's position at the top of the list of road accident deaths per capita - all the doctors in the hospital have stories of times when there were matatu accidents and the casualty was flooding with dozens of trauma cases in the middle of the night - presumably these dozens were all stuffed into (or on top of) one matatu when it crashed. but actually the trip wasn't too stressful - in fact i think i'm going to start using them as much as possible! we went with a kenyan intern who took us to the craft market downtown. we were solicited for our money (which i don't even have) so much and so heavily that i almost lost my mind. this is one thing i don't like about it here - have they never seen a white person before? (i know they have). has it ever crossed their mind that i might be more likely to buy their stuff if i could actually look at it rather than their frantic face 3 inches from mine, making sure again and again that i understand they they have the best deal in the city (which they most assuredly don't). and then when you try to leave they grab your arm and you literally have to run faster than them and never go back. forgive me, i rant. we then went to a restaurant called the carnivore, which serves crocodile and ostrich meat, but unfortunately their grill was closed so we ate burgers. we would have stayed until it opened later on, but apparently there is a significant risk of getting carjacked after dark on the road down to kijabe, so we wanted to catch the last matatu home before sunset.

tiny babies and huge giraffes

the last few days I have been in the nursery, which is a nice place to be! most of the babies there were born premature. the biggest thing for the babies seems to be increasing their food intake at the right rate - a lot of them have to be fed through ng tubes because they haven’t developed their sucking reflex yet. we can test for this reflex by putting our little finger in their mouth! also, a big problem for many of them is hyperbilirubinemia, which, long but physiologically fascinating story short, is treated by putting the baby under uv light. so the whole room is full of all these tiny babies in their incubators of sorts being bathed in blue uv light. the only drawback of the nursery is that they keep it very warm for the babies, but it’s a little too warm for an adult after you've been in there for a couple hours. the best part is that whenever there is a c-section they call us and we get to go and when the baby gets out, stimulate it and make sure its crying, and cut its umbilical cord off. I have also spent the last few evenings (as opposed to all-nighters) in the emergency room, which continues to be exhilarating in the fullest sense of the word.

if you are so inclined, you could pray for some people. anabel is a little girl who got burns over most of her body from boiling water. peter is a little guy who came into the e.r. last night (after being hit by a truck) and hasn’t become conscious yet. and there is a baby in the nursery whose mother is only 13 years old - she was raped by a family member :(

in other news, on friday night I went with peter and isaac to a classic african pentcostal worship service at the hospital chapel. then we went for tea at one of the kenyan intern’s place - turns out he is a undercover celebrity in the kenyan christian music scene, and does concerts around the country when he’s not on call. very nice (to be pronounced with borat accent, just for fun :) ) music videos! then on saturday we went to lake naivasha, which is about an hour up the road. we got a guy to come pick us up with his car, but when we saw it we wondered if it was going to make it. sure enough, as soon as the driver sat down, his entire seat broke off and fell into my lap. so eventually we stopped on the side of the road and get someone to weld the seat back on before carrying on. we went to this wildlife preserve called crescent island - although its not really an island because lake naivasha has basically dried up because kenya is experiencing a drought right now. anyways, there were giraffes, wildebeast, zebras and antelopes all over, and we could walk amongst them and even chase them (to try to get as close as possible)! perhaps nothing is more exciting than running right behind a giraffe - their legs are so long and they gallop so gracefully that it literally seems like everything is in slow motion!! you have to try it i guess. i climbed into an aardvark hole but I needed help getting out because I got stuck. we spent most of the time looking for a python but it was obviously hiding in the one place on the island we didn’t look. it was a good day. we’ve also been playing copious amounts of basketball just up the road at the rift valley academy boarding school (which, as some of you may know, is where my mother grew up and also was a teacher for many years!). from there one can look out over the great rift valley - truly a beautiful sight.

rural clinic

yesterday was an exhilarating day. i went with some doctors and medical students to a rural clinic about an hour away on very bumpy roads. many of the patients didn't even speak kiswahili, so their concerns had to be translated into that and then into english. luckily there weren't that many to see and we had all day, so there was no rush. it was great because we talked out every case in depth. the clinic was a little dispensory out in the middle of nowhere, and they only had a few drugs there, so thats all that could be prescribed. most people wouldn't have the means to travel anywhere else for healthcare. so invariably what ends up happening is that the few types of medicine there are just end up getting prescribed for almost everything, mostly just to treat the symptoms rather than the cause of the problem; this is called "jungle medicine" and unfortunately its the best that most africans get. they served us lunch there too which was delicious. then my two med student friends from chicago and i went over to this school that was there and dozens of little kids immediately vacated their classrooms (who knew where the teachers were), and crowded around us cheering and obviously about as excited as kids can get, presumably because we were white and and wearing white doctor coats. so we hung out there for a while.

that night one of the med students was to man the e.r. all night, so i stayed up with him. exhilarating. it was quite busy and all kinds of stuff happened. i learned how to take a complete history and i handled one young man who came into the e.r. from start to end! (it wasn't too serious). i even wrote him a "doctor's note" (he had no idea i wasn't a doctor :) ). we also got called to confirm a death on the ward; i got to peel back the guy's cold, stiff eyelids to see if he was really dead by seeing how his pupils reacted to light. then later we actually watched a lady die :( lots of interesting people seem to arrive in the middle of the night, like a masai woman with the huge necklaces, ear loop thingies and uncovered breasts who casually sauntered in with a baby with a huge growth on its head after walking for who knows how long to get here. and a case of hemorroids that was bad enough to warrant a visit to the emergency room in the middle of the night. i think i'm going to spend more time in the e.r.!

other than that there have been a slew of surgeries relating to an appendage unique to males that i have been watching during the day, some of them a whole lot more invasive than one might ever want to imagine. on saturday i went into nairobi with the doctor i am staying with's son and some of his friends and ate some delectable njera b'wat (if you don't know what i'm talking about you should find your local ethiopian restaurant and patronize it asap!) also, i am doing some research for the doctor regarding infection rates after hydrocephalus shunt insertions. the whole research dealio is a bit tedious to say the least, but hopefully if successful it will stoke my medical school applications a little bit. more importantly, it may also help the organization that provides the surgeries to convince the governments of neighboring countries that they should allow them in because their post-operative infection rates are so low, as currently there are a lot of kids suffering more than they need to in some east african countries because they aren't getting the operations they need.

the wonderful world of medicine!

i'm in kenya now, and have been kept very busy at the kijabe hospital! i'm staying with a pediatric neurosurgeon who is a old friend of my mom, and it has been great! i'll be here for the next 3 months, learning as much as i can about medicine. every day we head down to the hospital at 6:30 am, and do the rounds of the patients he will be operating on that day (often about 10 - he's an extremely busy man!). most of the kids have spina bifida, hydrocephalus or both. you should read the wikipedia articles on those if by some remote chance you're interested. but briefly, spina bifida is when the neural tube fails to properly close during development, allowing the spinal cord to grow abnormally and often outside of the body, often resulting in some or a lot of paralysis. and hydrocephalus is when the cerebrospinal fluid that lubricates the brain and spinal cord is blocked from circulating properly, putting a lot of pressure on the brain, which causes problems. and because baby's cranial bones are so soft, this pressure causes their entire skull to expand, often to extreme extremes, especially if they aren't brought for help soon enough. very sad. so, the doctor i am with does surgeries to deal with these problems, although often damage control is all that can be done. i have been in the operating room watching a lot of these and helping out when i can. also, thankfully the hospital is rather relaxed in terms of letting me get involved where i can, so i have watched some other surgeries and with cleaning some gnarly wounds, abcesses and burns, etc. in the recovery room. their are about a trillion acronyms or more in the medical world, so it has obviously been a huge learning curve sometimes even following what is going on. but it is very gratifying when one of the acronyms, disorders, procedures or drugs that i have managed to remember is used in conversation. i'm really looking forward to learning more and eventually becoming a doctor who knows what he is doing. also, the hospital is a training hospital - both for kenyan medical students and a few 4th year american medical students who are doing an international rotation. so i have spent considerable time with them as well, lately on the paediatrics (kids) team. they do rounds of their ward every morning with a "real doctor", looking at each of their patients and talking out the latest information on the status of the kids and treatment plans, and they have been kind enough to let me join them. it is nice because even though they are obviously a lot further along than i am they are still learning. they also share some interesting info (they are all really nice people). for example, i just learned that rickets (soft bones in kids) never used to be a problem in kenya, though now it is. it has finally been discovered that the cause of this is that the governent has been promoting a type of mixed grain flour that actually reacts with breastmilk in such a way that kids don't get enough calcium, which can cause rickets. so the moral of the story is - if there is a problem then it was probably caused by government. just kidding... well only sort of, haha. in this context the moral of the story is to make sure to tell the mothers with kids with stunted development who come into this maternal care clinic which is onsite (another place i have been hanging out with some of the interns) that they should avoid this type of flour even though the government tells them it is the healthiest (it actually is once the kid is done breastfeeding). fascinating. all the kenyans (at the hospital) speak english, although sometimes their accents are so foreign to me that i think they are speaking swahili, which is always a little embarrasing if they happened to be talking to me. just takes some getting used to. there is also a free kenyan lunch four days a week for the interns that i have been going to, followed by a technical lecture on a medical issue of note. needless to say my brain hurts a little from all the stimulus, as well as my feet from being on them all day basically without ever sitting down. but i'm getting used to it, and enjoying it thoroughly. honestly its like i've landed on a totally different planet, and have to learn a new language and way of doing things. but such is the beauty of life!