what's in a name?

i have been given now 2 names while here in kenya. in lwala, which is home to many luo people, i have been dubbed 'akoth', which means 'one who arrived in the rain.' this is because it was raining when i arrived in lwala, and so now i introduce myself as erin akoth.

a second name was given while visiting the maasai mara for christmas. a new and fast friend, robin, has close ties with several families in communities throughout the mara, near the ngong hills. she graciously invited me to join her for a holiday visit to her kenyan family, and i am so so thankful for the opportunity. her maasai name, neiserian, means 'one who brings peace'. beautiful. robin and i have a mutual friend, brenda, who actually introduced us via e-mail. it so happens that robin and brenda met in kenya during an intensive course in kiswahili (swahili) and subsequent internship. and brenda was also invited to the mara to meet robin's family. so, when robin neiserian introduced me as brenda nahmunyahk's friend, i also became nahmunyahk, which means 'blessed one.' this could not be closer to the truth :)

we really had a wonderful time on the mara. the festivity! a goat from the herd was slaughtered for the occasion, which is a very big deal, since meat is prepared perhaps 7 times during a year. other occasions which warrant such meals include weddings, births, circumcisions, and birthdays. there were several generations present, from a 3 month old baby, to older adults who couldn't recall their age or year of birth, and as a geriatric specialist, i would NOT attribute this to dementia or alzheimer's, honestly.

we were welcomed into the fold so so warmly, and i promptly made myself useful peeling potatoes, cutting carrots and tomatoes, sorting rice, and making a traditional bread treat, chipates. i wasn't involved in goat prep, but this was okay :) cooking is a social event. in a place where there is no electricity, cooking is over a fire. outside or inside. with many people, predominantly women, preparing the meal. and chatting, laughing, chiding the children. i can't speak or understand kiswahili or maasai, so i try to interpret body language. sometimes i may be right, most times i am probably wrong. so i am weaving my own fairy tale for you here.

and then there is the landscape. of course, i had my eyes peeled to sight a twiga (giraffe), but alas, i don't have maasai eyes and have not yet learned how to scan the horizon and see the vibrance that is there. i took many many photos of acacia trees, and the ngong hills nearby, and the desert clouds. but alas, no twigas.

however, on the way out today in the back of an open-air matatu (shared ride on the back of a truck! totally awesome!) i was riding beside a maasai friend of robin's, samuel, who knows how to look at his surroundings and see what's there. he knew i was keeping all senses out for giraffes, and i even made up a song about twigas. so, when he casually said, 'there are some giraffes, there' i nearly tackled him in my eagerness to see what he saw. at first, i couldn't see what he was looking at. he laughed and said 'there are 4' and i replied - sassily - 'there are 4 freakin' giraffes and i can't see a single one?!' and kept looking. finally FINALLY i did see what he saw. several slender tawny necks rising from the tree cover, far in the distance, but the silhouette was unmistakable. twigas!

back in nairobi, where robin lives and works for a great organization, free the children. heading back to lwala tomorrow for more holiday and soccer festivities there! and, of course, the nature of my time here, scoping out the clinic there for capacity-building opportunities. i am having a richly rewarding time in kenya. spent the day with a community health worker volunteer on tuesday, making the 'rounds' to various households (many of which are traditional mud huts with thatched roofs, being spiffed up for the holidays with a fresh 'smearing' of mud) to converse with people about their ARV therapy and adherence, as well as answering their questions. this is where i am having the most fun, hitting the street (well, dirt path trodden by many hooves and feet) for health and wellness. so much interaction here, people are so friendly and everyone we pass has a warm greeting and handshake. i am glad to be part of the community, names and everything.

lwala

i am here. today is my second day at the clinic. i was launched right into the realm and happy chaos of clinical care here yesterday, including a manual dilation&vacuum and lipectomy. wasn't expecting either throughout my time here, much less on the first day. truth be told, i actually began to feel fainty (sweaty, cold, nauseated) during the gyn procedure, perhaps partially owing to the nature of the procedure and the patient writhing in pain, limited airflow in the procedure area, it's hot here, and i was just arrived the day before. excuses, excuses...maybe i'll do better next time?

i should provide some more info about how i arrived from nairobi. i traveled via matatu, or shared bus, along with several other passengers and all of our assorted luggage. i, of course, took up the most space with baggage. i offered to buy an extra ticket for my bags, which would have been an additional 700 kenya shillings (less than usa $10). but it was 'not necessary' according to the driver, and before long we were on our way, out of nairobi and into the rift valley.

the rift valley. stunning. expanse of low vegetation and innumerable herds of sheep, goats, cows, and a few donkeys. i believe i sighted as well a zebra (a real zebra!). either that or a rather clever donkey masquerading as such. and some gazelles or impala. clearly, i have yet to master my 'east african wildlife' guide.

the ride was hot and dusty, i don't think i've been so graced with dirt since my mongolia days. i feel right at home, however, though bathing last night was one of life's greatest pleasures. my arrival in kisii, a larger town near lwala, was smooth, i was escorted into a protected waiting area with a very nice woman who was responsible for selling matatu tickets to passengers bound for nairobi. i tried my best to assist her, but my swahili is lacking, and now that i am in lwala, we are using luo, which is different from swahili, so i suppose it's okay that i didn't learn much before arriving?!

i was retrieved from kisii in the lwala ambulance, by boi the driver and another clinician whose name i can't spell. i used to be very very good with names, but this skill is fading, sadly. i'll get back to you. anyway, i rode in the front of the landcruiser as we made our way from kisii to the dirt road leading to lwala. we were escorted by a rainstorm, which made tremendous rivers of runoff along the roadside. it was impressive! arriving in lwala, we found it hadn't rained here, so we weren't sure people believed us when we told them about the weather. so, my lwala name in luo means 'one who arrived in the rain' (again, i'll have to get back to you, as my memory is a sieve). i've been told that people here are named according to the weather conditions during their birth.

i have wonderful accomodations in the home of the ochieng' family, very close to the clinic. saraa and dada are our hostesses, and cooks, and assistants...and everything. the food is fabulous. lots of local fresh greens, beef, and a white substance that is made from maize, i believe (?) and requires special cooking skills as it starts off looking like flour but when cooked more resembles porrige. it's great. and filling. we eat without utensils, i am practicing my dexterity skills, but once again hunger is a powerful motivator, and as i learned very rapidly to eat with chopsticks this summer in china, so i have learned to maneuver my own fingers to feed myself.

i am writing from the clinic, and eager to return to my post with the nurses, rose and vine, and admire their skills and work at the clinic. so i'll sign off for now. BUT here are some phone numbers to reach me:

the phone i share with alice, another volunteer: (254 - country code - double check...) 0725 084 630

phone for the clinic manager, omondi: 254 0712 724 263

on the eve of arrival in KENYA!

i am in africa. it's true!

have spent the day mostly sleeping, truth be told. my flight napping en route from jfk to cairo was interrupted by a passenger who may have been having a heart attack, and i was woken from uncomfortable contorted sleep by an overhead page for any 'physicians.' well. i marched right up to the flight attendants anyway and introduced myself as a nurse. there was another passenger as well, a head&neck cancer surgeon, who was helpful and knowledgeable. the passenger in question was stable throughout the rest of the flight, managed with oxygen. i now know that there are oxygen canisters on flights for just such occasions, and a fairly well-stocked med kit on-board too, although we had the flight attendants make another overhead page for aspirin (NOT tylenol) and some other people came along with nitroglycerin as well. i have learned never again to travel without my own personal professional awesome littman cardiology stethoscope and blood pressure cuff in carry-on luggage, as the ones on the plane were horrible and we couldn't hear anything with the scope and i think the cuff was not at all accurate. in any case we avoided needing to do chest compressions at 35,000 feet and tried to encourage the passenger to seek medical attention as soon as we landed. i hope this worked, he attributed his symptoms to 'something he ate'.

i, on the other hand, made a beeline to the pyramids at giza as soon as i landed. literally 15 minutes after landing i was in a cab, after exchanging currency and pleading my case for a transit visa stamp with egyptian customs. off i went, to the pyramids, through cairo at high speed (mom, really, drivers overseas make my vehicle operation skills appear tame, perhaps even sedate!!) taking in the sights of mosques, ancient historical ruins intermingled with modern day structures. we crossed the nile (the NILE!!!) which is stunning in its own right.

as soon as i caught sight of the pyramids in the distance, though, from the city, i was entranced. and that was that, i had arrived. but really, i hadn't yet, and the driver i hired for the day deposited me with some horseback tour guides. which meant that i was a horseback tourist. it's been a while since i've been in the saddle, but i hopped astride an equine friend, aida and off we went, circumnavigating the massive wall and fence that outline the pyramid site. there are few entrances, all of which are guarded scrupulously by 'the government' as my guide told me, and people charging admission. i did receive a student discount for admission, however :)

pyramids. they are phenomenal. gorgeous. breathtaking. there you are, in the sahara, aloft a horse while listening to the haunting call to worship from the minarets of cairo's mosques while looking at one of the most stunning historical accomplishments of civilization. ever. chilling amidst the afternoon desert sun.

one of my favorite scenes the whole day, though fleeting, was a flock of birds on the wing, alight over the ruins of a mosque at sunset in old cairo. nothing at the market could even come close to the pyramids or birds. certain female family members will have to wait for their egyptian treats (!!) and i'll have to decide which ones you will receive. but the pyramids. incredible.

i shared a nice meal with the driver, which included some scrumptous baba ganoush and grilled mutton. i managed to decline baklava at the bakery across the street from the restaurant, shockingly. there was still more traveling and those treats don't always sit as well as one would wish.

back to the airport to catch my flight to nairobi via khartoum. i was sitting alone, reading 'cherry ames, mountaineer nurse' (thanks, eden!!) when some very kindly and curious flight attendants from kenya airways joined me in the waiting area. they greeted me and started a conversation. now, being an introvert, and somewhat disoriented by jetlag, i wasn't sure how conversational i could be. but it wasn't a problem. these folks were so pleasant they carried the whole thing themselves, looking eagerly at my kenya travel map with me and pointing out their hometowns and asking me about my trip, which of course i could talk about at length. it was a nice start to a nice flight. kenya airways has bumped korean air from the top spot of my airway choices, for comfort and courtesy. and they have safari animals on their salt, pepper, tea, sugar, and creamer packets, as well as safari-themed pillowcases (one of which made it into my personal bag...) for the airplane pillows!

never imagined i'd land in sudan, but there i was at 3 am, on a darkened airfield in khartoum. couldn't see much, and slept through the takeoff. woke next for breakfast and a sunrise over kenya at about 5:30. the mountains caught the young pink light just right. we landed at about 6:45, and walked off the plane onto the tarmac en route to the entry hall. the warm sun was all i needed to know that i was here, and here for a happy while. visa acquisition and luggage retrieval were atypically painless, for which i am eternally grateful.

tomorrow i take off for kisii, a town near lwala, in a shared minibus, or matatu. perhaps there will be some livestock passengers! i will haul myself and my luggage (which was NOT over the weight limit for air travel, thank goodness, i dared not think what i would have to do with all of the donated medical supplies else) to the small rural community i will call home and family for the next month. i think i am caught up on sleep, nice long nap today, ready for bed again now. i have no worries. i am here, i am in africa. i am content and at peace :)

prepared for heartache on the eve of departure

somehow this week is almost over, and with it, another flurry of final assignments for the semester. i have vivid recollections of physical and academic discomfort while pumping out nearly 40 pages in the last few days, but this has all been vastly overshadowed by the fact that tomorrow is 12/12, which means i finally get to go to africa!

i've never been to africa. it seems like i should have been there many times by now, but somehow it hasn't happened yet. i think part of my reluctance (yes, i'll acknowledge reluctance) is that i i feared looking desperation in the face. feared it, not for the people living it, but for myself. i think i have been waiting for this perception to change, and at last, it has. i am finally prepared for africa to break my heart, but i willingly await this because i want to dedicate my life - personal and professional - to looking desperation in the face...and then doing something about it.

this elusive 'something' may take a while for me to define. in a tangible sense, i have nursing skills to offer. i still have trouble identifying myself as a clinician, but apparently i do indeed fall into that category. and introverted though i am, i still love people...i love to be with them, learn about&from them, find companionship with them. this doesn't change depending on where i am, i don't think.

of course, i am thrilled about the possibility of observing african animals in their natural environment! giraffes would be the top of my list, very closely followed by elephants, and cheetas. i plan to digest my 'bradt guide to east african wildlife' while in the air tomorrow! and perhaps brush up on (= learn...) swahili.

i'm ready.

dapple

Gerard Manley Hopkins (1844–89). Poems. 1918.

13. Pied Beauty

GLORY be to God for dappled things—
For skies of couple-colour as a brinded cow;
For rose-moles all in stipple upon trout that swim;
Fresh-firecoal chestnut-falls; finches’ wings;
Landscape plotted and pieced—fold, fallow, and plough;
And áll trádes, their gear and tackle and trim.

All things counter, original, spare, strange;
Whatever is fickle, freckled (who knows how?)
With swift, slow; sweet, sour; adazzle, dim;
He fathers-forth whose beauty is past change:
Praise him.

vermont to kenya: preparing for lwala

well, i didn't wander far this weekend. just north to my vermont home. it's beautiful right now, as always, but a special charm with the trees crowned with color. my purpose this weekend was to attend the screening of a movie called 'sons of lwala', a documentary of the genesis of a clinic in rural western kenya, in a small village called lwala, initiated by 2 brothers in a family of 6 children to commemorate their father's dream of building a place where his neighbors could receive health care. the brothers, milton and fred ochieng', are dartmouth alums and are both pursuing/finished with medical education at vanderbilt. in their 'spare' time during med school, they have been trotting the globe, literally, to campaign and fundraise to make their vision a reality. and so, the movie tells of their dramatic and passionate journeys, both literal and figurative, hither and yon.

i met milton and fred yesterday, along with their eldest sibling, omondi, who is visiting the usa for the first time, in honor of attending the movie screening. their 2 sisters, grace and florence, were also in attendance, along with the youngest sibling, solomon. this is the first time the siblings have been together since their father's death. both of their parents are deceased, from AIDS, which is prevalent in lwala as it is in many parts of kenya and africa. estimates of up to 30% of the population have HIV in their bodies. this is a lot of people. no one in the community is unaffected.

so, why this topic as an entry today? well, i am planning a visit to lwala from mid-december to mid-january to volunteer at the clinic as a nurse. finally having practical, portable skills is something new for me, a new adventure in travel, of perhaps being actually useful. there will be a lot of learning - mostly mine, i am certain - while i am there, overwhelming to be sure, with up to 100 patient visits per day at the clinic. the village itself is ~1500 people, but the catchment area has expanded to include ~50,000. this is perhaps because the lwala community clinic is the 'only game in town', so to speak, for miles. people arrive by foot, bicycle ambulance (mattresses strapped to the bike), wheelbarrows, livestock...

my hope in all of this is to do some good, get on the ground in lwala, and LOOK. SEE. FEEL. community assessment has been formalized throughout my public health and nursing education, and now i am going to press myself into service and see what i know. i also hope that this will be the first of many visits to lwala, i am looking for something to dedicate my energy and passion toward for a long term commitment. this could be it.

southern roots

 
 
 
 

southern roots

many probably already know this but i was born in atlanta, georgia. i spent the wee years of my life as a southern babe. this by default precludes me from native vermonter status, which requires that you (and your 7 previous family generations) all be born on green mountain soil. so. i found myself in the south once again this weekend to celebrate the marriage of a peace corps friend, allyson (who in my mind wins the tough cookie award having endured many difficult and random issues in mongolia, including her ger burning down), to her longtime sweetheart pearce (who i hadn't met until the wedding and now of whom i heartily approve), at gorgeous neverland farm near cumberland GA. i arrived in SC and drove, in the dark, to north georgia and became very very lost en route while navigating with a miniscule mapquest image and didn't arrive at my lodgings until 2 am. but i was greeted sweetly by angie, another peace corps pal, with whom i stayed at the black bear lodge, after her coaxing and encouraging me on my fleetingly battery powered mobile phone which did not receive or send signals very well in the mountains. we slept well that night and started our next day in the hot tub at our cabin! i could probably handle that kind of start to each day. saturday was mellow, including biscuits and gravy (!!) for breakfast at a local diner - talk about southern comfort - and a pedicure in the small town of helen, which is apparently the oktoberfest capitol of the state with permanent german-motif alcohol facilities everywhere. i arrived too late in the week to partake in the pre-wedding activities, which included a hillbilly golf tournament, karaoke, and polka dancing. and so, i am heading north again, so quickly after seeing such dear friends. i am blogging on my phone from the greenville-spartanburg airport in greer, SC, fortunate to have snatched the very last seat on a northbound plane after arriving at the check-in desk and learning the flight i needed had been moved to 11 am instead of 3:30 without my knowledge. ah, adventure american-style...

black sea and sea of marmara