Costa Rica 2011

Six years in the making, as Afrin prepares to graduate medical school and become "Dr." Afrin Kamal, my brother Robin, his wife Fahmeedah, and Jenny and I took our little sister to Costa Rica from April 16 - April 24 to celebrate the wonderful achievement. Four doctors and one future doctor set out to explore the rainforests, cloud forests, volcanoes, and beaches of this wonderful country - and we weren't disappointed. For many of us, the repelling down the 210 foot waterfall, zip lining 1 Km over the cloud forest in Monteverde, white water rafting in Manuel Antonio, snorkeling at Playa Baesanz, hiking at night avoiding the Fer-de-Lance (most poisonous snake in Costa Rica) that we almost stepped on, and horseback riding along Arinal Volcano, were first-ever experiences. Our hunger for red snapper and mango daquiris was fulfilled; a new appreciation for nachos was acquired. And of course, none of us can forget the rocking waves that took our snorkeling equipment, the too-close-for-comfort iguana while sleeping on the beach, Afrin's negotiating prowess in the tourist trap markets, and finding the elusive sloth one of the last days in Costa Rica - without a guide! For Jenny and I, it was our "leopard" (the only animal of the Big Five in Kenya we didn't see) and we were elated to stumble across two (!) on the way down to the beach. Wonderful memories of family, adventure, and food!

Junior Suite - Issimo Suites, Manuel Antonio

A surprise upgrade to the junior suite (which we almost uninentionally argued out of when she told us about the "change in the room") with jungle and ocean view while laying in our bed. On the Pacific Ocean and facing west, we saw great sunsets in the evening and heard howler monkeys (which are quite loud) in the morning as our wakeup call (whatever happened to roosters?). The beach was a 7 minute walk down the hill, and being a boutique hotel with only 12 rooms (with all three of our suites right next to each other), felt like we had a little home away from home.

Horseback riding in Arinal

For Robin, Afrin, and Fahmeedah, their first time horseback riding. Although it was our second time and felt more adventurous, the horses didn't seem to respond to our motivations to go "faster" - we were warned they were lazy, but wow!

Birds

Crested guans, toucans, hummingbirds, the (very rare) purplish-backed quail dove (pictured) and other random birds seen around our chalet and during hikes.

Macaw

The resident Macaw at the Arinal Lodge - certainly the apex bird for miles around and the apex predator during the (human) breakfast buffet. She watched over us as the walked from the chalet down to breakfast and then dined with us in the morning. Though she was used to humans, both Afrin and Fahmeedah learned not to get too close.

Scenery of Costa Rica

We traversed many types of ecosystems in Costa Rica - from the valleys and highlands of the Arinal (volcano) region to the cloud forest of Monteverde to the rainforest and beaches of Manuel Antonio. This picture is from our hotel room at the Issimo Suites in Manuel Antonio overlooking the bay at sunset.

Animals of Costa Rica

Through several days of hiking on the rainforest canopy floor and in the hanging bridges in Arinal and Monteverde we saw several species of migratory and native birds, insects, and mammals. Shown are pictures of the Quetzal (elusive, mythical bird of the central American rainforests), orange-kneed tarantula, hummingbirds, howler monkeys, spider monkeys, macaws, white-nosed coati, toucans, crocodiles, frogs, and lizards. We save several giant blue butterflies in the rainforest, which are hard to see, but only got pictures of their wings closed, a less-than-brilliant camouflaged brown.

Nana and Nani

My nana and nani are my maternal grandparents and the patriarch and matriarch of our collective family as we grew up. During our summer vacations in Bangladesh we spent most of our time at our nana and nani's house and their living room became the central social point for all the family to meet over snacks and tea in the early evening. During our recent trip we spent most of our nights at our nana and nani's house. My nana's pride and joy is his rooftop garden which consists of mango and guava trees, jasmine flowers, and many other flowers and vegetables.

Family

After 11 long years we got to catch up with our family in Dhaka including maternal grandparents, paternal grandmother, aunts and uncles on both sides, and five cousins. Everyone was very excited to meet the new member of the family (Jenny), sometimes even more excited than seeing Arif. They had heard many wonderful things prior to our visit and took to her as if she had belonged to our family for longer than the two years we have been married.

Scenery

On safari, van top open, driving through herds of zebras and gazelle, looking for lions and elephants, the view all around...

Friends Along the Way

We met several people at St. Mary's who made our time in Kenya so enjoyable. We will never forget their hospitality, help in acclimating to living away from home, and friendliness to total strangers from halfway across the world.

Children of Kenya

Through our outreach leishmaniasis clinic we had the wonderful chance to meet a lot of Kenya's people, including many children. For many, we were the first "mzungu" (white person) that they had met and most seemed enthralled by our light(er) skin and Jenny's blond hair. Kenyan children were by far the most well-behaved, disciplined, and stoic children we had ever met. Jenny would draw their blood and we never saw one child cry or even wince during this process. Sometimes because of the work we were doing the children were asked to wait quietly on a bench for a few hours - and to our surprise - did this without making a peep. For children that have so little, are commonly malnourished, and consider potable water as a luxury, their resilience is inspiring.

Rhinos

Rhinos are the hardest of the "Big Five" to find on safari and are only in a few protected parks. We saw these white rhinos in Lake Nakuru Park and were very lucky in that this pair essentially walked right up to our van. Rhinos are the second largest land mammals to elephants and are usually loners except during the mating season.

Dr. Father Bill Fryda

Dr. Fryda was kind enough to host us during our trip to St. Mary's Hospital. A Mayo internal medicine residency and hematology fellowship alumnus, Father Fryda attended seminary school after fellowship and felt a calling to help the needy in Tanzania. After almost 30 years of hard work and moving to Kenya, Father Fryda has been credited with designing, starting, and executing the cost-efficient model on both Nairobi and Rift Valley campuses. He is the man behind the mission.

Kampi Turkana

Michelle Leroux, a Canadian ex-pat, kindly let us join her randomized, placebo-controlled, double-blind clinical trial of ketoconazole for 28 days in treating cutaneous leishmaniasis. For this we went to two villages, Kampi Turkana and Gitare, to enroll patients, draw LFT's and HIV, distribute medications, and record findings. This study included a Kenyan dermatologist, a clinical officer, Michelle, and ourselves. Our travels really took us into the bush as we saw the most rural parts of Kenya. For many, we were the first white persons (yes, they included Arif as being white as well) they had ever seen. The need for water (it was deep into the dry season) and lack of plumbing certainly did not dampen their spirits as Kenyans will always remain some of the nicest people we have ever met. We certainly learned a lot - mostly having to do nothing with medicine.

P.S. "Kampi" means "place" in the Turkana language and "Turkana" is the name of the tribe that mostly inhabits the northern parts of Kenya. They had been displaced in the tribal clashes of December 2007 and were waiting for government authorization to permanently live on this land.

Gitare Village

Gitare is a small village around Gilgil (the nearest town to us) where we also setup the mobile cutaneous leishmaniasis clinical trial enrollment center. We borrowed a classroom from the school principal and triaged people into our study. We filmed our experiences there including the fun the children had seeing themselves on video.

Pelicans on Lake Nakuru

Buffalo in Lake Nakuru Park

Baboons

On our drive from Nairobi to Lake Elementaita was saw baboons on the side of the highway, during which Seth (our driver) asked "Don't you have baboons in the states?". I guess he could see our astonished faces when we saw them. We saw this baboon family as soon as we entered Lake Nakuru National Park.

Hippos

On our second day in the Mara we too a full day for game drives and travelled to the Mara Triangle, stepped into the Serengeti in Tanzania, and visited the hippo pools on the Mara River. There, with the protection of Kenyan police (because of how territorial hippos are), we hiked out onto where the wildebeast cross the river during the Great Migration, saw Nile crocodiles, and several hippos. The hippos bathe during the day and graze at night. You can hear the loud grunts they make in this video.




Oh, and in case you wonder how they protect their babies from the crocodiles (which are really their only predator), I've included a picture of a hippo skull to show how large their teeth actually are. They are known to bite a crocodile in half if it gets close to a baby, and couple that with their territorial instincts and ability to run on land up to 25km/hr, they can be a menace.

Maasai Giraffe

During our safaris we saw reticulated and Maasai giraffe. The Maasai giraffe we saw tended to be in small packs (with the occasional lone one) and were extremely curious with our presence, often just watching us as intently as we were watching them. Adult giraffe have no real predators as their extremely strong kick can deter any lion. Giraffe were plenty in both Lake Nakurui Park and the Maasai Mara.

Lions with a kill (buffalo)

On our second morning on Mara safari we came across two young, male lions with a fresh kill. The buffalo smelled something ferocious. Typically male lions don't hunt but these young ones had been banished from the local pride to go start their own and had cooperated on this kill. As one ate rump meat the other watched out (for something we were never really sure of). These lions stayed with this kill for the next 2 days, never leaving its side but never actually finishing it either. Alongside the lions were jackals, hyenas, and vultures in the trees waiting to swoop in when the lions were done.

Meals

Kenyan meals typically consist of fresh vegetables and meat (typically beef, occasionally goat, lamb, or chicken, and rarely pork) cooked in stews. Staples include rice, chapati (Indian flat bread), and ungali (a bland porridge made of corn flour). Vegetables are typically potatoes, peas, greens, carrots, cabbage, and beans. Cheese, tomato sauce, and fresh salads are hardly ever served. Kenyans also don't have much of a sweet tooth so finding dessert (outside of fresh-cut mango) in the guesthouse or even in a nice restaurant was an impossible feat. Overall the food was good and more importantly, very good for you.

Horseback riding to Lake Elementaita

One weekend we ventured to the Lake Elementaita Lodge (a lodge on the lake for tourists) to grab a Sunday brunch and go horseback riding down to the lake. We were surprised as they brought us retired thoroughbreds which had competed (and won) some Kenyan derbies. Our guides led us down to the lake where we saw several flamingoes and pelicans up close and we finished the day with a nice brunch and laying out by the pool.

Elephants

On our first game drive (while looking for lions) we ran into a herd of elephants. Led by the dominant male in the front, females and babies in the middle, and the lesser dominant male flanking behind, this herd was heading off to find a new savannah to graze. Elephants prefer the taller grass compared to the zebras, impalas, and gazelle which prefer ankle high or less grass to graze.

Sarova Mara Tented Camp - Maasai Mara

Jenny and I went on a 4-day, 3-night safari to the Maasai Mara, the largest protected game reserve in Kenya that runs contiguous with the Serengeti in Tanzania to the direct south. We stayed at the Sarova Mara tented camp, which by Mara standards was certainly luxurious, as we weren't sure that sleeping on dirt floors and not having hot water was the experience we wanted. But you certainly can find that if you want. The whole tented camp is based around game drives as meals are late to allow for people on safari to get back after morning and evening excursions. We got massages, sat by the pool, had really really good buffet-style food, and listened to birds as we fell asleep. Around our front porch was a family of baboons and a warthog that would visit the salt lick. And a sound we heard at night that we thought were only buffalo was actually the call of the elusive leopard. And although we saw leopard prints and heard the leopard call, we never did see one. Oh well, it leaves us a reason to visit again!

Cheetah and babies!

One of the true highlights of our trip to Kenya was hearing rumor of a cheetah and then starting on an hour-long quest to find her. Julius, our guide, had eyes like a hawk and found this mother and her two babies sitting under a small tree. She was understandably skittish by our presence which is why we had to stalk her from a distance with our van. The babies were quite young as their spots were only on their legs. Cheetah litters normally have 4-6 babies and the somewhat laid-back approach she took to mothering (as evidenced by the increasing distances she would allow between herself and her babies who tried to keep up) suggested to Julius that she had lost her others to lions or baboons. It was certainly one of the most exciting things we had ever seen!

Honeymooning Lions

We encountered on our first evening in the Maasai Mara two exhausted male and female lions who were taking a break from their "courtship". As we were leaving they resumed their "affection" and we decided to leave them to their privacy. There are 22 prides of lions in the Mara and one that lives close to the Sarova Lodge by Seekanani gate where we were. By the video you can tell that the lions don't mind us being around (as they're asleep most of the time anyway) and can easily disappear into the savannah if they feel they're being bothered.

The Guesthouse and Our Room

The guesthouse provides temporary housing for foreign visitors to the hospital and family members of patients who need a place to stay. It includes several bedrooms, a common area, and kitchen and dining area. Peter, our host and cook in the guesthouse, provided us with meals three times a day and the guesthouse provided us with amazing 360 degree views of Lake Elementaita to the west, the bluffs along the north, the mountains along the east, and the Sleeping Maasai (hill formation) to the south.

Tour of St. Mary's Mission Hospital - Rift Valley Part 1

St. Mary's Mission Hospital on the edge of Lake Elementaita in Rift Valley opened in late 2007 as a sister hospital to the original St. Mary's in Nairobi. In addition to extensive outpatient services, the hospital has a men's, women's, and children's ward for inpatients and facilities for basic radiology and surgery. Employees including physicians live on-site and all share ownership of the venture. Patients come from all over Rift Valley Province, are sometimes transferred from the Provincial Hospital in Nakuru, and are often brought emergently after frequent motor vehicle accidents on the neighboring highway. A cost-efficient, Kenyan-own and Kenyan-run hospital, St. Mary's is the new model of financially-viable, high quality healthcare in East Africa.

We recorded a walking tour of the complex from the front entrance to the guesthouse in the back.