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.

Tour of St. Mary's Mission Hospital - Rift Valley Part 2 and 3

Sunsets

Because we were 20km south of the Equator the days and nights were consistently around 12 hours per day without any seasonal variation. We ate dinner at 7PM everyday just as the sun was setting and left to round in the hospital every morning around 6:30 as dawn was breaking. Our first evening as we were heading to dinner was our initial experience with the breathtaking sunsets outside our bedroom window that we would see all month. Sunset over Lake Elementaita with flamingoes and pelicans in the background - just gorgeous.

View from the Guesthouse

After arriving to our room in the St. Mary's Rift Valley guesthouse we were instantly amazed at our breathtaking view from our own bedroom. The whole medical complex and our guesthouse was bordered by Lake Elementaita, a salty, alkaline lake that is home to thousands of flamingoes (that eat the algae) and pelicans (that eat the tilapia in the lake). These pictures are from our first evening.

Rift Valley

After arriving in Nairobi (we flew from St. Louis to Detroit to Amsterdam to Nairobi) we spent one night in the St. Mary's Nairobi Mission Hospital and then headed out to the Rift Valley along Kenya's main highway. The Rift Valley is where the oldest prehistoric man remains were found and although the pictures make it appear like a desert, it's actually not (the dry season from January to April makes it appear quite dry). The prominent mountain in the distance is Mount Longenot, an ancient dormant volcano.

Our visit to Kenya

Last year we were both awarded through the Mayo International Health Program stipends to visit Kenya for a one-month rotation in international health. We were very fortunate to visit and rotate through the St. Mary's Mission Hospital in Rift Valley Province in Kenya from March 2nd through March 26th. Under the mentorship of Dr. Father Bill Fryda (a Mayo alumnus) we had a wonderful experience practicing medicine in the inpatient men's ward and participated in a cutaneous leishmaniasis clinical trial through outreach clinics. With a wonderful mix of hard work, and even harder play, we were very fortunate to experience a life-changing month of practicing medicine in a country of friendly people, gorgeous scenery, and limited resources. We treated patients with AIDS and TB, malaria and buffalo attacks, car trauma and sickle cell, heart failure and hepatitis, and much more. We delivered babies, were in the OR, and rounded on our own when Dr. Fryda was gone. We hiked, went on safari, shopped, and went horseback riding. We saw lions, cheetahs, zebrahs, elephants, hippos, crocodiles, giraffes, gazelle, buffalo, white rhinos, flamingoes, baboons, warthogs, and so much more. And although we were sad to return and leave all the wonderful people and sights along the way, the lure of family and smell of cheeseburgers made us realize how much we miss home. And of course one of us (I won't name any names) missed Mishti (our cat) too much to stay in Kenya any longer. We are happy to be home but highly recommend anyone to visit Kenya - the first time you see a lion eating a water buffalo in the savannah, you'll understand why it had such an awesome effect on us.

Welcome everyone! Jenny and I have created a blog to let our friends and family follow our life and adventures. Since our wedding on August 4th, 2007 (which really feels like it was the other day) we've enjoyed our new life together and hope this "honeymoon phase" continues until eternity. As Jenny finishes her second year of internal medicine residency and I look to start our lives in Durham, North Carolina we look forward with a sense of optimism that together we can accomplish anything.