Revisionist History

It’s been 22 days since I first got here and freaked out after my IPOD touch went missing. On that day I thought I could stay here maybe 2 weeks at most. As the power went out for days at a time, as I woke up over and over in the middle of the night covered with the little bugs that make it through the mosquito net-I wondered how I was going to make it. Humor and lots of emails from the US is what helped me make it. I never realized how much of an impact the blog would have - so many people I don’t even know have contacted me to say they have been reading it and wishing me luck. To be honest with you, I felt more like a documentarian here than a doctor. I just had to soak in and understand what was going on around me so I didn’t go completely bonkers.



On 10-29, at 8am east coast time I will be on a flight back to Nairobi where I will be staying at a tent hostel called the Wildebeest. From there I leave Nairobi for the Massai Mara which is, in many native Kenyans opinions the most beautiful part of Kenya. It’s filled with lions, elephants, hippos, rhinos , giraffes and everything you can want-all getting killed and eaten-and I will capture it all in glorious 1080p high-def. Picture Planet Earth but with my goofy commentary as a wildebeest is chewed up by lions.

After that, I return back to the US, but the fun and the life of the Kenya blog WILL NOT STOP THEN! I literally have a list of topics to cover still on my computer! Also, remember how I said I would be arrested if I brought a camera to Kisumu? I went ahead and did it anyway and went to all the same places I went last time, taking over 100 photos while dodging bullets like Neo. These photos will be used to enhance already existing entries.

Also I have shot HOURS of awesome videos. Want to see a Vervet monkey dance? Want to see me teach the Orphans to sing? Want to see me teach a whole class of 8^th graders about HIV and anarchy? Want to see actual improv comedy monologues I made while I waited at the airport? Wait until I get back! I have over 17gb of pics and videos to sort through and edit and upload to streaming video sites and you’ll see it FIRST on the Medical MacGuyver blog. I almost feel bad at how little of the story is just in the text - you have to have the pics and videos to get the whole thing and it’s coming! Keep the blog bookmarked and check it frequently.

I’m going to have radio silence while I am on safari, but will be back in Memphis Nov 2^nd. Want to know the first thing I do when I get back to the states? I guess you’ll have to keep checking the blog!

Oh yeah, and you’ll get more swahili translations!

Hard lessons in Swahili-Thumper get away from that man in the white apron! NOOOOOOO!

Nyama ya sungura ni nyororo na tamu

Rabbit meat is tender and sweet (that rhymes!)

Red Ribbon Revival

Yesterday was a really special day for me. I got to go on home visits to HIV patients with the CCC (comprehensive care center). Maseno Mission hospital is the cornerstone of HIV awareness, prevention, and treatment within a 25 KM radius. What this organization does it truly remarkable considering how prevalent HIV is here. The CCC has a daily clinic where they take care of just HIV patients and get them to understand and take their medications. For those that are known to have HIV but aren’t doing well or perhaps haven’t shown up for their appointments, the workers go on house calls. Many of these workers walk all day to get to these places to check on their patients - it’s just like how medicine was practiced in the old days.

My guide on my long hike yesterday has a truly amazing story. Her name is Praxidis and she herself has HIV and Tuberculosis. Around the year 2000, she became very ill but rather than go to the doctor, she basically gave up on her life and prepared to die. She thought she was infertile and couldn’t have children. She turned to God for guidance and she was told that she had a purpose to be alive.



So, she went to the hospital and was tested for HIV in 2003. She was positive and was suffering from numerous complications related to her HIV. She found Dr. Hardison at Maseno Mission hospital as she was in end stage AIDS. This was before the CCCs existence. Dr. Hardison took her in and found antiretrovirals for her to take and over time, she practically came back from the dead. As she got on antiretrovirals she also got another big surprise - a pregnancy. She was scared like many here that her baby was doomed to have HIV, but Dr. Hardison helped her through this and gave her and the baby the best chance of making it through the pregnancy safe. Sure enough, both of her 2 children she has are HIV free.

She considers herself so blessed to be alive, she has dedicated her whole life around giving those who have given up hope like she once did, a second chance to turn their life around. This is why she walks 15 miles or more to visit HIV patients in their homes that have thrown in the towel. She has an infectious optimism and indestructible faith and she knows it’s her mission from God to spread it like wildfire . Even with her currently struggling with pulmonary tuberculosis and having already failed first line therapy, she still does these long hikes into the country to share her message of hope and faith.

I approached her the day before yesterday and told her I wanted to go on the hike to do the home visits with her. The CCC nurses looked at me and my spare tire and laughed. “It’s going to be a long way and it’s going to be hot”. I laughed right back at them and told them I can do it. The next day I geared up like Rambo for the hike - bringing water, snacks, sunblock, and most importantly – toilet paper (there’re no bathrooms where we are going). I tried to dress as inconspicuously as possible to not draw attention to myself... do you think I was successful?



We started our hike to Luwanda town - a much larger town than Maseno located several miles away. Along the way, she told me how she adopted a blind, neglected HIV positive child named Sophie (who I have helped take of while she was in the hospital) and now Sophie is doing well in her school for the blind. She said the education of her 3 children is her top priority because if something happened to her, they would have no one to take care of them. She wanted to fuel them up with as much education as possible so they could be successful if something terrible would happen.



Along the way, we passed under this banner for a good ole’ fashion tent revival. As I look up at it and snap the above picture, she turns to me and asks me “Are you a Christian?” I nervously laugh and tell her “well, I grew up catholic...”. She saw right through it like scotch tape, “well, are you now?” I replied with a negative and braced myself for her preaching, but she didn’t criticize me and when I stated some of the reasons I don’t agree with religion (namely the money-making nature), she agreed completely. She told me she had seen the prophet coming to speak several years ago and that was his message, that the churches have become too focused on the money and not the message. You could even take home a DVD of the sermon, available for sale on site :)

We proceed to enter Luanda town, which is a stark contrast from Maseno. The shops of Maseno are shacks composed of tree branches and tin roofs - the shops of Luanda town are made of concrete and you can actually walk into these buildings. There were paved roads and tons of road traffic and just many more people buzzing around everywhere. Praxidis was practically a celebrity here, as we move through the crowd, she’s pointing to people and telling me they are her clients (meaning they are HIV positive) - let’s see you try to get away with that in the US. As we go through the markets, we meet with another aid worker who comes with Praxidis and helps her find the locations of her clients. She also was wearing an ironic T-shirt, so I got her picture.



From Luanda town square, we proceed to get away from the paved roads and head into the sweeping country surrounding the town. There I see some of the most beautiful landscapes I have seen since I have been to Kenya. Under the clear blue sky, the rows of maize went on forever, herds of cattle mulched on the rolling hills cut by the now mostly dormant railroad. It was a breathtaking sight.

As we went house to house visiting the CCC patients who were either too sick to make it or have stopped becoming compliant, one thing really struck me. Most of these houses are the same - poured concrete with a roof made of stick supports and tin. Not a single house was wired for electricity or had running water. As we continued on our tour of the countryside, the houses stayed relatively the same, but the situations worsened. Toward the end, we went to a household where a woman was breastfeeding her baby.

Praxidis explained her story. She has 4 kids, 3 of them in the 4th grade (the older ones keep failing and repeating the grade). Her husband is gone during the day and only sometimes shows up at night - she has no idea where he goes. He does not help her raise the children. He refuses to be tested for HIV or wear condoms (which is a common occurrence here in Kenya, many of the men chose to remain on the down low). Her children have no food and are going to school hungry. She is breastfeeding her baby longer than the recommended 6 months for HIV patients because her baby has no other food - even though it might mean the baby may get HIV. Her tin roof was filled with holes which allow the rains to flood her small home. The small concrete house is probably 15x10 feet and house 5 people - 6 when her husband comes home. How can someone like this escape their situation when the odds are so stacked against them?



Undaunted, we went from house to house, at each place checking their HIV and TB medication to make sure they were taking it right and setting up appointments at the CCC clinic for those that needed closer follow up. After talking to the quail farmer (I talk about him in the food entry), we went to another house in the rural country. I learned something really interesting there. It seems that nzungu (white people) are considered good luck in the area where I am in... but in more rural places like where we were going, white people have NEVER been seen, so the children freak out. When we went to one house, I found this out first hand, all of the children started screaming and crying and ran/crawled away at top speed! I have a few pictures of this below.

Also, on the way back we came across a primary school (recognizable because the kids where wearing the typical blue and yellow school uniforms). As I came by I hear the usual “nzungu!” cry and they all ran up to the barbed wire fence to take a look at me. Recognizing the opportunity I missed while I was at the Orphan program, I tried to teach them to dance as quickly as I could. I instructed them to put one foot out and bend it at the knee. At the same time, lean back and move that extended foot like you are putting out a cigarette. In the US, this dance is known as the “stanky leg” and it was my goal to teach the children of Kenya this dance. I guess they didn’t know English though because not a single one of the 30+ kids followed my instructions through the fence - bummer-mission failed.



We hiked the whole countryside, coming across the quail farmer I talk about in the food entry. Once I feel like Praxidis and I are close enough, I ask her about Changaa and Bhang (moonshine and marijuana). She tells me that cannabis is grown in neighboring Uganda where it is less restricted and shipped here. Some folks in Luanda town grow it as well. The threat of police keeps it relatively low scale, but there is a small population of Rastafarians here. As we were leaving one client's house and I was talking about Bhang and how lots of people in the US use it, I hear reggae music in this distance and see the small shop where it is coming from. Praxidis’s friend walks up to the shop and I keep my distance, I ask Praxidis “what’s she doing?” She replies “she is seeing if they have Bhang they can show you”. I flip out completely, I don’t want to get arrested in Kenya - I’d never leave. Thankfully, they didn’t have any left but they showed us where we could get some down the street.

Are you ready for the real shocker? Guess how much a joint costs in Kenya-5 shillings! That’s less than 7 cents a joint! You can buy 15 joints for 1 US dollar. All you potheads should add on an additional ticket from Amsterdam to Kenya because bhang and changaa use isn’t heavily policed and you can smoke your brains out with maximum savings!

As we were going to Luanda town, I knew I had to get some money to pay for my rent here this month, so I found an ATM (there’s only 1 bank in the whole big town it seems). At least I felt comfortable getting money when the guards outside the ATM are carrying assault rifles. Walking back was extremely nerve racking carrying all this money, I did manage to get some obama gum but I also needed a way to protect myself. So, I did what any cautious citizen would do, I bought a pangaa (machete). Unfortunately, it comes in an unsharpened state, but Praxidis bought it with my money so I wouldn’t get charged the Nzungu (whitey or honkey) price. That’s a big reason of why I couldn’t live here, I would regularly get charged 4-5x more than everyone else since the prices are negotiable.

On the way back, it started to rain, so we got a matatu. In Kenya, there are 3 modes of public transport. Matatus are vans that you can (and regularly do) cram 10-15 people in that drive like a bat out of hell down the roads. There’re boda bodas which are bicycle taxis (you sit on the seat over the rear wheel and try to balance. Then there’s the piki piki which are motorcycle taxis. There’re no helmet laws here, so few people use a helmet on these bumpy dirt roads. Worse still, I have regularly seen entire families of 4 (which baby in the mother’s arms or sandwiched on the seat) on a single motorcycle. Considering the number of motorcycle accidents we see, if I could change 1 thing in Kenya, it would be to enforce helmet laws and maximum number of passenger laws.

Anyway, we took a matatu back and when we got in, they were blasting reggae music which made me wonder if they had some bhang or perhaps used it all before we got on. We hung on for dear life as they sped down the road and brought us closer to the hospital. As we walked back to the hospital, Praxidis showed me where the people in my village get changaa. About 200 yards from where we were walking, there was a banana plantation and several young men walking toward it carrying a sofa on their heads. “Those men are going to drink Changaa” she said “and they are bringing a sofa so they don’t have to stand”. She explained that the Changaa stand is hidden in the fields so that bystanders can not see what’s happening, but it’s common knowledge where to find them. Twenty shillings gets you 15 ML portion in a special commemorative Changaa shot glass (which I swear I saw for sale on QVC). It only takes about 2 doses until you are drunk and a few more until you are dead. We kept our distance from these guys, especially considering I was carrying a year’s salary in my pocket - Praxidis said the changaa boys regularly rob people.

As we made it back to the hospital, the rains picked up and I said bye to Praxidis and let her know more UT folks would be coming soon. The next day she helped me make a short video to let UT students know they are appreciated here and thanked me for my help. It was truly an amazing experience. I am in a time crunch, so no swahili translation in this entry, but look for double the swahili lessons in the next blog! I’m off to masai mara!

Beer Reviewed Article

Back on my birthday, I took this photo representing several of the Kenyan beers available here. I have tried nearly all of them and just wanted to say a few words about each of them in case you are at your favorite beer importer and need a recommendation. If you are one of those quitting “recovering alcoholics” I also have soda recommendations for you at the end... pansy.

More lagers than in a Canadian forest

So apparently Kenyans like the lagers, because all of them except the Guinness are lagers. The only one I don’t have pictured here is Whitecap, which is also a lager (and a good one at that), so porter lovers, black beer afficionados, wheat beer lovers, etc you are out of luck. Also, if you drink lite beer, you are out of luck (see food entry)

Allsopps

The cheapest of the batch pictured above also happens to be the one that tastes like Budweiser. This is not a compliment-it was the most watered down and my friends agreed.

Pilsner

Along with white cap are the oldest beers in Kenya although Pilsner is not anything to write home about, white cap has a better flavor overall and is available in a white and a dark lager.

Summit

Better than the Pilsner and Allsopps. I sat on the porch and drank this after a hard day, then went with David and climbed the mountain behind the house. It provided much more buzz than the other 2 and the flavor was much more smooth without aftertaste or being watered down.

Tusker

The most popular beer in Kenya and in my opinion-one of the best beers I’ve ever had. What makes this beer so good is that sugar and cornstarch are used in the brew as well as barley and hops. This beer is what kept me from pulling a Patrick after my IPOD was stolen.

Tusker malt-

Costs the same as regular tusker but you get 200ml less?!? The reason for its price increase is that it doesn’t have sugar or cornstarch. The flavor is excellent and a little bit stronger than regular Tusker, but I prefer the extra 200ml.

Guinness foreign extra

This ain’t your mama’s Guinness. I first had this in Dublin in January and enjoyed it greatly before the crushing disappointment of finding out it’s only available in Africa. Now that I am here, I really enjoyed this super-strength 6.5% alcohol version of Guinness. The flavor is much less peat-like than American Guinness, it has a darker head and can get you buzzed rather quickly.

Sodas

Only available in glass bottles in 300ml, 500ml, and 1L sizes (although you can get the bigger 2L in plastic in the grocery store). One way to get murdered in Kenya is if you walk off with your beer or soda bottle because each bottle is returned for a deposit by the seller. If you want to take home a bottle of beer, a bottle-fee is added to the price (I have been charged between 20-50 shillings for this-which may be as much as the drink) and it is refunded when you return the bottle.

The other day I was explaining the concept of the soda fountain and free refills to a Kenya native and they couldn’t really understand it-there are no soda fountains here and sure as hell no free refills.

Also, Pepsi has little to no presence here in Kenya and the market is saturated with Coke products. Top sellers are Fanta and regular coca-cola. It’s made with real sugar instead of high fructose corn syrup which is why many argue it tastes better here-but it also could be because a coke is like a birthday present to Kenyans and most can not afford to get it unless it is a special treat. Coke also makes a few other brands here in Kenya that aren’t available in the US. One is Krest bitter lemon-which is exactly as it says, a slightly tart lemon soda that is excellent. Stoney is even better, a ginger beer with a heavy amount of ginger-a very unique and excellent taste for sure.

Hard lessons in Swahili-Sounds like he had a “hard” time crossing the street!

Jogoo alikanyagwa na dereva wa lori

The cock was hit down by a motorist

The Good, the Bad, and the Ugali

“Let’s go out and get some Kenyan food tonight!” is probably not a phrase you have ever heard in your life. Kenyan food doesn’t have a large presence in America as far as I know. The funny thing is Ethiopian food is relatively common in America, and when a Kenyan wants to say someone looks starved, they say they look like an Ethiopian. So I am going to take you on a visual safari of a few of the basic Kenyan staples and since I’ve eaten all of these-I’ll let you know how they taste.

Ugali
Hands down the most commonly consumed food in this area and probably Kenya. Technically it is a super-thick bland porridge made from cornmeal. It reminds me of the clay mixture I used to make with cornstarch when I was a kid. Ugali is eaten with your hands and usually eaten with stews - the Ugali can soak up the gravy of the stew





Sikuma Wiki
The greens seen on the plate above are Sikuma Wiki, a local green commonly eaten as part of a traditional Kenyan meal. The flavor and texture is strange, it is a boiled green similar to mustard greens but it has a texture like a firm wet paper and a flavor similar to Kale. The other type of commonly eaten green is Cowpees (which said in Swahili sounds like you maybe got the wrong kind of milk). Cowpees has more of the flavor and texture of spinach and is boiled.

Other fruits/veggies
Certain crops we are used to getting in America are grown here but must pass several tests. Since electricity and thus refrigeration are not in most homes, the fruits/veggies must be hardy or be so plentiful that they can be sold and consumed quickly. Common produce include roma tomatoes-the most hardy tomato from a spoil point because it contains the least amount of water inside! Small purple onions, greens, dried maize, potatoes, avocados (which are only about 15-20 cents US here) bananas, and rarely pineapples (which are expensive). Maize dominates all the above and is the main crop along with red beans in this area. Red beans and maize stew is a common food used to feed massive amounts of people (it’s what we ate at the orphan program). Rice is also used here, but doesn’t grow in the region and is shipped from outside.



There’s chapati in my mouth and everyone’s invited!
One of my favorite foods Emmah our housekeeper makes is Chapati and lentils. Chapati is a type of fried flatbread with a somewhat oily texture and outstanding flavor. When covered with her lentil stew it’s absolutely dynamite. Chapatis are commonly eaten everywhere here, usually with boiled red or kidney beans to help soak up the gravy. Emmah’s recipe for chapatis is the following (makes 2 chapatis, so you will probably want to triple this recipe).
1 cup flour
¼ tsp salt
1/3 cup water
Mix the flour with salt and add water to make the dough-flatten the dough and spread oil on each side. Then roll the dough and cut into round flat pieces and pan fry them.





Meats (besides people)

Cows, chickens, and goats are found EVERYWHERE in Kenya. Many of the tribes in Kenya when they arrived here were herders of cattle - the Masai tribe being the most famous of them for stealing other tribe’s cattle and living on the blood of cows. Here herds of cows are seen walking down the side of the road and are often chomping on the grass a few feet from my front door. The hospital uses its native cows and chickens for an ever present source of milk and eggs. When you do need meat, you can do what we do and go to the Nakumatt (aka wal-mart) and get some meat, but only the white folks and rich people do that. The meat at the Nakumatt is prepackaged just like the kind you get in the store - the only difference is some of the meat - particularly chicken is MUCH smaller than the drumsticks you are used to getting at KFC and with far less meat. Score one for steroids and growth hormone injections! The majority of people end up getting their meat from roadside butchers (which I took plenty of pictures of). These small tin shacks usually have a hanging cow carcass hanging on a hook in front of you and the price is per kilo (about $1.40 US a pound). You tell the butcher how much you want and he brings out his trusty Panga (machete) and will cut off a piece of the cow-tendon, bone, and sinew and wrap it in newspaper. Small fish are also brought in from lake victoria and sold at market. Other meats besides goat, beef, and chicken are eaten as well.





While on our home visits today we came across a strange sight in the fields - a long flexible pole containing several wicker cages, each containing a quail. These poles were scattered in a roughly square shape and on the ground were a series of traps. I interviewed the land owner and he traps quails by using the calls of the caged quails to lure more quail into his area. Because quail do no fly very well, they walk on the ground to see what’s up and get stuck in the wooden traps on the ground. The farmer then sells the quails in the market for meat at 30 shillings each (about 40 cents US each).



There are not many restaurants that I have seen. Most of the small shops don’t have the capacity to be restaurants, so instead you might by some fried dough at one stand and some juice at another stand. The majority cook on their own, so eating out is a luxury in this economy. I have yet to see a single fast food restaurant since coming to Africa (although I have been in the sleepier part of Kenya).

Diet Nothing!
For somewhat obvious reasons, commercial foods you get in the supermarket actually have extra fats and calories over their American counterparts. Today, after 1 month, I finally found the only diet soda - Coke Light - which actually has about 70 calories! Foods are heavy in starch and calories and many things are corn (or maize) based because it grows well in this climate. Despite this, there are relatively few fat people here. The other day we had a patient that was 1 MU (or Memphis Unit-which is around 250 pounds, the average Memphis resident weight). The entire staff, including American Dr. Hardison, was scoffing at how fat this woman was and how could she let herself get like this. I have yet to this day, to find a man here that weighs as much as I (and I am not really that big), and have been declaring myself “the fattest man in western Kenya”.

British Invasion
Less than 50 years ago, this land was still the property of the Queen of England and they imported many of their customs, some of which still hold true today. At 10am, anyone that can afford to stops working and enjoys a hot cup of tea. Chai tea is the order of the day (which is tea with milk) and the tea field of Kenya are on the Western Province where I am located, so while I usually don’t like hot tea, the tea here is delicious and enjoyed by everyone.

Sweets
Most of the sweets in the area I am in are usually single biscuits or pieces of gum or candy. Most people are unable to afford the big tub of cookie dough or funfetti frosting you scarf while watching Julia Roberts movies by yourself on Friday night. Rather, many places sell single pieces of gum or small non-chocolate candies (chocolate melts too easily). After much searching, today I found the legendary “Obama gum” the gum with pictures of Obama all over it - available in Obama Orange and Obama Strawberry. Yesterday, while I was in Kisumu and talking with Ruth, a sarcastic worker at St. Philips theological college, about Obama and how so many people here claim to be related to Obama or be their neighbors or friends. When I asked her if she was related to Obama, she said “No, but I know what he tastes like.” I can only hope she was talking about the gum.



Breakfast
For me, breakfast is the same each day and includes the spread above, which is essentially black coffee and corn flakes every day. There’s also the dreaded wheatabix, which are whole wheat bricks resembling plywood and with similar flavor and consistency. There’s also bread and margarine with so much fat in it that it can be stored at room temperature without separating.



I left the supa-loaf out on the counter one day and it attracted a supa-fly
Look for another post about the drinks of Kenya!

Hard lessons in swahili-Where do babies come from?

Mayai yaliangua vifaranga sita

The eggs hatched into six children

Your Questions Answered

I asked for your questions about my Kenya trip and the response from both of you was overwhelming! I will take the time to selectively answer some of your questions - mainly the ones that do not implicate me in an international incident.

Have you learned things from a medical perspective that you would never have learned anywhere other than Kenya?

How to treat Malaria - nearly every patient is tested for it and almost all are positive. You have to deal with a high grade of ambiguity here, we only have an old xray machine and rudimentary ultrasound - preventative medicine is a bust here, but diabetes is rare and hypertension is much less common here. GI cancers are ridiculously common though.

Can you summarize the last month in one sentence? In one word? In one smell?

No

How truthful do you think you have been in your blog?

Are you calling me a liar? Sometimes when something is too strange to be true, it probably is. The material in my blog is very much true as experienced by me or read in good trustworthy sources.

What was your most difficult case?

I’ve seen some things here I probably won’t see in the US, but every case is difficult because of the cultural differences in medicine between here and the US - most folks here can’t afford to go to the doctor until it’s too late.

Are they using solar or wind to at least charge the smaller appliances like phones, flashlights etc?

Hahahahahaha, you realize that transistor radios are high tech here? Solar and wind technology isn’t used at all and the roadsides all pretty much have trash on the side of the roads. Since most people don’t even have electricity or running water, I feel they are a little away from that technology.

Are the Swahili translations for real? Are those all really from a kids book?

All of my translations from the same 40 page swahili kids book and I have only posted about 40% of the funny ones. I have the publisher info if you would like to get me a copy-you would be my hero.

and then the biggest question: Would you go back?

That’s the hardest question for me to answer. Folks are incredibly friendly, the landscape is beautiful, and the US dollar goes a long way in western kenya. Having to be locked in at night to avoid being murdered, being a constant novelty because I am white, being covered with bugs at night, fear of getting a disease or hurt and not having the facilities to treat it are all very real fears though. The fact that many of your patients are dying of problems that can be treated in the US is very hard. I would love to explore other parts of Kenya – especially Mombassa, but I probably wouldn’t do another medical mission trip here. I would probably go to a spanish speaking country next time - probably in South America.

Panga+Changaa+Bhang=instant murderer

This morning as I was getting ready for rounds, I ran into one of my favorite clinical officers: Francis who was on duty last night. I asked him what came in overnight and he said, “It was a night of Panga attacks - 3 different people came in with Panga injuries”. Now when you think of Panga attacks, you are probably thinking “aren’t they adorable and just eat bamboo?” Turns out that Pangas aren’t cuddly oversized bears, it’s the Swahili word for “machete”.

You see, the Kenyans appreciate a well manicured lawn like we do in the US, but the terrain is far too rocky and unpredictable to use a lawn mower (not like anyone could afford it anyway). The solution? People use what’s called “slashers” which are these hockey stick like blades (I have a video I will upload when I come back) and use a sweeping U-shaped movement with their arms to cut the grass. A Panga is used for the more stubborn jobs and cutting your veggies, so Pangas are sold in most stores and a LOT of people carry them on the their person.

If Kenya had a national celebrity other than Obama, it would be Changaa. Changaa has achieved a counter-culture rock star status like Marijuana has back at home. Everyone knows about it, knows where to get it, and many drink it despite it being illegal. I wish there was a way I could accurately describe what is in Changaa, but the truth is it is brewed differently everywhere in Kenya. Changaa is Kenyan moonshine, and as potent as rocket fuel and much more hazardous to your health. The main ingredient is whatever is on hand than can be fermented - in this area millet is used in the brewing of Changaa. From there, the ingredients can vary but often include formaldehyde and methanol (which is why Changaa is notorious for killing entire rooms of people or rendering them blind).

If the stuff is so dangerous, you may wonder why people drink it. The average employed Kenyan makes about 80 shillings a day, with some making as little as 50 shillings. One bottle of Tusker beer costs 100 shillings and it might take a few days pay to get you wasted. Changaa is so potent that a minuscule 1 or 2 shots will have most Kenyans doing the Pink Elephant walk and several doses of Changaa can be bought for 20 shillings or less. I have often asked folks here “where can I get some Changaa?”, and despite knowing where I can get it, the hospital employees are reluctant to tell me because they think I will get a bad batch with extra formaldehyde and die. It took a lot of asking until I found someone who either detested me or was annoyed with me asking so much that she told me where to get it. With its illegal status, as you can imagine there is no Changaa store, and in my area it is sold in a stand in the woods where they are not easily found. It’s like the lemonade stand from hell, where for 20 shillings (about a quarter in US money) you can get absolutely messed up out of your mind. Yesterday as I was walking through town, I noticed Sean Paul music being blasted in a house and when I walked by and showed my approval, the group of guys invited me in for Changaa and probably a good raping - I politely declined.

In my last entry, I talked a little bit about the death customs here, and this entry incorporates another one that involves Pangas and Changaa. Apparently, the members of the Luhya tribe practice a burial custom where they bury the deceased at night. During this funeral, heavy amounts of Changaa are consumed and there is almost no artificial light in this country and moon and starlight are similarly non-existent here - it’s that pitch black. It’s not uncommon with the couple of folks I interviewed about this to get drunk and settle your differences with the other funeral guests with Pangas - hacking them into pieces in complete darkness where witnesses despite being right near you may not get a good look at what’s happening.

Francis relayed a story to me that a friend of his was walking along the dirt road that leads to the Maseno Hospital (the same road I took my awesome sunset shots with Helen and David in my birthday post) around dusk/darkness. He was carrying a drum of cooking oil on his head (it is true that many people carry heavy objects by balancing it on their head). It started to rain, so the man took his jacket and placed it over his head and the cooking oil and continued walking down the road. Out of nowhere, someone jumps out from behind him and swings his Panga down on his head-splitting the jacket and the drum of cooking oil and what he initially thought were his brains running out of his head was the cooking oil the Panga buried in the drum.

If Changaa and Pangas weren’t bad enough, there’s one more thing to add into the equation that is guaranteed to make you into a homicidal maniac-and that’s Bhang. Like Changaa, Bhang is illegal but everyone knows where it grows and where to get it. Bhang is cannabis sativa (also known as Mary Jane, wacky tobacci, the sticky, bud, weed or marijuana for you drug fiends out there) and many folks I talked to believed that alone they can have some substantial effects-but when mixed Bhang, Changaa and Pangas turn even the most well behaved Christian into a lunatic death machine. I think the local churches have been buying up all the old copies of Reefer Madness and showing them like a documentary here if this is what the natives believe.

I find myself paralleling much of what e see here into what I have experienced in Memphis since I have been there. Mixing moonshine and machetes may seem like a relatively bad idea, but in Memphis in the past year, it has been made legal to conceal carry firearms into bars! I’m not sure if it has passed yet, but there were resolutions also being made to make it legal to carry firearms into churches. Sure, when I am particularly moved by a service, I can sometimes feel the Holy Spirit loosening the holster and removing the safety so I can squeeze off a few rounds of praise over my head and right into the Lord’s face. In all seriousness though - recently a doctor was murdered at a church in the US because he performed abortions. Having weapons available where people are emotional or inebriated is a bad idea, whether it be at church, a bar, or at drunken funeral in the dark. Rather than going to extremes and outright banning these things, I think it should be mandated that everyone be required to carry a drum of cooking oil on their heads. After all, an ounce of prevention is worth... something (I can’t remember the rest of the saying-I got a Panga haircut today).

Hard lessons in Swahili-this is what happens when you mix Changaa and Pangas

Pua yake ilikatwa na wezi

His nose was cut by thugs.

The Dirigible and the Dirge-less

What follows here is the tale of 2 deaths that occurred within a day of each other-rather than focus on how they died, I want to focus on what happened after they did and the contrast between them.

Every morning that I have been here I awake at the same time - almost to the minute. I don’t have an alarm clock or any time telling device at my bedside to help accomplish this either. The curtains in my room might as well be made of paper mache for their light filtering ability (and remember, besides water going straight down the toilet-dawn and dusk are at essentially the same time year-round. Rather than a lame radio DJ waking me up, I have the crow of the rooster-which acts like an alarm clock with a broken snooze button-I get my revenge on Saturdays. Greasy, delicious revenge with a side of mashed potatoes is on the menu!

Which reminds me, every day here is either a cow, chicken, or monkey day-meaning you will see a lot of one of these three any particular day Many of the hospital staff live in the houses within the hospital compound, and the entire hospital is single story and open air. This means that some stray animals can get in the ward, most notably-Ward Kitty. Monkeys are usually kept at bay by putting the patient’s leftover meals in buckets on stands outside-which acts as an effective garbage disposal as the monkeys dive in and chow down. Being here for several weeks, you get used to a very limited assortment of sounds-the crow of the rooster, the squeeking vervet monkeys, the mooing of a cow. Imagine my surprise when I heard drums, guitars, cymbals, and what sounded like the type of repetitive chanting you would hear at soccer game just outside the hospital while we were rounding. My curiosity was high, but rounds were lasting forever and I couldn’t go outside the gate and see what was happening in the street. It sounded like a parade, and I thought it could be that as this happened on 10-19, the day prior to Kenyatta day. Every time it sounded like the parade had faded though, it would come back minutes later. When I couldn’t take it anymore, I ran out of the ward, up to the house to get my new camcorder and ran out the gate to see just what was going on.

What I witnessed is hard to describe in words, hell even the video I shot of the event doesn’t do it justice. Maybe the picture below can help you imagine what it was like.

It looked just like this, except with darker skins, shirts, no turbans, and not in a cave-but otherwise the same thing.

What was outside was a group of mostly men and children and they were dancing/parading in the street and playing percussion, guitars, and other instruments and singing this one very uplifting verse over and over again. As I approached them, I wondered how they would take a Nzungu (whitey) with a video camera filming them. It was one of those things that could either be really good or bad, but as I approached the mob they gathered around me and since no one was speaking English and they were dancing furiously, I wasn’t sure what my presence meant. As they went by me, a child grabbed my pant leg and pointed ahead like she wanted me to join the parade. Turns out this parade is a Luo tribe tradition-during the formal funeral service, the parade served to guard the funeral that was ongoing on the hospital grounds.

Next to the morgue in the hospital, there was a funeral service being held around a white wooden casket. Thirty or so mourners were near the casket, but back about 40 feet on a balcony overlooking the service were probably 50 or so schoolchildren. The deceased was either an employee at Maseno School or a student-regardless, there was a mob of people for this funeral both inside and outside the hospital. After the service, the gate to the hospital was opened and the parade ran inside to help load the body into a MASSIVE Maseno School bus-which the whole crowd boarded-with people hanging off the side and on the roof like an Indian Train. One person on the parade route told me I had to go on the bus to where they were burying this person. I refused but he kept insisting, I had to tell him over and over again that the patients needed me and I couldn’t just grab onto the side of the bus and ride like everyone else. Later that evening, I talked with David and Helen about the experience-Helen and David learned when they were on home visits for HIV patients that a white person at a funeral or visiting just after someone dies is considered good luck.

This is Anne

Anne is one of the many patients of the Comprehensive Care Clinic (CCC) branch of the hospital that deals exclusively with HIV patients. Helen and David met Anne on their home visits which the CCC does weekly to check on their HIV patients without any way to make it to Maseno Hospitial. This involves the workers of the CCC walking miles on end to see these patients. I tried to go with the CCC this past friday on their home visits, but the distance was so far they were going to have to take a Peki Peki (a motorcycle taxi) and if I went with, they would charge a lot more because I am white-so I didn’t go. When Helen and David met Anne in her home, her family was preparing for her to die. She was extremely malnourished and cachetic-skin taunt against her protruding bones. The CCC employee told her she needs to be admitted to the hospital immediately. Her family was not oblivious to the situation-they stated they didn’t have enough money to pay for the hospital visit, so they were going to let her die at home.

I need to interject something very striking about health care in Kenya. There is a feeling of duty to pay for medical services here completely unlike the US. If you are sick in the US, you go to the hospital regardless if you can pay or not-but not in Kenya. We actually keep patients until they can pay their bills-and charge them daily until their bill is paid-this is standard practice at all hospitals here in Kenya-even the government hospitals.

Back to Anne’s story, David and Helen tell me about this woman at dinner and how her family was going to let her die at home because they couldn’t afford hospitalization. Imagine my shock when 2 days later-she’s here in our hospital on the wards. She was unable to swallow anything and when we did the chest x-ray she had milliary tuberculosis all through her lungs.

We put an NG tube down her and began feeding her aggressively to help gain back some of her strength and started her on anti-TB medications. Then something amazing happened, despite her wasted state and constantly frantic appearance (she didn’t talk), over the next 2 days she started to look better-she was getting plenty of calories. We have pulled folks with advanced AIDS from the brink, would this be another one saved just in time?

It turned out that it was not meant to be.

She died on the 3^rd day in the hospital, we tried hard to give her the best chance...but we lost her. Worse still, there was now a 5000 shilling hospital bill-converting this into US dollars-this came out to be around $66 US. Her family walked out from their home over 6 miles away and talked to me and Helen. They didn’t have enough money to pay the bill (as we already knew) and they wanted to know what they should do because the hospital wasn’t going to let them have her body for burial until they did pay. We as doctors (or more specifically volunteers-even Dr. Hardison is an unpaid volunteer) have no control over the finance department of the hospital and unfortunately the financial department was closed because she died on a Sunday. The family had to walk all the way back the next day.

In Kenya, there are no cemeteries. When you die, you are typically buried on the family land. If Anne’s family did manage to pay their bill and get Anne out of the morgue-she was going to be carried back to home-not in a huge Maseno school bus with scores of people-but carried overhead, 6 miles, back to her family’s land to be laid to rest where she was born-I didn’t see the family the next day-I don’t know if the bill was paid so they could take the body-I just hope she is finally able to get some rest in heaven.

Painful Lessons in Swahili

I have to side with Sade on this one-Yams are stronger than pride-c’mon, eat through the shame!

Alijivunia kula viazi vikuu

He was too proud to eat yams.

They had to make another death binder just for me

Revenge of the Witch Doctor’s Curse

Remember before I was telling you about Samson, the boy whose head I drained of about 400 mL of pus after he went to a witch doctor to get his headache cured.


To this day, we don’t know what happened when he went to the witch doctor and they cut on his head. When he left the hospital over a week ago, he looked great and felt great. I was surprised to see him back in the wards after an overnight admission. The report done by the clinical officer (which is a medical personnel that is trained to function like a M.D.) was not clear as far as the reason for admission. It turns out since Samson left, he has had 3 grand mal seizures for the first time in his life. When we looked at him yesterday, we saw papilledema in his eyes which means he has some increased intracranial pressure and was pressing on his optic nerves. In layman’s terms, he has something compressing is brain causing him to have seizures.

We stressed to the parents that he needed to go to Kisumu to get a CT scan (which is about 20-30 miles away) and they refused. Today poor Samson was seeing double and we were not going to let him sit around here without a diagnosis. We wrote transfer papers and discharged him, but it’s up to the parents now to bring him to the hospital. Dr. Hardison and I talked about this afterwards. Apparently it’s not uncommon for the family to say they will bring the patient to a higher level of care facility but end up taking them home. If Samson doesn’t get a CT and figure out what’s going on and get intervention, he could continue to have worsening seizures, lose his vision, or worse. We have no idea what the witch doctor did to Samson or what those 3 incisions on his head were from, but I pray he is able to undo the curse put on him.

Kenya Q+A

Greetings everyone! It’s my last full week here in Kenya so I wanted to open it up to a question and answer session about Kenya! The cybercafe is closed on Sunday, so it will be a few days before I answer the questions, but I will get to it and I will post the best questions right here in the blog! I miss you all and remember, feel free to call me (I am 7 hours ahead of those on the east coast). The best way seems to be skype (google voice’s quality was bad)-my number here is 0714 831 451 Please call me sometime, it would be great to hear from you!
Painful lessons in Swahili-the double entendre
Aliandaa mchuzi ulionoga


He prepared a tantalising sauce

The last one alive

Staying sane here is no easy task, especially since all visitors are locked in their house at night (and since we are on the equator-sunup and sundown occur at the same time every night). Getting through those nights here, Helen and David and I would have long chats over dinner before going to brave the bucket showers. When I first arrived here, I was jet lagged for a week and was going to sleep at 7:30-8pm Kenya time. Now that I have finally acclimated to the time change, I have been regularly staying up to 11pm or even into the next morning if I am writing a blog entry. David and I stayed up many of the nights in the last couple of weeks talking about the big picture of life. David has gone through numerous major career changes and huge life changes but he has always followed his heart. Unfortunately, this did not come without a very high cost to him-and I hope to feature a journal entry dedicated to him very soon. Helen left Weds to go back to San Diego and her next rotation. Helen was quite a bit different than David and I. First of all, she loved every aspect of being here-she didn’t care about the lack of electricity or running water, grocery stores, restaurants, or the general American life. She is planning on going into family medicine so that she can practice in 3rd world countries eventually. She jumped on learning Swahili when she arrived and at least knew a lot more phrases than I ever learned. She also got more personally involved with all the hospital staff and was going to the houses of the clergy and hospital staff. When she left, only the thought of going back to her husband helped her leave-people came to visit to say goodbye here and I could tell she didn’t want to leave. David on the other hand needed the same things I did-the ability to go out at night, utilities, not having to sleep under a claustrophobic mosquito net, etc. He was counting down the days until he could leave. Like myself, he had a great appreciation for Kenya’s natural beauty and fell in love with the kids here-but he reiterated over and over, there’s only so much suffering and injustice one can tolerate seeing. David worked like a dog while he was here, news that an ENT was in the area spread like wildfire and people came from all over to see him. He’s an excellent teacher and taught the staff many simple, sustainable ENT treatments for the common problems here. When he left yesterday (without anyone coming to say goodbye but me and Hardison) it was devastating for me, but this man belongs to the ocean. He can hear the surf from his house in Cape Cod and is an avid diver-the man needed salt water in his veins to be truly alive-and I hope he gets back in the water today as he arrives home. Last night was bad though, rather than write, I did the things I didn’t do because I was always up talking all night-watching mythbusters episodes and playing some Nintendo DS. Emmah, the housekeeper is still here, but she is a ghost here-barely talking to David or I (she would chat with Helen quite a bit) and keeping to her room. For the rest of the trip, I will be alone here in the house-just like in Memphis but this isn’t the same. While I now have a much larger bed (no more having to worry about getting up and smacking my head on the top bunk) and a small desk to type from, the only noise now comes from the multitude of roosters outside-Helen’s constant singing Swahili hymns and David’s chatter just an echo is the past now.
I miss them, I miss Bethany even more.

Painful Lessons in Swahili-this is why I can’t go out at night

Mlinzi wetu alipigwa hadi akafa na wezi


Our watchman was beaten to death by thieves

Obsidian from the blood of 10 million beggars (The Cull of Duty)

“Kenya will become a country of 10 millionaires and 10 million beggars” - member of parliament J.M Kariuki ‘s criticism of the Moi administration before he was arrested and found murdered a few weeks later-1975

October 20^th is a national holiday in Kenya and all the schools and businesses, including my priceless cybercafe were closed. The hospital of course, remained open to take patients. The holiday is Jomo Kenyatta day and celebrates the first Prime Minister/President of Kenya after it gained its independence from the British in 1963. This is one of 2 holidays in October celebrating past presidents, the other being Moi day on October 10^th. Now call me a cynic, but I happen to have this theory that if you have the same person on ALL of your currency, this is probably not the type of government that allows dissent. Of course, Kenya is not at all like that-there’s 2 men on the currency-Kenyatta and Moi (the first and second presidents respectively).

When I first was flying into Kisumu, I was given a newspaper with the days news on the plane. That morning on the way to the airport, the cab I was in was by a suspicious police blockade, and I was told to shut my mouth and stay low while they inspected our vehicle. I was already suspicious of the police here and the newspaper, although obviously favoring the sensationalism of your Sun or National Enquirer was filled with stories about senseless police brutality as seen in the headlines below.

Over time here in Maseno, I began to piece together the history of Kenya from its English speaking residents (both at the hospital and the nearby Maseno University). Keeping within my head the numerous tribes of Kenya (there are over 30-each with distinct culture and language) was difficult, understanding how the government operates was also difficult. I didn’t think much of it until I had a friend from Maseno University over for dinner (Jackson-the student from “a night at the opera”) we talked for hours about Kenya’s fragile political structure and how tribalism was being used to create the social strife necessary to keep the politicians in power. I had to know more from this point eventually dived into my own research, grabbing any books I can find with Kenya’s history and downloading wikipedia articles at the cybercafe to read later at home. What I will give you is a super quick summary of what I have learned of recent Kenyan history and why this is all very relevant to what I do every day here and draws considerable parallels to recent US history.

Kenya’s freedom from the British was the result of a long a bloody revolt in which the Kenyans actually lost. The Mau Mau Rebellion was started by the Land and Freedom Army, which itself was composed of Kenyan World War II veterans who were trained in guerrilla warfare after Vietnam-esque Jungle campaigns in Burma. The LFA were able to get a following since after so long being denied any rights in the government, having all their land given to foreign settlers, being heavily taxed, and even being required to carry passports in their own country to track their movements. While the rest of colonial Europe dissolved after World War II, Kenya was still tightly in the hands of the British and Kenyans were not given the same rights other allies in World War II had earned. Violent revolt was almost inevitable as Africans were denied seats in government and treated as worse than second hand citizens (slaves from India shipped in to work on the railroads had more freedoms and government power). Mau Mau was a terror campaign, small attacks on white settlers and pro-colonial Africans with a special emphasis on complete barbarism. The idea was to make the deaths so horrible that while 10 people die, 1000 people will be scared. Victims were decapitated, their genitals removed and scattered and displayed for others to see while the perpetrators (mainly the Kikuyu tribe) slipped back into the Jungles. Their fear campaign was so effective that British came in, declared a state of emergency, and began arresting suspected rebels or simply shooting you on sight if you were in a prohibited area with known rebels. The British eventually captured almost every Kikuyu (over 1 million) and put into internment camps, much like what we did with the Japanese during World War II to prevent sedition. Despite the elusive nature of the guerrillas, their leader was eventually captured by the British and executed-the Brits won the conflict and maintained an iron grip over Kenya for another 8 years.

The British control began to crack when the press learned that the internment camps never really stopped functioning after the Mau Mau conflict ended. A scandal of Guantamino bay proportions erupted at Hola detention camp where it became known that groups of prisoners were regularly being beaten to death by the British guards. The African Kenyan politicians before this time were already organized into something similar to the NAACP in the United states to help unite the tribes to gain rights in Kenya-but there was a large schism in these groups-radicals who wanted an independent Kenya and those who wanted the protection of the crown but without the restrictions I mentioned before. The radial tribes (mainly the Kikuyu and Luo) were the ones however responsible for the insurgency and held the playing cards to keep the British in fear of another large scale rebellion. Using this fear, politicians were able to gain seats and power in the Kenyan parliament and Jomo Kenyatta, a Nelson Mandella like figure who was able to inspire tremendous nationalism from his literary works he wrote while being in prison (ie Facing Mount Kenya) and after Kenya gained independence he quickly rose through the ranks to become the first prime minister (the queen was still technically the ruler) and eventually declared independence from the British in 1963 with Kenyatta as the first president.

Now getting back to my original point of why there is only Kenyatta and Moi on the currency, it actually makes a good deal of sense because there have only been 3 presidents since Kenya won its independence in 1963. Kenyatta, Moi, and the current president Kibaki. Moi was Kenyatta’s VP and succeeded him after his death, and Kibaki was Moi’s vice-president and succeeded him after Moi was president for 34 years! Open elections did not even happen until 1992 and prior to that Kenya had a single political party-the others being absorbed or made illegal outright.

Any good conspiracy theorist should be able to rattle off numerous conspiracies surrounding the World Bank and the IMF, but Kenya’s political sandbox is like a conspiracy theorist’s ultimate fantasy. Kenya was pressured by Western and European governments to become multi-party when the World bank and IMF threatened to denied Kenya money until they started other political parties and privatized their utilities and railroads. This ended up being a failed experiment as the single party was seen as necessary by the African founders to keep the 30+ tribes of Kenya from splintering off into their own parties to push their own interests. When the utilities were privatized, much of infrastructure was scrapped and left to rot, such as the case of the railway that used to run through this country. This privatization also lead to the telecom nightmare I have talked about numerous times - landlines are non-existent in more rural areas, and now numerous companies are all trying to get high speed internet wiring here, but without government involvement, the process has taken so long that the rest of the civilized world is several steps ahead in every area of technology.

While some commentators I have read consider Kenya to be a “stable” country compared to its African neighbors because they aren’t currently engaged in civil war and have political stability, I have serious problems with this statement. Kenya has too much political stability and far too much power in the office of the president. In fact, I was able to learn much about Kenyan political history in it’s post-colonial area in a relatively short time because so few people have been allowed to have power. Even the dissenters that managed to live long enough or not be jailed to cause any significant notice are extremely few and far between. A similar analog in US history is William Jennings Bryan or Eugene Debs who ran for president over and over on losing platforms. Once you lose once, why would people vote for you a second time? This is not true in Kenya, Raila Odinga and his father have been since the beginning the same “voices of dissent”, and Odinga got 3^rd place in the election in 2002 but ran again in 2007-this time getting 1^st place...yet the president right now is the incumbent Kibaki. Confused yet?

When I went to the orphan program last week and stood in front of that 8^th grade class, I asked and then pleaded over and over again what those kids would do to make their country better place. I wanted so badly in my heart to hear just one voice of hope in that class, and instead I was received dead silence. One child in the back said so quietly that few could hear him “Bring the people together and rise up and overthrow them ”. I was so shocked I walked up to him and foolishly asked him who “them” was...and was met with the same deafening silence and glares from the teachers. How could these kids be so quiet after the country was rocked the previous year from the 2007-2008 election?

Remember the shock the nation felt when Al Gore lost the election to George Bush? In the 2007 Presidential elections, the incumbent Kibaki was getting killed at the polls compared to Odinga and the polling stations reported a victory for Odinga and so did the news. Suddenly though, Kibaki jumps into a HUGE lead, the voting is stopped and Kibaki is immediately sworn in!!! The rub salt in the wounds, the US almost immediately calls and recognizes and legitimizes his win. A fury and brutality that had been brewing in the people of Kenya since the days of the Mau Mau was unleashed, their freedoms stolen like they were by the crown some 40 years before and the country exploded. Massive riots erupted in every major city when the results were released, the brutality of the Mau Mau had come full circle as the Kikuyu (Kibaki’s tribe-and those blamed for keeping the power, land, and fortune to themselves) were targeted for death. Kikuyu were locked in their homes and places of worship and burned alive. Any efforts for the people to organize and peacefully rally were met by riot police and Kibaki’s General Service Unit-a group of highly armed shock troopers which beat and murdered the protesters. Eight hundred people are killed in the brutality nationwide, and over half a million refugees are displaced from their homes and live in government settlements. Today I heard on the radio that the president considers these camps an “eyesore” and plans to displace all the refugees soon.

You might be asking yourself what this brief expository has anything to do with my trip to Kenya. It has everything to do with my trip to Kenya. I feel the same fear that many Kenyans do when the police come by with machine guns. Today, one of my patients had to sit for the Kenya equivalent of the SAT despite the fact he was in the hospital with a 40C fever (the test is only administered one day). To make sure he didn’t cheat, a guard armed with an assault rifle watched him as he took the test. This is not made up. In Maseno, order here is upheld by private security firms and occasional mob justice. In the rural communities of Kenya, witches are still burned alive and no one goes to jail for this.

Unemployment in Kenya is endemic, but the odds of escaping poverty here once already in it are nearly impossible. I have had numerous people here personally tell me that when they have applied for jobs that it is common practice to pay an “application fee” or bribe to even be considered for the job. This bribe is never any small amount either, usually 2-3 weeks pay for Kenyans (US $25-$50). Now imagine if you are educated, but poor and unemployed-there’s no way to ever climb the social ladder. The sad reality is people do what they can to earn pennies-they plant crops or live in the cities toxic garbage dumps sorting recycling. On the way to Kisumu, alongside the roads, you will see dozens of men sitting on a pile of small rocks chipping away day in and day out. These folks are hand carving gravel for roads and sit on their pile until it can be sold for a few shillings in an attempt to make a living. Meanwhile, at the current rate of inflation a coke and a loaf of bread cost more than what the employed Kenyan earns in a day.

The solution and the end of the 2007-2008 election violence only occurred after Odinga was promised a spot as the Prime Minister of Kenya-a position which was designed to limit the president’s power but has not done this in any way.

What this all boils down to is this. The politics of Kenya are soaked in blood and corruption, and any factions that form opposed to this have been made illegal to be a part of-you can be arrested for being in any organization the government considers anarchistic. Even now, firearms are being imported at an alarming rate for the 2012 election when this is expected to reoccur. What hurts me so much is how many of the children I see every day, smiling into my camera lens and joyfully repeating the only phrases they know in English to me, will have to have die the next election? How many of them would stand up for what they believe in when the dissenters are killed?

What I envision will happen here is that when enough blood is spilled, it will begin to boil with the anger trapped inside it-eventually transforming it into something useful-a weapon-an obsidian spearhead to end the corruption, greed, disease, and poverty instead of maintaining Kenya in a de facto state of emergency like the British did. The revolution is coming, and this country of immense natural beauty will be cut and scarred forever for it.

(I invite all of you to research the Mungiki (literally meaning “the masses”), which is a secret shadow organization with apparently millions of members, seen by the many I talk to here as the “Kenyan Mob”-but have definite socialistic goals here. They have successfully destabilized major cities and have fought Kibaki’s special forces...they might be the best hope at change)

Learn Swahili! Despite the fact that all government business is in English which only the most educated and fortunate are taught in Kenya!

Askari waliowanyanyasa washukiwa walishikwa

Police who harrased the victims were arrested (I think they meant the victims are arrested)