Culture Shock has an enantiomer.

I'm sitting here in the lobby of the Kempinski now, awaiting my taxi to Nyerere International Airport. In less than 4 hours, I will begin my long journey home. I will get to see loved ones, particularly Steph, and hopefully my parents, close friends who have been supportive over the past several weeks both via chat, email, and this blog, and many co-workers who I have missed. I hope to enjoy steak again, and drink beer so dark and rich that it absorbs light (Goose Island Bourbon County Stout, I'm coming for you!). There are bills to pay, bachelor's parties to attend, apartments to find in Philadelphia, and weddings to look forward to.

So why am I feeling so internally conflicted right now about all of this?

Something profound happened as I walked into this hotel yesterday afternoon. I had been expecting to walk in and feel as if I had stepped back into a little piece of my world here in Dar. Instead, I felt quite alienated by it all. It felt so unusual to hear people speaking english around me. I tried to greet people in Kiswahili, and they uniformly replied in English. I had to wait in a small lounge area, and I was put aback by how clean and polished everything looked, how well-kept everyone sitting there was (esp. knowing how scruffy I had become); this rather cosmopolitan setting, from which I had come just 6 weeks ago, was now quite foreign and uncomfortable for me. I stared at the menu... can I eat pork here, is it safe? WHY does this sandwich cost 9,000Tsh? How is that just? 6000 Tsh to print out a single page flight itinerary? 30,000 Tsh for dinner? These sorts of costs, which had certainly not bothered me on my trip here, now seemed completely outlandish.

This all troubles me deeply. How much has changed inside me during this short period of time? If I react this way to the Kempinski, how am I going to respond to Manhattan? How am I going to interact with friends? Many of them have traveled before; Have they experienced this "reverse culture shock" before, or will they think I have lost my wits whilst in Africa?

For now, I will focus on seeing Stephanie on Thursday morning to guide me through.  I fear though, that as my friend Dan had predicted, I really may not see things in the same light as when I had left, and that this feeling I am experiencing now is my brain starting to process everything that I absorbed while here.

My return to Dar Es Salaam and the Kempinski Kilimanjaro

Now that we have gotten past the long-promised safari-related posts, time to continue to update my status.

After such drama getting TO Zanzibar, I had quite a bit of anxiety with regards to my boat trip to Dar. I hardly expected it to go as smoothly as it did. By the time 12pm rolled around and it was time to depart the Clove Hotel, I was ready to do so. I had grown weary of the much more aggressive street touts, always trying to harangue some form of payment via tour, taxi, etc; they were much more aggressive here than they had been in either Dar (where they were still fairly intense) and Mwanza. A taxi came and took me to the dock. As I got there, a torrential downpour began, but fortunately the waiting area was covered. Many ex pats and travelers were here, awaiting the ferry as well, and I anticipated it would end up being quite crowded.

Surprisingly, the ferry arrived on time. It was quite large, and there was plenty of room for both me and my garish green luggage ;) The trip was smooth, lasting about 2 hours, and I spent some of it (about 20 minutes) writing blog posts (until my battery died), and the rest just listening to my ipod. I unfortunately did not have a a great window seat, but I tried to strain to see through a window on occasion. The seas were smooth and Neptune was smiling upon us, granting us smooth passage.

I arrived in Dar, quickly found a taxi, and for only 5000Tsh arrived at the Kempinski unscathed. What happened next, however, was extremely unexpected... and is something I am still dealing with to a significant extent now, and I anticipate will get worse over the next several days....

Safari Day 3 pt 2 - The Final Chapter

After visiting the Masai camp, we packed up and drove for about another hour through some very rocky terrain, reaching the edge of Olduvai Gorge. For those who are unfamiliar (as was I until someone reminded me) Olduvai Gorge is often referred to as the "Cradle of Mankind". It is an extremely active archaeological site, yielding so far Australopithicus Boisei (or Africaans) and Homo erectus, as well as what is thought to be the earliest footprints of man thus far found in the fossil record. It was quite powerful standing there, knowing what has risen from this land. Excavation is on-going with a team there from Rutgers University.

After Olduvai, we had lunch and began our journey home. It was a long ride, cutting back through the Serengeti. We saw more lions, giraffes, elephants, and jackals along the way, but at this point we were definitely a bit tired.

We reached the Bugando Guest house at 8pm, at which time we all took turns showering, before calling it a night. What an amazing weekend! And I also think we were quite lucky to have such an excellent driver/guide in Moshaka, he did a great job of pointing things out as we went and helping us see the more rare animals.

Safari Day 3 part 1

Day 3 started much the same as Day 2, only substitute Waffles for Pancakes. Again, a familiar taste that I was very welcome to see. We hit the road early again, around 8 a.m. Our first destination was an actual Masai village. We got there around 9:30 am. For a small fee, we were allowed to tour the village, see some traditional dancing, their housing, their livestock, and even sit on their school for the youngest children.

I had mixed feelings about this experience. On one hand, it was an excellent cultural opportunity to view the Masai, in one of the natural villages, see their houses and how they still live to this day, etc. It was very impressive, and I left with a profound respect in their ability to maintain such religious and cultural practices in a rapidly modernizing Northern Tanzania, as cities like Mwanza, Arusha, and Kilimanjaro continue to expand due to tourism and industry.

On the other hand, it bothered me deeply that I was there. I view this sort of interaction in a "schrodinger's Cat" kind of light. For those who are far removed from basic chemistry, "Schrodinger's Cat" is a bit of a thought experiment we are told as freshman in college, an analogy to allow us to better understand the Heisenberg Uncertainty Principle. The essentials of it as as follows: It is impossible, at any particular time to know exactly where or how fast a particle is moving, we can only estimate. We can attempt to measure the location of the particle, but the closer we try to getting an exact location, the more likely we are to move the particle in our attempts to measure it- Where do cats come in? Well Shroedinger came up with a similar example involving his beloved cat. Imagine we had a box on the ground and in it was a cat. Also inside the box was a radioactive isotope, that may or may not have killed the cat. We can postulate by looking around the outisde fo the box or listening to the box to see if the cat is alive, but actually opening the box will trigger a massive release of isotope, assuredly killing the poor Kitteh. So we can only ever estimate whether the Kitteh is actually still purring inside.

By visiting the Masai in such an intimate manner, I really got to see their culture and learn a great deal. But how much of their culture is actually intact, if they are constantly receiving renumeration feom groups of mzunugus coming out of Ngorongoro. How much of their local economy is now dependent on such tours as opposed to herding cattle? How much of their real culture is still in existence, and how much of it has become some Colonial Williamsburg re-enactment?

I guess it is impossible to tell. BUt I do feel a profound sadness that these visits may be eroding into the very culture they intend to portray, much to the chagrin of the elders in these villages, I am sure.

Coming up next on Frank's Safari: Olduvai Gorge, Mary leakey, and the birthplace of mankind.

Safari Day 2

We began the second day with breakfast at the seronera Lodge. Pancakes taste awesome, regardless of quality, when you haven't had them in 2 months ;) We left early, between 7:30 and 8:00 a.m, and soon saw another hippo, and several lions. The majority of the morning was spent driving to Ngorongoro Conservatory, which has slightly relaxd restrictions in terms of living there, allowing the Masai, a local tribe that subsists on their own herded cattle as opposed to hunting, to still settle in the area.

At the gate leaving the Serengeti, there was a large herd of elephants. Since we had to stop there to get permission to carry on anyway, this made for a great pictures. We continued to drive, and as we approached the crater rim we saw several tribes of Masai herding their cattle, and several villages (more on the Masai during day 3). There were many gazelles, a few jackels, and even a cheetah along the way, in the distance. We reached the crater edge around 11am.

There are several pictures I will be posting to flickr involving Ngorongoro crater. Let me tell you that none of them do it justice. This is one of those sights that, I guess without uber-wide panoramic style lenses, can not just be captured well, much like the Grand Canyon. The decent into the canyon was harrowing, a very narrow, very steep, very unpaved dirt trail that us about 45 minutes to transverse into the crater floor. Once there, the vistas were even more impressive. A massive lake was at the center, filled with thousands of pink flamingos. Wildebeasts roamed everywhere, as did zebras. We saw atleast 10 lions in the crater, 2 of them approached ours and several other cars, sniffing them and looking puzzled. We stopped by one of the lakes for lunch, but were told to keep away from waters edge for fear of crocodile attacks.

In the afternoon, we hunted for the elusive Black Rhino, an extremely endangered species. We caught a glimpse of one that was visible with high power binoculars, but photos were not possible with our equipment. Later in the afternoon though, much like the first evening, Moshaka got a call over his CB radio, and began to drive very quickly across the canyon fermament. We were moving through a mixed herd of zebras and wildebeasts, but noticed that some of the animals were fleeing from some large, black shape off in the distance. As we approached, Moshaka yelled to us "BLACK RHINO" and we all quickly stood up to see. Sure enough, about 50-75 yards off, was a black rhino, chasing away a few animals, and then breaking into a light jog. Such an impressive animal!

Later we saw a mother lion with her two cubs, less than 10 ft from the car, and also spotted 2 more cheetahs, well within photographic range. So, with Day 2, we completed the "Big 5" of game viewing, and headed up out of the crater, proceeding along the outer portion of the southern rim. It was here that we stayed for our second night- The Ngorongoro Wildlife lodge. Another impressive lodge, with great food, amazing views; the crated physically sat on the edge of the southern rim, with all windows and a massive outdoor patio looking out into the crater. We had some more Tusker, showered again, and called it a night, even more fatigued than the night before.

Zanzibar update

A brief update on my location/status etc.

I've made it to Zanzibar, but was unable to post about it initially due to difficulty in finding internet connectivity. My technical situation has worsened significantly here: I think the fluctuating power supply in Tanzania has permanently damaged my battery in my laptop, a full charge now lasts only 15-20 minutes or so. Ironically, Internet access and electrical outlets are frequently not in the same place. So until I get to Dar Es Salaam for my final night, it may be harder for me to post.

My trip to Zanzibar was fairly stressful. It started with a flight from Mwanza to Dar Es Salaam, and was then supposed to be followed by a ferry ride to the island; it is about 25km off the coast of the Tanzania. Things appeared to initially be going smoothly. My taxi to the airport arrived on time in Mwanza. I got to the airport and checked in, and yet again had to pay the "weight overlimit" fee of 2000 Tsh per 1kg over, and I was 10kg over the limit of 20kg. An aside: how does one pack for 6 weeks and have their luggage be any less than 20kg?? Anyway... I also noticed lots of passengers bringing large plastic opaque jugs and styrofoam containers with corporate names up and checking them, and thought that a bit odd.

I boarded the plane, it was a larger propeller plane, with an engine on each wing, and about 40 seats. I saw them bring my large, rather awesomely garish lime green duffle trolly over to the plane, and even saw them put it into the cargo hold area. I thought I was safe, and closed my eyes for a bit as it was still fairly early and I was up late packing. So, I was quite shocked to notice that, as we began to taxi, my bag was sitting on the runway about 100 yards from the plane. Needless to say, my flight from Mwanza to Dar was not a relaxed one. This is Africa.

Two hours later, I arrived in Dar, expecting the worst. I made it in one piece (and given that Mwanza International Airport has no real Air Traffic Control system, this was something I was quite grateful for, all things considered). And as I had suspected, my luggage had not been so lucky. I brought my electronics in a rucksack and several days worth of clothes and few fragile souvenirs in another carry on, but my duffle with all of the remainder of my items (re: most of them) was nowhere to be found. I went to lost and found, where I found about 15 other passengers had a similar issue, many with connecting flights (one poor girl had a connecting flight to Dubai in 6 hours, and then was off to Manila).

So what happened? Per the staff of precision air, the actual airline(!!), our luggage was removed from the plane in order to make more room for fish transportation . I couldn't make something like this up if I had wanted to! So I spent the day in Dar Es Salaam awaiting my luggage. Noticing that the next flight from Mwanza was at 4pm, I deduced that I wold most likely be missing the last ferry to Zanzibar, which left at 4pm. So, not to be deterred from meeting two friends on the island, I quickly ascended the management chain of Precision Air at Dar Es Salaam Airport, and when done, had a plane ticket for a small plane leaving at 18:00 for Zanzibar Int'l Airport, at a markedly reduced rate (32,000 Tsh, less than the 50,000 Tsh ferry ticket), and waived luggage allowance for that flight.

Thankfully, my luggage arrived around 16:45, and I was able to easily make it to my 18:00 flight, which lasted all of 15 minutes. Once here in Dar I was able to get a cheap taxi to the Clove Hotel, where I have now been for two days.

Zanzibar is amazing. It is incredibly hot and humid here. You sweat sitting still in the shade with a good breeze. The sun feels as if it is 10 feet from you, you can feel it beating at your skin. The beaches are white, the water is blue and clear, probably around 75 deg. F. 40 -50 Dhows litter the coast off of Stone Town in the evening. The island is 90% Muslim, and the architecture is a mixture of Arabic and Indian. The streets here in Stone Town are tiny, about 5-6 feet across, with shops on the first flood and apartments occupying the 2nd, 3rd, an 4th floors. Most locals wear traditional Muslim garb, though I don't know how the women manage in this heat.

I went on a spice tour yesterday morning. Spices are the island's main export, particularly clove, but also including Coriander, chili, pepper, cumin, coffee, cocoa beans, lemon grass, etc. An interesting note about cocoa- the island exports massive amounts of dried and roasted cocoa beans, annually, but lacks the processing ability to actually make chocolate, so they end up importing it from Switzerland and Germany, of course for markedly elevated prices.

I went on a walking tour of Stone Town early in the afternoon yesterday, and then spent a few hours sipping a Tusker lager on the beach until about 5pm. Dinner consisted of some very fresh Marlin, the seasoning was of course top notch.

So, next up is Dar Es Salaam, one more night there, and then the final journey begins. My hotel there promises to have both internet and electricity, so I am hoping I can upload some photos then, and even write more about Safari. Sorry for this brief interlude!

Tuta onano badai (see you later)

Safari Day 1 pt 2

Lunch was served at a small series of cocrete tables, about 15 feet from the base of the hippo and crocodile infested pool. we could hear the Hippos splashing water on their backs as we ate. The first day's lunch was on us, so had packed a bunch of pbj sandwiches as well as some left over beans and Chipate (a flat fried bread sort of like a pita but greasier) from dinner the night before. We each topped it off with can of Tusker beer, which everyone is rather fond of (we had purchased a case for the trip).

The afternoon kicked off with some more monkeys and baboons initially, as well as my first Tsetse fly sighting. Tsetse flys are these large, half brown, half black flies that transmit a parasite that causes Trypansomiasis, or African Sleeping Sickness, which can be fatal if not aggressively treated. We were advised to not wear blue or black clothing, as this can attract the flies.

We soon saw our first lions in the afternoon, a pair by the side of the road. Being most a predator at night, most of the lions appeared rather lazy during the day. There was both a male and female within maybe 10 yards of each other, about 15 to 20 yards off the road. We stopped for many pictures from the safety of our vehicle. We also saw a massive hippo jogging along the roadside. We asked Moshaka if lions ever attack hippos. Apparently this is extremely uncommon (which is unfortunate, because we were eager to capture some animal violence). Hippos are massive when not submerged in smelly ponds, and can move quite quickly! We saw several more giraffe, zebras, and monkeys before the last big sight of the day.

Around 5:30pm moshaka got a call over his rdio that there was something important to see. He drove very quickly over this muddy, rough terrain, and in the distance we could make out the silhouette of 4 or 5 other jeeps sitting still. in the same spot. As we cgot closer we slowed for our final approach and we could make out the barrels of some lenses which must have been quite impressive ;) In the grass, about 25 yards from the road side, was a large cat, which we soon learned was a leopard. Leopards are much larger than their couosin the cheetah, and are powerful climbers as well. I managed to get a few pictures at a distance. According to Moshaka, seeing a leopard is extremely rare, as they usually hide in the trees or brush during the day, far from the road.

After the leopard we looked for some more lions, but ended up settling for some more hippos, as well as some rare birds, whose names escape me. (Can you blame me, given everything else i saw that day?) We drove off to our lodge, which was only about 30 minutes away, in the middle of the Serengeti.

Seronera Lodge was amazing. It is literally right in the middle of the park. It was great enjoying some tasty food, as well as a few more Tuskers and a hot shower, we were all covered in the reddish dust that was constantly blowing about. We called it a night around 11pm, and had to be up around 6:30 am for day 2.


Barry If you are reading this- Have u seen the finale of Battlestar Galactica by now? I've missed the last 4 or 5 episodes over here, but, without spoilers, how bad ass was it?

Safari Day 1 pt 1

Finally, the much anticipated summary of Day 1.

We left around 7am. The first 2 hours consisted of exisiting Mwanza and heading east. The road was paved, and every 15 or 20 minutes or so, we had to slow down for a large speed bump. At these sites were small towns, with shacks extending back from the road, people bartering, and daladalas lining the street. It was early, even for Mwanza, but the roadsides were still densely populated. Many would see us drive by and glare; others would of course yell out Mzungu.

As we moved away from Mzungu, the buildings became much more simple in construction, eventually regressing into mud forms, often with straw based roofs. The dress looked the same, and even in these areas mobile phones were often visible.

We hit the park around 10ish. The gate was littered with small monkeys, playing with each other, jumping on our vehicle etc. After a short break for our driver Moshaka to show the gaurds our approval paperwork, we went into the Serengeti park.

We first saw wildebeasts, far off in the distance. We were quite excited by this, but we did not know they were so common ;)We also saw some gazelles. Baboons were next. And then we saw our first Giraffes. They were far off, but we stopped to watch. Little did we know that before we knew it, they would be standing 5 ft from our car.

We stopped by a small waterpool to watch some crocodiles and hippos. Then Moshaka announced we would be eating here, and we drove around to the other side of the pond, with just a thin line of trees separating us from the crocodile pool. We pulled over, still in awe of the vastness of the Serengeti, and the number of animals we had seen, and ate lunch.

To Be continued....

Tourista!

So, as I am sure many of you are aware at this point, I have fallen behind on my declared goals of posting about my safari this week. I unfortunately am recovering from a wicked bout of Tourista, otherwise known as Traveler's Diarrhea. It started on Tuesday night, and left me incapacitated most of Wednesday. After much immodium without success, I finally broke open the seal on my emergency Norflox, and today am feeling a bit better. Finally ate some food (first meal in > 24 hours) this afternoon and so far, so good.

So I apologize for not being able to write more about my travels over the past weekend. I should be able to post more pictures this afternoon, however, and then tomorrow post about Day 1 of safari.

Sorry again for the delay. Also want to start writing about some of my other experiences here and post them as I prepare to leave; if there are any topics or questions you have, please post now as I will def. answer them.

Safari Survivor

Habari asa bui! (Good Morning!)

Just returned from Safari late last night. Sorry there has not been post, but electricity was scarce on the Serengeti and in Ngorongoro crater ;) It was an amazing experience, I have never seen anything so vast in my life, except perhaps for the Grand Canyon. Seeing so many animals in their wild habitat was breathtaking.

So you probably want details. And details you shall have! But patience will be required, as the internet here is quite polepole (slow) today.

I figure the dissemination of information should have something of a time-table, to satisfy my type-A personality. Plus things got unexpectedly busier in the hospital making it difficult to post

So, it will go something like this:
-Hopefully later today Ill post about day 1
-then tomorrow or the next day ill write about day 2
-then hopefully by saturday Ill have posted day 3

In addition, I plan on throwing up 10 pictures or so per day. I took over 200, some suck, many are good, and none of them capture the actual scope! I also took about 20 smallish movies, and flickr now supports streaming video; I don't think I'll be able to post them until I am in Dar Es Salaam on Tuesday (after a few days of sun in Zanzibar, where I figure internets will be slow)

Safi Sana! (very good)

Kwaele (Good bye)

T.I.A.

Not to be lame and quote a Leonardo DiCaprio movie, but knowing the phrase "This is Africa" actually has some utility here. It helps to set the mood, to generate a basic ruleset for all sorts of interactions and operations here. Most things here, inside and outside of Bugando Medical Center, happen at a speed that can be a bit numbing for an east-coaster such as myself, and many of my colleagues here. Time slows down. Things that should happen tomorrow take four more days (laundry instantly springs to mind, as I just finished counting the remaining pairs of boxers I have, hoping that I will have enough pairs to get me through the safari this coming weekend). The exact reasons for this are unclear. Perhaps it is the synergy of the oppressive daytime heat, the often-lacking infrastructure, and an intentional slower pace.

Regardless, knowing the phrase TIA to help us mzungus cope in times of stress has proven vital, as we try to re-arrange flights, check luggage, book hotels, etc.

--

On to more personal news: I am still waiting for more information to trickle in about the drama back home at Cornell Medicine. It sounds very serious, however. I don't know how much I am allowed to talk about yet, and as soon as I get word that it has become public knowledge, I'll be sure to discuss my feelings on the issue.

Safari in the Serengeti and Ngorongoro are this weekend. We are spending 3 days, 2 nights. the travel will be by a HUMVEE-looking jeep that seats up to 8. At night we will be staying at two lodges. The first night will be at Seronera Lodge and the second night will apparently be at Crater Lodge. Looking forward to it.

Finally, as I approach the last 1.5 weeks of my time here, I am trying to figure out how to plan out my trip to Zanzibar at the end. I think I will end up flying into Dar Es Salaam on March 22nd, try to check my luggage at the Kempinski hotel, then catch a ferry out to zanzibar during the day there. I figure from there I will try to spend one to two nights, likely in Stone Town, then head back to Dar on Tuesday, March 24th. Wednesday March 25h, I begin my trek home from Dar to Dubai.

Time flies, even if this is Africa.

Trouble back home.

There is major badness brewing back at my home residency program that i just got wind of. Don't know how much I am allowed to talk about. Will write more later.

A Day in Mwanza

I've received a few messages asking what my day to day existence is like here inn Mwanza, so I thought it might be useful to talk about my schedule at the Bugando Medical Center.

My day starts around 6:30 am when I wake up. I'll usually lay there for a bit (it's only over the past 4 or 5 days that I've finally started to sleep ok here) before getting out of bed and showering. I usually eat at house next door. Breakfast is on our own to prepare, so I usually will make some toast and throw some peanut butter and jelly on it. Around 7:45 we walk into work.

Morning report starts at 8 AM. It is on the 7th floor of the hospital (the ground floor is the 3rd floor). It usually consists of the interns and residents on call from the night before presenting any of their admissions. The amount of discussion on these admissions is highly variable, determined by the number of attending (supervising) doctors presents. Sometimes there is a presentation on a topic after this. Morning report ends at about 9 AM.

The visiting Medicine residents then head down to the second floor to round in the ICU. The ICU team here consists of an AMO (AMOs are equivalent to PAs or NPs in the US), Dr. Peck (a member of the faculty here and at Cornell, and the director of our visiting program, a pulmonary fellow who is visiting from Cornell, and 3 medicine residents. It is here in the ICU that the limitations of the facilities and services here si most acutely felt. Intubation is rare, medications available are limited, central venous access is not available. There are two pressors for blood pressure support in the setting of shock, and both the families must pay for in advance. It is a constant struggle for the Bugando residents to do they best they can with these critically ill patients, and they deserve so much credit for accomplishing what they can. ICU rounds typically end by 10:30 or 11 AM.

After that, we head to Major Ward rounds. My ward is back on the 7th floor, so I climb 5 flights of stairs to get back there. The ward team consists of 1 intern, 2 MD5s (senior medical students), a third year Bugando resident, and a visiting medicine resident. We round on a huge number of patients. There are 4-5 large rooms on each floor, each with 8 beds, and we walk from bed to bed, talking to and about patients, examining, performing procedures if emergent. Most of the time the wards are full. At the end of the large rooms, there are usually several smaller private rooms as well, which only have 1-2 patients in them (which is more akin to the layout of most american hospitals these days). Ward rounds last until about 1 PM.

We all head back to the Guest House for lunch at 1pm, and usually stay there until about 2pm. Lunch is prepared, it usually consists of a tomato + cucumber salad, plus some sort of carb. After lunch, we head back around 2pm.

In the afternoon, we primarily teach the medical students. We return to the wards to see if there is anything they need help with. We then usually give a case-based lecture until about 4pm. After that, we usually go back to the wards briefly, then head to the library. There we try our best to use the internet there to check email, work on future lectures, etc. It's often not very effective :/

I'm usually back at the Guest house by 5:30 or so. Several of us usually will go for a run every other day around then, 3-4 miles long. Dinner is at 7pm. Our nights usually consist of working on lectures +/- watching some dvds that people brought on one of our laptops. Occasionally there is a bottle of Kili or Castle or Safari thrown in there.

The weekends are ours for the most part- Saturday mornings us folks from Internal Medicine go to round on the ICU patients for an hour or 2, but then head back. Sundays are off.

I hope this helps to give you an idea of what my daily schedule is!

A night in Mwanza proper- The Stone Club.

This past evening we decided to head in to town with one of the local Bugando medical residents to see some of the local nightlife. Previously we had been to a few places up on Bugando Hill, and to several restaurants, but we had not yet been to any of the local bars or clubs. What a night it turned out to be!

We started at a local Mzungu hangout, the pizza restaurant in town. I had heard their pizza was fantastic, and I was certainly not disappointed! The 6 of us ate 3 12" pies, my personal favorite being the Banana pizza. There was also a very small pepper on one of the other pies I had not seen before, and it had a significant amount of kick to it!

We left there around 9:30pm, and walked across the street to a locals bar called "Rumours". We had been advised to be very careful there, that there were often fights. I guess 9:30 was a bit too early for any of this ruckus, as Rumours was empty. We all had another beer, and supplemented our previous pizza with some Chips (french fries) Masala (indian seasonings and sauces are ubiquitous here). Then we left for the main attraction of the night.

To say the Stone Club was a unique experience would be a significant understatement. We had asked several people in town over the previous two weeks where the best nightclub was in town before last night, and uniformly the answer was Stone Club. What a cultural mash-up. The spot was lit in blacklight throughout, with graffiti as decoration all over the walls. The dance floor was about 1000 sq ft, and empty when we got there around 10:30, but quickly filled. The music started as mostly african, and later transitioned into US R+B and hiphop, with the crowd going nuts and singing along with each song. People dressed in anything from more traditional party dresses to full-on hip-hop garb to the nines, from the flat-brimmed yankees hat to the long t-shirts. We planned to stay until about 12MN before it got too shady, but we decided to stay later because we were having such a blast dancing. we also met some people from the Netherlands and the UK there as well.

We ended up getting home around 3am. I don't think I'll be doing that again, but it was definitely worth it!

I'm On A Boat!

Not to quote Andy Sandberg, but last night I actually was ;) Had the chance to set sail on Lake Victoria with several of the visitng residents as well as the local Pediatrics Housestaff. Being out there really allows you to appreciate the size of the lake. The water is green, lots of algae. The rock formations coming out of the lake are unlike anything I've seen before. I was fortunate enough to have some pictures taken by my friends (as I had forgotten my camera), hope to post some soon!

Frank

Thunderstorms

Last night brought the worst taste of the "rainy season" that I have experienced thus far here in Mwanza. Rolling thunder, claps of lightning, intense winds that lasted through to the morning, the result of which was power outages all over Bugando Hill, including the Bugando Guest Houses ;) Candles and matches were readily available, however. Power fluctuated throughout the day to day, and was even out when were considering starting to cook dinner. So it goes on this side of the world.

I've met three more residents over the past 3 days from the states. They are here through the HVO- Health Volunteers Organization (I wonder if the HVO will need Medicine or Gastroenterology doctors in the future to go to far away continents ;) ) We went down to Fortes Tours this afternoon together to try and start setting up a safari for all of us. We have managed to wrangle 5 people (myself included) into coming, which, coupled with a discount for being here at BMC, might make this a touch more affordable. We are planning on taking a 3 day weekend and heading through the Serengeti and into the Ngorangora crater on March 14th, 15th, and 16th, though after hearing about a co-resident's tent getting stomped by elephants I don't know that I'll be doing the camping option; instead we plan to rest at night in lodges along the way. Looking forward to this!

Also, if anyone out there is incredibly bored or very motivated to help me- I've been having a hard time figuring out the lunar cycle out here. I am trying to see if there will be a full moon while I am in Zanzibar; If you known when the next full moon is here, or could figure out, I'll be sure to bring you home a fresh new Nile River Perch-skin bookmark. Celebrate your thirst for knowledge with this little momento that exemplifies your thirst for global commercialism, corrupt local governments, and 2 million starving tanzanians (that I happened to purchase BEFORE seeing the movie).

Siafu

The term for those killer ants is Siafu.

There is a good wikipedia article on them, with youtube video that I unfortunately can't view with the nets here ;)

Anyway- a post from last night that i wrote at home:

28.2.09

I know I already posted about ants today. But some days are just so perfect that they require a part 2. Maria and I walked down into town today using some of the dirt paths, which took us through alot of the local village areas. It was really impressive. I was unfortunately unable to find replacement laces for my running shoes (my laces broke this morning, I ran 3 very hilly miles anyway, but now my ankle is telling me that isn't a good idea). We went to dinner at Isamilo Lodge tonight. Situated high above Mwanza on Isamilo Road, and actually facing in an angle I had not seen before, this lodge has some of the most majestic sunset views I have ever seen. We took several photos during our fantastic dinner. I had the Chicken Curry and requested for it to be extra hot. While it was spicy, I don't know that it officially made "extra hot" levels. We also met an Emergency Medicine attending named Dan from Oakland, CA, there. Dan is here to develop somme research protocols on the use of ultrasound in high risk pregnancies. I hope that some day I could find funding to occasionanlly come back here and keep doing good.

He took an awesome picture of us with his considerably more high-tech great; I hope that he can email it to us. I also was able to play with the ISO and stop times on Steph's camera for the first time to really soak in some darker dusk scenes, and I think those turned out really well. Hopefully I'll be able to post them to flickr soon!

When ants attack

I had my first experience with the feared Soldier ants of Tanzania yesterday evening. I had heard many stories of them, but had not had the chance to see or feel them in action. But I had been warned, and several people had told me they were around recently.

It was Friday evening, and we all had been working a bit hard this week. So we decided the appropriate way to manage such stresses was by having an impromptu happy hour before dinner on my back porch (which is fenced in, pictures are coming at some pt, I promise. We had a combination of vodka, an african Gin, several mixers, and several bottles of Kili beer. After we all had several beverages, we migrated to the house next door to eat dinner. It was after dinner that the trouble started.

We decided to spend the rest of the night playing Yahtzee, but the yahtzee set was in my house. I walked back to my house, which is only about 50 ft, in the dark. It was about 30 ft into this walk that i began to feel them. By the time I got to my door and into my house, my feet were covered in aboout 20-30 1cm long ants, many of them making their way up my pant legs or biting into my toes. Flicking them off once attached was extremely difficult, and even a bit painful. And I had to rapidly strip my pants off (I am sure this is where the phrase "Ants in your pants" came from) to be sure to remove those rocketing up towards my nethers.

Once removed, these beasts are impossible to kill, often taking 4-5 stomps to send them on their way.

When the sun rose this morning, I had the chance to go outside and look around for these critters. They were very much still there, burrowing through the dirt rapidly across the sidewalk and yard, marching 4-5 ants wide, erecting walls on either side of their makeshift highway with ants that were not so fortunate to survive the journey, and other ants standing on their hind legs to protect them. When they hit patches or just dirt, they burrowed, creating walls of the loose sediment. Later in the day, there were even tunnels opening along this path, where you could see the ants moving through tunnels underneath.

The amount of organization was really impressive. That being said, I hope I don't have to see these critters again. I took photos, and will try to upload to flickr when I can. I also heard there is a swahili word for these critters, when I found out what it is I will be sure to post it.

Pole!

25.2.09

One week since my arrival in Mwanza,and it has been hard in many respects. Adjusting to life here has been challenging, from the change in temperature, to the change in living quarters ;) (I still promise to post pictures of my quarters here at the BUgando Guest House). ADjusting to the food, the water, the showers, the traffic, the sounds of animals I've never heard before outside my window. Missing Steph and not being on a similar schedule with her, only getting a few minutes at most a day to talk to her... All of these things have taken some serious adjusting to.

But as I listen to the din of those living in the small tin shacks jsut yards from our facility, cheering in unison watching what must be a football match, I am reminded also of the people I have met here so far. As I've already stated, my co-residents are all amazing, having come from all corners of the US, some having paid the majority of the way themselves to be here and help these people. The program director here, and all he has given to be here, moving with his entire family to Africa 2 years ago just weeks after finishing residency in the US. The residents and interns here who, despite the lack of tests they can run, or imaging they can get, try so hard to find their way around it.

And finally, the medical students. They are the future here at BMC. As the first class graduates, it reminds me of how fortunate I am to be here to teach them. How eager they all are to review a new admission with us, or discuss a new finding on physical exam. Every afternoon we get the chance to lecture to them, and helping to guide them is our primary assignment here at Bugando Medical Center. We will be gone, but they will be here to teach their own medical students just a few years from now, and then onward to go practice in their communities. Spending time with them makes all of the negatives worth while. 28 days left to help.

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On an administrative note- As I am sure some of you are aware, my posting frequency has dropped off some. My intial goal was to find a decent internet connection here daily, and post while online. It has become apparent that this was rather unrealistic. How mzungu of me. (mzungu meaning foreigner, remember?) Fret not. I will continue to write. But they will be posted in bursts. So expect to see 2 or 3 days worth of posts at once sometimes. Also, to those who have emailed me, thank you so much for taking the time to do so. replies are forthcoming. I've installed some betaware with google gears that should let me compose replies while offline. Again, I only see myself being able to connect a few times a week, so please bear with me; they are coming!

And "Pole" means "Sorry!"

Darwin's Nightmare

I had the opportunity to see a documentary called Darwin's Nightmare last night. The majority of this movie was filmed here in Mwanza, and it did a fairly good job of depicting the extremes of poverty found in this city.
The brief synopsis is as such: Some time in the mid 1950s or so, someone (the film insinuates someone of european decent) introduced the Nile Perch into Lake Victoria, where it had not previously been present. This fish is a top-level predator, and as such it then proceeded to eat the other fish around it, becoming the dominant species. These huge fish are not particularly amenable to netting, and must be caught by hand. Fast-forward to 2004- 25% of Tanzanian gross export is related to the movement of filets of River Perch from this region to Europe. The economic and societal impacts of this are far-reaching. While millions of tons of filets are exported by large russian planes out of the dilapidated and ill-equipped mwanza airport every day, millions of Tanzanians are starving to do death, forced to eat the remaining heads and carcases left behind after the filets are removed because they are unable to afford the filets themselves. The pilots of these planes feed into the local prostitution industry as well.

Its hard to watch. Its harder to be here having seen it; things look even more dire now. I've been to many of the places shown in the movie. And while I haven't been down to the beach communities just yet, I think I have to. I don't know that I'll ever look at a filet of fish the same way again. Definitely recommended viewing, you'll likely have to netflix or buy it, but be prepared for a very difficult 104min of suffering followed some serious introspection into how we live from day to day.

Habari?

Just got the chance to upload some photos while I work on a lecture for the medical students here for Tuesday. We are back at the Hotel Tilapia, utilizing their internet connection. The weather is again gorgeous today.

Made it down into the market today for the first time. My friend used the term "sensory overload" to describe it, and I think that is an apt description. Many people, all packed into a small-ish area. People all speaking rapidly in swahili, loud music occasionally blasting, and intense odors of all sorts. The roads vary in quality from full sized with paving, to alley sized or smaller, as small as 4-5 ft wide, composed of dirt, mud, and puddles. We also visited a small hide shop that focused on goods made of fish skin, lizard skin, and even some zebra stuff; products ranged from bookmarks, to wallets, to shoes. Very cool stuff.

Tonight I think we may try to experience some local nightlife again, perhaps hit a club. Tomorrow there is talk of visiting a local orphanage as well.

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Habari
The literal translation is "the News" but it is a question, which most approximates "How goes it?" in english. It is commonly used in greeting someone, and is heard frequently on the street. Greetings are extremely important here, people often spend several minutes just saying hello, before saying anything else.

Karibu Mwanza!

I made it here unscathed! The flight in was actually on a small jet. but the airport we landed in was everything i expected. Nothing more than a concrete box with a tin roof, and only one level. The baggage claim was literally 5 ft from the tarmac, with them just throwing the bags at you. One of the staff looked at me and said "mzungu" and then decided to help me out. I don't think I could have managed the large crowds without her help.

A taxi driver was waiting for me there, and he helped me get out of the fray. The drive back was just as impressive as the ride to the Kempinki. markedly more foot traffic than car traffic.

The houses are very cool. two identical houses next to each other. Electricty has been relatively steady, though we lost power for several hours this morning. Mosquito nets are included. My room is small but adequate, with shelving for all my clothes.

My co-residents are awesome. 3 pediatric residents, 2 anesthesiology residents, and a pulmonary fellow from Cornell. They've all been so welcoming, and so great in terms of showing me the ropes.

I can't talk more right now, am currently doing this from a bar. Will write more soon, can't wait to post about my experience so far!

Dar Es Salaam

I arrived safely in Dar Es Salaam. Staying the night here in one of their more posh hotels, the Kilimanjaro Kempinski (courtesy of a discount rate by the Touch foundation), then leaving at 830am for the airport.

A few thoughts:

The Nyerere International Airport here in Dar is everything I thought it would be: chaotic and frenetic in a sort of harmless way. Taxi drivers swarmed around me. They tried to lead me to an exchange counter with a poor rate. But once they started to pick up that, while I am certainly mzungu I did come with a plan, they backed off. Skylink Tanzania helped hold my bags for a bit while we waited for the shuttle.

The Hotel is amazing. Definitely earn their 5 stars. I wish I hadn't bundle packed my gym gear, but I still might try to hit the treadmill for a bit tomorrow morning. Great food. really cool lounge on the roof; I look forward to coming back here in 5 weeks and staying for a few days while I explore Dar.

Finally, the ride between the airport and the hotel- those who live in the US and were born post-great depression know not the extremes of poverty that exist here. the juxtaposition of shiny new banks and manufacturing centers with mud paths, massive groups of unemployed Tanzanians, and small rickshaws is impressive. I am sure this will be even more apparent in Mwanza.

REALLY finally- Tanzanian beers are light, a bit more flavorful but reminiscent of American lagers such as Budweiser and coors. I've tried Kili Serengeti lager and Tangu Safari Lager. Safari is a superior brew.

New photos of my time here in the hotel and in dar being uploaded as we speak- http://www.flickr.com/frankis/

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Swahili word of the day: Mzungu- foreigner, and particularly a Caucasian foreigner. However, it is said that it does not carry a negative connotation.

The first leg

I'm currently sitting in Dubai's airport. I've never seen so many jewelry stores, electronic stores, watch boutiques, and perfume stores congregated so tightly together in my entire life. Take the most high-scale mall you've ever been to. Double it's high-scaleness. Welcome to Dubai international. Swanky stuff.

But of course juxtaposed to this is the mandatory starbucks and burgerkings ;)

Emirates is a serious airline. So many movies, television shows, and video games, HUGE meals, Multiple pillows. Also my flight was empty. Flying 12 hrs is not so bad when you have 3 seats to yourself!

Time to head over to my gate. And thanks to Adam for the new blog title!

Shikamoo!

Well the initial leg of my journey went without a hitch- I now have 4 hours to kill in JFK airport awaiting my first flight to dubai ;) I am very excited about the Emirates flight though.. per Ed's report, beer is free and there are 500 movies. I hope they have a good stout available!

I also just received email from both Sky Tanzania and the Hotel Kilimanjaro that my reservations and travel accommodations have been made from Dar International to the hotel, back to the airport the next day, and then to Mwanza. Things move at a significantly different pace in Africa, and I am sure this will work wonders for my excessive type a-ness.

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Kiswahili lesson of the day: Shikamoo (prounounced "sheekamoo" is a greeting used showing high levels of respect, it is reserved for those who are older than you and is roughly translated to "Hello."