10 Days in Tanzania!

On May 1st Nancy Chescheir and I headed out for a safari to the Serengeti and Ngorongoro Crater in Tanzania. Here we are at the KIA Nairobi Airport, very happy!

I must say from the start that aside from being my boss here in Gaborone, Chief of Staff at the Hospital, doctor at UNC Hospitals and friend, Nancy is an extraordinary photographer. So if I neglect to credit her for the pictures on this blog post, just assume that all the clear, non-shaky and perfectly timed pictures are hers!

From Nairobi we landed near Mt. Kilimanjoro (no mountain climbing on this trip) and headed out for Arusha, which is on the western side of Tanzania and known for its coffee and banana production. It was a lush and colorful ride there.

I had been in Tanzania in 1983 as an undergraduate doing a field study in Dar es Salaam. I didn't travel much outside of Dar at that time, so it was great to see this part of the country. Arushsa today is a lot how I remember Dar to be 27 years ago. 

This is the local transportation all over Tanzania. The "dala-dala" is a mini van stuffed with passengers ("dala" refering to "dollar").

You never want to be too far from a "House of Lubricants":

We were shown around Arusha by a local guide and I told him that one of the foods I loved when I was in Tanzania years ago was roasted "mhogo."  That's cassava roasted and sprinkled with salt and pilipili (hot pepper).  He promptly took us to a woman roasting and selling mhogo and it was just like I remembered!

Then we went to a bustling farmers market.

We made our way to a lodge overlooking Lake Manyara.  It is a freshwater lake and covers about 90 square miles (230 sq km) in the midst of Lake Manyara National Park.

The Lodge pool was at the edge of the cliff overlooking Lake Manyara below.  (I was happy!)

The next day we drove around the Lake en route to the Serengeti.  One of the morning highlights was coming upon a hippo pool with dozens of hippos.  We were allowed to get out of the truck (the only time on the trip) and stand in front of a sign that said "don't go beyond this point" - which we didn't!

We drove around the rim of the Ngorongor Crater to get to the Serengeti.  The Crater (which we would see more of later) was filled with yellow flowers and it made it look like a scene out of the Wizard of Oz.

The Ngorongoro Crater is huge and it took several hours to get around it to the Serengeti.  And we were richly rewarded.  

We came upon a Kopje, granite stones that erupted from the volcanic rock and ash of the Serengeti and were made even more solid by the heating and cooling of the African sun.  They are a favorite hangout for lions and we were not disappointed to come upon a pride of females looking down on us from above.

The breathtaking thing about the Serengeti is that it is vast.  It is like an ocean filled with animals.

The most dramatic flood of animals into and out of the Serengeti is the Wildebeest Migration.

In October they travel south from Kenya into Tanzania looking for the rains and in April they travel back north.  We were there in May and just seeing a fraction of the numbers seen during the peak of the migration (about 1.5 million Wildebeest and around 200,000 Zebra migrate, along with antelopes and of course, the predators).

In the picture above the Wildebeest were streaming in from the right - as far as you could see. It was so dramatic.

On my birthday we visited a Maasai village.  I always thought the Maasai in Africa these days were dressing up for tourism - and that is somewhat the case when they are wearing all their jewelry - but they live all over the Western part of Tanzania in small villages much the same as they have always done.  And the colorful cloth wraps they wear are their daily dress in the village.

They are known for their jumping dance - and they jump very high!!

They invited us to dance with them.  The women sing and jump in unison.  Their beaded neck jewelry flys up and down in unison too.  I got the hang of it by shrugging my shoulders to pop the necklace up in rythmn.

That day we also visited Olduvai Gorge, a ravine in the Great Rift Valley and home to some of the earliest human fossils ever found - some dating back 1.8 million years ago.  Louis and Mary Leaky did their excavations there, and the fosil "Lucy" was also discovered there.

The Serengeti  is packed with animals and we saw all of the "Big 5":

Mom and baby Black Rhino

Male Lion

Cape Buffalo

Elephants crossing the river

We never got too close to the last (and most elusive) of the Big 5 - the Leopard.  We did spot one in a tree, facing the other side.  You can mostly see the back of it's head and the ear.

An amazing trip and a truly memorable birthday in Africa!!

Victoria Falls

Last weekend I went on a 4-day road trip to Victoria Falls in Zimbabwe. I went with Dr. Edmand Munatsi, friend and colleague who is a Medical Officer at the Hospital and is from Zimbabwe. He has lived in Vic Falls and invited Abigail and I to travel with him so he could show us his beautiful country. Beautiful it was. And everything about the trip was a blast! Driving there took us through the Tropic of Capricorn, the southern most boundary of the tropics (the northern boundary being the Tropic of Cancer).















The ride there took us through Francistown in Botswana and Kasane. Driving through northern Bostswana is like a mini-game drive. We passed by elephants and zebra on the side of the road, and warthogs at the border crossing.

































I also saw my first bona fide Baobab tree since being here. They really are massive.






















Soon after we arrived in Victoria Falls we went to dinner at the Victoria Falls Lodge. There I had another first... warthog for dinner! Belive it or not, it was delicious and tender (and no, it didn't taste like chicken)!
















(Abigail, Edmand and me)

















(Warthog!)

Before going to the Falls we stopped by an extraordinary art gallery run by Edmand's friends (and idential twins) Pineas and Pineal. The gallery featured stone sculptures that I fell in love with.






















































And of course there was the reason for the trip: Victoria Falls. Walking along the falls can take more than an hour. They go on and on. We were on the Zimbabwe side and the other side is in Zambia. The spray from the falls is so extreme that we were told to bring umbrellas or bathing suits. I opted for the umbrella!

(A rainbow at one of the 7 wonders of the world)
































(Abigail and Edmand)

That night we took a sunset cruise along the Zambezi River.

Not only did the price of the cruise include unlimited drinks, but the river was teeming with hippos! This was the closest I've ever been (or ever want to be) to hippos. They are one of the most deadly animals to humans in Africa as they can stay under water for a long time unnoticed and then can charge out of the water surprisingly fast and agressively.

















Along with visiting Victoria Falls we also drove to Bulawayo, Zimbabwe's second largest city, and stopped at Matopos National Park. This is a site rich with the history of battles, rock paintings, and an abundance of eagles. To me it had a very ancient and powerful feeling. This is also the site where Cecil Rhodes, the namesake of colonial "Rhodesia," is buried.

















For such a short trip we did quite a lot including being hosted at a Braii (BBQ) in Vic Falls by the twins and their new wives, seeing Bulawayo and seeing parts of northern Botswana. We met many of Edmand's delightful and very hospitable friends, covered quite a distance and had one of the best road trips I've ever been on. I loved Zim and and would go back in a heartbeat!

Christmas in Gabs

It has been a very low-keyed Christmas season for me here, partly because Christmas isn't as visible and commercialized here - so there have been very few decorations or signs of the holiday in town - and partly because it is summer here - it was 95 degrees on Christmas day. Most people in Gaborone leave the city for the holidays. Shops close until the week (or two) after New Years and people either go back to their villages or travel to South Africa or any other nearby holiday destination. Lots of staff from the hospital have left until after New Years.

The two holiday-type things I did before Christmas were to attend a concert at the #1 Ladies' Opera House by the University of Pretoria Choir. They sing songs in each of the 11 languages of South Africa. They finished the concert with a few Christmas sing-along songs. Their call and response harmonies and dancing reminded me of one of the things I love most about this continent.

Nancy Chescheir took these pictures. She really captured how lively this group was. I only wish you could hear their singing.

The second holiday event I attended was the Hospital Employee Christmas Party. About 250 of us gathered in the large outside courtyard located in the center of the hospital for food, caroling and some great dancing at the end!

On Christmas Eve 4 of us went to a small local game park in Gaborone that I had not visited before. You can drive yourself around Gaborone Game Preserve so we had a leisurly drive and spent a lot of time watching monkeys.

We found one of the biggest termite mounds we've seen so far. Way too many termites here, which is why there are hardly any wood-based buildings.














Here I am with my buddies Abigail and Jane with a herd of warthogs in the background.

On Christmas Day a few of us left at the hospital staff housing held a Braai (BBQ) in our complex. It was small, but there was plenty of good food.

I hope you're all having a great holiday. I miss you!!!

Mock Drill

We are in high gear at the hospital, preparing for our opening on January 11th. There are 13 working days left before we open and in the midst of that are the holidays with lots of key people gone.

This past week we had our first hospital-wide "drill" with mock patients - to see how everything from registration to triage, clinic visits, transport of gurneys, the IT system, etc. are going to work. I was a mock patient in the Accident and Emergency Department coming in with a “suspected ectopic pregnancy.” I went through all the different things a patient would and wound up in the Operating Room to get an exploratory procedure and then ultimately surgery.















When they were “done” with the surgery they wheeled me on a gurney to the post-op area. On our way, wouldn't you know, a fire drill began! I was wheeled on the gurney outside, in my lovely cap, while we all waited for the “all clear.” Pretty wild.

Madikwe Game Reserve

Last weekend 6 of us went to Madikwe Game Reserve in South Africa. It was less than two hours drive from Gaborone. The game park was amazing. It really surpassed what I was expecting. We stayed at Buffalo Ridge Lodge, a beautiful, small resort in the bush.















They have a spectacular pool right at the edge of the mountain, overlooking the valley below.














The best part were the two game drives we went on with our guide, Israel.

From L-R: Nita (Biomedical Supplies Consultant), Jane (Midwife), Abigail (Nurse Practitioner), Israel, me, Becky (Nurse Consultant) - Mo is taking the picture

Early in the first drive we saw 2 endangered black rhinos. Our guide was amazed because there are only 50 in the whole expansive park. They rarely leave the protection of the bush, but we happened to catch them crossing the road right in front of our truck.















We also saw giraffe, wildebeest, elephants, zebra... and lions! The two lions we saw were a male and female. We were incredibly close to them but the truck didn’t phase them at all.














In fact they were mating! They mate on average from 3-4 days straight when the female is in estrous.














The actual "act" takes less than 1 minute (seriously). After it’s over they nap for 20 minutes. Like clockwork the female gets up after 20 minutes and goes over to the male and they do it again. Every 20 minutes. Our guide said they sometimes don’t eat for 3 days. It was truly amazing.

More animals: Here is a baby Zebra with it's Mom. Our guide told us that baby Zebra have legs almost as long as their mother's. They stand very close to the mother so that if predators come, the stripes just blend and the baby isn't seen.
















Here is a Waterbuck. I made the mistake of asking our guide Israel what the significance of the white circle on the backside was.

He promptly told me that someone had painted a toilet seat with white paint and the waterbuck sat down. OK how many times has he told that joke.

Happy Thanksgiving!

Most of the Americans from the Hospital (about 20 of us) went to the Phakalane Golf Course for a gourmet catered Thanksgiving dinner. It was really nice - turkey, ham, lots of sides and desserts. It was quite fun and made it a bit easier to be so far from family and friends.

(Tom, Julie, Craig)

(Julie, Patty, Richard)

Unfortunately no days off for Thanksgiving, which is OK because we are all in very high gear in terms of work. The hospital was supposed to open November 30 but last week it was pushed back to January 11. We are not ready to open, so the delay was wise, but it will still be a big push to make the January 11th date. We have lots of nurses yet to hire and train and supplies need to be distributed throughout the hospital.

















I moved into my hospital office last week and that has been so good. I'm managing the medical library (among other things) and it is a very nice, big space with 8 computer stations for staff - which they are already using every day. It's gratifying. The internet connection is pretty good at work and there are no flies(!) which there were an abundance of in the temporary offices.




















OK here's a picture of a very cool grasshopper on steroids I found in the bathroom of the temporary offices.














I actually love my job. I've been setting up trials for a digital medical library and have been doing a lot of networking, both to figure out how to establish a Continuing Medical Education program for the doctors and advance practice nurses at the Hospital and also networking in the community. There is no formalized CME program in Botswana yet, so I’m really working from scratch, although there are many people here quite interested in CME in Botswana, not the least of whom is our Chief of Surgery who was in Zimbabwe for many years and was very instrumental in setting up a CME program for that country’s doctors (although it took them 10 years).

It is the community networking part of my job that I’m loving most. I met with the Executive Director of the largest women's organization in Botswana to talk with her about possible collaboration on a domestic violence initiative. I also met with the Executive Director of the only Women’s Shelter in Gaborone, maybe the country. Domestic Violence is a very pervasive problem here and there is only one women's shelter, which can only support up to 20 women & children. Funding seems to be a big problem for all the non-profits in the area, perhaps except for some HIV/AIDS funding coming in from outside. About 5 years ago or so Botswana was designated a middle income country by the World Health Organization. While that is great and means the country is doing very well compared to other African countries, one downside was that most of the non-governmental organizations lost their international funding. Last night a group of us went to a fundraiser for the Women’s Shelter. And a couple days ago I was invited to an event in town to commemorate the international campaign "16 Days of Activitsm on Violence Against Women and Children." I heard I was filmed in the audience and shown on Botswana TV!
















Things are definitely getting better here as time goes on. I finally got internet access in my apartment, which makes a huge difference in quality of life as does renting a car, which I did a couple weeks ago with Abigail and Jane. We live about 30 minutes (on a good traffic day) from the city, so getting a car was imperative. I'm getting the hang of driving.
















If you ever want to use ALL your brain cells and prevent Alzheimers, forget about Soduku and try sitting on the other side of the car and driving on the other side of the road for a while. In traffic. And on round-abouts. The inside rear view mirror is on the left and the windshield wipers are on the left. That means often when turning we Americans signal our turn by turning our wipers on (the Batswana just aren’t as responsive to that as I had hoped.) And it isn’t just driving that is “backwards” – even my circular birth control pill pack runs in the opposite direction! Then there are Setswana language lessons which I’m taking 3 days a week. It is not an easy language. There are about 8 or 9 ways to make a word plural (I haven’t gotten far enough along to know exactly how many ways yet) depending on the prefix. Is there no rest for the weary?

I hope you all had a wonderful Thanksgiving!!


















(Photo by N. Chescheir at Sanitas)

Monkeys - I Must Be in Africa!

Last Friday a group of us went to the Grand Palm hotel for drinks.

Sitting outside gives you a little extra attraction - Vervet Monkeys running around the grounds!

Pretty wild!