The final days and returing home.

Nov. 30, 2008. We left from the Poenarus by Land Rover at 830AM, a little later than planned en route to Ndabibi, a 2-hour drive initially by very nice highway followed by progressively worsening and dusty dirt roads. In the end, I am not certain the last few miles really qualified as roads! We were constantly battling car-losing potholes, smothering dust and heat, and frequently competing with large herds of Masai cattle and/or sheep for the narrow space available. Many times we actually nudged our way through these herds, close enough to the vehicle that we actually got dumped on! That’s driving in Africa! We arrived at our destination the Ndabibi church right on time. Many people had already gathered outside and many, many children were playing around the outside and singing inside the church. The church itself measured about 12 by 28 feet, and was built of an interwoven network of sticks and branches filled in with dried mud and cow dung. Sounds pretty crude, and it is, but it has been standing for the past 30 years! Only in the past 2-years has Dr. Poenaru been involved and helped fund-raise to put a new roof on the church and find sufficient funds to pay a fulltime pastor. The seats were 5-foot long by 12 inch wide simple benches and it was quite obvious that any decorum around the church, including the pulpit, were hand-made. The floor was dirt. The roof was corrugated iron, and the windows were simply spaces left in the walls. There were no lights and the ambient light through the windows was sufficient.
Prior to the service, we were invited to the parsonage, a mud hut behind the church, consisting of a combined main, sitting, eating area about 6 feet by 8 feet and an adjacent small bedroom. Again, the floor was dirt and the roof corrugated iron. Two handmade couches were on each side of the main room and these were fashioned with material backs but rough lumber seats. The cooking area consisted of a propane tank with a small burner on top and the cutlery was contained in an empty plastic ice-cream container. Oh yea, it was very rudimentary, yet this pastor was well educated and spent 4 years in Moffatt Bible College before being attracted to this humble place. Not all of the people in the area are supportive of his ministry and he his humble abode is regularly robbed or threatened by opposers.
Before we went inside the church again, there was a beautiful serenade from the 4-6 year old children. Their voices were accompanied only by a home-made skin drum. And this was the only musical instrument for the whole service. We also had recitals from the teens, the young women, and the older women’s choir. Let there be no doubt, they are a musical people! The note-finding, harmony, and rhythm was a spectacle in itself. The service went on for about 2 hours including a sermon by Donald in a South Carolina drawl and simultaneously translated by the regular pastor, who incidentally was recovering from typhus and he still looked pretty drawn and weak.
Following the service we were invited on a tour of the church property to see the plans for a new building, the pastor’s garden, and the comparable sized garden area meant for the congregation. Interestingly, even though the land was free for their use, they had not cultivated it at all, unlike the pastor.
After our tour we were invited back to the pastor’s hut and were served a typical Kenyan meal of stewed lamb, cabbage, veggies, and chipatta bread. This was followed by chai tea, all of which was quite tasty and hit the spot by about that time!
On our way back to Kijabe we stopped again at the SOPA Resort (erroneously referred to in a previous entry as Naivasha Resort); this time there were no animals to be seen so we sat around the pool and enjoyed mango juice – yummy!! We took an alternate route through the Rift Valley and once again passed by the IDP (internally displaced persons) camps. This leads through Maui-Maui, a trucker village on the main highway through the valley where drug-resistant HIV is rampant. It looked like a dump! More pleasant sites along the way included Lake Naivasha, including Crescent Island where “Out of Africa” was filmed. We also saw Elsamere where another well-known movie, "Born Free" was filmed. I also spotted a huge flock of pink flamingos along the shore of the lake but it was too far for a good look or picture. I saw 2 camels, zebras, gazelles, giraffes, and warthogs. Lake Naivasha is a protected unique biosphere which has plentiful fish when the waters are high, but when the water is low it becomes very alkaline, promoting the growth of crayfish and other critters that appeal to the flamingos. It was also accidentally populated by papyrus from WWII float planes flying between the Nile and Lake Naivasha.
We arrived in Kijabe via a less-travelled route, a short cut that Dan was aware of, but a little uneasy about as car-jackings are apparently a common event along this section. Fortunately we saw nothing out of the ordinary.
We had our final supper with the Bransfords at 6PM and shortly after I decided to skip th shop-talk in favor of finalizing my bags.


Dec 1, 2008. This was departure day and I was ready; my bags were packed at least 3 days ago. But before we left though, Ivan and I were invited to make home visits on some palliative care patients in and around Kijabe. After what seems to be a typical more-than-relaxed African style, our 9AM pickup happened at 10AM as the agreed upon arrangements had actually not been made! We finally got arrangements for a driver and he picked up the hospital ambulance and in turn me, Ivan, and teo community nurses, both named Maggie! We headed into the Rift Valley to the community of Longonot which happened to be home for our driver. Longonot is best described as a widely apread-out community on the grassy plains of the Rift valley, right below Kijabe. We were taken to the shamba of Susan, a 52 year old woman with recently diagnosed esophageal cancer for which she required an esophageal stent in October. Her main problems were reviewed as well as her medications. She was examined and advice was dispensed. It was an excellent learning opportunity for Ivan and me as well as a good chance to provide feedback to the community nurses. The community palliative care service is in its infancy here and though they are trying hard, it is clear that much needs to happen yet. Susan’s main complaint was described as vomiting but in fact she was merely spitting up excess mucous, without associated nausea. Her pain was upper abdominal burning sensation and she was using morphine every 6 hours with some benefit. The morphine being used was made into a solution by combining it with Paracetamol (Tylenol), and it was delivered from the hospital to the patient by the visiting nurse. Other medications being used included vitamins, metoclopromide, sugar tablets and a liquid glucose solution. We recommended changing her morphine schedule to a more usual 4-hour schedule with prn breakthrough dosing as well. Susan was very grateful for the visit, especially of 2 physicians, and white at that! Ivan was able to leave a prescription for one of her medications by simply writing it on a scrap of paper for the local chemist.
Our next stop took us further in towards the bas of the mountain on which Kijabe is located and then along a winding dusty, dirt road up the escarpment towards the crest of the mountain! It was very picturesque with many vistas and picture opportunities as well as the usual competition with herds of cattle or, more commonly, donkey carts carrying water or firewood. All along the road there were people walking, some carrying a head-bound load of wood (typically it appears that this is usually the woman followed by a man with a much smaller cargo such as a jug of water), water, leaves, potatoes, etc. At one point we stopped to take a picture of the view and I was quickly approached by 2 young boys quite obviously wishing to have their picture taken. I obliged and they seemed delighted with the result; too bad I could not leave them a copy.
After climbing through the spectacular scenery which included the crater of Mount Longonot, several other crater-like large hills, and an ever-panoramic view of the Rift Valley, we finally reached the top of the mountain and corssed the Mombasa-Kompala highway to arrive at another small village. Here we visited Gladys, a 92 year old woman who had suffered a fractured hips 2 years ago and a stroke 3 months ago which left her speechless, unable to swallow, and unable to move her left side. It was a sad situation for sure; she was being cared for by her family and had had a nasogastric feeding tube (which she apparently oftened removed) and a foley catheter. Because of her immobility she had developed pressure sores on both of her hips and the family felt they were improving so had stopped changing the dressings. She appeared to be in pain as she was repositioned for our inspection of her ulcers. We provided some advice including the wisdom of continued use of a very uncomfortable NG tube, the need for pain medication, and the need for wound care. I could not help but think that if I were ever in that situation, I would certainly not want the intervention of a feeding tube, especially nasogastric.
We then left the nurses at their village near Kijabe and returned to wash the dust off. The shower was a welcome opportunity just before saying our good-byes to the Bransfords, to Justus, Dan, and others. Mike (Adkin) picked us up and we loaded an incredible amount of luggage and 4 of us into his VW to head out for Nairobe. The route was the usual rally-style race, previously described. We stopped to check in on his daughter who decided to join us for supper along with her mother (Janet) at the Mediterraneo restaurant. I had Nile perch and prawns; excellent and a spot that Veronique and I will hopefully enjoy some time.
Following supper we headed out for Jomo Kenyatta International Airport; the traffic was mind-boggling! It took us an hour and a half to get to the airport which, as the crow flies, probably was less than 15 miles. Again, the apparent numbers of people not only driving but also walking was mesmerizing.
We arrived on time, after 3 security checks, and boarded on time. However, our flight was delayed because one set of luggage that was checked in had no passenger who boarded with it. So, the crew unloaded the baggage until they found this luggage and removed it from the aircraft for obvious reasons.
Our flight to Heathrow was uneventful and it was nice to be able to sit around the Executive lounge, have a shower, have breakfast, etc., all included in the World Club Traveller package; man, it's the way to go!
See you later to day; unfortunately I was unable to find some perfume for Veronqiue as her specific one is not available in the duty-free shops at terminal 5.
See you later today!!