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Kenya

Swimming Pool

One of the things I find difficult about living overseas is not being able to get enough exercise. I love to swim, so I was delighted when I found several swimming pools in Embu. When I arrived, I asked my Kenyan colleagues about which was the best pool for swimming lengths, but no one knew. I asked a taxi driver, who came up with half a dozen. I made an arrangement with my colleagues, whom I had infected with my enthusiasm, to do a “pool crawl” in the taxi on Sunday. Unfortunately, my colleagues preferred to have a lie-in on Sunday, so I decided to go exploring for pools on foot by myself. The weather was perfect, warm sunshine and cotton-wool clouds in a blue sky.

I found the Royal Minni Inn, which had a small pool with a boom across the shallow end to keep non-swimmers boxed in. This left about 15 metres to swim in, which isn’t enough. One kick off from the end wall and I’d be at the boom. It had a gym with some basic equipment and a mirrored room for aerobic dance classes accompanied by thumping drum N bass music. A sign on the wall read, “No Idle Sitting”. It was cheap, but I didn’t stay to loiter.

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Some of the pools were in hotels on the outskirts of town. My idea was that I would go to a pool after work at 5pm and get home by 6:30pm, so I’d prefer a central location. The best I found was the Panesic Hotel’s “L-shaped” pool, about 20 metres long with a children’s area off to the side. On the poolside, there were small circular tables with parasols where people were eating.

I thought it was promising, so I telephoned my colleagues who had taken a taxi to the Mountain View Hotel, a couple of kilometres out of town. I decided to join them, but when I arrived it began to rain. I joined them at the poolside. I thought it was rather comical all the people in the pool got out as it rained more heavily. After all, they were already wet. Then there was a peal of thunder and I realised it wouldn’t be safe to be in the water if there was a lightning strike.

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The curved, shallow pool was divided in two by a rope, with children on one side and cavorting adolescents on the other side. It wasn’t suitable for swimming lengths, though if I fitted a rudder between my buttocks, I could have swum in circles.

One of my Nordic colleagues had not applied sunscreen and he looked like a boiled lobster. I told him he needed to cover up and stay out of the sun. We ate lunch under a parasol (masala chips, pizza and fish and chips) but the service was slow and the food mediocre.

It took about three weeks for his sunburn to heal. One doctor suggested that he take a cold shower and it would be better in a few days – she had never had to deal with Scandi-skin before. I offered to get him some hydrocortisone cream, but he’s a big lad and there was a lot of sunburn. Searching the internet came up with spraying menthol shaving foam all over his body, but we couldn’t find any in town. And his skin was far too sensitive for it to be shaved.

Eventually, he was able to venture out during the daytime at weekends without being in pain and we walked down to the Panesic Hotel. A large notice outside the changing room said, “Pay here before entering the pool,” but the booth was empty. On the far side of the pool, there were half a dozen young men dressed in black trousers and white shirts, sitting around, chatting. I asked them if I could pay them, but they said that they were waiters. “Shall we wait with you waiters until the manager comes?” I asked. They thought this was very funny. One walked off to the main reception and eventually, someone came to take our money.

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We got changed in a dingy male toilet with a bench and no lockers. There was an audible gasp of astonishment when the Kenyans sitting at their shaded tables had the double shock of seeing a pink man and a white man wearing budgie smugglers walk to the poolside. We commandeered a table and got into the water. It was about 25C, cooler than an indoor pool in the UK, but pleasant in the sunshine.

We had just started to swim lengths when a crowd of young men joined us. Some decided that they wanted to practice diving from the side, others wanted to race. I waited till the activity died down and resumed swimming laps.

The water was slightly cloudy and there were no markings on the bottom of the pool or the wall, so when I was swimming fast, the wall loomed very quickly into view. I had to be on my toes in order to avoid crashing into the wall. At about 5pm, it began to get windy and I could see thunderclouds across the valley. It was time to get out.

I didn’t use the tap in the changing room to shower off the chlorine; I felt safer with the chlorine still on my body. We chatted to the gang of waiters who had not budged since we had arrived. I asked when would they be serving food, and what was it like. One man replied that it was the best in town. “Really?” I asked. “Yes, but I have to say this because my job depends on it,” he replied. Honesty.

Since then, the weather has been too cold to go swimming in an unheated pool. It is winter here in Embu and although today the temperature hit 24C, it rained heavily last night and it was cold this morning. Perhaps by Christmas, it will be perfect for swimming.

Categories
Kenya

Buses with Attitude 2

Some coaches have been converted from trucks, like this green one. Others sport the livery of soccer teams, usually from the Premier League – Arsenal, Manchester United and Chelsea being the most popular. Others are named “Compliant” or “Reliable”, aspirational targets perhaps, relying on the power of prayer and other spiritual messages.

But sometimes, as in the last photograph, it all goes horribly wrong.

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Categories
Kenya

Buses with Attitude 1

The buses of Nairobi usually have extravagant paint jobs to make them more attractive to paying customers. Some feature celebrities or famous figures, such as Muammar Gaddafi. Graffiti style is popular. And there is always some Christian iconography.

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Categories
Kenya

Nairobi National Museum

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I had to cross eight lanes of traffic to get to the Museum, but it was worth it. I had to sign in at the gatehouse, show my residence permit (I have diplomatic status, but not like Boris) twice and pay the US$6 fee. This got me into the museum and the snake park. Viewing the dinosaur in the gardens was free.

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The main galleries are arranged around a central hall. This has an artistic pile of calabashes, a map of Kenya made from butterflies and a remarkable necklace made from feathers. On the ground floor, there is an exceptional collection of East African stuffed birds in glass cases. The note cards giving the name of the bird, its habitat and snippets of information have been typewritten. This makes the presentation look dated, but the exhibits are phenomenal. Look at all these different types of hornbill, for example (and I only photographed half of them). There are almost a thousand specimens on display.

I could have spent an hour scrutinising the birds, but I had to attend a meeting in the afternoon, which was the reason I was in Nairobi. Also on the ground floor, there was a collection of mammals and a fascinating exhibition displaying skulls of hominids found in the Rift Valley. The oldest human remains found at Baringo date from 7 million years. Kenya was the place where apes evolved into humans. I stopped to watch a flickering video loop showing how scientists investigated the surface of teeth of different hominids using a scanning electron microscope to find out what they had been eating.

On the gallery of the first floor was an exhibition of the life and paintings of Joy Adamson (“Born Free” the book describing how she reared Elsa, a lioness). These showed flowers, fish and fierce warriors from different tribes.

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George and Joy Adamson – typical colonial picnic, with HP sauce and big cat

I enjoyed reading about how a traditional healer used goat’s horn to store herbal remedies, keeping all his paraphernalia in a satchel rather than a Gladstone bag.

There were glass cases containing children’s toys, masks and skeletons. A large part of the upper floor was occupied by an exhibition of the struggle for Kenyan independence, with photographs of the mau-mau commander, General China. The exhibits were quite outspoken, openly criticising corruption.

Finally, there were a couple of galleries devoted to modern art – colourful, a bit derivative, pleasant, but nothing I would want to have on my living room wall.

I walked down the hill to the snake park. It was looked a bit drab and needed some renovation, new snakeskin if you like. In glass cases built into the wall were black and green mambas, puff adders, spitting and non-spitting cobras. In the courtyard pit, a boomslang twisted around a sign which read, “Trespassers will be poisoned.” There was a massive African rock python in an open area and another which was housed in a shed. Its keeper brought it out to drape around the shoulders of brave tourists willing to pay a fee. Behind a fence of chicken wire were three Nile crocodiles, looking very bored.

On my way back to the entrance, I strolled through the botanical gardens. A group of workers clad in blue overalls were sprawled on the grass, sleeping in the weak winter sunshine. A park attendant walked past and threw a stick at one of the sleepers. He woke up, rubbed his eyes and went back to sleep.

There was an old, faded red postbox in the garden, overgrown with creepers. It didn’t look as though anyone would be making a collection from it.

Categories
Kenya Medical

Psychiatric Unit

“He dropped out of school because he was receiving messages from God,” said Lucy, the veteran nurse in the Psychiatric Unit in Embu. “But his family thought this was very strange because he didn’t even go to church.”

Just off the main Nairobi – Meru Highway, close to the Isaak Walton Hotel, is the only psychiatric unit in Embu County. It is a square building with an internal courtyard, built in “Public Works Department 1960” style. To gain access, one has to pass through a locked gate by the nursing office. It has two wards, one with twelve male beds and another with six female beds. Adjacent to the female ward, there is an outpatient consulting room. The seclusion room has a steel door secured with a large padlock. There is a recreation room with a caged television and a broken pool table.

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According to a national newspaper, there are only six psychiatrists working in the public sector in Kenya. One of them works here in Embu. Each time I have visited the unit, I have only seen Nurse Lucy, as the psychiatrist spends a lot of time doing medico-legal assessments for the courts. There is only one other psychiatric nurse, who manages the inpatients. Student nurses do placements here, but few of them want to make mental health nursing their career.

On my first visit to the unit in May, all the student nurses were huddled in the nursing office by the gate. No nurses were in the open courtyard where some patients were walking around in the winter sunshine. I asked why the student nurses were not mingling with the patients. It was suggested to me that they found it too cold to leave the office.

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Lucy told me that drug-induced psychosis was common. “Embu is the catchment area for khat,” she said. (I am not sure she got the right word; “epicentre” would have been my choice.) The shrub khat contains two mild stimulants which are released when the fresh leaves are chewed. It is commonly grown in East Africa, where it is known as “miraa“. To get the best price for the leaves in the markets of Nairobi, drug traffickers drive like maniacs from Embu down the A2 highway in the early morning.

Although amphetamine psychosis is well-recognised, I had never heard of khat causing psychiatric disturbances such as hyperactivity, mania, hallucinations and, with prolonged misuse, psychotic depression. I learned that khat is used with other drugs, such as cannabis, to calm down as the feeling of elation recedes.

Lucy regularly visits schools to talk about mental health and the dangers of drugs and alcohol. She supplements this activity by health promotion using social media. Sadly, outreach clinics in the community have ceased. She has no vehicle and there no community mental health workers. Many people think that mental illness is caused by being bewitched. Rural communities tolerate people with severe mental illness until they start breaking things or attacking goats. Then they bring the person to Embu for a psychiatric consultation. During my previous visit, I saw a woman whose hands had been tied with rope sitting calmly in the outpatient waiting area.

Lucy also said that puerperal psychosis, schizophrenia and severe depression were common in patients attending the clinic. If she could not manage patients suffering from these conditions, she would refer them to Mathare Mental Hospital (formerly known at Nairobi Lunatic Asylum) in Nairobi.

It was obvious from visiting the unit that the patients were cared for with compassion. Lucy was a true champion for people with mental health problems. Unfortunately, she has plans to retire in 2022 and at present, there is no one being groomed to be her successor.

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Kenya

Kazi Pamoja

Teamwork is very important. Without machinery, how else do you get building materials from the ground to the first floor?

How do you get the kids to see their granny for tea?

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Categories
Kenya Thursday Doors

Thursday Doors in Camphor

My father says that his mother used to send him to school with a small cloth bag filled with camphor tied around his neck under his shirt. Apparently, the pleasant aroma of the camphor protected him from noxious microbes. It seems to have worked; he was 94 in April.

My colleagues and I went out for a walk one Sunday afternoon in Embu. We were ambushed by a man looking to be employed. He told us that he had done all the gardening for a new housing development a few hundred metres away down Spring Valley Road. He desperately wanted to show us his handiwork.

We followed him down a paved road to a clearing in the trees. There were several massive bungalow-mansions with pillars and curlicues. He beckoned us to go inside to take a look. It was very posh, far too fancy for volunteers working with a medical humanitarian charity. This is the reception room, with a balustrade and mirrored wall cabinets behind.

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We heard men working in the bedrooms. The carpenter told us that he had designed and made the doors himself. He was planing down the edge by hand to get a beautiful smooth finish. Disappointingly, the vanity unit was made from veneered MDF.

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The carpenter said that he was using camphor wood. We gathered up the shavings and smelled their wonderful odour. I seem to remember it being used instead of mothballs. He said the trees had been cut down locally, so I presume this was actually East African camphor (Ocotea usambarensi) rather than the Taiwanese variety.

Camphor has many uses. It was employed during the First World War to produce smokeless gunpowder – soldiers didn’t want to reveal the location of their machine guns. It had the added advantage of being less likely than conventional gunpowder to jam weapons.

It has other medicinal uses, as a rub for painful joints, to reduce fever and as a decongestant. The Ancient Egyptians used it in the mummification process. It is toxic in large doses and can cause lethargy, as seen in my last photograph.

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Categories
Kenya Medical

Heart Attacks in Embu

“You have chest pain. It might be a heart attack. How do you get an ambulance in Embu?” asked the lecturer. The events room at the Isaak Walton Hotel was silent. I didn’t like to say that I have one sitting in front of my house, on standby.

Someone mumbled that there was an ambulance at a private hospital in town. Another person said that there was one at the “Level 5”, Embu Government Hospital 200 metres away across the Nairobi-Meru Highway. There is even Collo Rescue Team ambulance, in Kirimari Ward, Embu.

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“But what’s the number you need to call?” Dr Mo Jeilan, consultant cardiologist at the Aga Khan University Hospital in Nairobi.

No one shouted an answer. A few people flipped through screens on their smartphones. There is no 999, or 911 or even 111 emergency number in Kenya.

“Well, you had better write this number down. It could save your life one day!”

Dr Jeilan’s next slide showed the main entrance of Glenfield General Hospital in Leicester. “This is where I trained to be a cardiologist,” he said. I turned to a colleague and whispered, “My home is about 5 kilometres from there.”

“Now you have your ambulance, what now?”

“Get an ECG!” shouted a doctor in the audience.

“Do ambulances carry electrocardiograph machines in Embu?” asked Dr Jeilan. “They don’t. So where is the nearest ECG?”

My colleague chipped in, “Level 5 in the Diabetic Department, but no one knows how to operate the machine when the ECG technician is on holiday.”

“Yes,” said Dr Jeilan, “the ECG is usually considered so precious that it is locked away in a cupboard at nights and weekends. And the nurse who has the key has gone home.”

Everyone smiled. It was so laughable, but it was true.

“You have your ECG. Can you read it? Let’s say it is an NSTEMI, a non-ST elevation myocardial infarct. What do you do now?”

Someone shouted out “Troponin!”

“It takes an hour for the troponin levels to rise in a heart attack and another two hours to process the test. Meanwhile, your heart muscle is dying, starved of oxygen.”

Dr Jeilan told us he gets SMS and WhatsApp messages every day from doctors all over Kenya, asking his opinion about an ECG tracing. “A colleague from Meru telephoned me with chest pain. His ECG showed a possible NSTEMI so I asked him how long it would take to get the result of a troponin test. He said two days. Two days! How come? The test has to go all the way to Nairobi to get tested.”

“It’s not like this in Leicester,” he explained, going on to tell the story of a middle-aged man who developed chest pain on the golf course. It didn’t go away after five minutes, so he called an ambulance. The ambulance got there in eight minutes. An ECG showed a heart attack and the patient was being wheeled to the cardiac catheter lab twenty minutes later. Within an hour, the clot in his right coronary artery had been sucked out and a stent inserted to keep the lumen patent. Job done.

“What’s that circular thing on the Xray?” asked Dr Jeilan. I thought it was the metal part of a patch for an ECG lead connection. “No, it’s a nipple ring,” he said. “Men do strange things over there in England.”

“That man’s heart muscle was saved. I see some Kenyans who have had chest pain for days, when it is too late to prevent the muscle from dying and going black, like gangrene.”

There are no cardiac catheter labs in Embu. There are no facilities for “clot-busting” streptokinase either. So what do we have? Chew an aspirin. But the news is that there are two local volunteer cardiac champions who are about to start training.

The next slide showed a scientific paper published just after Kenya gained her independence in 1963. It reported that a Kenyan man had suffered from a heart attack, a previously undocumented event. Fifty years later, the numbers of Kenyans having heart attacks is skyrocketing. The next slide showed a seated man sporting a huge belly. Obesity, the new epidemic, leading to diabetes and cardiovascular disease.

I turned to the surgeon sitting on my right. He was a big man. He looked worried.

Dr Jeilan ended the lecture and handed over to a local doctor whose brief was to talk about diabetes. Unfortunately, the meeting started over an hour late – African time – so the diabetic talk had to be seriously curtailed, or we would have missed supper. The lecturer got a bit flustered, flipped forward and back through his slides. None of the fancy modern drugs to treat diabetes he was talking about is available at the government hospital, unfortunately.

The sponsors of the meeting took the stage to talk about nutritional supplements, antioxidants and micronutrients, then we filed out of the hall to queue outside the dining room. Everyone was chatting excitedly. I eavesdropped and heard that the first ever kidney transplant in Embu was in progress at Level 5. A team from Eldoret had removed a kidney from a live donor that afternoon and it was being transplanted into his brother, who had end-stage renal disease. A historic moment. I wonder how long it will take before the first angioplasty takes place here?

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Kenya

Nail Polish

There were two small upright tents at the entrance to the public park in Nanyuki. “John’s Nail Arts and Gel Polish,” said the poster. I couldn’t resist going inside the tent to see what was going on.

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Anna, a waitress at a local hotel restaurant, was sitting with her legs stretched out, resting on a stool between John’s knees. He was busy with a file, scouring her toenails and poking back the cuticles. I introduced myself, sat beside her and asked if I could watch. I felt like a voyeur, peeking at an intimate act.

“Wow, those toenails are very long,” I said. “Perhaps he should clip them for you.”

“No, I want them long,” she replied.

“I can see why you would like long fingernails, but toenails? Do you think it is attractive to have long toenails?” I asked.

“Yes, a man might notice them, might like them,” she said.

“Hmm, I am a man, and I would not be attracted to them,” I said. “Maybe you can use them as claws to entrap a man!”

Anna burst out laughing. “No, I cannot use them as claws.”

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By now, John had buffed up and primed the nails so that the nail polish would hold. “What colour do you want?” he asked.

Interestingly, she wanted green. I want green nail polish to apply traffic light colours to our plasticised dashboard sheets. No marker pens will do, it has to be varnish. Red means failed to achieve the target, gold means target partially achieved and green means fully achieved.

There was no green.

They chatted in Kiswahili for a minute or so and finally, she picked out fluorescent pink. “Good choice,” I said.

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As he worked his way painting her pinkies with lacquer, I noticed John had a bracelet on his wrist which said, “Azab”. I asked him what it meant and he said it was his name. “Not John, then?” I asked. “That’s my business name. I am called Azab,” he replied.

Azab had a very steady hand. He wasn’t going over the lines. When the nails were dry, he applied a second coat. On top of this, he used a fine brush from a small white bottle to draw the same design on each nail. It looked like he was using Typex correction fluid.

The whole pedicure and nail art cost Kenya shillings 100/-, about a US dollar. Azab wasn’t going to get rich in this game. I told him that in my country this work would usually be done by women. “Why?” he asked. “I’m not sure,” I replied. “Maybe men are not experienced at doing it, or they might feel it is not manly. Or perhaps women would not want men to be touching their feet. It seems a bit pervy.”

“What’s that? Pervy?” he asked me. “Perhaps some men might find handling women’s feet erotic, sexually exciting and women would not want that,” I replied.

He burst out laughing at how preposterous this idea was. “No, here in Kenya, this is man’s work. We do the best nail art.”

Anna was very pleased with the result. We both left the tent and I noticed the tent opposite was also manned by a male pedicure/manicure artist. His poster said that he did nail extensions, facials and eyebrow shaping as well as applying and removing nail gel.
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He was holding a tool like a Microplane grater. “It’s for removing hard skin from the bottom of the foot,” he told me. Having grated the tips of my fingers several times with my own Microplane grater (they are expensive, but they are the best), I could see how effective it would be.

As I walked away, it dawned on me that both young men were very handsome.

Categories
Kenya

Funeral Cortege

A cavalcade of boda-boda motorbikes passed our office. The riders were spread out across the road, driving more sedately than usual, all honking their horns. I raised my camera and started filming. Drivers and their pillion passengers saw this and began to pose, thumbs raised in greeting. Behind them came a motorcade of cars flanking a private ambulance, Collo Rescue Team, siren wailing and roof lights flashing. Two men in suits leaned out of a saloon car, one taking photographs. A black hearse from Tenri Ena Funeral Home came into view, followed by more cars and another black hearse.

“Who is the dead person?” I asked a bystander. “It is the fireman who died last week,” he replied.

I read about this sad event a few weeks previously in the newspaper. Apparently, at 2am on a rainy night, the fireman entered a government compound through a gap in the perimeter wall. The guards did not recognise him, called out and then opened fire as he tried to escape the way he had entered. He was killed instantly by the hail of bullets.

Security is tight in Embu like it is in the rest of Kenya. Twenty years ago, the US Embassy in Nairobi was bombed. Al Shabaab terrorists killed 67 people in Westgate Shopping Mall in 2013. Three years ago, gunmen attacked Garissa University College in the North East of Kenya with the loss of 147 lives, almost all Christian students.