A Fool’s Departure, A Hero’s Welcome

The day prior to my departure was a melancholic and lazy day. Even the sun felt the pain of our impending separation and decided not to come out the whole day. The night before, we had a great big Indian feast with the chair of Amy’s department and her family. Unfortunately, the combination of rapidly changing weather patterns, the continued challenges at work, and perhaps the overexertion from preparing such a large meal finally got to Amy and she fell sick with a cold. That meant that in addition to the doom and gloom of the day itself, she was sick also. Phooie.

Around 8 pm, I decided to check into my flight. As I was filling out all the online information, it bleeped at me that my flight had already departed and that checking-in was not possible. Obviously, I thought this was a mistake. I fished out my itinerary that was mailed to me and Amy was the first to spot the discrepancy. Jeevan, the bungling fool, was supposed to be on the flight at 1:10 on February 17^th not 1:10 on February 18^th as I had convinced my self. I was trying to check-in to a flight 7 hours after it had left! At the time of the discovery, I should have been cramped into a seat at 35000 feet over the Atlantic on the way to Amsterdam! Wonderful…

There was not much to do that night. Hugh and Marty had already departed for Europe, it was a Sunday and the travel agent could not be contacted. I informed Marc, the overall medical director of the mishap, and we both concluded that whatever pursuable remedy there was would have to be postponed until the next day. I finally relaxed after repeatedly chastising myself and we enjoyed the rest of our extra evening together.

The following day was a rush in the morning. I contacted the travel agent but she wouldn’t arrive in the office until 11:30 m EST. The next flight that would allow me to maintain the original itinerary so that I could travel with H&M to Musoma was going to leave at 1:10 pm that day. So, I ran to the airport, hoping that the agent could pull of a miracle and if that failed perhaps I could talk myself onto the plane. Well, neither thing happened and I was still grounded.

So, we returned home and we enjoyed yet another extra day and night together. Initially, the one travel agent had said that booking me on the flight that I tried to make would cost almost $5000. However, Georgia, the main travel agent we dealt with, was able to re-arrange the whole itinerary so that I would leave on Tuesday and arrive in Musoma on Friday thus allowing me to reach Matoso on Friday also. Despite the SNAFU that I created myself, the itinerary would only be delayed by 2 days. So, if anybody wants to make whatever travel arrangements, it is likely he/she would have an excellent experience with Georgia Terry of James Travel Points (well, you know, good service should be complimented).

The rest of the trip was relatively uneventful. I hung out in Dar. I stayed in a nice hotel. I had one more hot shower before arriving in Matoso. A bit of a pleasant surprise.

The flight to Musoma was pretty cool. It was a prop plane but we cruised at 25000 feet. I was able to see Kilimanjaro, Ngorogoro crater, and the Serengeti plains from the air. Unfortunately, the cloudiness and the dirtiness of the windows prevented me from taking any reasonable photographs. It was neat nonetheless.

I arrived in Musoma, took a taxi to the bus stand and took a matatu to Sirari, a border town where Marico was going to pick me up. The matatu ride was an interesting experience. We crammed 27 people and their luggage into this mini-van that originally was probably meant to seat 8. The trunk was closed with an external lock so that it wouldn’t fly open. Thankfully, the inability for it to close properly ensured that there was proper ventilation in the vehicle. I was crammed in so tightly that I literally could not move any part of my body below my waist except my toes. I’m glad the ride was only 2 hours.

When we reached Sirari around 1 pm, we all jumped out. I walked past one gate to the Tanzania immigration building. I again filled out one of those stupid blue custom forms that I had already filled in at Dar Es Salaam. They stamped my passport. I then walked past another gate. When I passed the gate, I could see the Lalmba vehicle. It was a site for sore eyes. After all this traveling, I finally saw something that represented my home away from home. Jackson and Marico were there to meet me. We embraced – a nice happy reunion. They then lead me to the Kenyan immigration building where I filled out yet another stupid blue form and received a stamp for my efforts. We then happily jumped into the car and drove off to Migori.

In Migori we ate lunch, we talked about the situation in Kenya, we bought a few things and then around 4 pm made our way to Matoso. When we reached it, I saw Joyce walking home from work. We reached the clinic around 4:45 pm and so everybody was heading home. The first words out of her mouth were “Hi! How’s Amy?” So much for the good doctor’s home coming.

However, I did get the hero’s welcome when I got out of the car in the compound. Nancy, Juliana, Jenifer, Prisca all greeted me with big smiles and big hugs. Everybody was very glad to see me and that I had made a successful return trip. Sammy, Isiah, and Daniel also greeted me heartily and embracefully. It was a happy reunion.

Wilkister then came out of the clinic and mentioned that they had some very sick patients. I worked until past 6 pm helping Willis with them. This 15 year old patient was vomiting blood, barely able to walk, and extremely cachectic. He had this liver that reached all the way across his midline and to below his umbilicus. It was huge, hard, nodular, and not a pleasant site. He was certainly going to die and we explained it to the brother telling him that the best course of action is to take the kid home and make him comfortable. That patient would eventually die that evening itself.

The next morning, I was woken up to help suture a kid’s scrotum. He was gored by an unhappy cow who did not like his grazing interrupted. The skin had been ripped and separated such that it revealed the right testicle. Thankfully, there was still skin left to suture together. I was able to successfully do a nerve block of the superficial scrotal nerves and the scrotal branches of the pudendal nerve. I was amazed that it worked so well. I was able to sew everything up so easily that the kid almost fell asleep during the procedure. As Hugh said, when I groggily made my way up to the clinic to assess the situation, “No rest for the wicked.” He probably meant wickedly handsome and talented. At least, that’s what I’ll tell myself.

Well, it looks like “I’m in it up to my neck.” (reference anyone?) We’ll see how well this doctor does now that he’s back in the thick of things.

To return or not to return: That question has been answered.

The sojourn on the other side of the Atlantic was nice. Although the weather was not welcome, being with Amy at our home, eating well, having laughs, enjoying the antics of our crazy canines were a grateful respite from the immersion in uncertainty and recurring news of violence and upheaval that characterized Kenya prior to and after my departure.
The decision to leave Africa was a good one in that I was able to have the opportunity to enjoy myself without feeling the purposelessness while waiting in Dar es Salaam. I was able to help Amy with day to day errands, make the phone calls that she has not been able to deal with considering her busy schedule, and do some general catch up on the real life challenges that seem to always plague us on a daily basis.
After coming home there was much discussion between family and friends about the necessity of returning to Matoso. The uncertainty of stability, the lack of a provisional government, the potential challenges of lost supply lines resulting in food and medicine shortages, and the worst possibilty of physical isolation without means of any movement for fear of violent consequences were all on the minds of everybody including myself. However, Lalmba USA, within a few days of my arrival, did make the arrangements for all of us to come back to Matoso within the ensuing 4 weeks. We would return to the clinic as a group. The quick decision to return was made mainly because of the scarcity of airplane tickets. Had things deteriorated further, those plans would have been canceled.
As news of continued violence persisted, the decision to return persisted to be a difficult one. Our communications with Kenya continued to indicate that the Migori area was calm. All of the Kikuyus had been “liquidated” and the violent proclivities of the Luo in South Nyanza seemed to have been satisfied. The roads were opened, the medical transports had resumed, and obtaining medicines was without difficulty. Marico, the project director who had always given correct analyses and appropriate advice, continued to maintain that returning to Matoso was still a good plan.
Amy and I had discussed the decision to return at length. She was comfortable with the idea. Knowing what the situation was on the ground gave her the reassurance to support the thought of my going back to work here. When things initially prompted us to leave, she felt that an eventual return to the area was still warranted having seen the nature of my work and the positive attitude of the community towards me; when things were so bad that returning was too dangerous, she insisted that I come home; and when things had settled down and Marico advised that returning would not be difficult, she agreed that going back was still a good idea.
It was still a challenge to determine what the right course was. The detractors and supporters of the idea of going back was interestingly split along generational lines: those of our generation felt that going back was indeed acceptable, while the older ones felt that the risk was unnecessary. However, the problem was complicated. Of course, I felt needed. Prisca, our registrar, had called me with her own money while I was in Dar asking that I should come back soon. When I mentioned that Marico had indicated that things were too tenuous, she agreed, but still she hoped that my return would be sooner rather than later. Joseph had also called saying that I should come back soon. Both of them called me with their own money and considering at the time money was difficult to come by and cellphone cards were also a rarity, it is indication of their hope that I would return.
Moreover, I was afraid that they might think that my not returning would constitute a desertion. Despite the fact that it was a good personal (and financial) decision for the previous volunteer to not return, for some of the people here, there may have been that sense of abandonment. I’m not sure if that is the case or not, but I certainly did not want to augment the idea that the volunteers come and then when things are tough they abandon the same people they came to help. It was important to me that that not be the case.
Finally, as Murphy’s law dictates, the timing of this SNAFU could not be worse. We were on the verge of launching our new TB treatment program, we had just moved to the new PSC, and we were going to introduce the new PSC in-charge to the workings of the institution. Then suddenly I had to leave to ensure Amy’s safety and successful return to the States. Her job was of paramount importance – no job, no money, no ability for me to continue working for nothing. In light of the upheaval in the country as well as to the functioning of the clinic, I felt it was necessary to come back so that I could help make sure that these other programs could be reinforced and that they were also in a stable position for when the new volunteers come to take over from me. As everybody knows an organized transfer of responsibility is vitally important to the continued functioning and eventual self sustainability of any project. Plus, reinventing the wheel is no fun.
Therefore, the combination of these factors lead me to decide that returning was necessary to the satisfaction of some to the chagrin of others. Regardless of where anybody stood, all were supportive of my work and my choice. It was difficult even for me to come back after having spent such quality time with Amy and the dogs. But in this case, the call of duty was strong enough to wrench me away from the comforts of my home (the weather notwithstanding) and my family. And now this latest blog entry comes to you from Kenya.

P.S. - Oh yeah... if you look hard, under the picture at the top of the blog is a link to our Kenya photo gallery on www.smugmug.com. If you're too lazy to look for it, click here. And, if you like them, look at all of our photos: jeevamy.smugmug.com