August 2011

Kenya’s Maasai: Do They Have Hemophilia?





I’ve been back almost two weeks now from my African adventure, and the Kilimanjaro climb, and my toes are still healing! One of the great privileges I find when I travel to Africa is the chance to meet and chat with the Maasai. The Maasai are an ethnic group of semi-nomadic people who live in Kenya and northern Tanzania. They are among the best known of African ethnic groups (which the Kenyans call tribes). You can’t miss them with their beautiful red cloth (indeed, “Maasai” means red), elaborate beads, braids, spears and daggers. They tend to be tall, reed-thin and love to jump super high in ceremonial dances. They live out in the savanna, in circular villages (which you can see from an airplane!) called bomas. Their culture is based on cattle: cattle is their currency, their food, their livelihood, their everything. They speak Maa, and many can also speak Kiswahili and English. There are about 840,000 Maasai in Kenya. Quite a few visited the Keekorok Lodge, where we stayed for three days after our rigorous climb.

Indeed, as soon as I stepped off the bus that brought us to the Lodge after a quick 5-minute ride from the dirt airstrip, I saw a Maasai waiting at the front lobby to greet us. It was Daniel! I met him last year during my visit. We had a wonderful chat while he was welcoming the other guests. We also caught up later that evening, after the Maasai came to the Lodge in full force and sang, or rather chanted and whooped, around the dinner table! The Lodge pays them to come and entertain the guests. They sing, do their walking/chanting, and then go outside to do the leaping that really is their trademark. They all try to outdo one another with their leaping. I learned that whoever jumps the highest attracts the most girls!

They can look very ferocious, and indeed, one of their rites of passage is to kill a lion. Around age 18 or so they are expected to become warriors, and to do this they must have several things done. One is to kill a lion with a spear. When I mentioned to Daniel and Lepapa, another Maasai I met last year, that we are taught to fear lions, they both looked at each other and smiled knowingly. “There’s nothing to fear from a lion,” Lepapa said. “Now Cape Buffalo, that’s an animal we fear.”

Another rite of passage is circumcision. This is also usually done at age 17, as part of a group. The young warrior-to-be is expected to not make a sound when then circumcision is made. This is how he shows his bravery. With me in this discussion was Julie Winton, a nurse with BioRx, who had made the Kili climb. We both naturally wanted to know if there was any prolonged bleeding. With a population of 840,000, there is a good chance that the Maasai have someone with hemophilia. In fact, I recall in a previous visit to Kenya, maybe in 2001, I met a Maasai who had hemophilia, though he lived in the city and not in a boma.

As fierce as the Maasai are, they are really gentle, very soft-spoken people. Quietly, Lepapa said, yes, there are some who bleed excessively. What is the reaction of the elders, and those conducting the circumcision?

“They would say it’s a curse,” Lepapa acknowledged.

Julie explained about blood clotting, and that this wasn’t a curse. The two young men were very interested but explained the elders tend to be more superstitious. Obviously Daniel and Lepapa are more educated and have more experience with the world than perhaps some of their elders. Still, Julie and I thought how fascinating it would be to find a Maasai with hemophilia, and to try to bring care to them.

A huge challenge for many of the Maasai is that they live far into the savannah, and not near any major town. There is often not even a medical clinic for routine problems like broken bones. A clinic is something Daniel’s village needs, he noted.

It was a very interesting meeting of cultures; the young warriors (although Lepapa has admitted he didn’t kill his lion yet, and “..really have to in the next two months..”) were curious about our work with hemophilia, and Daniel’s eyes popped wide when he saw Julie’s iPad. He has seen them before, but hers had pictures of cows. Julie lives on a cattle ranch! The topic switched from hemophilia in Maasai circumcision rituals, to artificial insemination and calving.

That night we celebrated our climb by dancing with the Maasai.

Great Movies, Which Showcase the Maasaiq

Mountains of the Moon

About Irishman Richard Burton (Patrick Bergin) and Englishman John Hanning Speake’s (Iain Glen) exploration of the African interior via Tanzania in the mid-1800s to find the source of the Nile, and how their friendship unraveled as a result. Incredible story. Stylish, action-packed, thought-provoking, and true. 1990

The Ghost and the Darkness

True story: In the 1800s, Irishman John Patterson (Val Kilmer) is chosen to build a bridge for the new railroad in Kenya. Work is delayed when two lions break all natural instincts and become serial man-eaters. Nicknamed the “Ghost” and the “Darkness” by the African workers, everyone lives in fear of their reckless killing. Up to 100 were killed, and Patterson seeks to kill them himself, but soon enlists the help of a lone hunter (Michael Douglas) who brings in the Maasais. Great ending, not to miss! Lush, beautiful film, score by Ennio Morricone, but adventure packed and intense, like an African “Jaws.” 1996

Kilimanjaro: Days 4-6

We must embrace pain and burn it as fuel for our journey. —Miyazawa Kenji

Tuesday August 9, 2011

Facts: More than 20,000 tourists attempt to climb Kilimanjaro every year. Six out of 10 will not finish. About 10 people die each year during the climb, usually from high-altitude sickness.

It is cold now, about 40 degrees. We awake in our tents in the Barranco camp, which sits in a valley, at 6 am as “Young” Frank and Ellie bring us much-appreciated hot tea. It’s hard to complain when they are up before us, wear less than we do, tote our gear the same rough path we do, earn a few dollars a day and always serve with a smile. There’s no chance of washing up in this winter weather so we change into whatever clean clothes we can find, brush our teeth, spitting into the bushes, and then quickly get to the mess tent. We have this getting ready thing down to a sort-of science.

After breakfast, Jonas unzips the mess tent door flap and walks in, with Jacob in tow. Today we will walk about seven hours to base camp, Jonas tells us in his solemn baritone. seven hours. Jacob always stands a bit behind him, on his toes, grinning like the Cheshire cat, enjoying the look on our faces. We’ll arrive around 3 pm, have dinner at 6, go to bed and try to sleep a bit, then get awoken at 10:30 pm, pack and gear up, and strike out for the summit around 11:30 pm. We are nervous, and excited.

First we must scale the 800-foot Barranco Wall, a steep fortress of volcanic rock at 12,959 feet that requires what’s known as a “scramble,” hand over hand climbing, and provides some scary moments. It takes about an hour and a half to do this, and while we grunt and sweat, porters seem to zoom by us with their heavy loads. Truly amazing to watch. We respectfully step aside when they pass.

Once we scale this wall, we again descend, knocking small rocks and gravel down below us. Soon we are on steadier footing. As we pass through the Karanga Valley, the walk is quiet, as if we are lost in our own thoughts through this alpine desert which continues to enchant me. Rocks abound, creating a barren, lunar landscape in the middle of lush Africa. At first the rocks were lava, black and pitted remnants of an ancient volcanic explosion. They are huge and massive, all around us. Then, they appear smaller and smaller, until they look like little cannonballs scattered about, as if some African battle had long since been waged. Finally, about five hours into the rigorous hike, the rocks turn to sedimentary rocks, Jonas tells me, which are flat, stacked one on each other like pancakes. A dozen people walking on this new pathway make the rocks crack, sounding like stone chimes with each step. It’s an odd feeling, as nine Americans shuffle on the dusty trail quietly in this eerie atmosphere now, dust kicking up around our boots constantly. Our vision is now limited by a mist or cloud that has moved in. We trudge forward like explorers in a new land, unsure of where we are headed. We keep our heads down to watch our footing, and also because we can’t see much other than the person in front of us. Looking down, I see a sprig of pretty yellow flowers, like a surprise greeting. The asteraceae. The strange juxtaposition makes me want to take a photo, but I remember ruefully that Jonas has my camera. Later, as I look through my photos for the day, I see that he took the very same shot that I wanted!

Dust is our enemy today. It is everywhere: in our nasal passages, our ears, hair, hands, and fingernails. Our boots are embedded in dust; our pants sift dust. Kelly has had a cough the whole trip and the dust must affect her terribly but she never complains. The rocks and our slow pace affect Jeff’s ankles; while he also never complains, he asks if he can go ahead of the group at a faster pace, which will actually make it easier on his ankles. The angle is really hurting him. The guides grant permission and he and Frank take off. I tell you, these are tough hombres with me.

We will be on the trail today for seven hours. I slog behind Brittney now, the last, with Jonas bringing up the rear. Since he has become such a good photographer, I let him keep my camera. At 3 pm we finally arrive at base camp, exhausted. As the porters have arrived ahead of us, as usual, our tent awaits us and I sink to its floor. I’m sure we are all thinking the same thoughts: this is it. No turning back. We are going to attack Kilimanjaro in a few hours!

It is freezing. It must be about 15 degrees. The tent offers a little shelter, and we quickly unpack and pack our gear and clothing, stock up on Gu gel and Cliff bars, Advil and electrolytes. I am thinking rapidly, fueled by adrenaline. Even if we sleep a few hours, the summit will take about seven hours, bringing us to morning. That means we will have had only a few hours sleep in 24 hours, while all the time pushing our bodies to the extreme in zero degree summit weather. I focus on packing instead.

Dinner is a tense affair as we are all excited. We speak about what we feel: some feel nauseated, some think we can do it, some don’t want to think about it. We eat a little and then head off to our tents. Keeping warm is all about layers, so I plot out how I will dress: thermal base layer, top and bottom; flannel pajama bottoms (nothing could be warmer), and another thermal top; fleece top with a hood and ski pants next; my EMS super-warm black jacket and rain pants for bottoms. Topped by a down ski parka. A balaclava for my head and my fleece hood, and the ski parka hood and I am good to go!

We strip off the layers for now, bring some of them into our sleeping bags to keep them warm and settle into our bags. My bag is rated for zero degree weather and even if I only wore a t-shirt and shorts I am as warm as toast. It’s amazing how light it is and how much it protects me from the cold. I stick in my ear plugs as the porters clean up, pop a melatonin and eventually drift off to sleep for a while.

I wake up at 10:00 pm, hot, and it’s about 5 degrees out. My excellent sleeping bag? Eastern Mountain Sports Mountain Light 0°. I throw it off me, worried about sweating. Once you sweat and get wet, you could be in serious trouble with the cold. No sense in sleeping anymore as young Frank will be by soon to wake us up. Now I am nervous. The mountain looms before us, and we must go. I start by putting on the layers, including head, feet and gloves. Oh, forgot the head and foot warmers! I unlace my shoes and insert the foot warmers, and get a set of hand warmers going. Once I am done, I stumble to the mess tent, where Jonas, ever solemn, waits to tell us what to expect tonight.

We have a light meal of porridge and toast. Some in our crew are feeling nauseated, mostly from nerves, and cannot eat. Jacob comes in to “motivate” us which means “Get out of the tent, everyone! Get out of the tent!” He knows there are many teams wanting to climb tonight, and he doesn’t want to get stuck waiting behind a line of climbers. We switch on our head lamps and go. Bundled up, geared up, we are ready to climb Mt. Kilimanjaro, the highest peak in Africa. We will attempt 4,000 feet in zero degree weather all night long.

It is biting cold; the stars overhead are brilliant. The air is still and calm. We fall into our formation, with me in the rear, as usual. Jonas is behind me, Frank ever in front. We carry only our backpacks but there are more porters with us, I suppose in case someone falls ill. Altitude sickness is a true concern. Its symptoms are a headache which gets progressively worse, like a migraine; nausea; and chest fluids. So far, we are all good. No one has really had any symptoms. Once in a great while one of us will feel a headache but it goes away.

We trudge, one foot in front of the other; it’s 11:45 pm. We should only concentrate on one foot, one step at a time. I don’t recall exactly when I start feeling the profound effects of oxygen deprivation. After one hour of climbing, we stop and rest, eat Gu gel or have water. The air is dry and thin and hydration is the key to success. Our noses are runny, and will continue all night long, and for days afterwards, we will all have sore, raw, peeling noses. It’s hard for us to navigate our own backpacks, so the porters are there to help us. The minute I fumble with my mitten, just even to check the time, Joseph is close at hand to help. I marvel that their clothes are not as thick as mine; their shoes not as good as mine. Yet, they are ready to help in a split second, whatever our needs. On we go.

Wednesday August 10, 2011

It’s 2 am, and I am stripped of every ounce of energy. My mind is clear, no nausea, but my legs feel as if someone wrung them out as you would a towel. I feel as though my muscles just shriveled into nothing. There is no power that can make me put one foot in front of the other. My breathing is very labored: “Uh…” I exhale, “Huh!” I inhale loudly. We stop again, collapsing onto our trekking poles. The porters and guides are all fine; they are all acclimated and feel none of the effects that we do. They wait patiently while we try to get more breath to get oxygen to our bodies. We are all feeling something.

I am surprised to get a hot cup of tea from Joseph! Where did it come from? The tea revives me. When we stop, it is a relief as I can catch my breath, but then a deadly cold sets in, and so we must keep moving.

It is a surreal experience. I look overhead and have never seen so many stars, so clearly, so close to earth. I feel like I could reach up and touch them, if I wasn’t so oxygen starved. The moon shines brightly, illuminating a large stretch of rock that we are climbing. Below us are clouds! It is beautiful, primitive, captivating. Time to go, Jacob pushes us on.

We hear singing. Jonas has started a song in the clear and frosty night air, and the porters all join in, chanting. It’s in Kiswahili, so we don’t know what the song is about, but it is great. The rhythm helps us find a stride, and the singing is motivating. On my right, Jonas walks alone, singing, overseeing all the climbers. On my left, several porters silhouetted in the near dark, outlined by the moon, climb swinging side to side, like dancing, swaying to the music, right leg out, left leg out. I feel like we are dancing our way to the summit. Overhead, stars burst the night sky like fireworks. I see Orion low on the horizon, kissing the clouds below us. Directly before me, my fellow climbers, all in a row. We walk in formation, right, left, right, left, feeling like a chain-gang, for we cannot leave now. We’re in too deep. Chanting, we move slowly up the mountain, stepping up rocks, hoisting ourselves with our trekking poles.

Leaning heavily on my poles, I place one foot in front of the other. I realize I need to stop again. Then again. Then again. I cannot get 25 footsteps without stopping to gasp for air. Can I go back? How can I do this ridiculous feat? Twice I ask Jacob if I can go back; I don’t think I can make it, and I don’t want to keep holding the group back. There are more climbing teams below us, and Jacob doesn’t want us to get clogged on the mountain trails. Yes, I want to go back. What a disappointment! I scaled the mountain for two hours, but I cannot in my wildest dreams imagine another four hours of my legs burning and collapsing under me. I simply cannot will them to go on. How can you make your body move when you are completely depleted of any reserves?

Joseph waits patiently for a decision. He will do whatever the guides decide. He is like my personal servant, ready to help me remove my gloves, which I did at one point, in ten degree weather! The minute I started searching for the Camelback tube, fumbling with my mittens, Joseph is there to guide the tube to my lips. I never felt cold. The layering worked well: I only felt some chill and slight numbness in my toes but all else is perfectly warm.

I’m not the only one hurting. Brittney looks vacant, staring; Julie, who was in the front, vomits, resumes her hike, and then vomits again. Jacob moves her to the rear. The next thing I know, Jonas has Jacob put me in the lead. Why the lead? This is the worst idea! I am so slow and will slow everyone down, and the entire set of climbers below me… such is my confused thinking. Joseph is now ahead of me, and I plod along at a snail’s pace, losing all sense of where my teammates are. Maybe they are ahead of me after all? All I know is that it is deathly cold, the stars are beautiful, and only Joseph and I exist in this strange, surreal world. One step. Another step. Another step.

I rest again. When will this end? I see that the group is behind me a distance, and I actually gained ground. This encourages me and I start up again, feeling that I am doing better than I realized. Jonas starts singing again, and I recognize the tune “How Great Thou Art,” my favorite Christian tune, sung in Kiswahili. I love that song because it praises God’s hand in nature, and it’s appropriate as we are surrounded by some of the most beautiful nature in the world. This compels me to focus and push on. The next song is another beautiful Christian hymn, one my grandmother used to sing, “Rock of Ages.” Also appropriate. I wonder if Jonas actually does have a sense of humor after all.

By 3 am, I am so dead, I want to lie down and be left behind. I know now why people who are caught in winter storms, like those on Everest in 1996, want to just lie down and fall asleep in the snow and die. It’s so inviting, and my legs are once again bereft of any kind of reserves. They feel hollow, worthless. My trainer, Dan French, told me during training that when my legs were depleted and exhausted from exercising, then my body would start using other parts, like abs or the back, and this is where my previous back spasms came from. I started thinking about this as my legs are now depleted. Sure enough, my back starts aching viciously, and then my abs. Three more hours of this? Impossible.

I am no longer put in front. I guess I am in trouble now. I would later learn that the singing is a way to help motivate climbers—it works. Putting the slowest in the front is also a psychological trick to get the climber motivated. When they are “last,” they feel worthless, a burden, hopeless. True, true, true. And that worked, for a while. The only things not working are my legs.

Jonas now steps in to help me. Jacob is sent to take care of Julie. I am given Red Bull at 3 am in zero degree weather. I sip it but oh, horrible stuff. I feel like a child refusing its milk, making faces. “You need energy for your muscles,” Jonas tells me. He continues to tell me about how it will quickly get energy into my system. Joseph helps me get up, and this time Jonas locks my left arm tightly with his right arm and paces me; he pulls on my arm and I follow. This is good and bad. It works; I move up the mountain. But it means I am not going to my sleeping bag any time soon.

“Do you have a headache?” Jonas asks dispassionately. No. “Do you have nausea?” No. “How is your chest?” I’m fine; no coughing or fluid buildup. “You’ll be okay,” he states matter-of-factly as he squeezes my arm tightly. I consider lying next time he asks.

Up we go. My life is now reduced to a few things: one foot in front of the other; hydration; labored and noisy breathing; leaning on this arm of iron. I need to focus on something other than the burning and constant pain in my legs. I recall that President Theodore Roosevelt would recite his favorite poetry when he was in trouble on his expedition to Brazil, after his presidency. He traveled to the River of Doubt, which was not completely charted on the world map. He did finish the expedition and put what is now the Roosevelt River on the map, but almost died in the process. While suffering from malaria, he recited the poem Kubla Khan over and over. So I started to recite my favorite childhood poetry, and realized that I don’t recall a lot of poetry. My favorites were from Rudyard Kipling’s Jungle Book so I started reciting it in my brain. Now Chil the Kite bring home the night that Mang the bat sets free. The herds are shut in byre and hut and loosed till dawn are we…

I am now stopping to gulp air every 25 steps. At this rate I will summit sometime next week. Why doesn’t Jonas let me go down? Please, I beg. He once again coolly and without the slightest emotion asks: Do you have a headache? Are you nauseated? How is your chest?

Lie, lie, I tell myself. But I don’t. I confess I am fine; I don’t have altitude sickness.

“You can make it,” he replies calmly, amid the struggling climbers, and me, slumped on his arm.

Where have I heard those words before? I realize that this climbing Kilimanjaro is a lot like childbirth. In fact, worse than childbirth, and having had three kids, I know what I am talking about. You are in extreme pain; you are exhausted. The night is endless. Your vision has been reduced to tunnel vision. You can focus on nothing but the pain. People are telling you to push (on). But in the back of your head, you know that there is a glorious outcome waiting for you. You feel alone, though you know you are surrounded by caring people. You want to scream at those same people when they tell you you’re okay; you will make it; you’re doing well. And worst of all, you asked for this!

Jonas and I walk about as slow as two humans can walk, up the steep incline, energy melting away with every step. I stumble along the endless switchbacks; I fall; I trip over every rock and trekking pole. We take breaks; I ask him to sing again because it really does help. I can’t recall if he ever did.

Things get so bad when we pause that I start sinking to my knees. Jonas supports me by giving me a hug, allowing me to lean into him, and pats my back and with no emotion says, “You can do this, Laurie. You can do this.” He doesn’t want me to stop walking, knowing that cold will overtake me. The next rest time, I am hanging on to him with what strength I have, saying, “I’m trying” or “Ok.” I apologize a lot to him for all my inadequacies as a human being, for wasting his time, for trying to think I could do this. He doesn’t really answer these ramblings. Probably he has heard all these confessions before from every climber, and then some.

It’s a macabre dance: plod, plod, plod, hug, hug, hug, head buried in his parka, struggling to breathe in air that is 50% less oxygen than sea level. Joseph stands ready to help with water, and at one point, to help drag me. When they allow me to sit down, which isn’t often, my eyes close right away. “No sleeping,” Jonas lectures. This is absolutely taboo, but so hard to comply with. My eyes have a will of their own.

I decide that counting helps me focus and maybe I can measure my improvement? I count out loud my steps with a raspy, labored voice. I get to 25, and we must stop so I can breathe again. Eventually I get to 30 before stopping again, then 50. I am getting encouraged! Somehow we make it towards Stella Point, at 18,848 feet, where the ground gets flatter, and I actually reach 100 steps before I have to stop. It’s amazing how quickly the legs recover and get oxygen when the slightest pressure from gravity is removed. I continue to count out loud. Jonas, who seems to have no sense of humor, surprises me with a hint of one. “Laurie,” he said, “Try counting in your mind. Save your energy.” I felt half rejected and half amused. I think Jonas just made a joke at my expense.

“Only 20 minutes now to summit,” Jonas informs me. Incredible. The night that seemed so endless, so pained filled, is nearing the end? Suddenly the wind picks up and blows fiercely. The ground is covered in snow and frost, which surprises me. When did this happen? We see more people, though they move like ghosts in the blinding flurries. Yes, the end is in sight; I start to walk independently, and finally, after six and a half hours, reach Uhuru Point, the highest peak on the African continent. My teammates are there already.

I think I collapsed on a rock, my mind foggy and slow. Most everyone was okay; 14-year-old Alex had his eyes closed, slumped on a rock, and Brittney was staring blankly. They all had fluffs of snow frozen onto their eyelashes and hair. My buddy Julie made it, but she also had a dazed look on her face, as I am sure I did. So we were all accounted for. Jonas had insisted I bring my 35 mm camera, which is quite heavy, to take pictures. I wanted to bring only my Sony Lumix, to reduce weight, but Jonas insisted. You just don’t argue with Jonas. He tucked my camera in his parka the entire night. At 6:54 am, he began taking pictures in the terrible weather. We couldn’t see the sunrise or even anything further than 15 feet in front of us, which is sad because we should see a spectacular view of Tanzania from here.

It was hard to see, and hard to hear one another above the roar of the wind, and visibility was bad, but we were happy. We pulled out banners and had our photos taken at the sign that signifies the highest peak. We even had a couple of humorous moments.

After about 15 minutes we had to start down again. The wind has picked up to about 50 miles per hour, and actually pushes against us. We take shelter momentarily behind a large boulder with other climbers not in our group, and when there is a break, move on down to Stella Point.

After Stella is the part I don’t recall well. It took over six hours to summit, but seemingly a few minutes to descend to a point where the snow was gone, and we could shed our layers, and see base camp. But that’s impossible. The sun was shining high now, as if to celebrate with us our victory, and a great valley spread out before us like a welcome mat. I was still weakened by the oxygen deprivation, and Jonas retained a firm grip on my arm. Joseph was ever present to hydrate me. What I do recall is hitting sand on the mountainside, and being made to “scree-slide,” which means we skied down in the sand using our boots, digging in our heels to slow ourselves. The hike down took in reality about three hours, according to my watch. The sand slopes caused me to use different muscles, and the altitude was less, but I still needed Jonas to help steady me.

The times I tried to hike down independently, I often lost my balance or tripped. Being rather proud, I wanted to walk down but I had to admit my limitations. “You are like a baby,” Jonas said. “Let us take care of you.” And they did. Soon we caught up with the group at a large outcropping of rocks, where we stripped off a few layers and enjoyed the bright sunshine. Somehow there was mango juice for us to drink, which normally tastes rich and delicious. Now? It tasted rancid, as everything did with the effects of altitude. But with two six-foot wardens standing over me, I sat on a rock and obediently sipped the seemingly bitter juice, wondering if I could toss it over my shoulder when they were slightly distracted. They never were.

The team was excited, even in our depleted and painful state. We did it! This was the thought uppermost in our minds. We actually did it!

Barafu base camp is visible but seems like an optical illusion that keeps moving further away the closer you get to it. At last, at last, the endless night is over and blessedly, we arrive. Mary and I collapse into our sleeping bags. It’s 10 am.

For reasons unknown to me, I’m up at 11 am, ready to march again. We still have a full day’s hike ahead of us. So after lunch, the porters break down camp and we pack up our rucksacks for them to carry, slung on our backpacks and headed out. We were taking a different route home, Mweka, which proved to be amazingly simple. Just downhill, on a trail strewn with rocks and rock steps. The going was painful due to our cramped muscles and swollen toes and knees, but it was fun. Julie and I fell behind the others, as usual, but had such a great time chatting. Jonas trailed us like a bodyguard and willingly took my camera to once again take amazingly wonderful photos. The day was sunny, warm and Kilimanjaro National Park expanded to our left as we descended the mountain trail.

We finally arrived at camp around 5 pm, late. The others had arrived about 20 minutes earlier. This was a nice camp, with a registration cabin and amenities. There were many other groups present. Pine trees surrounded us and we were all deliriously happy with the results of the day. And starving! We enjoyed our dinner immensely.

Thursday August 11, 2011

The pressure is off; we climbed Kilimanjaro! We feel some sort of euphoria which helps us to forget our swollen knees and aching muscles. I am amazed at Jeff Salantai: yes, he’s young, at 31, and incredibly fit, but he has hemophilia and just endured a major ankle operation in February. I don’t know how he managed to climb Kili! But he did, and he is limping today, but he grits his teeth, cracks a joke, makes us all smile, and carries on. Such strength! He is a poster boy for hemophilia perseverance and accomplishment!

Today we descend to the Mweta Gate, to be collected and brought back to our hotel. We have about a 3-4 hour hike downward. It’s all on trails that are very stony and rough, but well defined. And it’s downhill! That’s good news; the bad news is it will play havoc with our joints, muscles and toes. I pop some Advil to help with the swelling, have breakfast and pack up once again.

It doesn’t take long for Julie and me to get separated from the group again. We love to chat, and I like to stop to take photos. With our swollen knees, it’s easy to go slower. The scenery is beautiful in the brilliant daylight. We hike through the desert again, the sedimentary rock, then to the moorland. On our left is the broad expanse of the Kilimanjaro National Park. This way down seems so easy! We are coated in dust and there just isn’t a way to stay clean. Trailing ever behind us is our lead guide Jonas, who happily answers our many questions and begins to joke with us. Really. Julie even laid it on him: Don’t you ever smile? To which he smiled. The rest of the two hours is a walk with three friends, as we each shared more and more of ourselves. It was lovely. Who knew that Jonas was a Maasai? Did he kill a lion then, as the young warriors are expected to do? He claims he did and told us a fascinating story about it.

Nearing the end we reach the forest again, and a light rain sets in. I have no desire for rain gear. I let the rain wash away dust and refresh my skin. We start to pass locals on the trail, who know one word in English: “Chocolate?” I wish we had some but I dole out Cliff bars instead.

Porters race by us now, eager to finish and collect their pay. Excitement is filling the air as the trip nears its end. When we reach the gate, we are reunited with our group, and Neil is there, to welcome his daughters back! It was great to see him again! He was so very proud of his two girls.

The porters and guides surprise us with a birthday party, there in the dusty parking area, surrounded by locals. Tomorrow is Alex’s 15th birthday! They sing Happy Birthday to him, and despite the long journey, they are animated and happy. They present cake and “champagne,” and Alex, despite his father’s strict southern gentlemanly upbringing, devours his piece before the rest are handed out.

My toes are gruesome. The downward walk for hours has jammed my big toes’ nails, and they are inflamed, blackened and soon, infected. They will stay this way for about two weeks. Of course, Julie immediately provides me with antibiotics. What would I do without her? (Thirty minutes after my plane lands in Boston I am off to the podiatrist to have them lanced.)

We have a 90 minute ride back to the Kibo Palace Hotel in Arusha. First, a lunch break at a local restaurant, where our three guides give us a chance to regroup and chat about the trip. The wash basin is right in the dining area, and I am ecstatic to see soap and hot water. I wash and wash but cannot believe how dirty my hands are; the water runs black. I am so excited, I go to the back of the wash line to wash them a second time!

The food is fresh and good—I eat chicken, but Frank tempts me with the strange looking beef on his plate. Tastes like, liver? Oh, it’s ox tongue! It’s all washed down by Cokes and Tusker beer. Jonas, Jacob and Frank seem happy: another mission accomplished. The ride back is quiet and I snap a photo of everyone sleeping—except Kelly Herson, who as always has a megawatt smile on her face. Back to the hotel, we shower, some of us for an hour, and become relatively human again. We invited the guides to dinner at the hotel that night at seven. We are all clean now, with fresh clothes. Jokingly, I reintroduce myself to the men I just spent six days with, as I am sure they will not recognize me without a Nike hat, hiking gear and black smudges.

Jonas presents the climbers with certificates of their climb and we leave them with some of our climbing gear as a gift, generous tips and happy memories. These guides are with Team Kilimanjaro, and I will praise them as professional, personable and efficient. I highly recommend this outfitter and its guides and porters. www.teamkilimanjaro.com

Tomorrow we head for Nairobi and then fly to the Maasai Mara for a three-day safari, our third adventure in a trip filled with adventures. As long as there is no hiking, we’re good!

Outfitters used: www.teamkilimanjaro.com Experts in climbing and summiting! Thanks to guides Jonas, Jacob, Frank and Alex, and the 40 porters who carried our supplies and equipment. Thanks to my great teammates! Thanks to all who sent their prayers and good wishes. It helped!

Thanks to all our corporate sponsors: BioRx, ASD Healthcare, Bayer Corporation, and Grifols. Thanks to the dozens of individuals who donated funds to help us reach over $60,000 for our African programs! We will be starting college scholarships, a microloan program and continue outreach to find those with bleeding disorders who suffer in silence…

Our Route up Kilimanjaro

Machame route

▪ Machame Gate (start of trek) (5718 ft/1738 m)

▪ Machame (9927 ft/3018 m)

▪ Shira (12355 ft/3756 m)

▪ Barranco (13066 ft/3972 m)

▪ Karanga (optional camp, used by 7-day climbers)

▪ Barafu (high camp before summit) (15239 ft/4633 m)

Stella: 18,848

Uhuru: 19,349

▪ Mweka (descent) (10204 ft/3102 m)

▪ Mweka Gate (end of trek) (5423 ft/1649 m)

Good Book I Just Read

Not On Our Watch: The Mission to End Genocide in Darfur and Beyond
Don Cheadle and John Prendergast 2007

Actor Don Cheadle was compelled to help end genocide after starring in Hotel Rwanda, a movie about the role one man played to save hundreds of lives during the ethnic massacres of April 1994. Together with activist and journalist Prendergast, he has started a nonprofit that seeks to educate and motivate average citizens to act. With the realization that change will only come when we link economical and political repercussions to the behaviors of sovereign nations, such as embargoes and divestiture, and not just military action, he focuses on the mass killings that occurred in and around Sudan’s Darfur region, and also inspire people to step up and speak out in an effort to generate more attention to what is happening in this part of the world. The book provides a brief history of how the Sudan incubated genocide, what role other countries have had, and what this means for the world.

The weakest part of the book is that it is an overview, not a detailed analysis. The style is difficult: Cheadle is very casual and talks a lot about himself, how he got involved, right down to detailed (and very banal) dialogues with his relatives and friends. Prendergast is quite full of himself! They flit back and forth in the first-person voice, then third-person… so you never quite know who is talking when, and the flow is interrupted. Is it a book about them, or genocide? It’s a book about two celebrities writing about genocide and their own efforts.

A lot has happened since 2007, when the book was published. The UN finally stepped in with muscle, sent an arrest warrant for the president. The UN estimates that 300,000 people have been killed in the five year Darfur conflict, which was launched against the non-Arab people of the south. And as you may know, on July 9, 2011, South Sudan has become the world’s most recent new country.

The strength of the book is its simplicity and call to action. I applaud these gentleman (Cheadle was absolutely fabulous in Hotel Rwanda, one of my favorite movies) for undertaking such a task, for motivating the public and for not just rallying but giving concrete, doable tasks to make a difference in the world. Could be used for any international activism subject. Three stars.

Kilimanjaro, Days 1-3 “The Enchanted Forest”

Our African travels now bring us to the Main Event—the Kilimanjaro climb. Up 19,370 feet in harsh weather in the middle of the night to raise money for Save One Life, our nonprofit child sponsorship program. Nine other people are now gathered Friday night in the lounge of the Kibo Palace Hotel in Arusha, Tanzania, to listen to two men, our guides, on whom our lives will depend, speak about our climb. With me are: my daughter (17), Eric Hill, president of BioRx and son Alex (14); Julie Winton, RN, BioRx; Jeff Salantai (31), BioRx; Neil Herson, president of ASD Healthcare and his two daughters Kelley (16) and Brittney (20). The only problem is my gear is missing, as is Eric’s and Alex’s. Eventually mine shows up much later that night (after many phone calls), but Eric and Alex are completely without clothes and gear. They will need to rent gear from the outfitters, Team Kilimanjaro.

We were up at 6 am on Saturday at the hotel, and ready by 7 am. It’s a lot of packing to think about, being gone for 6 days in the wilds of Africa! We don’t really know our guides yet; there’s just one guy with a big smile that seems to connect with everyone. On the bus Julie got everyone to sing our theme, “Ain’t No Mountain High Enough”! She likes the Marvin Gaye version while I like Diana Ross’s. There’s lots of chattiness; everyone is excited.

Machame gate

It takes 90 minutes to get to the Machame Gate. Along the way we saw rural Tanzania, how poor people are compared to US standards. We stopped half way at a convenience store, where most of the team bought little bracelets from a street vendor. Soon we are at the Gate. This is where it all begins! We filed out, and saw pandemonium. There were hundreds of people swarming. Porters lingered everywhere, big bags of gear sitting in the muddy and dusty roadway, other hikers of all nationalities… we wait about an hour to complete paperwork. It’s a bit confusing. We start putting on our hiking gear—gaiters, backpack covers—while waiting. The air is chillier than I expected. Finally we’re done and we start. It seems surreal: all our training, planning, fundraising, and here we go!

Our lead guide is Jonas Gerald, tall and impassive, assisted by Jacob Slaa, the guy with the big smile, and Frank, who perpetually smiles. We hike today from 12:30 pm until 6 pm, with one stop for lunch. I am so surprised when on the trail we pull up to a table, chairs, and wonderful food, in the middle of a forest!

We will go through 4-5 ecological zones on this climb. Today we hike through the forest. It is beautiful: nice and cool, moist, on a defined trail. There is huge green moss growing up and around the trees like some fuzzy, green sloths. Lichens hang down from other trees like trails of lace on a Victorian gown. It seems an easy hike, not too steep, a few rocks, and a set trail.

Julie is amazing: she thinks of everyone else on this trip. Today she has snacks for everyone and keeps everyone hydrated. Even the guides and porters get snacks!

14-year-old Alex, the youngest, is a strong hiker, as are Kara Ryan, and Kelly and Brittney Herson. I had wondered about the Herson girls and how they would fit in, as no one really knows them, but they are super sweet, strong, and soon, everybody loves them and their can-do attitude! We are fortunate to have a diverse group of 10 people who all get along well with one another.

We break for our first camp around 6:00 pm at the Machame Hut. We have a mess tent with a table, so we can all have dinner together. Dinner is hot veggies, celery soup, potatoes and fried fish. I learned Sama hani means “I’m sorry” (for stepping aside when porters brush by us) and Twende means “Let’s go!” (used often by our guide, Frank).

It’s fun to go to bed in our tent, with our sleeping bags. It’s been so long since I’ve done something like this, and I love it! And we are tired; we climbed from 6,000 feet at Machame Gate, to 10,170 feet tonight. We wait to see who will first feel the effects of altitude.

Day 2 Sunday, August 7, 2011 “Into the Mist”
I guess I didn’t sleep too well. I fell asleep from 9:30 pm to 11 pm, but the porters kept us awake till 1 am or so with their animated chatter. They work very hard; I’ve never seen anything like it. They are efficient, powerful and zoom by us on the trail laden with all our tents, food for 6 days, sleeping bags, and clothes, all bundled into sacks, which they balance on their heads. These porters are often young guys, slim, and often without great gear themselves. Some wear sneakers with tears of holes; they are gloveless in the cold and wear regular street pants. I was up until 2 am and then slept off and on. I had strange dreams.

“Young” Frank (not the guide), a sweet, 20-year-old boy with a shy smile, starts our day with a cup of hot tea. It’s so nice! Ellie, another nice young man, tags along to add sugar. This is luxury! We sip hot tea in our sleeping bags and begin our day. I put on make up in the morning sunlight, which makes Eric laugh out loud. I will abandon this practice the very next day. Contrary to my belief, it’s not all about how you look on Kili. We are all sharing a small stand-up tent for a bathroom, which has a portable toilet in it. If you think about it, it’s kind of gross, but honestly, when you are there, it seems perfectly normal! We are even grateful for this small luxury!

Breakfast is eggs, toast, jam, and porridge.

The camp is crowded with other groups, including a loud Japanese or Chinese delegation. It looks like a refugee camp here!

We start out earlier than most groups, at 8:06 am. The climb today takes us away from the forest and into the heather, or moorland zone. The topography changes dramatically. It’s cool, and mist rolled in above us and around us. I feel surprisingly great. We will climb to 12,461 feet when the hike is done. We move more slowly today, with Alex the guide leading the way, steadying our pace. There are lots of rocks on the trail and narrow turns and ledges. The trees are beautiful! At first I think we are in a scene from the “Wizard of Oz,” when they come to a poppy field. Then later on, I think this is like a scene from Peter Jackson’s “King Kong.” Very primordial, with lava rocks and giant boulders.

A popular plant we see is the lobelia deckenii, or what our guide calls the “Antifreeze plant.” It closes up tightly each night to protect its leaves and unfolds to catch the morning light.

The air is crisp, cool, and moist; we don’t sweat much today. But the dust! The air is filled with baby-powder fine dust that infiltrates everything. Our nostrils are black, faces were smeared with dirty streaks, and our fingernails are ringed in black.

Up, up, and up we go. There is still a clear trail, which I didn’t expect. Sometimes the trail is made of stone steps, winding, twisty, steep. Neil falls further behind us, and I am next to last as I am kind of slow. Jacob stays with him while the rest of us push on. The air is thinner and it is harder to walk at 12,000 ft.

Julie and I hang out together, walking slower than the rest. I am also taking photos, which slows me down. The scenery is spectacular! We need to stop now and then to eat, take water. The porters truck past us on the trail, their loads frighteningly heavy. We are constantly shouting, “Porters right!” to let them by us.

Lunch break! We have peanut butter sandwiches, fruit and avocados, and carrot soup, which is delicious! Then they bring out pasta and sauce! I couldn’t eat any of that.

We walk slowly the next hour and a half through the Shira Plateau to the next camp. This is when we get our first real look at Kibo, the dramatic summit of Kilimanjaro, rising up above the rocks, blue in color with clouds challenging its summit. At one point, I am totally alone! Not another human being in the place. It is glorious. I look all around, and hear nothing nor see anything. Just me and Kili. I wish it could have lasted longer. Privacy is one thing you don’t get on the popular Machame route.

I stroll into Shira Cave camp and am greeted by the others. I wash up for dinner and everything is black. My legs and arms were filthy black.

Neil arrived around 4:50, a full 90 minutes after we arrived in camp. I bring him hot tea while his girls put him in his sleeping bag. I also brought him a Cliff bar for fast energy. When Julie comes on the scene, she takes charge to help; altitude sickness is serious and must be dealt with. We are so blessed to have Julie with us, as a nurse and compassionate friend!

Day 3 Monday “Walking on the Ocean Floor”

I took melatonin last night and had a great night’s sleep, despite the cold. I am shocked when I unzip my tent to see frost coating everything. I left my boots outside and they are frozen today. Huge white-necked ravens sit in the small trees near us, cawing for some food. (Which of course I toss to them) Sun strikes the far away ridges of the mountains, which are separated from us by clouds and looked beautifully surreal. We are actually looking down on the clouds! Breakfast is on, and I’m hungry. We had porridge, toast, eggs and jam.

After some discussion, it’s decided that Neil will go back down the mountain today. The rest of the trip will only get harder—and higher. It’s a loss to our group, as Neil was such a driving force behind our fundraising and so motivational for us all.

Today will be a long day of climbing, about 7 hours. We will go to 15,000 feet, then descend for the evening back to 13,000 feet, to help us acclimate. We hit the trail by 8:06 am and walk for two hours. Within 10 minutes we can feel the 12,000 ft. altitude. Our quads burn and our legs feel heavy. We walk in single file quietly, shouldering our back packs, following a trail that leads us toward Kili, heads down, like a herd of burdened, untethered pack mules. Frank is in the lead, walking pole, pole (slowly, slowly). It’s cold, but when the sun comes out, layers come off quickly.

We stop frequently as we tire easily. We sip water from our Camelbacks, and slow our pace. I want photos so I hang back a bit from the others. The terrain is more sparse now, just scrubby bushes with so many rocks! Some of the monoliths are huge, standing erect like those statues at Easter Island, keeping vigil over this ancient mountain. Small boulders dot the lunar-like landscape, with clumps of red straggly moss hanging off of them. It’s easy to remember now that Kilimanjaro is a volcano, and what I see around me were lava rocks from inside the volcano, deposited here long ago after an eruption.

I feel at times like I’m walking on the bottom of an aquarium, which someone tried to decorate to simulate the ocean floor. It occurs to me that this area may have been submerged in water millions of years ago; like the high mesas in Canyon Lands, Utah, where you can still see salt beds, remnants of a receded salt ocean millions of year ago.

It isn’t a difficult hike, but tiring, due to the thin air. Eventually we stop for lunch near the Lava Tower, and I find myself staring blankly. Lunch is great: hard-boiled eggs, sandwiches, fruit, cornbread, avocado, and tea. We don’t rest long. Today we climb to 15,000 feet, and then camp at 13,000 feet. So far, no altitude sickness.

After lunch we descend down a very steep, rocky path, into the Barranco Valley, and we trek through the alpine desert. It’s beautiful—for a rock lover like me, this is heaven. The rocks are enormous, pitted and some are shiny black. Mist rolls in and it becomes very chilly. The topography looks like a scene from the movie Lord of the Rings. As we hike, we feel like characters in the movie. The air becomes dramatically colder and we all threw on more layers and rain gear. I think the temperature might be freezing, until I step in some mud and see a little rivulet. The wind chill makes it feel freezing.

The group soon forges ahead, leaving Julie and me with Jonas. I enjoy this walk the most. The alpine desert is hemmed in by ridges of Kilimanjaro, dotted with lava rocks, and decorated with the most unusual looking trees. We laugh that they look like those from a Dr. Seuss story, such as the Lorax. Truffula trees! They also at times remind me of saguaro cactus. These are the giant senecios. Hard to believe that they’re cousins to the daisy. I thought I might hear songs run through my head while gazing at such scenery, but no. My mind is silent, in the moment, observing and taking it all in.

We arrive at Baranco camp, where a few other groups await. Everyone is tired, and sits about doing their own thing: Jeff napping on a rock; Kara writing in her journal. I hike ahead of Julie and Jonas and had a bit more time to walk alone in solitude, which made me happy. This camp sits in a little valley, and is beautiful.

What will tomorrow bring? It’s much too cold to change clothes or even wash up. Washing in the hot basin that Frank brings each morning is great, but there is nothing to dry oneself on. Thankfully we brought little towels that seem to dry quickly. We do our best to stay clean!

Tomorrow, Day 4, will bring us to the foot of the summit path! More to come….

Kenya Day 4 Thursday Murang’a

We achieved our dream: our team summited Kilimanjaro on Wednesday morning, August 10, at 6:54 am, and raised over $52,000! I’ll give a detailed blog about that but let me finish up with Nairobi first.

We were thrilled to hear that Eric Hill, president of BioRx and a sponsor, and his 14-year-old son Alex were finally arriving in Nairobi this morning, August 4, at 6:30 am. Their flight Tuesday was delayed in DC, which caused them to miss a connection, then they spent a day or so in Europe waiting for another flight to get out. The worst part is that their luggage containing their climbing gear disappeared! All the climbing gear needed for Kilimanjaro was in limbo. We thought they must be tired, and we had a full day of family visits ahead out in Murang’a, about a two-hour drive from Nairobi. Amazingly, they wanted to go straight from the airport, meet us at the hotel and come with us.

They were in for an amazing day. After introductions to Maureen Miruka, president of the Jose Memorial Hemophilia Society-Kenya, and Paul Kamau, person with hemophilia who also works for the JMHS, Isaac and Adam, young men with hemophilia and volunteers, Jagadish, who has a son with hemophilia and is a board member, we all piled into the van and headed out. With us: Julie Winton, RN, of BioRx; Kara Ryan (20), medical student; Alex and Eric Hill, Jeff Salantai (31), person with hemophilia, of BioRx; and my daughter. Battling thick Nairobi traffic, we reached Murang’a in two hours and first stopped at the Murang’a District Hospital. Driving up the red clay road and driveway, this was our team’s first look at a county hospital in the developing world.

Murang’a is where a whopping 80% of the JMHS’s hemophilia patients reside. Maureen and her team have done exceptional outreach to locate the patients. We met with Dr. Charles Kigo, chief of the hospital and Dr. Nguyo, who treats the hemophilia patients, and they were amazed to meet Jeff Salantai, who has hemophilia and is healthy, physically fit and strong. Dr. Kigo kept eyeing him up and down in amazement. Jeff shared his treatment regimen and lifestyle. We also presented the doctors with a gift of much-needed factor.

We toured the wards and were able to see the conditions of rural healthcare, a place where 40% of births still happen in homes. The waiting room is outside, with bench seats, protected from the elements only by a tin roof. There is a nice neonatal ward, which is nonetheless in need of a new paint job and incubators for preemies. One hemophilia patient was admitted, Zakayo, who I wrote about in April 2010, when I visited him in Muthare, the psychiatric ward in Nairobi. The poor young man had been traumatized by rioters, and admitted. Now, he was in the county hospital to treat a bleed. Still, he needed a few more tests before being released, which he could not afford. We gladly paid the bill to get him released the next day and return home.

Next stop: Peter’s home, my second visit here. Peter is Zakayo’s brother, and also has hemophilia; he looked great on this day. His home was just a quick ride up a dirt road from the hospital. Our team sat with Peter and his mother to hear how they cope with hemophilia. They were able to look about and see their poverty: a small, two room home for four adults and one child. No place to cook; the mother must cook outside in a pot. They own a bunk bed, an old couch, a small table and chair set, a bookshelf and one bed for the mother. The mother is single and pays heavily for rent and electricity. She cannot afford these things. Some days she cannot feed her children. And she must look for odd jobs because she cannot hold a steady job; the boys require too much care. How will she live? We gave her some money to help her stay solvent, pay her electricity bill in arrears, and vowed to help more.

The images of poverty continue to assault us as we moved on. Next stop: Stanley.

I met Stanley in April 2010. He was in a new location now, again a short drive from the hospital but situated off the main road, on a dirt road and down a dirt path. There’s no electricity or plumbing. They use candles, and an outhouse. Stanley has a small “farm”: one cow and some vegetables. He told us about how difficult it is to farm with joint contractures. He wants to start a business, being a street vendor selling shoes. It would cost $400 to get started, to purchase the initial inventory of shoes, and Maureen and I immediately considered him for our new micro-loan program. Our team was able to ask questions about his treatment, bleeding episodes, and life day to day. His wife is pregnant with their third child. This was an eye-opener for our team, to truly see how the other half lives. Hemophilia in such a place can be a death warrant. Julie immediately saw the need for home infusion, something that is unheard of in most developing countries. Our goal will be to break this mindset and get as many patients as possible on home infusion. We presented Stanley with his Save One Life money.

Alex began handing out candy to the many children who gathered to see the strange parade of foreigners, and they giggled and jumped with excitement! The children followed Alex and the team right up to the van windows, hoping to catch more.

Last stop before heading back to Nairobi was at the house of Virginia, Paul’s aunt. She remembered me and greeted each of us as if we were long lost family members! We all got a kick out of her enthusiastic hugs and megawatt smile. This is a beautiful lady with an incredible face etched with character. Again, the extended family lives in a jungle or forest: dirt floors, no windows, and no electricity or plumbing. They farm a few vegetables. The biggest shock was seeing little Derrick, who has a sponsor in the US. Last year’s photo showed an adorable little two year old with hemophilia. Now, he had suffered a fall, hit his head, and had a massive swelling on his forehead. Luckily, Derrick is well cared for by the JMHS, and has been receiving treatment. But with no car, no public transport, families like this are stranded! Dr. Michael Wood, founder of AMREF, the Flying Doctors of Kenya, once said that in Africa, you cannot wait for patients to come and see you; you must go see them or they will die. This is the foundation upon which Save One Life operates—we must see the patients, note their needs, and empower them. Home infusion is the only way.

I’m happy to say that all of the patients we visited have sponsors, and their sponsorship money makes a huge difference in their lives. They struggle for every single Kenyan shilling they earn, just to survive. Our dollars improve their lives instantly, giving them money needed for transportation, medicine, food and vitamins. On this visit, our team saw first-hand the difference Save One Life in partnership with the JMHS is making.





Do you want to sponsor a Kenyan child with hemophilia? Please visit www.saveonelife.net! They need your support!

Kenya Day 3: MP Shah Hospital Tour

Having a good discussion is like having riches. Kenyan proverb

Chilly weather continued in Nairobi, probably about 65 degrees. Jeff Salantai, Julie Winton, Kara Ryan and my daughter were all up by 7 am for a delicious buffet breakfast. Today we stayed in Nairobi, to visit the Health Ministry, the MP Shah Hospital, and the patients. Maureen again met us at the Southern Sun Hotel after breakfast and we set out in considerably less traffic. Within 30 minutes we arrived at the Health Ministry. We were disappointed to learn that Dr. William Maina, the director of non-communicable disease department, whom I met last year, was unable to join us due to a meeting. He did, however, graciously come to the parking lot to say hello and greet the American visitors.



With time on our hands, all dressed up and nowhere to go, Maureen took us to the Westland market to buy souvenirs. My colleagues were all first-timers to Africa, and Africa has a beautiful and colorful array of gifts: from Masai warrior shields in red leather, to stone carved animals, to pottery, beaded jewelry and the colorful Masai blankets made of wool. All at bargain prices! Everyone got an opportunity to bargain the prices, although most Americans are not comfortable doing this. We did have with us Paul Kamau, Adam, Isaac and Jagadish, who helped translate and then negotiate. There were so many vendors, with blankets spread on the concrete, wares displayed, hawking for our attention. Jeff and I decided to visit the vendors in the rear, as they seemed neglected. We laughed that it was like a hemophilia meeting, where the vendors in the front often get all the traffic!

We decided to have a sit down lunch (when traveling to the field to visit patients we often skip lunch entirely!) and Jagadish, who is Kenyan but also Indian, suggested a good Indian restaurant. The food was amazingly good and we relaxed and had many laughs. Our favorite moment was when Julie mistook the jalapeño pepper for a green bean (a green bean, Julie?) and we caught her reaction on film!

After lunch came the real purpose of the day: to tour the MP Shah Hospital and then meet the patients. Dr. Paresh Dave, hematologist, took us on a tour of the beautiful, private hospital, where many hemophilia patients find expert treatment. Julie especially was intrigued with their level of care. The hospital is clean and efficient. When asked what he needed that we could help supply for his hospital, we were surprised to learn that Dr. Dave requested butterfly needles! Imagine. The things we often toss away if they are not the preferred size in our factor box. Julie was proud to relay that Alex (still en route to Africa at that point), age 16, had solicited two pallets of medical supplies for the MP Shah and shipped them, courtesy of his dad, Eric Hill. Though delayed in customs, the shipment was in Nairobi and butterflies were on their way.

After the tour, we went into the lecture room to meet the patients. I was beaming with joy to see so many I had met over the past two years. Flora, a lovely woman whose son Victor had passed away at age 15, just four years ago. Florence Odwar, who we had just visited on Monday, and her daughter Moline, who has VWD; Charles, who I had visited last year at his home, far outside Nairobi, now living in Nairobi and working, and proud father of baby Alvin; Gladys with son Justus and nephew Kevin, who wants to be a doctor. I gave lots of hugs to so many I knew; the Kenyans are truly warm and gracious, and really know how to make you feel welcome!

Dr. Dave opened with a warm and even funny speech about how much they have progressed as a team, and how he will commit to continue to help. Maureen reviewed the history of their society, and complimented her team on their help. She stressed the importance of patient and parent involvement. I also gave a brief speech to remind everyone that our foreign visitors were here to raise funds, so that we would have the money to start micro loans and scholarships through Save One Life, our nonprofit that works at a grassroots level in developing countries.

Flora spoke, Kevin spoke… it was very heart wrenching to hear of the loss of some children, but stunning to know even those who lost children are still working with the society so that other families would not suffer. These include Maureen herself, whose five-year-old son Jose died just four years ago.

Maureen asked Julie, Jeff, Kara and my daughter to say a little something, so each guest got up and spoke. Jeff was very emotional in thanking everyone, as he realized fully his blessings in life compared to those with hemophilia in Kenya. Julie could barely speak as she was overcome with emotion, facing the towering strength and dignity of the parents, despite their losses and suffering; Kara thanked everyone for the privilege of letting them be a part of their lives.

After the speeches, we had tea and snacks, and Maureen and I handed out toys we had brought from the States. Stuffed animals are not common in Kenya, so these were a prized commodity! We also gave away kazoos, balls and T-shirts.

Julie had a brilliant and spontaneous idea: with all the patients present, why not conduct a home-infusion workshop? She simply got to work, and found her first volunteer. Many of the children have very hard-to-find veins, but Julie is a pro! Before she knew it, every patient in the room lined up for an infusion. In fact, we left her there to go back to the hotel to work out!

Kilimanjaro looms in our mind and I was getting a bit nervous not working out, after an intense two months of working out. I hit the gym and gave a good hour of cardio. We joined Julie, Jeff and Kara later than evening for a light dinner to review the remarkable day. “Having the good discussions” by the patients, and the home visits yesterday, have given them all a good slice of how Africans live with hemophilia, their obstacles to care and the culture that keeps patients quiet and uncomplaining.

Yeah, they are in love with Africa. I knew it would happen, as it happened to me, too, long ago.

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