It’s been a while since I documented anything on here, so this will probably be a long post! I apologize for the grammatical errors, I don’t have time to proofread. I would like to talk about some of the things I have learned since coming here four weeks ago:

1. The people in Kenya are some of the most kind and selfless people I have ever met. Everyone in Kenya says hello to you, even if they don’t know you. I’ve found myself starting to do the same thing, which I love. They always ask about life in the US or our family, which is kind of ironic, because we heard that asking about their family can be perceived as offensive. We have a housekeeper at the IU House named Maggie, and she is the sweetest. Every time I see her, she is wearing a doctor’s white coat that was left here and she always gives me a hug – she’s awesome. I have seen some of the best of humanity by working at the hospital as well. Patient’s at this hospital have to put items, such as land, up for collateral, in case they can’t pay their hospital bill. As a result, other patient’s families will help pay for their hospital bill. It is usually around 1000 shillings, so about $10. Also, since there is limited nursing staff, patients will also help care for other patients. For example, one of my 91-year-old patients had COPD and heart failure and was coughing up a ton of mucus, so one of Savanna’s patients helped hold a bucket underneath his mouth, so he wouldn’t cough all over himself. Also, we see patients helping other patients walk to the bathroom or outdoors all the time. It amazes me because they never seem annoyed to help them; they do it without even thinking about it. I also think that since some patients have the ability to go outside and interact with other patients, it aids in their recovery. There is also a man, Wycliffe, who has been teaching us how to speak Swahili in our free tim

2. Kenya has altered my perception about what I thought Africa was like in many ways. There are a lot of aspects of Kenya that you have to see to believe and understand how truly amazing it is. Everything in this country is full of color. Everyone’s outfits are vibrant colors, and all of the buildings along the side of the road are painted, each with a different color. Paint companies also advertise their colors by painting on fences and the sides of buildings. I wasn’t sure what I was expecting regarding what the buildings would look like prior to coming here, but I have learned it depends on the type of area you are in. Many farming communities have houses made out of tree limbs and hardened clay. Whereas, buildings towards the centers of towns are made out of different shaped pieces of wood. I have also never seen so much vegetation in my entire life. Before coming to Kenya, I was expecting it to be more like a savanna because that is how Africa is typically portrayed, but everything is green with different crops, trees, and flowers – it is so beautiful. The green color on Kenya’s flag also stands for this country’s vegetation. Lastly, a lot of assumptions that I had previously made about Kenya were derived from how Africa is typically portrayed in the media. I expected to see a bunch of people struggling to obtain food or housing, but that is not the case. Even though they may live in what the US considers poverty, no one here that I have met acts like it. They may not have all the resources that we do in the US, but they are content with what they have.  

3. I love the clinical role I have on this rotation. My days mostly consist of rounding on patients with my healthcare team in the morning. I am on the Men’s Ward (Umoja Ward), and we admit new patients every four days. My team consists of a registrar (medical resident), two physicians assistants (COs), and three medical students (one from IU School of Medicine). The patient’s past medical history is all documented on paper and contained in a yellow file folder. Each morning we review the files for any updates prior to rounds, so we can have recommendations ready before hand. All our patients reside in cubicles that contain 8 beds, and some patients even share a bed. We visit each patient at their bedside, talk about updates on the patient, and make any pharmaceutical interventions as needed. Our registrar always asks for the pharmacist’s opinion, which has given me a lot of confidence in making recommendations because I feel like I HAVE to know the answers to the questions he asks. I have gotten really good at looking answers up on the fly lol. At the same time, I feel like I am finally utilizing my pharmaceutical knowledge, which is really exciting! We also have been bringing medications, such as Tums, to the wards from our own supply because the pharmacy does not have them. Others have brought food from IU house to feed their patients since the food at the hospital is not very good- it’s like a soupy bean mixture? Not even sure tbh.  

Over the past couple of weeks, I have had the opportunity to learn more about AMPATH’s BIGPIC program. It’s actually pretty cool. All across Western Kenya, there are microfinance groups that have been set up and lead by a financial advisor to teach citizens about how to manage loans and learn about investments and interest. Through this group, each member pays a certain amount of money to put into the loan fund. This fund can be used to set up a group farm or other service, or it can be used if a member or family member has a serious medical illness that requires hospitalization. The money can be used to pay hospital bills. It can also be used to pay for NHIF, which is essentially equivalent to Medicaid. During these financial meetings, a physician’s assistant and a pharmacist will show up and provide point-of-care services, such as blood pressure, blood glucose, and heart rate monitoring. Each patient carries a booklet to keep track of past lab values. The pharmacist brings medications from the Revolving Fund Pharmacy, which has medications in the instance when there is a shortage of medications through the Ministry of Health. Patients can receive medications for conditions such as hypertension, diabetes, and hyperlipidemia at no cost if they are an NHIF contributor. To be a contributor, it is about 500 shillings a month. There is also a research project surrounding this program that proves that this type of program is effective at reducing complications associated with these particular diseases. More patients are seeking care as a result of this program.  

On another note…

The past two weekends have been amazing. Last weekend, we went to Lake Baringo. It is a freshwater lake located in the plains. When we arrived, it felt like we were in a totally different area. All the cows on the side of the road were replaced with goats. There were more cacti and a lot more sand. Our hotel was pretty nice; I think we were the only ones staying at it though because we had all the amenities to ourselves. A lizard fell out of my curtains; I was a little freaked out, but we were too tired to care by the time we went to bed. There were a pair of ostriches that hung outside of our hotel. They literally walked right passed us like we were in their way lol. We also saw a lot of crocodiles – they would just chill on our beach. Our hotel had a fence that separated us from where the locals that would swim, and I always saw the crocodiles swimming along the shore where the locals were at – it was giving me anxiety.

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We went on a boat ride around the lake. We met up with a local who gave us bait for the African Fish Eagles. We would throw a fish out into the water and the birds would come and pick it up straight out of the water – it was only a little smaller than a Bald Eagle. Then, we traveled to a little island that had a lot of kids on it.

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There were hot springs, so we got off the boat, and all the kids kept asking us if we had cookies to give them. The only cookies I had were completely smashed, but I gave them to this child that was about three years old. He inhaled the bag of cookies and had the crumbs all over his face – it was adorable. I also bought two bracelets and a pumice stone because I couldn’t say no to a bunch of kids.

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Then, we traveled back to shore, but passed this shallow water where a hippo family was hanging out. We were only about 20 feet away from them – it was crazy. When we got back to the hotel, we had dinner with our driver, Austin, and went upstairs to the bar afterwards to play cards.

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The next day, we went to the snake park. We saw a bunch of different poisonous snakes that are native to Africa, such as the black mamba and cobra. We got to hold a python, which was insane. It was about ten feet long, and the worker would pretty much wrap it around our neck like it wasn’t going to strangle us lol. I held it twice because my hands were shaking the first time. We also saw a turtle pee on one of the workers – good times.

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This weekend, we went to Lake Naivasha – such an interesting weekend lol. We hiked Mt. Longonot, little did we know this was going to be an expert-level hike. We got to see some zebras, but the beginning was straight uphill. When we finally reached the stopping point, it was worth it though. Longonot is a volcano crater, so when we got to the top, we could see inside the entire crater. The inside was full of vegetation, which was surprising.

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We hiked about 3 miles around the entire crater. It was really cool because all you could see was greenery for miles while on top of the mountain. That was the most physical activity I have done in a while though lol. When we got back, we ate lunch at the hotel, and a monkey tried taking other people’s food. In the afternoon, we went on a boat ride at Lake Naivasha. We thought that it was going to rain before we even left, but we went anyways. We saw a bunch of different birds, and there were a ton of hippos that kept disappearing underneath the water. We also saw wildebeest and zebra on one of the shores. All the sudden, the wind started to pick up and it started pouring. For some reason, we were the only boat still on the lake lol.

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So not only were we trying to dodge the storm, we were also trying to dodge the hippos in the water. We ended up having to dock at a place not even close to where we originally started, and our tour guide told us to walk the rest of the way back to our car. He said he would walk with us, but left us about 50 ft in. So, here we are, wandering aimlessly through a forest in Kenya, and then we stumble upon a herd of animals that at first looked like wildebeests. All the sudden, we see this guy walking towards us with a life vest, so we thought he was trying to help us. He walks past us and all he says is “welcome to Kenya” lol. So we decide to walk through the herd of animals, which turned out to be Waterbucks. Then, we finally get to the fence line, and it is electric, and we are soaking wet, so we have to find a ladder to climb over the fence. We made it back safe and sound though. When we got back to the resort, we were serenaded by a neighboring country music festival and “Country Roads” blared in the background. Such a strange day.

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The next morning was much better. We went to Hell’s Gate National Park. We biked on a trail that lead us through herds of animals: zebras, buffalo, warthogs, guinea fowl, and various antelopes. It was crazy, there were literally crossing the road right in front of us. We got as close as 50 feet away from the zebras. The entire pathway was lined with mountains and Acacia trees – I felt like I was in The Lion King.

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We eventually stopped biking and started walking down a path that lead around the inside of an old volcano. This was also a more intense hike than we were aware of. We all thought the tour guide was kidding when he wanted us to use a tree limb to climb down to a lower path with a creek at the bottom. I definitely brought out my inner Tarzan on this hike. We were climbing on and in between rock ledges, through streams, and we had to use a rope to climb up a cliff at one point. We got to see the Central Tower, which is the center of the volcano, and we saw the volcanic vent that lead directly to the center of the volcano, which was also cool. There were multiple freshwater hot springs, and we collected obsidian rock throughout our tour. We approached a staircase that was called “Heaven’s Gate” because it signified the end of our tour. After the tour, we all went to Java House for well-deserved vanilla brownie milkshakes.

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Last week was extremely busy for all of us. We started getting the hang of rounding with the healthcare team for each of our patients, while learning a lot about the different diseases and treatment options offered here. Through all of it though, there is one topic discussion we had with residents of the IU House that really stood out to me. We had the opportunity to read a few articles about how Westerners view international service learning experiences and discuss why this view can actually do more harm than good. Students from higher income countries generally feel that just by going to a low income country they are automatically going to do so much good for that population. In reality, this view can actually worsen your experience, as well as negatively impact the lives of those you are trying to help. Students can be so concerned about accomplishing anything during their time in a new country that they forget about maintaining good relationships or taking part in activities that actually benefit that region they are in. Most people who travel to a low income country think that whatever works in the US is automatically going to work in a low income country. More often than not, the projects Westerners try to implement isn’t exactly what the people in a low income country need or want. It takes an understanding of the region and culture you are visiting, as well as, communication with people living in those areas to discover exactly how you can help throughout your service learning experience. A common problem that students also face is that they feel most differences in the healthcare system of another country can be easy fixes, however, if this were really the case, it would have been done already. This inspired me to be more inquisitive while rounding and talking with my team to determine what they are already doing for their patients, as well as their expectations for me when I start rounding by myself. The purpose of an international experience should also be seen as a bilateral exchange of knowledge, expertise, and skill sets. There is something that can be learned from anyone in any situation if students keep an open mind throughout the experience. This also means that any intervention we try to do internationally should be seen as a learning experience for both parties. People in other countries are capable of doing the same projects as Westerners, however, sometimes the arrogance surrounding the notion that our training may be better than theirs could get in the way of learning experiences for others. There have been instances, for example, of Westerners coming to low income areas and building a bunch of houses, workshops, etc. however, the Westerners do all the work, do not teach the residents anything about the project, and expect them to sustain the infrastructure without guidance – this is the complete opposite of what we should be doing on service learning projects. More often than not, generosity is muted by indebtedness, or the thought that the community you are trying to help owes you something, which also ruins any relationship you are trying to build. As a result, I desire to approach this experience with humility, open-mindedness and patience in hopes to provide quality care for my patients.

On another note…

One of the aspects of treatment that I really like at MTRH and AMPATH is the comprehensiveness of care that patients can receive. For example, if a patient is diagnosed with HIV, they do not just give them their medications and see them three months later like most disease states in the US. AMPATH has addressed many social aspects that surround this disease. They have integrated peer educators into each patient’s care, which is a person who also has HIV and has gone through the treatment process, as well as the stigma associated with the disease. Since the addition of a peer educator, positive healthcare outcomes have increased 400% because patients feel more open to talking about their disease state with someone who has actually been through it. They also offer pharmaceutical services for essential medications for hypertension, diabetes, etc. for those who were unable to receive the medication at their actual pharmacy. The Kenya Ministry of Health only keeps 30% of the total medications needed on hand for their patients, so AMPATH has arranged a way for the 2/3 of patients to get patients their medications. They also offer legal counseling for women to address social issues such as land and home ownership, stigma, and domestic violence, which all often accompany a woman with HIV. Also, I’ve noticed when rounding that doctors take into account what the patient can actually afford for their treatment. They do not run any unnecessary tests if they know the patient cannot afford it, which is very unlike the US.

This first week of rounding really tested my abilities as a pharmacy student. We round with a healthcare team daily. Our team sees about 30 patients, and our entire team can consist of 20 people at any one time. There are 8 beds in a cubicle, so it is very hard to crowd around a patient’s bed to come up with a comprehensive treatment plan. Besides being able to hear what the rounding team is saying, I struggle quite a bit with reading treatment sheets and the patient’s chart – everything is handwritten. Treatment sheets are held by the pharmacist to edit during rounds, and it is a way to document what drugs the patient is prescribed. The nurses also mark when the patient was given a medication.

It has also been really tough watching my patients struggle from diseases that are 100% curable in the US. The hospital just doesn’t have the manpower or availability of invasive/diagnostic procedures to give quicker care. For example, we have a patient with an intraventricular hemorrhage (brain bleed) who was prescribed labetalol to decrease his blood pressure, so he would not worsen. However, nurses do not have the time to continuously monitor all 30 of their patients, and his condition worsened over night because he had not received any labetalol. He was hardly responsive to a sternal rub, which usually wakes patients up due to the pain. That’s also what makes leaving my patients at the end of the day harder because I want to help monitor patients in any way I can. We’ve also started to feel guilty about taking advantage of all the awesome experiences Kenya has to offer while our patients are still in the hospital. I have, however, gained more confidence in my ability to make recommendations as a pharmacist.

Kakamega Rainforest…

We spent the weekend in a cottage in the Kakamega Rainforest. It was so peaceful to be disconnected from society for a bit. The gardens surrounding the property were so pretty. We went on a hike through the rainforest and actually got rained on! We didn’t even care because that was on all of our bucket lists lol. Our guide pointed out a couple plants that natives use medicinally for ailments such as malaria, prostate cancer, and sore throat. We got to try the root of the tree used for sore throats, and it actually made our throat numb; it was super bitter though. We came back for afternoon tea on our balcony, which was precious. We also went on a sunrise hike the next morning, and it was seriously breathtaking. We chilled with a herd of cattle at the top of a hill while we watched the sunrise over the mountains.

Today, we left at 0830 for Kerio View. Kerio View is considered the “Home of Champions” because athletes from all around the world come to this area to train. During our drive, Max explained that Kenya has made 47 counties, each with a governor, like the US states. There are also 43 tribes; each tribe speaks 1 of 3 languages: Bantu, Nilotic, or Cushitic. While driving, we also got our first “Mzungu” today, meaning “the white people.” When we got to Kerio View, the first thing we did was order our food. We chose to order ahead of time because Kenyans follow a polychronic model for time, meaning time is cyclical, and their concept of time is “free-flowing.” As a result, it usually takes us longer to get food because Kenyan meals usually last for hours. After we ordered, we started our hike.

The hike started near Rift Valley, and we walked past the house that Taxi Max grew up in. Some of the houses had grass roofs that were designed to prevent water from getting in. Before we even started the actual hike, I knew it was going to be tough because the pathway we were on was straight upward and rocky. When we started walking, two little girls from the village came and met us to say hello. We had to take breaks like every 10 minutes on the hike. During one of the breaks, Max explained that the valley is always moving because the tectonic plates are shifting. The hike is located in the highlands, which provides a good environment for farming. Along the hike, groups of Kenyans passed us – each one of them shook our hand and said hello. One guy with really white dress shoes asked to take a selfie with us.

We walked to a waterfall that was really pretty, and we took pictures on the edge. The water was super cold, so it felt really good while hiking. We kept walking to the highest point of Kerio View, which was 7000ft above sea level. The view was amazing. You could see all the different colors from the clay, farmland, and houses, and you could see mountains in the distance.

One of the girls we saw at the beginning of the hike, and her older sister, ended up passing us because we were taking so many breaks (they were also in crocs). We met up with them at the main peak. Savannah and I gave them some of our cookies we got from the IU House because they love sweets. The older sister got a machete out of nowhere and began chopping weeds on our hike – we were not expecting that at all. The walk back down was wayyyyy easier than the walk up – I was actually able to stop gasping for air lol. We also saw Colobus monkeys swinging in the trees while we walked back. We heard crickets that had the highest pitch noise ever. There was also a herd of goats and sheep just casually walking past us at one point. The mountain was so steep, a couple of us slipped on the way down. We drove back to the restaurant and got our food almost immediately. Alison and I split a goat platter and cinnamon chapati, which is like a thinner naan. I also got a fresh mango juice to drink – omg so good. The view from the restaurant was also amazing, you could see directly into Rift Valley.

On the ride home, all of us napped, and then I napped more when we got back. The rest of the evening has been pretty chill, and tomorrow is our first day rounding at the hospital with our healthcare firm (team)!

Today, we left for Kruger Farms at 0830. On the ride over, we saw a lot of farm animals being herded down the road. They also burn a lot of their trash, including plastic, on the side of the road. There was a giant line of people waiting for something at a little shack-like building. Taxi Max then told us the government wants citizens to have one common ID form (which is why they were in line), however, the citizens do not want that. Taxi Max showed up in a safari van that he made from a Land Cruiser. Kruger farms was started by a Dutch farmer who came to Africa to farm wheat, maize, etc. He had extra land that he started a giraffe preserve on. We walked on a clay path all the way around the farm, which climbs up the side of a large hill. We saw dik-diks, which are like mini gazelle. We also saw a chameleon, and apparently, there is a leopard on the farm. When we got somewhat close to the giraffes, we climbed through brush on the side of the hill to approach them from behind. We had to be extremely quiet, so we wouldn’t scare them off. There was a large giraffe eating alone that had 3 horns, which meant he was an older giraffe. We learned a lot about giraffes – Max was very interested in them. We walked back down the hill to observe the rest of the giraffes – there were 14 total.

Where we ended up standing was literally 100 ft away from the entire herd. The giraffes were so beautiful and peaceful. Some fought with each other using their horns. We sat there watching them for about half an hour – it was awesome, and it was only $5! We walked around the outside of the farm back to the main area. Then, Taxi Max drove us to Java House, which is like a mix between Starbucks and Applebee’s. It was pretty good, I had legit strawberry lemonade and a turkey, cheese and avocado wrap. When we got our food, we forgot they all would have lettuce on it, so we will probably be feeling it tonight – oops. The chocolate cake at this place also looked amazing, so we will definitely be going back there. Max then took us to a liquor store he recommended. We each got a bottle of wine to drink tonight – the wine is very sweet and cheap. Then, he took us home and I napped for 2.5 hours. Tomorrow we are going to Kerio View!

My shower definitely woke me up this morning – the power went out, so the hot water did not work. We walked to IU House at 9 AM. I noticed that one of the court buildings we walk past on the way there has a cinder block fence that is lined with broken glass as a security mechanism

My group shadowed in the AMPATH pharmacy today. The whole pharmacy is about the size of a master bedroom, with little airflow. Bottles of HIV medications line all the walls. There is a peer educator who is in charge of reporting adverse events to any medications, as well as counseling patients on new prescriptions. Patients come from the clinic with their new or modified prescriptions, and the pharmacist enters them into the computer system. They are then filled almost immediately and given an entire month’s worth for free each time. Patients are required to bring their old or previous month’s bottles to the clinic to determine how many pills to actually dispense. While watching the pharmacist, I started getting really hot and light headed. I turned to CC and said, “I’m going to throw up.” Everyone in the pharmacy must have heard me because they all scattered while I found the sink they use in the pharmacy (lol). All the Kenyan’s thought I had been poisoned. I was good after though!

We then went back to IU House to get our Pupil Pass from Immigration. This pass essentially lets you do everything in Kenya at a Kenya citizen’s cost, instead of a visitor’s cost. Then, we headed back to the hospital to have orientation with Rakhi. We were separated into groups for rounds – Savannah and I will be working together! We ate at Mama Mia’s for dinner, which is about a tenth of a mile away from the house. I had chicken tikka masala and garlic naan (Indian food is very common here). Rachel got ravioli, and the inside was literally bright green.

The past couple days have been crazy busy with hospital orientation and catching up on logistic stuff for traveling and our rotation. I had my first experience showering at the IU House. To get heat for the shower, we have to flip a switch on the wall. To adjust the heat, we have to turn the dial on the shower for more or less water – less water equals more heat? For breakfast, I have been having avocado toast, and the avocados are actually the size of my face.

Today we met Sara Fletcher at 0845 to walk to Moi Teaching and Referral Hospital together. It is a short walk, probably less than a quarter mile, just past a local Hindu Temple. It is on Nairobi/Uganda road depending on which way you are traveling. When we got there, we were separated into 2 groups. The first day, we shadowed in the Nyayo Pharmacy, while the others shadowed at the AMPATH pharmacy. The Nyayo Pharmacy is similar to a retail pharmacy in the US. It’s a small, L-shaped room, with small boxes of medications filling the table in the middle of the room. If the boxes are empty, that means the medication is completely out of stock. They also post an inventory report each day to let the team know what is available. There were also a few medications that we don’t use regularly in the US. It was interesting to learn that one of the most common causes of death by suicide is due to organophosphate poisoning or paracetamol (acetaminophen). Organophosphate poisonings are not as common in the US, so they have more of a supply of pralidoxime on hand. Patients crowd the window during the busy hours to get their medications, pay at a separate billing area, then come back to the pharmacy to pick up their medications at the outpatient window. This pharmacy also keeps their main door open, and the few controlled medications they have are not locked in a safe, unlike the US. All the record keeping is done on paper except the prescription entry process. IVs are not compounded in the pharmacy; most IVs are hung from the vial or diluted at the patient’s bedside. There is one pharmacist that works in the pharmacy at all times, and four pharmacy technologists. Julie is the lead technician in the pharmacy, and she has a totally different personality than most of the people in Kenya. She is an older, spunky lady, whereas the majority of Kenyans are very soft spoken. Technologists are in charge of gathering medications written on T-sheets to take to the wards. Nurses or pharmacy students will drop off the T-sheets at the window around 11 AM, the technologist fills it, then puts the medications in baggies that go into a large cart. The large cart is wheeled into the hallway for nurses to grab medications when needed. They also have an insulin room. Eli Lilly funds an insulin program that provides donated insulin to patients. The hospital also has clinics for anticoagulation, diabetes, mental health, and HIV/AIDs.

We also met five different Kenyan pharmacy students on their internship at the hospital. Emma and Anita were the two students that toured the wards with us. One of the pharmacists asked us to go on rounds with him, and we weren’t supposed to do that until Monday, so we all freaked out a little at the thought of doing big girl things. The wards are separated into male and female wards, each has 96 beds.

In the afternoon, we had a tour with Sonak, who is another Purdue-affiliated pharmacist at the hospital. Sonak graduated from UNC, with an MPH from Harvard, and he has worked with AMPATH since 2008. Throughout the tour he explained the history of the program, what the program does for its patients, and he asked very insightful questions. His view of global health really changed my perspective on the way I think of global health. Global health is about what you give back to your patients, and not necessarily what country you live in. For example, we wouldn’t really consider most of the pharmacists in the US to be global health pharmacists, however, a common opinion is that pharmacists residing in other countries are all global health pharmacists. He also stated that 60% of Kenya’s population lives on less than $2 a day, 40% of those live on less than $1 per day.

A little history on AMPATH…

Dr. Joe Mamlin, a physician from Wishard Memorial Hospital retired in 2000, then came to Eldoret, Kenya to participate in the IU-Kenya partnership. Him and his wife, Sarah Ellen, stayed for another 19 years, and he started the AMPATH program in 2001. AMPATH stands for “The Academic Model for Providing Access to Healthcare.” It is a global partnership between Moi Teaching and Referral Hospital in Kenya, Moi University, Purdue, Indiana University, Duke University, and many other universities from the US, as well as the Kenyan Government. The goal of AMPATH is to lead with care, and then work to combine that with nutrition, education, jobs, and self-sufficiency for patients. AMPATH builds programs in the public sector that eliminate health disparities and deliver essential healthcare services. Training of new medical students and residents, as well as advancing research are also parts of the AMPATH program. Besides my desire to work with underserved patients in the future, there are also world-renowned pharmacists and physicians who work to train students at this hospital. AMPATH has a focus on patients with HIV/AIDs. The program has since expanded to most of Western Kenya, and now treats more than 3.5 million people. Imani is the workshop that AMPATH organized for patients to make and sell clothing, jewelry, journals, stuffed animals, and figurines. We plan to go here to support their business. To learn more information about this incredible program, visit:

https://www.ampathkenya.org/

On another note, it started raining while we ate dinner. Then, all the ginormous slugs came out, literally the size of my hand.

17 hours of flying with an 8-hour time change – I’m starting to feel the jet lag, but definitely excited to finally be in Eldoret, Kenya! We landed in Nairobi, Kenya around 9 PM last night, and then slept in a hotel for 3 hours before we had to catch our flight to Eldoret at 6AM. Pro-tip: the Eldoret airport is not a 24 hour airport, so if you’re trying to check into your flight 2 hours early like you would in the US, you will find yourself waiting on the sidewalk outside the airport, without a cab, while the Kenyan police wonder why you got their so early. During all our flights, the group I was traveling with wondered when it would start to finally set in that we were going to be in Kenya. It did not officially hit any of us until we stepped off the plane at Eldoret International Airport, and we could tell the atmosphere was totally different.

When we got off the plane in Nairobi, we took a bus to customs, which was a large, tent-like room that only had one security line everyone filed into, and there was a separate area where we got our Kenyan SIM cards and shillings (1 USD is approximately 100 Kenyan shillings). We took a propeller plane from Nairobi to get to Eldoret (JamboJet). Two gentlemen met us at the airport to drive us to our compound. IU House is where all the Purdue and IU students, as well as physicians and pharmacists, stay – it is an 8-house compound that provides daily meals (today we had Chinese and a mix of cuisines for lunch). It is also located 15 minutes away from the hospital we will be working at. Driving to IU House was an experience. In Kenya, you drive on the left side of the road, however, motorcycles (bota bota) can pretty much drive wherever they want. There was also a bota bota that was seen driving with another bota bota on its passenger seat. Apparently, they can fit 7 people (on a 2-person bike), and there are 7 of us here, so we were told not to use them – understandable. Taxis and bota bota are a common form of transportation. Our taxi driver, Taxi Max, explained the driving situation well: organized chaos. Citizens in Eldoret jump in and out of taxis while the cars are still moving. Bota bota will pass cars on either side of the road, there are hardly any road signs and definitely no stoplights, but somehow everyone knows whose turn it is on the road. There is, however, a heightened sense of awareness for pedestrians while driving because they walk in the middle of traffic frequently.  The air in Kenya smells like the red-clay dirt that makes up most of the walkways in Kenya. Most of the roads and walkways are also lined with small shops and restaurants, or animals being herded down the road. This season is supposed to be the rainy season, but they have been experiencing a drought recently.

When we arrived at IU House, we met Tina, one of the pharmacy preceptors, and we were able to check into our room. Our room in IU House is made up of bunk-beds, a desk, and a closet. The beds are shielded by mosquito nets, and we also all take Malarone to prevent malaria. Eldoret is at such a high elevation, and mosquitoes tend to cultivate in lower elevations. After getting settled in, we met with Taxi Max to organize our weekend adventures around Kenya (details to come later). Later in the evening, we sat down with Tina for a fireside chat about the street youth in Kenya. These youth have had very tough lives while trying to provide for their families. Many are beaten by pedestrians and police when they see them trying to ask others for money on the street. However, there has been much effort to provide for these youth through the Tumaini Innovation Center. This is an organization that provides food, shelter, and education for street youth. Eventually, we will get to visit this site and interact with the members of this program. Overall, today went really well. I am excited to see the hospital we will be working at tomorrow, and I cannot wait to officially start pharmacy rotations!

Thanks for joining me!

Good company in a journey makes the way seem shorter. — Izaak Walton