HICOM Travel Blog

Leaving Zanzibar

We left Zanzibar with a swarm of Italian tourists.  From there we flew to Qatar & then Geneva, where we’ve been for the past few days.

reunion

My best friend from childhood was our most gracious hostess here.  She and her husband showed us a wonderful time in and around Geneva – eating reclette & fondue, meeting Pere Noel, visiting medieval castles.  It had been 35 years since we’d last seen each other, so a remarkable reconnection.  Amazing that the tomboy I used to run wild with in Jakarta has grown into such a beautiful, intelligent, together sort of person.

climate shock!

The weather was good enough to snow for us – fortunately I’m still a better shot with a snowball than J.

Marie-Therese

I was really happy to have the opportunity to meet Marie-Therese, a Swiss acupuncturist who had helped translate our Haiti NADA guide into French.  We had a most fantastic meal at a Thai restaurant, and spent hours talking and making tentative plans for a future collaboration.

Tomorrow we are off to the airport in the pre-dawn hours for the last legs of this journey – Geneva-London-LA-Hilo.  It has been another whirlwind adventure full of interesting people and places.  Infinite gratitude to all those who’ve made this trip possible.

Zanzibar wrap up

review after clinical sessions

The repeated clinical sessions give trainees valuable experience.  During these sessions, the residents at Detroit house had uniformly positive responses.  After the first sessions here the clients who received treatments were so enthusiastic in their responses that all other residents decided to take part in the next session.

more clinicals

At the Bombay house, there were mixed responses to the first treatment session. One client complained of headache after the treatment, another man said he felt dizzy and weak, and yet another said that his regularly good sleep was disturbed after the acupuncture. We discussed these responses and how best to provide a safe and supportive treatment environment, and how to best manage a variety of treatment responses.

fine tuning

We adjusted treatment times, number of needles, had a round table discussion with the residents, and offered but did not push them to receive further treatments.  Some of the residents here had had really positive experiences and they also shared these with their housemates.

Bombay house

Almost all of the residents decided to participate in subsequent treatments, and by the last day were all feeling the benefits of the treatments.  They repeatedly thanked Shosi, Athman and myself for coming down from Kenya to assist, and asked for a group photo.

Group shot, Bombay house

On the last day we had our certificate ceremony.    There was lots of applause, lots of jubilant shouts, and afterward one of the trainees asked me if I understood what was being said when she came up for her certificate.  “They were saying what a mess I was when they first met me [when entering  rehab] and to look at me now.  I’ve made so much progress and can now help others with their recovery!”

exhuberance after the certificate ceremony

This group was wonderful to work with.  They have excellent teamwork, creatively problem solve, and a strong sense of community.  We established a communications network, a way to resupply their needle stock, and a team leader.  Congratulations to the hardworking staff and volunteers at Drug Free Zanzibar!

Zanzibar training group 2011

More Zanzibar training

more point location

more practice treatments

lunch time

documentation

first client treatments - Detroit house

confidence increasing

working at Bombay house

Zanzibar

island life

stone town waterfront

spices drying

Foradhani Park night market

fresh-squeezed cane juice

some eating options at Foradhani

how J spent his time in rehab

full moon over stone town

more Zanzibar Training

Detroit house in the morning

The trainees were raring to go the 2nd day.  It’s a tightly knit group - most have seen each other through extremely rough times, & they spend tons of time together both at the sober houses & in their spare time.  Very much a community, and most feel closer to each other than to their families, who don’t always understand the journey they’re on.

1st treatments for co-trainees

We did mock treatments on each other.  This group of trainees was interesting in that they vied to be needled, and were clearly benefitting from even these mock treatments.  During other trainings, the trainees sometimes avoid getting needled or complain of sore ears, but I didn’t see anything like that here.

practice treatments

pretty good for day 2!

There were a few ‘naturals’ in the group – both for point location/insertion, and for oral presentation of the protocol & in answering questions.  Because this group had very little if any medical background, we had to spend a lot more time on ear anatomy, clean field, and safety protocols than was necessary for the group in Nairobi.

Detroit & Bombay sober houses are on this street

We usually caught the #507 ‘dala dala’ public transport buses to the sober houses in the mornings, and most days Mani or Sabri gave us (& a load of others) a ride home in Suleiman’s jeep.  Suleiman is in Mombasa on holiday, and left the car for these guys to use.  I found it very interesting that my friend in Dar, who has a high-ranking job with a foreign NGO that advises for groups like the UN and the Swedish government, has not had a Tanzanian license for 2 years (paying appropriate bribes as needed) but both Mani and Sabri have current licenses and drive extremely well.  Sabri said that as ex-users they have to do everything ’absolutely correctly.’

my Kenyan colleagues arrive!

I spent the first few days of training as the lone trainer.  Because of communication challenges, my Kenyan colleagues were unable to reach me or the local organization (which was also the reason for my own challenges when arriving on Zanzibar).  Eventually they found someone in Mombasa who verified that I was on Zanzibar so they took a leap of faith, took the ferry from Dar, called Sabri while we were driving home one day, and we all met up on the waterfront in Stone Town.  I was sure glad to see them!  The training had been going well, but I knew it would go quicker with better instructor/student ratios, and using more Kiswahili.

The road to Zanzibar

Mt Kilimanjaro

Reunion in Dar

It was a long and winding journey from Arusha, but in Dar Es Salaam I reconnected with friends from West Africa that I’d know 20 years ago.  It was really special & I wish we’d planned more time there.

Ferry to Zanzibar

Instead, we were rushed and crushed and virtually ambushed onto the ferry heading for Zanzibar where we arrived a bit bruised and battered on Wednesday.  Attempted communication with both my Kenyan and Zanzibari work contacts was fruitless so we had to resort to our wits – always a dangerous option.  There’s an exhilaration that can come from landing in a strange land with no directions and not speaking the language, but I wasn’t feeling it.  Instead I wondered what ridiculous notion got into my head to come to this far-flung place on such a flimsy premise. 

Welcome to Stone Town

the view from our room

With our usual good fortune, we landed at the Rumaisa Hotel just on the edge of Stone Town.   It is newly opened, but super luxurious compared to our usual fare, “in traditional Swahili style with all the comforts modern life demands.” 

the noodle factory next door

The owner has been really kind to us, especially once he found out the kind of work I am doing in Zanzibar, as he is strongly community minded.  Last night he drove us over to Rosani gardens, a public square that has a night food market with pancakes, grilled meats & seafoods, sugar cane & ginger juice fresh squeezed on the spot with a giant press, and traditional music wafting out of the ‘House of Wonders’ next door.  His father is apparently quite a musician, playing the traditional oudh, and I have visions of some kanikapila with oudh & ukulele dancing in my head.

Arusha – Over the Border

We woke before dawn our last day in Nairobi to catch the Impala Shuttle to Arusha.  We had gone out for dinner with Claire and Nara the night before so had leftover pizza to take for lunch, & C & N had packed up some cupcakes for treats.  We arrived at the Silver Springs Hotel (very fancy, across from Nairobi Hospital) in plenty of time, so stopped in the coffee shop for some java before launch time.

The bus ride was pleasant:  sharing cupcakes with the bus driver (we were in the front seat), taking photos, & playing ukulele along the way.  We hit the Tanzanian border about 2 hours along.  Crossing the border entails getting out of the bus, queuing to hand in departure paperwork on the Kenyan side, then walking down the road dodging trinket sellers and money changers to submit paperwork on the Tanzanian side.  We didn’t have visas, so we had to stand in one hot sweaty line to get the forms to fill out, then another line to hand in the entry paperwork & visa application and register our fingerprints, then stand in yet another line to retrieve our stamped passports.  In line around us were American ngo workers, turbaned sheiks, Spanish tourists, an ‘algorithmic traveler’ (he had a whole theory about globe trotting & was on his 43^rd country or something), chic Kenyans over for holiday & all sorts of other East Africans on various missions & expeditions.

The countryside went from Nairobi’s urban sprawl to scrubby savannah to the green rolling foothills approaching Arusha.  Arusha is at the base of Mt. Meru which was stretching up into the clouds as we rolled into town.  Along the highway are mostly Maasai folks wrapped in blankets in warm colors:  oranges, reds, purples (is purple a warm color?).  Many of them have shaven heads, sometimes the men have ochre smeared over their scalps & the women have elaborate ear ornaments (‘earrings’ connotes too plain of an adornment) & necklaces.  We passed herds of goats & cows, saw impala peering over embankments, & saw lots of weaver birds darting in & out of their nests dangling from acacia trees.

Arusha is an incredibly green city – at least the bits we’ve seen so far.  The people seem more laid back than Kenyans, and there is a nice sense of space and ease.  Our hotel is comfortable.   I’m still researching whether there is actually hot water (which would be nice as our elevation means it’s still a bit chilly), but the food is good:  Chinese, Swahili, Indian & European options.  There is also a putt-putt golf course which J & I have gone the rounds on.  The grounds around the hotel buildings are full of greenery, and there are rabbits and turtles roaming around as well as a turkey and a rooster.  There are also monkeys in the trees of the neighborhood, little vervets I think they are.

Nairobi Training Group Dec 2011

Checking pt location

Georgina & Nellie

Didi & Michael

We had more needle practice in the morning yesterday, including treatment sessions for the askari (guard) and groundsman at the Riviera Villas where the training was held.  The ‘patients’ were understandably nervous coming into our little ad hoc treatment area, and the trainees were reasonably nervous also.   We did a short intro, a demo & got them needled.  Once the needles were in most of us went into the kitchen for lunch so we wouldn’t all be standing around staring at the guys.  Christine stayed with them, and when the time came she removed the needles.  Christine reported that the guys had been really please, in fact one of them didn’t want to have the needles removed and both of them asked when they could come back for more.  They said that they felt relaxed, they could feel their blood moving, and they felt lighter.  The trainees were surprised and pleased to hear all this, as their only experience up until then was within the training group.

Nellie & Christopher

The clinicals at Asumbi came together as well.  We found out that the reason they had been cancelled the day previously was that the clients were ‘on strike,’ and not attending classes or otherwise doing the participatory things they were supposed to be doing, so admin decided it wasn’t the best atmosphere to bring our group in.  I wonder whether it actually would have been especially useful to provide NADA in such a climate, as NADA usually promotes program participation.

It was a bit bitter sweet to be at Asumbi.  One of the people I had trained last year who works at this site had relapsed, and is now a participant in the program.  I was so sorry to see him going through this struggle, but he was as sweet and handsome as ever;  I hope that the next time I come he’ll have found his feet.

There are two other NADA trained folks with Asumbi who had also participated in last year’s training, and one of them was on site to welcome us.  She is now a clinical psychologist and doing very well in her work at the rehab center.  She greeted us as we arrived, introduced me to the new site manager, and got us situated with the site nurse and other staff who were facilitating our program.

At 2pm we turned off the Nigerian soap opera blaring in the large sitting room, to explain and offer the treatment to clients.  There were a few questions, but it was a pretty quiet group.  After the explanation and demonstration, the trainees set to work getting people’s needles in.  Several of the clients then called me over to ask more pointed questions, including a man from ‘Jersey City’ who had never heard of the treatment though he had been in and out of treatment for decades.  He was pretty skeptical at first, but after the treatment was asking how he could get trained in the protocol.

There were lots of men who initially refused treatment, but in the end almost everyone at the facility received the needles.  The response was really positive, and the clients wanted to know when they would be able to get more of this, and where they would be able to get treatments once they finished the Asumbi program.  Usually I’m not sure exactly what to tell them, as after the training the trainees go on about their lives, I’m leaving the country, and it’s up to the management to schedule ongoing treatment (a recent turnover in management at this site resulted in discontinued NADA treatments, which is why this particular group of clients wasn’t familiar with it).  Fortunately, several of the trainees have decided to arrange their own clinicals and will be visiting the rehab center a couple times a week to get more practice and keep treatments available for the clients. 

It’s been a super group to work with here in Nairobi and I’m excited to see what they do with the training.  They’re also particularly lovely people so I hope to keep in touch with them as we all go our separate ways.

End of a training

Nairobi Training

The Nairobi training has begun at Abha Light’s Kilimani offices.  Didi Ananda Ruchira, Abha Light’s director, is always extremely generous with her hospitality.  In between seeing patients, managing her pharmacy and running all over town on her own errands she has provided printing and internet access and amazing vegetarian meals for the training group.

In the pharmacy

Lunch chez Didi

This is Rachael’s 3^rd time as my co-trainer, and it’s great to have someone this knowledgeable assisting.  She has her own clinical experience to draw from, as well as a much better understanding of local healthcare dynamics, attitudes and policies. 

My co-trainer Rachael

The training group is small, and they are picking up the information quickly.  Although small, the group is diverse:  there are students of natural medicine, practitioners from rural health clinics, a kickboxing, surfer photojournalist who is moving into the healthcare profession, and a yogic nun who does relief work.  Each of them has an interesting story behind them, and bring a lot to the group.  The nun, for example, is in Kenya laying the foundation for a microfinancing/spirulina growing/famine relief project and is traveling all over the country and into Somalia to do her research and site visits. 

Michael & Christopher

Christine & Nellie

Today we were to have our first clinicals at Asumbi rehabilitation center after a morning of review & needle practice.  Our clinicals were, unfortunately, cancelled because of a communication snafu at the center, which was a great disappointment.  The trainees were nervous but excited for the experience with ‘real’ clients, but took the change in plans pretty well in stride.  We’ll hopefully be able to reschedule for tomorrow.

En Route

The closest we got to a Thanksgiving meal was turkey chili at JFK airport in New York.  We’ve been thankful all the way though, with smooth transitions, super helpful & competent airline staff, good in-flight food & entertainment.

Notes on Geneva:  As we flew into the airport in Geneva, the clouds were a carpet below us with the dragon spines of the alps sticking up all around.  I was surprised there was almost no snow to be seen, and I weathered a short walk outside the airport without suffering any frostbite. 

Flying into Geneva

Notes on Doha:  Flying into Doha at night is beautiful – swirls and arcs of lights on a flat landscape.  It doesn’t look like the sprawl of most American cities from the air.

We’re in Doha overnight, so are getting to know this airport well.  For an international airport with direct flights to Hong Kong, Kathmandu, and Helsinki it’s surprising that there is only one little scraggly food court.  J & I were able to eat a full meal there for less than it cost us to get specialty coffees at the bistro downstairs afterward.

Coming off a flight one is fed into a large and frenzied duty free area appealing to our drive to consume. In between the electronics and the chocolate are two cars that are being raffled off, an Audi A8 and an Aston Martin – wasn’t that a James Bond car?  J was unimpressed, despite the hovering bands of virile males vying to ogle, caress and pose with the cars; guess he’s not a car guy.

The bathrooms here have shower heads in them for cultural differences in toileting.   I have to say that after being on the road for two days this seems like a pretty great idea.

We’re seeing more Saudis here, distinctive in their red-checked head scarves and flowing robes.  There are also hardier versions of tourists (singly or in pairs, funkier clothes, more authentic looking trinkets, serious camping/hiking gear), lots of Asian business men, a Malawian soccer team.  Being reminded of the diversity of the human experience is part of what I love most about traveling.   

Sunrise over Qatar