The reason my hemoglobin is catching up to my age

Today I woke up at 5am to drive an hour with my running buddies Ngaire and Renaud to Lobatse to visit Ngaire's boyfriend Phillip's farm. It's one of the biggest cattle feeding stations in Botswana, which basically means cattle ranchers pay him to fatten up their cows before slaughtering them for beef. Of course, we did a 2 hr run first in the rolling hills before meeting Phillip and a few others for a gourmet brunch overlooking the cattle. I've come to learn the word "farm" in Botswana is a loose term. While I usually think of fenced-in muddy squares with chickens or pigs, here, it usually involves hundreds of kilometers of empty bush with 200 meters or so of animals or crops. It's not the land that has the real value but the cattle. A man is judged by how many cows he has on his farm, and a woman is worth a certain number of cows in exchange for marriage.This was sadly somewhat of a farewell brunch for Ngaire, because she's going home to Australia for three months. I'm pretty devastated, because I don't think I can routinely get out of bed at 6am on Saturday mornings to run without her overly enthusiastic peer pressure. Luckily, I still have my Frenchman Renaud who's training for Comrades, the 89km survival race in Durban.

I haven't yet mentioned my fantastic news from last week: I FINALLY GOT ETHICS COMMITTEE APROVAL TO START MY STUDY! For the past week, I've been frantically collecting data in the Emergency Department, which gets interesting after 5pm or anytime it's slightly overcast outside, because the office ,with a broken overhead light, gets completely dark. I'm continually learning that headlamps really are a miracle.

Anyway, I feel such a boost of encouragement and energy, and I can't wait to analyze the data. Unfortunately, the data will have to wait at least another couple weeks, because Sarah and I are off to Zanzibar tomorrow in our new matching $2 beach wardrobe. Life is so tough this year.

Happy Hannukah! And more...

So I do actually know there are 8 candles in the Hannukah menorah, but I couldn' fit 8 in the special star of David cup! I'll figure something else out for the second night.
In other news, it figures that as soon as I become a badass marathon runner, everyone decides to become all obsessed with biking and their super cool zip-up bike club shirts. All I hear is, "30k climb this" and "50k ride at 6am that". I see two solutions: either I buy a used bike and an automatic ticket to the clubhouse, or I steal everyone's bikes and sell them to buy more running spandex. Also, it's SUMMER! Just about every day we get an intense downpour, and a couple spots in the orange dust bowl are actually starting to turn green! Check out this crazy sea monster plant attacking the Dingo.

Spandex-o-philia

My birthday party in Gabs was a huge success! The theme was "philias and phobias," though I seemed to take it a bit more seriously than others. Thanks to everyone for a very special night!

I've Got a Fever

If there is one thing I have learned in Gabs, it's dancing. I've never had such dance fever in my life, and as soon as the weekend hits, my hips refuse to lie. I'm not just a frenzy of American two-stepping though. I'm trying to update with as much African booty influence as I can. This usually means standing behind an unsuspecting well-endowed booty shaker on the dancefloor and copying exactly what she does. Unfortunately, all dancing here involves gyrating booty spins, so I always get caught in the act.

My proudest moment yet was not my dance-off with a bedazzled cowboy who drank beer out of a bull's horn but rather when a busty woman looked me up and down, slapped my butt, and said, "I like the way you move."

The President of Botswana Drives an ATV

This weekend I blew up 60 blind-folded teenagers who stepped on newspaper mines in my team-building activity at Stepping Stones bootcamp at the President's farm outside Gabs.

Stepping Stones is an incredibly successful NGO in Mochudi, Botswana that offers after school programs, counseling, and summer camps to at-risk and vulnerable teens. Many of the kids have suffered abuse at home, others have HIV, and most are not succeeding in school. I heard about this bootcamp through its organizer, who wanted to model it after his training in the British Forces. He also happens to be the nephew of the President of Botswana, and he was able to fund the weekend with help from the Lady Khama Charitable Trust.

My "command task" was called the Mine Field and involved a 3mx3m square full of exploding newspapers that the 6 blindfolded teens had to avoid while working together to rescue some paint buckets. Basically, I stood on the sidelines making explosion noises while baking in 100 degree heat and direct sunlight. Then, after 30 minutes of baking, we searched for a few inches of shade in the bush to debrief with the kids about what had gone well, but mostly to lecture them on why the task hadn't worked because they had cheated. We also asked them what they wanted to do after school, and I learned that a mine field was perhaps not the best choice of leadership activity since many of them "wanted to join the army to kill people".

In all honesty, the weekend was an enormous success for the kids and for me. Some of the teams of kids became incredibly trusting of each other, but mostly it was clear to me that Stepping Stones had already formed a group of strong young leaders. I heard many stories from staff including one about a 16-yr-old boy who first came to the program a year ago refusing to speak a single word, and he was now his team leader directing all his teammates across the minefield. This is the most successful and worthwhile NGO I have witnessned firsthand, so check i out if you're interested http://www.steppingstonesintl.org/newsite/.

On Sunday morning, as the kids were shaking their booties and singing in a circle, we heard reving engines getting closer and closer. Then, in the middle of the bush on the Khama farm, Ian Khama (the president of Botswana) drove up on his flame-striped ATV followed by his flame-striped posse. After seeing his portrait in literally every establishment and office in the country, it was a surreal moment for me too. He shook our hands and then drove off...without seeing our mine field, but I'm sure he had other things to do.

Africa for Beginners Part 2: Photographic Evidence

Thanksgiving in Botswana! Penn med student Ali and Columbia Derm resident Vishal are hard at work preparing turkey from World Foods, an import store in Gabs that inherited some turkeys this year after they were unsucessfully smuggled from SA to Zimbabwe! Alex, another Penn med student awaiting the fruits of our labors.

The Hash ceremonies! Newbies and those guilty of misdemeanors during the run/walk have to enter the circle and chug the most disgusting thing the "brew master" can create. And yes, those are children.

This hash took us past the former church and home of Dr. David Livingstone, the Scottish explorer and missionary who re-named Victoria Falls, and disappeared while exploring Southern Africa. His church was up and running in 1860, and it's now the pile of rocks seen below, which makes colonial Boston and Williamsburg seem all the more impressive.

Here Ryan and I are struggling in our lack of modern conveniences...

Plea for music and books!

I am desperate for new music! Please email me music or send a cd to my mom who's visiting in a few weeks.

I also cannot find many books around here that don't have aliens and/or lingerie on the cover, so if you've read any good ones recently, please send them to her too!

Mailing address:
749 Chestnut Rd
Sewickly, PA 15143

The Day I Hung An American Flag

Tonight I duct taped a square-shaped American flag to my bedroom wall. I miss my country! I miss not having five layers of dead bolts on my doors, downloading PDFs in less than an hour, having seasons, being able to swim in bodies of water without fear of crocs tearing off my limbs or dying a slow death from schistosomiasis, walking down the street with my laptop without fear of it being grabbed, seeing patients getting great care in the hospital, my friends, girls nights, and the New England outdoors.

Don't get me wrong. I'm still having a great time exploring Botswana and meeting new people, and I can't wait for my mom to come visit in January for Mom-fari, but I think the different pace here, referred to as "Botswana Time," is staring to get a bit on my Type A(minus) American nerves.

I suppose it's time I talk about my research project. My pneumonia severity score project is part of a larger "Botswana Pneumonia Guideline" that the Ministry of Health asked UPenn to draft for the country. To begin actually collecting data, we need ethics approval from three institutions: The Botswana Ministry of Health, Princess Marina Hospital, and UPenn. About a month ago, we got Princess Marina approval, and UPenn has told us they will follow quickly after both Bots approvals.

So, here we are still waiting on the Ministry of Health. If you're scratching your head, you're right--they did ask UPenn to draft the protocol in the first place. They have been sitting on it for five months now, which means that my mentors actually did a stellar job getting everything together ahead of my arrival, but no one could have foreseen that the Ministry would take this long. Our UPenn staff keeps having meetings with Ministry officials in which they report, "We are understaffed, and that person who reviewed your protocol is on vacation...out of the office...not answering his/her phone...unheard from." Last week I was told that the committee is having a meeting on Tuesday to plan when to have a meeting to discuss the protocol.

I keep having to remind myself that I knew things would be extremely slow, and this cultural experience is what I signed up for. All in all, while "piloting" the study, I've been doing a pretty good job finding other ways to keep busy. I bought a guitar and have been playing more than ever, I run everyday with friends, I volunteer at an orphanage, I started teaching swimming lessons, and I've been cooking more than ever. It's just so different!

So, after that rant, rest assured that I am happy and enjoying life in Botswana, and I'm just saying that sometimes it can be a little frustrating...

Drinking Club with a Running Problem

This Sunday morning I had to chug a cup of tomato juice and mint liquor for the misdemeanor of being "too enthusiastic" about running. This is a normal part of the closing ceremonies for the Gaborone Hash House Harriers, a professed "Drinking Group with a Running Problem." Every Sunday morning a different hasher sets a running and walking course, and different markings on the road steer runners down occasional false trails so that we all eventually end together at someone's house or an outdoor grill for a "bring and braai."

This morning's hash was comprised of many walkers and about 10 runners, most whom were white-haired South African men in short-shorts, and then me. An interesting surprise three miles into our run was the Gaborone Cricket Club bar, where we were commanded to stop and have a beer before running the next 3 miles. Towards the end of the run, the markings on the bush trails got a little unclear, and the "hare" who had set the course had to pull out a map, which was also later considered a misdemeanor.

When the walkers (ages ranging from 2 to 80) and runners finally convened at the house of "Cow Herd" (one of many Hash names), we circled up for the ceremony. When the category for misdemeanors came up, two hashers were called out for cutting short Baylor's 13km Pediatric AIDS Institute fun run yesterday. One of them then dared to point to me and say I had run the whole 13km. I argued that it wasn't a misdemeanor, but they fired back by saying it was overly-enthusiastic. The category then became the "Over-Unders", and the circle sang the hashers chant as we choked down our minty tomato punishment.

Here's me finishing the 13km charity fun run yesterday at 7am in 90 degree heat!

Gaborone Moments

This is a favorite Gabs afternoon activity. It's called: "Pushing the alarm panic button to see if anyone shows up or calls, and when they don't, watching men climb into Sarah's closet to move around some wires."
Oh yes, another classic. This one's called: "Oh, your mechanic stole your battery? Let's call mine instead."
And here's some elegant ballroom dancing at Botswana-UPenn's 10th Anniversary celebration last week at the fanciest hotel in town. The Minister of Health, Embassador to the USA, and some Chancellors of something were all in attendance. All I can say is that study nurses know how to get down.

Marathon Bliss!

The Soweto Marathon was AMAZING! My goal was to not stop running, and I accomplished it, even on the evil final 7km of hell, I mean hills. I came in at 4 hrs 14 minutes, and considering all the hills and the altitude change, I'm pretty darn happy about it! I had a reward system for myself consisting of chocolate GUs (basically packets of chocolate frosting) and Lady Gaga, and it worked!

There were around 10,000 of us running, and the vast majority sprinted the first 10km in the excitement and then died. It was tough to watch so many people pass me at first, but I stuck to my slow and steady strategy, and then for the rest of the race, I was passing people like crazy. Weaving in and out of exhausted, sweaty joggers and walkers was actually one of the hardest parts, especially since the Combis (public transportation vans usually driven by psychos) were sometimes trying to do the same thing.

Running through such an important spot of apartheid history was incredible and overwhelming at times. The race took us through all areas of Soweto, including up Vilakazi Street, where Nelson Mandela and Desmond Tutu have houses. We also ran by the Hector Pieterson memorial which honors the 11-year old boy shot in the Student's Uprising in 1976. The high schoolers in Soweto were trying to passively protest new laws that forced all schools to teach only in Afrikaans, and the chaos resulted in Hector being accidentally shot and killed by police.

On marathon day, the streets were lined with villagers cheering, even as early as 6:30am! Groups of large women in colorful scarves clapped and chanted, "Go lady. Go lady" when I ran by. There were also groups of kids holding out their hands, which I assumed meant they wanted me to high five them. Nope. It turned out they wanted us to give them our Energade sports drink packets. I must have been a huge disappointment for them. However, I was lucky, because even in the middle of the pack, I got enough Energade and water at all the water stations. I had heard rumors that they sometimes run out!

I slowly picked up my pace starting at about 20km, and I died around 35km, which was better than I thought would happen. I kept going though, and I had enough excitement and adrenaline to sprint the last 1km into the stadium. I annoyed all the people around me at the finish line by high-fiving everyone and telling them how excited I was. Then I sat down in the field, and could not stand back up! My thighs were so tight I thought they were going to explode, and my left foot arch was not very happy. Getting in and out of the car at the border patrol stations was PAINFUL. This past week my quads occasionally "gave out" while I was walking in the hospital, but today, a week later, I finally feel like I'm back to normal.

Anyway, I'm totally hooked on marathons now, and I'm in training for the next one (country TBD).

I'm sad to say I don't have any pictures of the race because I didn't have anywhere to keep my camera, but I do have an awesome picture of what awaited us in Gabs. Meet Marlow, Ryan Davis's newest addition and my neighbor!

Bots loves its meat

Apparently in Bots, Sunday is the new Friday. Actually, it's "jazz night," which means anything from bumpin' hip-hop to swanky "house" music. Pretty much anything but actual jazz.
Mountain Rest in Gabane is a short trek from Gabs, but the slabs of raw meat that you buy at the bar with your beer are definitely worth it. Then you grill it...with your fingers.

Then you put it back onto your E.coli soaked piece of cardboard, and enjoy. Again with your fingers.
Then you dance.
And then your dinner also works for halloween...

When in doubt, DANCE PARTY!

I have been going to the SOS Children's Village most Monday nights since I arrived in Gabs. It's an enormous orphanage with hundreds of kids split into houses of eight or nine and one "house mother". At first we were taking giant green grocery bags full of books, cards, and toys, and sometimes we could make it to one of the houses before the bags exploded from lots of grabbing, but most of the time couldn't. I now only carry one or two toys.

There are two houses that have the youngest kids, and one of them has five adorable little girls who are usually wearing old party dresses. My third week, I tried branching out to get to know some other kids, but I've since come back to the little girls, and they are decidedly my favorites.

SOS seems to have a pretty decent school, and we've since met some older kids who are now enrolled in the University of Botswana. The saddest part about the orphanage is the lack of personal attention each kid gets. When one pinches or hits another, the ten-year-old house brothers either intervene or they don't. For this reason, manners are basically non-existent, and I am lucky if our game of Go Fish goes two rounds without someone grabbing cards out of turn or knocking them all off the table. It's always the smallest and cutest ones I have to watch out for!

Last week I was so frustrated by their bad behavior, that I just gave up on scolding them and sat silently for a minute listenting to them bickering.

Then it came to me. I got up and just started shaking my booty. After a few seconds of shock that "Teacha" was acting like an idiot, all the little girls joined in, and their brother played the drums with pick-up sticks. We clapped, kicked, twisted, and spun. It was glorious and full of giggling. The host mom joined in as well and turned on the music video channel. Her booty was going nuts! I left that night wiping sweat from my forehead.

Tonight when I showed up with Go Fish, the girls immediately demanded a "dance party".

The Spice of Life

I'd like to introduce you to Aromat, the secret to all good cooking in Bots. Allow me to share with you how our relationship began and blossomed:

For the first few weeks here, I was using whatever spice mixes I could find in the grocery store. The variety was astounding, and included such diverse options as "beef spice," or "chicken flavor." Even though all the meat looked a little off-color, and the vegetables had their own ant farms, everything tasted incredible. It wasn't until halfway through Sarah's bottle of "Parmesean Pesto Spice" that we discovered our new best friend's name: monosodium glutamate, otherwise known as MSG. I immediately stopped messing around with the add-ins and fancy names and bought straight up Aromat Original. I will never eat another bite without it, and I'm saving at least half my suitcase to welcome my new friend to America.

Things They Don't Tell You About Running

Over the past week, I've been sporting some not-so-stylish wounds on my chest. Basically, everywhere my sports bra had a seam during the 32k run, I now have an unsightly scar. The diagonal dashes actually look surprisingly like the traditional medicine scars I saw on patients in Tanzania. For many patients presenting with cardiac issues, the traditional healers had generously marked the precise spot of the heart murmer with a concentration of small linear burn marks. It made the med student's job a little easier, though unfortunately, we usually had just as few tools as the traditional healer for actually healing.

Mine, fortunately, are not cardiac related, and today for our 2 hour run, I tried a different method that involved a large piece of duct tape. I thought that if this worked to prevent blisters while hiking, it would certainly prevent sports bra chafing. I was feeling pretty proud of my ingenuity until about 4 miles in, when the intense itching began. I'm embarassed to say I now have a bright red duct-tape-shaped contact dermatitis cooling off in a slathering of Neosporin. Somehow these chafing issues don't feel quite as badass as running's other effects...

One of the coolest things about our new house is its abundance of weaver birds. There's one giant tree hanging over our cement yard, and it's full of tiny woven baskets with spouts coming out the bottom. Ryan D pointed out that we must have several species in the area because the nests at his house have side-spouts, whereas ours come out the bottom like "prolapsed rectums".

Last Saturday morning at 7am as I was waiting for Ngaire to pick me up for our long run, I watched all the mommy birds flooding their nests at once. They clung onto the spout entrances and stuck their heads up inside, and I could only assume that meant breakfast time.
So we all know that what goes in must come out. As our single male neighbor has been having more and more visitors lately (always well-dressed women who come and leave alone and occasionally make grunting noises in the kitchen while...cooking), our covered parking spot has occasionally been occupied, leaving us to park on the other side of the yard under the weaver bird tree.

Because Research Projects Don't Give Out T-shirts

In my fellowship, I'm supposed to have one "primary project" that I can ideally complete in one year, and then I can be a part of larger projects, and I can do additional smaller projects as well.

My primary project just became PROJECT MARATHON MACHINE. aka: my original "primary project" on pneumonia continues to gather dust on the Botswana ethics committee's desk, my new fill-in mentor is in the Dominican Republic for a couple weeks, and I just cranked out a small project on antibiotics.

So, the only thing left to do is to become a beast. With that in mind, I signed up for the Soweto Marathon in 2.5 weeks. Maybe you think that is nuts. I prefer to think of it as healthy coping. Sarah's going to do the 10k. Total credit to her for this post title.

I have been told the Soweto Marathon is a once in a lifetime experience because it's the only day of the year when historic Soweto is safe enough to explore. My first reaction when I heard that was probably something like yours: "Then keep me the hell away," but several others have since recommended it, and if I can keep my car from being stolen and not suffocate or cramp to death in the altitute change, I will be a happy camper.

With that being said, I'm off to practice running some hills! ...on the treadmill...if it's not broken today...

Living the Dream: first 20-mile training run

I'm officially signed up for the Two Oceans Ultramarathon (56Km) in Capetown the first weekend in April. The course is along the coastline, and it's supposedly the most beautiful marathon in the world. When in Africa, right? Now I need to pick a c0uple marathons to run before April to make sure I won't die.

So that brings me to today: my first 32km (20 mile) training run through the scorching Botswana bush. A few weeks ago I was introduced to Ngaire, an Aussie ER attending, and ever since, she's been taking me on epic runs around the city and into the bush in preparation for her first New York Marathon.

Today's run was a bit more epic than usual. We did the first 10 miles on crazy narrow bush tracks, and I had no idea how Ngaire knew where she was going. The crazy African dagger thorns (see picture I took a few weeks ago) kept stabbing up through the soles of my shoes, and at one point we had to stop. There was one nasty thorn that we couldn't get out with our fingernails, so...I may have used my teeth. It worked, and I could run the next 10 miles!

This was very good for me in many ways, but mostly because I realized I have no idea what I'm doing. I brought one small bottle of water and no food, assuming it would be like a normal run, just longer. Luckily, Ngaire had snacks for both of us, and she called her boyfriend to come throw us some Poweraid bottles when we popped out of the bush. He was a real hero. I think by the end I'd had 3 full waterbottles, 2 Poweraids, and 1 large can of coke (apparently a secret weapon).

We ran the last 8km back to the car on a main road, and 9 out of 10 passing cars honked or cheered us on. I spent most of that part staring at Ngaire's heels and dumping my then near-boiling water over my head.

Incredible experience, and it made for a glorious bath in the posh palace's giant tub, followed by one of the best naps of all time

A Botswana Kind of Day

There is definitely something a little off when you spend all day serving cookies, fruit, and Coke Light to workmen because they are locked inside your house. First, the internet guys came and could not get out the gate, and then the gate guys came and could not get in the gate, and now the locksmith is on his way. At least I finished the lasagna before anyone got here...

Yet again, so much has happened in just one week. Harvard's Doris Duke program sent us to Durban, South Africa for an HIV conference, and we turned it into a five-day glorious Global Health Camp reunion. Eleven of us doing Doris Duke fellowships in Africa rented a huge beach house, and we took full advantage of the enormous waves crashing 30 ft from our doorstep. Alex was man enough to rent a 9-person party van to transport us back and forth to the conference (see picture).
After conference hours, there were many more hours of grilling (called having a "braii"), swimming in the ocean, and making bonfires on the beach (woo team Dartmouth!). On Saturday, Melike (Doris Duke in Malawi), Jon (Doris Duke in Ghana), and I rented a car and drove 2.5 hrs to the Drakensberg mountains. The car was a manual, which made for a very interesting experience for 2 people who sorta thought they could drive stick, and one person (me), who'd never done it. Let's just say that by the end of the trip, we were all experts! Okay, not experts, but I feel confident enough to temporarily move the car in one direction, and I think Melike mastered not stalling at each toll booth.
The 7 mile hike was incredible. I kept wanting to sing songs from the Sound of Music (hence these pictures of me frolicking). We came across waterfalls with crystal clear swimming pools so clean that all hikers drank from them. I even climbed one of the tiny waterfalls not to look like a wuss after Jon and Melike did it. It was terrifying, and all the pouring water basically took off my shorts...
It was so great to see everyone and hear about cultural experiences and hear the echo of "Yeah...things are going pretty slowly". That made it a little easier to come back to Bots to find out that my IRB (what needs to be approved before I start collecting my data) will be delayed another 2-3 months. Long story short, things in Africa move a LOT slower and less efficiently. I'm trying not to be too frustrated about it, and luckily, the big boss researcher here came up with a few other project ideas that I can do in the meantime. They sound pretty exciting and are actually pretty similar to the other project, except they already have IRB approval.
In other news, Sarah and I are officially moved into the posh palace, and it is glorious. Somehow we are living in semi-luxury...with down comforters. Yesterday I came very close to forgetting I was in Africa until I saw the colony of ants setting up shop in our jacuzzi. Okay, not really jacuzzi, but it could definitely hold 3 people.
To give you a sense of my hood, I took a few pictures of Main Mall, where we sometimes go to the grocery, bank, restaurants, etc. This is Bots baby!

From top to bottom: 1) Riding in the safari mobile to the pans. 2) Planet Baobab's huts and a giant Baobab tree. 3) Meerkats! 4) Speaks for itself 5) Cousin Ryan grilling up some multi-colored sausage. As for the green ones, your guess is as good as mine... 6) Cannot believe I signed a waiver 7) Tessa and Matt chillin before our safari to the pans.

Makgadikgadi Salt Pans: If you're not coughing phlegm, you're not saying it right

Wow, what a week. Thanks for being patient those of you who follow this...ahem...mom. No, wait, you emailed me twice asking if African bushmen had carried me off. To answer your question, not quite, but I did venture far into the bush this past weekend on our trip to the Makgadikgadi salt pans in northern Botswana. Eighteen of us caravanned through cows, goats, and shanty towns to Planet Baobab, named for the huge and creepy Baobab trees that dominated the campground. I know what you're thinking...we must have carried in massive amounts of hand, foot, and mouth disease into the bush. Nope! There were several "check points" along highway A1 that required walking through muddy pesticides and driving the Dingo through deep puddles of it. It felt very similar to fording rivers in the Oregon Trail in that I had no idea if the Dingo was going to make it. In other news, no one on our trip died of cholera, but Sarah is likely to feel the effects of Salmonella soon, after eating half of her insanely raw chicken wrap at Wimpy Burger in Francistown.

We pitched our 8 tents at the campground and had a massive cook-out. I think this is an appropriate time to mention this country's obsession with sausage. The meat rack at the grocery store is approximately 90% sausage. There's lighter-colored sausage, darker-colored sausage, bloody-colored sausage, and old-looking chicken sausage that no one seems to buy. It is also impossible to buy less than 10 feet of sausage. And it's impossible to pay over $3. Anyway, let's just say that our cook-out included multiple sausage designs of Princess Leia's hair buns, or, what I thought looked like sizzling tape worms.

The next morning was spent with goats and hornbill birds (Zazu from the Lion King) at the pool. Apparently, we couldn't leave for our tour of the Pans until 2pm because it was "too hot". Anyway, making good Botswana time, we left for our tour at 4pm in two giant safari trucks. My window seat turned out to be a serious liability as we sped through the bush and its knife-like thorn bushes. Our first stop was to join five Japanese tourists in harassing a family of Meerkats (Timon from Lion King) by slowly pushing them off their land with 18 giant cameras. Not going to lie, they were pretty freaking cute, and much smaller than I expected.

Next, we pulled up to an isolated village of three small traditional huts next to a herd of cattle. "A cultural stop," I thought to myself. Wrong. Behind dilapidated mud hut #1 was none other than 15 badass ATVs! Sarah and I claimed one, and she maniaced our way onto the salt pan, which felt like floating onto the flattest, whitest beach I've ever seen, except no water.

Sadly, because it started raining, we didn't get to camp overnight on the salt pan and experience the famous peaceful star-gazing we'd heard so much about. Instead, I drove our ATV back to dry land, and we camped another night by the Baobabs.

Pictures to come. For now, I have to prepare for a powerpoint presentation to the Emergency room staff tomorrow, and exhaustion is hitting me like a carton of shake shake. Oh there's so much more to tell...

Bush League

Last night we went to the circus. We haven't been able to drive anywhere without passing the tents for the past week, so I decided I had to see it. Wow. Apparently there is no handbook of international circus standards.

To start, as soon as we pushed our way into the dusty tent, there was no hope of leaving for water, food, bathroom, or, as Ryan Davis pointed out, fire escape. We paid 90 pula ($12) for "Ringside Seats," which meant we were placed 3 feet from the caged tiger entrance. Mostly, it meant we had the best view of the carnies smoking cigarettes on the sidelines. It also gave us a nice view of the extreme terror on the faces of Rita the tiger trainer and her backup man with pockets of meat as the 6 enormous Bengal Tigers seemed to do disobey them in just about every way possible. As hell broke loose, her fake plastered smile got wider and wider. This happened again with the poodles, the horses, the ponies, and even the acrobats.

There were only six human performers who kept reappearing in different sparkly garb with different stage names such as Magic Rashid, Mongolian Jugglers, and Feline Frenzy. Then, during the intermission, the talent all put on hair nets and served cotton candy, popcorn, and light-up swords to the crowd.

Overall, it was a good time, no one was eaten alive, and we had some fun with cotton candy...

Happy Birthday Sarah!

Sarah's birthday party was a great success! Lots of friends, balloons, and even a 4-month-old (apparently no one gets left out of the fun, including our maid's two very small children).

The Ryans, Tessa, and I sneakily made a cake earlier in the day. Tessa, using her veterinarian vision, made a perfectly-striped zebra cake! Then we ruined everything with the frosting, so it was promptly covered it in neon sprinkles in what became a Lisa Frank nightmare. But it still tasted good!
Pictured here from right to left: Trynos, our mechanic, his friend Bruce, Erin with Tando, Sarah, and Cousin Ryan. Trynos was surprised and impressed that the Dingo and I had made it all the way to Ramotswa and back. I don't know which of us he doubted more...

Hunt for Pneumonia

I survived my first 40 km drive, dodging goats and potholes, to Ramotswa, on a hunt for more pneumonia patients at Bamalete Lutheran Hospital. Not going to lie, I was sweating bullets in the roundabouts and just about every time I passed a car on the highway in my too-close-for-comfort right-sided driver seat.

I was paired up with Dr. M, a jolly generalist from Zimbabwe. When I say generalist, I mean that I followed him back and forth between the outpatient clinic, maternity ward, and operating theater. Old school docs here have all been trained to practice medicine anywhere at anytime, and they find the idea of an orthopedist or a dermatologist ridiculous.

My goal was to feel the place out in terms of its pneumonia burden. I saw a vacuum birth, an abdominal mass, a few broken bones, a LOT of hypertension, one case of the hiccups, and no pneumonia. Looks like I will not be returning to Bamalete...

The highlight of the day was definitely Dr. M, who grew up with the African health system, but still finds humor in its ridiculousness. He told many stories, such as a patient who drove 200 miles to get his blood sugar checked, and when he arrived, he was carrying a glucometer.
"Why didn't you check it yourself?" Dr. M asked.
"Because this is the clinic where I received the diagnosis," answered the patient.
"I was diagnosed with diabetes in Scotland," answered Dr. M, "but that doesn't mean I need to go back there."

A woman today was worried about gaining weight while pregnant: "I've gained some recently," she said.
"No, no. You were much bigger the last time I saw you," replied Dr. M.

On the drive back, I missed my turn approximately 12 times, but I made it. Sarah's birthday is tomorrow! Stay tuned for lots of pictures from her party!

What ate your baby?

Our new Mitsubishi Dingo! Spacious like a minivan, yet small enough for us not to be soccer moms. It's not either of the two we were considering earlier, because when Trynos, our 6'6" mechanic, pulled up in the Dingo, we just knew. When we drove to the UPenn-Botswana office after picking it up today, the office staff flooded outside to see it. Most actually climbed inside and shut the door to get a good feel. Proud car-owner moment.

The rest of the day was a mix of excitement and terror, as we took our first solo mission driving on the left side of the road. When I test drove a different car last weekend, I discovered what a neurological hemineglect syndrome must be like when I ran the left side of the car (along with Trynos who had the window open) into a thorn bush. It's weird to worry about so much car on the left! Anyway, the neglect syndrome was in full force today as Sarah and I both gripped the left-sided passenger seat as the other occasionally straddled the the white lines.

The Dingo's most impressive feature is its ability to fold all four seats into beds! Camping here we come! No tent necessary!!
Here's a glimpse of the car-buying process...