SUVs in Africa = international health and humility

I arrived in the town of Choma, Zambia Sunday night to observe and provide feedback for the facilitators of the HIV prevention program I am working on as they practice in preparation for implementation. Located on the main road between Livingstone and Lusaka in the southern province of Zambia, Choma has roughly 40,000 people and a bustling main street. It also, apparently, has as many NGOs as it does people.

Everywhere I look, I see Land cruisers, big Toyota off-road trucks and other Japanese-made off-road vehicles that proudly display their various NGO affiliations, including World Vision, Hope International, CDC, USAID, AFRICARE, DFID and many, many others. They are easy to distinguish not only by the fact that they dwarf the other vehicles, but that despite the roads being incredibly dusty they manage to stay sparkling in the sun (thanks to daily car washes), as if to underscore that they were funded by perfect, sparkling, developed countries.

Seeing how I myself am traveling in one of the giant, gorgeous white Toyota trucks complete with a nifty CDC logo on either side, I certainly can’t claim to be any different. But I can’t help recalling when I was a thrifty backpacker traveling through Laos and Cambodia, and the scorn with which the locals viewed the innumerable NGO vehicles that clogged their streets, and the air of self-importance that comes with the neo-colonial ritual of international organizations sending people to “save” the unhealthy and dying locals. Back then, I both wanted to be an international health care worker, and understood the frustration of the people who I spoke with who felt that money was being squandered or not going to the right people, or was being extorted and siphoned off bit by bit.

But now I am that international health care worker, and I can’t help but look around at all of the vehicles and offices in this small town, and wonder how much of a difference they are making. Of course, many of them are making a huge difference – but I wonder whether the citizens of Choma are getting tired of the endless parade of organizations and information/sensitization programs. Even more importantly, are any of the programs making a lasting, sustainable difference for when the money dries up and the organizations leave to begin a new program in a new country? Will the program I am helping to implement be successful not only in my eyes but in the behavior and health outcomes of the community?

It is not that I am jaded (I haven’t been at it long enough) – although I certainly do know that many programs never see the results they set out to achieve. If anything, it has to do with my amazement at the sheer numbers of international public health workers that are living and working here in Africa and elsewhere in the world, and how so many can all be working in one small town (reminds me of how every time I read an article about research conducted in Kenya, it has been conducted in the same province/town [Nyanza province/Kisumu]). And it is also a healthy dose of humility as I am driven around in a fancy white truck by a driver for the local NGO I am working with (how embarrassing), knowing I am just another international health worker here for a brief period.

A typical Saturday in Livingstone

My work here in Zambia this time around has been far more difficult and busy, leaving me with only Saturday free and a full day of work on Sunday (boo). Being exhausted, my boss and I decided we'd rather relax and see the Falls than do an expensive touristy activity (I'll have time for that in the next weeks).


The dry season has hit here in full force, and the elephants have begun closing in on Livingstone trying to find food in the bushes and trees along the road leading from the Zambia-Zimbabwe border (the bridge over the Victoria Falls through Livingstone and up towards the airport. A herd of elephants has been hanging out along the road not far from the border bridge, and i have had the opportunity to see them a number of times on my way to and from the Falls and the bank. Now, with the border right there, you constantly see men on bicycles weighted down with hundreds of pounds of goods they bought in Zimbabwe (for cheap) and are bringing to Livingstone to sell for a profit. But when these elephants are on the road, they don't dare bike past them. and so you can always tell when the elephants are out because you will first see a line of men standing next to their bikes, warily watching the herd tear up trees and cross the road.







Once past the elephants we arrived at our favorite hotel hang-out - the Zambezi Sun hotel on the banks of the Victoria Falls. This is the same hotel that in a previous blog from my last trip here, I described the cheeky monkeys who terrorized the tourists at breakfast. And so I found it too funny when we arrived to see a man relaxing as he read a newspaper, unaware of the monkey hiding behind him that was about to steel his pair of Crocs.



After sunbathing and enjoying a well-earned mango daiquiri, we headed down to see the Falls, running into the herd of zebras that live on the hotel property (the baby zebra that was one-week old when I was last here is so big now!).







On we went to the Falls, which is so different now in the dry season than it was when I was last here in March. Mainly, I could actually see it! Before, the water was so high the rain mist hit before you could see much. Not so this time.













All-in-all it was a lovely day off, hopefully things will slow down and I'll actually have two days off for a weekend...though I can't complain when I can get in elephants, zebras, monkeys, water falls, and sun-bathing in a single day.

On the way to the bank...

You would think that as a world-traveler, savvy in every way when traversing the continents, I would have cemented in my mind one of the most important truisms ever offered by a commercial: “VISA – it’s everywhere you want to be.” Unfortunately, my reliance on my MasterCard meant that I found myself unable to use my debit card here in Livingstone, Zambia.


When I think about it, I’ve had a number of blog posts over the years relegated to the search for ATM’s, frozen credit cards that always occur when it’s a national holiday back in the States so I have to wait two days to get it cleared, traveling six hours to a town to find there are no banks or ATMs, bringing my credit card instead of my check card (last time here in Zambia), finding ATMs only to learn they are broken/out of cash/for Nationals only/have a personal grudge against Drewallyn Riley for some reason.


Thus I found myself today on a journey of discovery – tracking down the elusive, endangered ATM that accepts something other than Visa. Of which the last one was apparently hunted down by a Texan last week. Fortunately, I am so used to something going wrong with my bank cards that I wasn’t too worried, plus being here for work means I have a driver to take me to banks, rather than catching local public buses with 25 people in 6 seats or walking 10 miles (love it!) – not that it made it that much easier…

We picked up a woman who worked at the organization I’m working with.

We picked up her children from school.

The first bank ATM was being refilled with cash.

The second bank ATM wouldn’t take my card; inside there were so many people (it was lunch hour) that I couldn’t get in the door.

We dropped off the children at their home.

The third ATM didn’t take my card.

We dropped the woman off to run an errand.

Then we drove down to the touristy Zambezi Sun hotel located on the edge of Victoria Falls (see previous posts on Zambezi sun), about 5 miles from downtown Livingstone, as the driver knew that this hotel was so fancy it had its own branch of Barclays bank with clerks who could run my debit card. I went in, they said “no problem, let me have your passport.” And being the responsible, world traveler I am, I had left in my hotel room safe.

Back in the car to my hotel. And on the way, on the side of the road...a large herd of elephants, leaving a tell-tale trail of massive dung across the road. Of course, being the responsible world traveler, I had also left my camera in the safe. Well done Drew!








Went to the hotel, got my passport and camera.

Took pictures of the elephants on the way back to the hotel bank.





Arrived at the bank with proper documents (yeay me!). asked them for $600 USD worth of Kwatcha (Zambian currency). They gave me $600 USD. Tried again – finally made it out of there with a massive wad of kwatcha ($1 = 5,000 kwatcha, with the largest kwatcha bill being 50,000 or $10, making for a very big wad of cash). Let’s just say if I tried to act like a local Zambian woman and stash my cash in my bra, I’d of suddenly jumped to a D-cup.

Took more pics of the elephants and some baboons scampering across the road.




Picked up the woman from her errand.

Dropped the woman back off at the office.

Came back to the training I’m observing in time for everyone to have finished their lunches.

Couldn’t find my wallet, nearly had a heart attack.

It was on the floor of the car.

I win!

Nothing is cuter than baby elephants...

My boss and I unexpectedly had free time Tuesday morning, and decided to do a bit of sight-seeing around Nairobi. For such a large city, from which tourists head out in all directions for various safaris, I found that it has surprisingly few things to see and do. However, two of the things highly recommended (besides the Nairobi National park safari I did the day before) is the baby elephant orphanage and the giraffe sanctuary.










We first went to the baby elephant orphanage, which is formally called the David Sheldrick Wildlife Trust. A British woman, the widow of David, began rearing orphaned elephants and other animals and spent 28 years perfecting a suitable milk formula and caretaking strategy to successfully rear baby elephants, which until the age of three are milk-dependant. Every day from 11am-12pm visitors are allowed to come and watch the babies get fed out of bottles while their caretakers talk about each of them and how they became orphans. There are currently 21 orphans under the age of 2 years at the orphanage. Once they reach the age of three, the caretakers begin the long process of introducing them to wild herds of elephants in other parks, with the hope that eventually (sometimes after a year or two) the herd will accept the young elephant into their family.






Us visitors gathered around a loosely fenced pen, and watched the keepers lead a long line of adorable baby elephants down from the forest where they were practicing foraging to the feeding pen. It was amazing how fast the babies could down the giant 2 litre bottles of milk. And it was amazing to see how close they were to their keepers- one female baby kept wrapping her trunk around her keepers arm and waist as he gave his (clearly rehearsed and memorized) monologue on information about the baby elephants. We supposedly got lucky with a “small” group of visitors since it was a working day. The babies were very pushy- pushing into each other and the keepers and clearly craving contact. We were able to touch them as they came up along the fences, and practiced drinking water from large wooden buckets. It was truly one of the most adorable things I’d seen, and I learned a lot from the keepers. For instance, about half of the orphans’ mothers were victims of poaching, but the other half had almost all fallen down various wells dug by humans in their first few days of life and were thus rescued.










From there we went to the Giraffe Centre, created by a Kenyan conservation organization to educate Kenyan children and other visitors about Kenya’s wildlife and environment. Here, visitors get to feed the endangered Rothschild giraffes cereal pellets and learn all about giraffes in a cute little wooden auditorium. Watching baby elephants and feeding giraffes was certainly a great way to spend the morning.

Nairobi National Park: Yeay Lion!

This morning I went on my final safari in Nairobi National Park, which, as it may sound, is literally butting up against the outskirts of Nairobi and offers a rare chance to see the outline of African animals with Nairobi high-rises behind them in the distance.

It's still a national holiday today for Easter, so there were very few other cars in the park. Unfortunately, it was a very cloudy morning and most of my pictures did not turn out very well, nonetheless, you can clearly make out the three new animals I was able to add to my list of those seen on safari: ostrich, rhino and Lion!







We were driving on the side of a hill looking down onto the plains, and my driver was saying how when you come upon a herd of zebras or impala and none of them are eating but all looking in the same direction, there is either a cheetah or lion there. Just then, we come around a bed and notice a herd of zebras all staring intently in one direction. Far off towards where they were looking, a herd of impala was staring nervously back in the direction of the zebras. And right in the middle of the two herds was a young lion, sitting there trying to figure out what to do. Clearly the lion was screwed, both herds were intently watching it. So finally it turned and made its way directly towards us and actually crossed right in front of us on the road and into the thick bushes on our right, where the rest of the pride must have been waiting.





The crazy thing about this was, the car stopped behind us had four tourists, and of course they decided to get out of the car to see the lion better. the occupants in the car in front of us and my driver all pleased with them to get back in, and finally, begrudgingly they did. When the lion passed the road and went into the bush, the bush starts literally on the side of the road, and it would have taken all of two seconds for one of its family members to have jumped out and attack the idiots standing outside their car. It reminded me of all the stories over the years of stupid tourists at Yellowstone National Park and Glacier National Park in Montana that had been killed because they tried to pet a buffalo or get up close to a moose or Grizzly. I guess anywhere in the world, there are stupid tourists to be found.





I was also very excited to see rhino and Ostrich, and I was surprised at how BIG they both are, even more so than they appear on TV. All in all I felt so lucky to have seen a lion, and also felt it was very special to be seeing rhinos at this park, as my parents were doing the exact same thing here in Nairobi around 32 years ago. I grew up watching the slide shows of my parents travels in Kenya, Tanzania, Uganda and all through Africa. It is truly a dream fulfilled to be walking in my parents footsteps through Africa.




On the way back to my hotel, we drove past the entrance to Kibera, the famous giant slum of Nairobi. According to Wikipedia, Kibera (which is a Nubian word for forest or jungle) is a neighborhood and division of Nairobi, Kenya. It is the largest of Nairobi's slums, and the second largest urban slum in Africa, with a population estimated at between 600,000 and 1.5 million inhabitants, depending on the season. It is a little smaller than Central Park in New York City, but is home to more than a million people -- most of whom lack electricity and running water. Kibera accounts for less than 1% of Nairobi's total area, but holds more than a quarter of its population. Insane. Ban Ki-Moon visited Kibera, and Kibera has been the sight of an amazing amount of NGO work and research on public health topics ranging from sanitation to HIV to sex work.

Victoria Falls

This weekend I was finally able to visit the awe-inspiring Victoria Falls. It is currently nearing the peak of rainy season, and the falls are at their max with the rolling thunder of water, which could be heard from the Zambezi Sun hotel I was staying at.



from the hotel, you exit a gate and directly into Mosi-o-Tunya National Park, and the entrance to the Falls. Once at the Falls, there is an unreal bridge you cross to get to an island on the edge of the falls, that is constantly begin sprayed by insane amounts of water. Due to the peak of the water level, crossing the long bridge requires holding onto the rail since you can barely see with all the intense waves of water rushing over you, and the inches of water cascading down the bridge. You can rent a pncho or raincoat, but it is a waste as there is no way to keep dry (although it did help me protect my camera).



the island boasts amazing views - although facing the falls you can't see much due to all the water spraying up. But facing the other direction I could see the bridge that connects Zambia to Zimbabwe - the location for the Bungee jump and other extreme thrill activities.





But what made this excursion so surreal to me was when I went to cross back over the bridge. It was 4:30pm, and the sun was hitting so as to make the most perfect full rainbow directly over the bridge as I walked back - it was like in a dream since I could see the start of the bridge but not where it ended on the other side- it was like crossing into another world (cheesy, I know).

Zambezi Sun

I spent the weekend at a fancy, touristy resort located on the banks of the Zambezi river right at Victoria Falls. When I arrived back from my week in the small town of Sesheke, I took a walk to see the Falls. It is astounding - the water is at its peak since it is the end of rainy season, and the thunder of the water can be heard from the hotel rooms. Zebra, ostrich, impala and other animals roam the grounds of the hotel, and across the Zambezi river begins the Mosi-oi-Tunya National Park.








Upon arriving at the hotel, I was given three separate documents pleading for me not to feed the monkeys, baboons and other animals. This morning i was sitting at a table directly under the edge of the restaurant room, and thinking to myself how i hadn't really seen any monkeys yet and recalling some people saying the monkeys would steal food from people's tables. As i was sipping my cup of coffee, a monkey came out of nowhere and jumped on my table. I instinctively grabbed my camera as the monkey grabbed my mango, I hissed and yelled at the monkey, who jumped off the table, and came at me two more times trying to take more food, hissing at me as i made as if to hit it. it then ran away, begrudged to have made off with such little booty. I was left laughing, my coffee spilled all over. The next hour as I sat there I watched the various hotel staff chasing the monkeys trying to get them to leave, throwing small rocks at them. Nonetheless, I saw a number of them successfully make off with a good amount of breakfast items.

All I could think of is my Dad and how much he always hated on monkeys. He and my Mom spent a year back in 1979 traveling through Africa, and he would always say about monkeys: "They steal your wallet and your food, and then throw their scat at you!" he would say angrily. I wished he had been there with me then, just to see his reaction. It made me think of when he and I were staying in Thailand together and how cautious he was around the monkeys; meanwhile the other tourists were busy trying to feed them and the next thing they knew, the monkeys had taken their wallets and cameras...










On my last evening I decided to try and find the giraffes and zebras that wander the hotel grounds. I had spotted earlier a promising-looking trail, and as soon as I hit it- there they were! What I didn't know but makes sense is that the hotel employs someone at all times to stay close to the animals and ensure the hotel guests do not try and get to close to them or feed them. The young mad who was watching the animals was very nice, and I spent an hour with him and the animals, which included a young father giraffe and the herd of seven zebras, including a ten-day old foal (soo cute). The giraffe apparently follows the young man around because he likes to have his head scratched (just like horses) and I managed to be five feet away from him.

Chobe National Park: Land Safari

We climbed aboard a typical safari truck with three sets of bench seats in back and headed to the land safari that went along the same stretch of the river that we had floated that morning. Chobe National Park does not have a fence around its boundaries, and so the animals cross out of the park and into the nearby village and road quite often – there was plenty of elephant dung on the road to prove it. On the land safari we first came to a mud hole with maybe three herds of elephants using it in turns. Again, watching the babies roll in it was amazing, and also seeing the teenage males play fight and test their strength. What was most amazing was how close they got to us! We were literally 5 feet away from them at times. According to our guide, Chobe does not have a problem with aggressive elephants, and they tended to be very comfortable with the vehicles (all of the animals were) because there was very little poaching and no culling of elephants. Parks in which they’ve had to round up and cull elephants due to overpopulation (which is now a problem at this park) has lead to extremely aggressive behavior among the elephants and it is impossible to get close.











We also saw a black-backed jackal, wart hogs, a sable antelope, a cool dung beetle rolling a massive ball of dung in the sand and a number of impala. We then left and began our circuit of the park. I was extremely excited to see a number of giraffe, who would just slowly amble past right in front of us. The rest of our drive was full of elephants, which were still really fun to see. Everyone was disappointed we didn’t see the pack of lions that cover this area – they were seen on the opposite side about 35km from us that today. Despite no lions, I was thrilled with the whole experience.













It really can’t get better than a river and land safari in one day. And I didn’t even have to wear khakis and a fly fishing-type vest with tons of pockets! We were driven in the safari truck back to the border, where we went through emigration, then to the river where we crossed again in the motorboat, then through immigration back into Zambia, then onto our tour bus for the hour trip back to Livingstone.





Having had such a perfect day, I decided to take myself out of the hotel for a nice dinner. I decided to go to a place called “Oceans Basket”, as I had been told it had good seafood. I put on a dress, got in a taxi, and when we pulled up the place was dark save some candles. I had to ask the taxi driver where the entrance was. It didn’t dawn on me until the taxi had left and I was walking into the restaurant that the electricity was out not only in the restaurant but in the shopping mall it was located. No matter, so I sat down at a table outside for a romantic dinner-for-one by candlelight (the mosquitoes were very insistent on joining me). I figured, “it’s not Africa if there aren’t power outages.” So I had some wine and a nice fish and calamari combo. The electricity returned half way through my meal, and I learned that, in fact, this restaurant was a chain originally from South Africa and owned by Greeks.