===The Giraffe Center outside of Nairobi===
Kenya was not even on the list, so why was I on a plane to Nairobi? Was I lucky or what? I had seats for two on Precision Air and was being served a large packet of golden brown cashews (mmmm...my favorite!) and a choice of exotic tropical fruit drinks. And all the arrangements had been made for me; I just needed to show up at the check-in desk and show my passport. A guy named Anton met me on the runway when we landed in Nairobi and whisked me off to get critical things -- my luggage, Kenyan schillings from an ATM and a Kenyan SIM for my smart phone-- before delivering me to the car and driver that would take me across town where I would stay in a private suite with 24/7 service. This was totally unexpected!
As I said, Kenya was not even on the list. I had planned to spend up to a month in Tanzania and maybe two or three more weeks to see the small countries of Rwanda and Uganda. As usual it was a flexible plan; however, I had already spent time on Zanzibar, almost two weeks in Dar (I'd really felt at home in the Kariakoo market area) and after my safaris in Tarangire and Ngorongoro I had made friends in Arusha and found it hard to leave. But my time was running out. My TZ visa was good for multiple entries allowing me to go to Rwanda and Uganda and then come back if I did it within the allowed 3-month period. I had already used up over half my time.
Finally, late one night I had a minor epiphany, counted the days left on my visa and made a decision and acted. First thing the next morning, i bought a bus ticket, traded in the two Kiswahili books I had bought for a small, lighter phrasebook, scoured the pharmacies with my list of medications and found a few portable snacks for the trip. However, it seemed that everywhere I went, someone was telling me Elia was looking for me; a few offered their cell phones to call him. I didn't have time right now. I wanted to go back to the market area for a crisp, cool blue and white kanga I'd seen and I needed to do some major organizing and packing to prepare for my 6am bus.
I never got that kanga and somehow Elia had found me and invited himself along. My friend Kathy who believes in fate had emailed me and asked why I was in such a hurry to go to Uganda. She observed that I was enjoying Arusha and had some unfinished business. She suggested I stay in Arusha and see what was meant to be. She pointed out once again that I sounded happier and more relaxed than I had been for my whole RTW-- why not go with it? Well, I was stubborn and had already bought my ticket. Besides, now the unfinished business had a ticket and was going with me!
The bus was a teeth-rattling, chiropractor's nightmare (or dream since it generated business); it threw us several feet up in the air and snapped our necks as it rode roughshod over the dirt road, doubtful detours and seemingly endless construction without benefit of a single shock absorber or an empathetic driver. After over 12 hours, Mwanza and the vastness of Lake Victoria were a welcome sight.
In Mwanza, we ate our fill of fresh fish, spent a few nights out of the city on a stretch of quiet lake, visited a friendly fruit vendor on a regular basis, took a ferry to some small villages, and generally walked a lot. On our last day, we went to church in the morning and then headed out for one last dinner together. Elia was carrying my larger pack and I carried my small shoulder bag with my electronics and a few things to make my night on the Victoria -- the huge ship that would take me to Bukoba-- a little more comfortable. I had a mid-priced ticket with a bed in a cabin for six.
We were both anticipating a good dinner at a place we'd eaten at before. From there we'd go straight to the dock where after saying our goodbyes, I'd board the Victoria. Elia would head back to Arusha early the next morning...around the same time I would be arriving in Bukoba. I didn't know if I would return to Arusha. After Rwanda and Uganda if my TZ visa was about to expire, I might have to head straight to Dar for a flight...or maybe I'd fly straight from Uganda. I didn't even know my next destination since I still didn't have a visa for India. And who knew what would happen in Rwanda-- this was an exciting time. The news was filled with reports from Rwanda as they commemorated the not so long ago genocide with programs and special events to educate the world in hopes that the horrific events would not be repeated elsewhere.
With these thoughts, we walked in silence to dinner. To my left, as usual, Elia was a little ahead of me. I think it's a Masai thing, but it's also sometimes impossible to walk side-by-side with erratic sidewalks or sometimes the lack of them. So I don't know what actually happened; I assume I tripped on the rough, uneven 'sidewalk'. Suddenly, I was propelled forward and waving my arms in the air to catch my balance. I had been thrown off to the right toward a half meter deep cement ditch. I successfully avoided falling in, but failed to regain my balance. In fact, avoiding the ditch had put me even more precariously off-balance. I was in a bit of shock and desperately trying to regain my balance as everything surrealistically occurred in slow motion-- yeah, just like in the movies...and I was probably sporting the same terrified face and mouthing 'noooooo...!' as I continued to flail around hoping to avoid a fall.
This wasn't a nice grass soccer field where I could relax, fall and roll with it to avoid injury. This was mixed terrain and I continued to be propelled forward over the rough, erratic surfaces. But I didn't fall. Instead, I stopped when I slammed downward, shoulder first on my right side into a cement wall. Then I fell.
I hit the wall hard and still off-balance, bounced off, thrown backwards and landed on my left side-- my lower half in the dirt hole by the wall and my upper half balanced on the 6-8 inch rough cement embankment that I had landed on under my ribs. My small shoulder bag with my netbook and equipment was also partially underneath me and the corner of netbook was digging painfully into my side. The physical/mental shock lasted only a few seconds. I had barely wondered if my netbook was damaged when I was hit by overwhelming pain. I could barely say Elia's name and I couldn't get up or off the pack which was one source of the pain. Then someone grabbed my right arm to pull me up. I think I screamed. I think I even blacked out from the pain for a few seconds before I found myself laying on a cement surface still unable to sit up on my own.
I briefly registered that I was surrounded by men who had witnessed my fall. There were a lot of them and I didn't see Elia. I was begging them to stop pulling on me, but in English--not their Kiswahili-- so no one understood me. The pain was now intense and I could barely speak. Then I briefly saw Elia's face. I pleaded with him to tell everyone to stop pulling on me. [Elia had been unaware of my floundering fall until he heard me cry out-- he turned around and saw people already crowding around me.]
The pulling stopped, but I lost sight of Elia again. The crowd had moved in closer and I looked up again to see a sea of black faces-- all well-meaning male strangers who wanted to help. Then the pulling started again...they seemed to think if I could stand up, I'd be okay. but it had me screaming again. I remember trying not to scream as I knew it was considered rude...but tears were streaming down my face and I just needed a minute to figure out what was wrong. I called out to Elia to tell them I needed space and not to touch me as it was painful. He set about reassuring the crowd and telling them he would take care of me. Once they were dispersed, with my instructions he assisted me to a sitting position gripping my left "good" side. It was incredibly painful, but it was clear that it was my right side that was the most damaged and generating the most pain. I began my inventory.
My left side hurt...either cracked ribs or severe bruising. There was some pain with a deep breathe, but I couldn't use my right hand to explore the damage and my left hand was cradling my right arm. I couldn't lift or move my right arm-- it refused to respond. My first thought was it was dislocated. Carefully, I tried wriggling my fingers. I could move the three middle ones slightly, but not much...I could not move my hand or anything above the wrist. There was a scraped knee and arm evident from the stinging under my pant leg and sleeve, but the real damage was concentrated in my right arm and to my left side. With great effort and pain, I let Elia bundle me into the waiting taxi and we headed for an emergency room.
Holy Crap! Each stop or bump or turn had me wracked with additional pain. I cradled my arm as tightly as possible, swallowing my sobs as waves of pain took over. I was relieved when we arrived at the hospital. However, when getting me out of the taxi's back seat proved difficult due to excessive pain , the hospital attendant who came to the taxi with a wheelchair refused to take me. Based on my level of pain and immobility, she said they wouldn't be able to help me. We were referred to a larger facility which meant another painful stretch on bad roads.
After arriving at Bugando Medical Centre's emergency entrance, it wasn't over yet...just suffice it to say I had six hours in a bare bones emergency room eventually to be sent away still cradling my own arm. The only treatment I had received was a pain shot in the butt that proved to be insufficient. The two x-rays that had been taken by incredibly antiquated equipment-- one of my left ribs and one of my right shoulder-- were proclaimed unreadable later on. The one of the arm/shoulder was blurry and the single angle didn't reveal the fracture. The doctor on duty was in surgery until my last hour in the stark emergency room. When he arrived, he ordered additional pain killers and after diagnosing a dislocated shoulder did some painful manipulations. He released me with the recommendation that I get an MRI as soon as possible. He told me that the only place in Tanzania to get an MRI was in Dar Es Salaam-- a 24 hour bus ride across the country. He recommended that I fly rather than be jostled on a bus.
===The Victoria - The ship that sailed without me to Bukoba===
Still cradling my arm, I went back to the hotel where I discovered that climbing the stairs was as bad as a taxi ride. It was impossible to lay down, but luckily there was a big, soft, over-sized, fake leather armchair in my room. With a pillow and a pain pill, I was actually able to get some sleep. I had already called my travel insurance agent and had been reassured that they would fly me to a place for appropriate treatment. I could be on a flight by mid-day tomorrow. I just needed to complete and return some forms and submit the report from the hospital in Mwanza.
Ha! Did I say 'just? TIA...This is Africa (as a Tanzanian friend likes to say). We woke to a power outage. Only a few places with generators had any electricity. I sat in the back of a taxi, holding my arm and grimacing with each bump as we went from pharmacy to pharmacy looking for the recommended immobilizer for my arm. After six pharmacies, Elia parked me in the lobby of a hotel with a generator while he continued the search. He had the cafe serve me a bottle of water so that no one would object to my being there over time. The cyber cafe was across the street so that we could print and sign forms as soon as the power came back. But six hours later the power was still out and Elia had exhausted the possibilities of a pharmacy with a immobilizer. We backtracked to four different pharmacies to locate a simple arm sling so that I could stop holding my own arm.
Back at the hotel to rest while Elia went to get something to eat, I heard the AC come on. Yep, the electricity came back on, but the internet was still down. In the end, my insurance contact presented my situation to the panel and they pre-approved my flight contingent on the documentation being submitted and meeting approval. I would continue trying to send the docs; it took me the rest of the day. I went to four different internet places encountering problems of various sorts at each one. I finally gave up and went back to my hotel where, the server had just been fixed so that I was finally able to print off the forms. I completed the forms and then used my phone to take pictures of them and email them...I finished sending them about 2am. After a few calls and emails, I had a flight for that afternoon.
The accident occurred on Sunday evening. On Tuesday, Elia took me to the airport. I presented my passport and was escorted away without hardly a goodbye to Elia who was to take his own flight to Arusha an hour later thanks to one of his business contacts. That evening, after a 3-hour car ride in one of the infamous Nairobi traffic jams from the airport, I checked into the emergency room at Aga Khan in Nairobi, Kenya.
I had new x-rays taken from multiple angles by two different technologically up-to-date systems and was diagnosed with a fractured humorous. The fracture was where the humorous (upper arm) fits into the shoulder cuff. I was told that it would require surgery so I wasn't given food or water the next day. I was put into the CCU (Critical Care Unit), but not knowing that I 'innocently' asked if I was in the mzungu (white) ward as all the staff were black, but all the patients were white (that included the one Indian patient). Later, I was told by a doctor that they had thought I'd be more comfortable there. After two nights in my private room with my own nurse and assistant, I was moved into the surgical ward where I had a small curtained cubicle in one of the two four-bed groups where I was the only mzungu in the women's wing throughout my stay.
Thankfully, I never had surgery. An MRI confirmed all my ligaments were still attached, so I just needed 6 weeks for the fracture to heal. No cast for a fracture in that location. Someone from physical therapy came and fitted me with an immobilizer which turned out to be a fancy sling with a wide strap that velcroed my arm into place against my chest. I found it interesting that the box said it was manufactured in Seattle, Washington.
The following days were challenging and much of it was spent drugged on strong narcotics. I asked them to give me something a little lighter. Every time my insurance company called, I was too dopey to talk. I was not able to get in and out of bed by myself since my arm was useless and my other side had massive tissue damage that made most movement painful. But little by little, I was showing some improvement. The insurance company wanted to know when I would be ready to fly home. What?!?!
I started to review my choices: stay in Nairobi to access medical care while I healed for approximately six weeks; return to the US without finishing the last six months of my RTW (India, Nepal, SE Asia, Indonesia and Australia) and where I technically had no residence; or return to Arusha and hope my friends at the Flamingo could provide sufficient support until I could hoist my pack and continue on my journey. I was leaning toward the latter when I got a call the next day.
"I'm coming to get you."
It was Elia. I told him he was crazy. He pointed out that I couldn't do anything for myself and I needed someone to care for me . I told him he had his hands full with the program he was enrolled in and making up the classes he had already missed because of me. He said that he would get a temporary passport first thing on Monday morning and catch the 4-hour Arusha to Nairobi shuttle that same day or Tuesday at the latest. He pointed out that I needed help with the hospital and insurance paperwork as it was too much for me to do in my condition and that he could care for me 24/7. I told him that he had his classes and wouldn't be available to do that and that he didn't know what he was getting into. I would need help getting dressed, tying my shoes, cooking my meals, getting in and out of bed... and he couldn't do all that... and certainly not for six weeks. I was sure we'd kill each other by the end of the first week.
Elia arrived in Nairobi on Monday with the assistance of his huge intricate circle of friends and contacts (how else do you get a passport within a few hours?). I have never known someone with such a strong support system...and now I was to be supported by it too. Somehow, my RTW was going off track, but it seemed okay.
SPECIAL THANKS TO:
Anton-- the airport staff who met me with a wheelchair, claimed my luggage, took me to an ATM, helped me get a Kenyan SIM for my phone and then connected me with a great car service. That was his job, but he called me that night to ensure I was getting medical care and continued to call or text me each day to find out how I was doing and reassure me I was in his prayers. He was there to see me off when I returned to Arusha. All above and beyond his job.
Erickson-- my driver in Nairobi whose thoughtfulness and driving skills protected me from excessive pain and who made a stop to get me food and then parked and came into the emergency room to ensure I was being helped before he left me. All that after a gruesome 3-hour cross-town drive in traffic that should have taken 30 minutes if Nairobi would address their worsening traffic issues.
Sylvia-- the hospital aid who felt more like a friend than an assistant and who made sure I had a lovely shower and fresh cotton pajamas and robes each day...it made such a difference!
My sister Becky-- for being my confident and contact until I knew what was wrong and could tell my mother, other family members and friends without them worrying during the long period before I was diagnosed and had a confirmed treatment plan.
Kathy and Juan-- the two friends I also confided in who both offered their assistance in spite of being far away in Seattle and Mexico D.F.
Dyness, Grace, Mamuya, Joyce, and Costa at the Flamingo (my home/family during my original stay in Arusha)-- for the continued support and friendship.
Elia-- Asante sana mchumba...