Physician Educator: Health comes home

March 18 - April 3, 2017

After a lovely whirlwind tour of Uganda with mom and sister, Dennis and I were quickly back into full swing of life in Mbale.  

Malaria Think Tank with
Health Educator Jasraj

Sunday March 19th I traveled east via matatu to the town of Tororo to participate in the Malaria Think Tank Uganda Mini Boot Camp, a four day educational conference for Peace Corps Volunteers and their local counterparts.  The camp covers education about what is malaria including the life-cycle and how it is spread, prevention from mosquito bites, and how to educate each of their communities.  I gave a lecture on malaria in pregnancy (HUGE contributor to both maternal and fetal morbidity and mortality), as well as HIV and malaria co-infection.  Each year malaria claims over 400,000 deaths worldwide, with an incredibly disproportionate 90% occurring in Africa.  The key to prevention of malaria in the population, especially for pregnant women in the first trimester, are insecticide treated bed nets to prevent bites.  These have been shown to be a cost effective intervention with significant health benefits.  

How can we get bed nets to more people in Africa and around the globe?  The economics of interventions is complicated.  While in Uganda I have found the greatest challenges not necessarily from the rare cases or severe diseases presenting to the hospital, but rather from the basic supply chain or lack thereof in the hospital.  As luck would have it, Jasraj - a Peace Corps volunteer in agriculture with a degree in economics - has become more interested and involved in health education, while I have delved more deeply into the commerce of healthcare in Uganda and developing countries.  A winning team :)

During the HIV and malaria talk, there were several unanticipated questions regarding HIV and its transmission.  I discovered that there are several community beliefs and myths about HIV, transmission, and treatment.  The think tank participants talked of partner coercion with many demanding their significant other not get tested for the virus, or others paying healthcare workers to say they are negative when in fact they are positive for HIV.  Many felt that HIV could be treated by having the blood "cleaned" in the U.S. (false), while also questioning the origins of HIV through transmission from chimpanzees (true).  It was wonderful to have such an active and engaged group; I would love to continue the education in the community in the future!

Afternoon rain outside Endiro Coffee

On the matatu ride back home, the possibility and origins of so many fantastic myths was solidified when I found a fellow passenger reading a newspaper article stating that second hand clothes (a huge market of the donated clothes from all over the world) can cause cancer.  Yikes.

As the rainy season approaches, I have loved the afternoons, evenings, and middle of the night rainstorms that come pouring down on Mbale.  The days cool off during the rain, and there is something incredibly soothing about sitting at home or in one of the local coffee shops, working or reading while listening to the rain and thunder outside, or watching the clouds filled with bolts of lightning striking in the distance.  Some coffee shop work has included sending wedding cards to friends who have gotten married over the past year.  In one day we sent cards from Africa to three other continents.  So far most have arrived!

Dennis teaching effective power point presentations

The week that followed the malaria camp was full of lectures to the third year medical students, morning meetings, ward rounds, and the operating theatre.  Each day's schedule is always unpredictable, as lectures or meetings will be scheduled or cancelled at the last minute.  Tuesday March 21st a grand rounds presentation was scheduled to be coordinated by my colleagues Dr. Waiswa and Professor Wandabwa, except that Professor was out on his annual leave and even out of the country in Cape Town, South Africa presenting at an international conference.  I organized the grand rounds on ectopic pregnancy for that day, only to find out a few hours before that the course coordinator had rescheduled a written examination for that same day, interrupting the grand rounds presentation and cutting it short.  Frustrating.

On March 24th, health came home.  Dennis and I were awoken early by a fellow GHSP volunteer who needed some minor medical assistance.  As the day continued, the situation progressed to needing major medical assistance.  What happens when you become acutely sick in Mbale, Uganda?  There is no phone number like 9-1-1 to call for an ambulance.  The Peace Corps Medical Officer attempted to call a local ambulance company, however no one was picking up the phone.  We arranged a ride with a local driver, and made our way to the designated hospital in the area.  In the U.S., we are used to a team of nurses and doctors quickly converging on a patient, with an IV placed, labs drawn, and necessary medications given within the span of minutes.  In Uganda, you have to first pay the consultation fee and present the receipt for a doctor to even begin to see the patient.  Obtaining vital signs takes several minutes, with the main focus of vital signs being blood pressure.  The nurses or physicians took one look and said everything was fine, not noting a heart rate in the 120s.  Definitely not normal.  Once a treatment plan is underway, you then pay upfront for the requested cannula, tubing, IV fluids, gloves to be worn by the staff, and the cost of the labs before they will be drawn or sent.  Dennis and I did not have enough cash on us, making a run to the ATM another hurdle to overcome.  When the labs did come back, there were some significant abnormalities that were either very suspicious for a lab error or were very worrisome.  And there wasn't the correct fluid in the hospital to attempt to treat these abnormalities.  During this time we were incredibly thankful for a visit from three of our lecturers that we work with at the university, Professor Wandabwa, Dr. Tegu, and Dr. Masaba, who we dubbed the three wise men.  They were incredibly supportive, and I know made things happen in the hospital that would not have otherwise been accomplished without their presence.

During this time we were also coordinating transportation to the capital; from the time we began arranging transport it took two hours for the ambulance to actually dispatch, then another six hours before it arrived to the hospital in Mbale.  The ambulance itself was more well supplied than the entirety of the hospital we were at.  It was another six hours before the ambulance arrived at the hospital in Kampala.  A total of 15 hours had passed from beginning to coordinate care and transport to being in a full fledged facility.  This story is true around the world, as noted in a recent NY Times podcast report from Venezuela.

The following week we went to Kampala to check up on our colleague, who was doing much better and out of the hospital, however heading home for the remainder of the year.  Julia and Dennis were also shopping for items for the nursing skills lab with Julia's grant she received, which turned out to be more onerous than expected as most places did not have supplies in stock that Julia was told would be available on her arrival.

From Kampala I made my way via the Homeland bus to the town of Gulu to shadow Angie, a Peace Corps Volunteer working at Lacor Hospital.  Peace Corps Uganda created a new GHSP/PCV exchange program, where volunteers will get a chance to shadow in the hospital and at local community sites, respectively.  At Lacor, Angie is involved in a multitude of projects, including mosquito net education to the HIV-positive patients, teaching how to make re-usable menstrual pads (named RUMPS) for women who cannot afford the very expensive disposable pads, making a "big book" for teaching a large class out of grain sacks, and also forming an empowerment club for the women of Gulu University Faculty of Medicine.  She was an incredible hostess around Gulu and Lacor, and it was a pleasure meeting her colleagues, counterparts, and seeing the incredible work she is doing!

After a day of shadowing, I was off to the hotel to meet with the rest of the GHSP group who traveled from all parts of Uganda for a training design and evaluation workshop, preparing orientation for the next cohort of GHSP volunteers!  It was a great few days catching up with our colleagues, many of whom we had not seen since in-service training in November.

Once training was completed we had a lovely dinner under the stars at Elephante.  A few of us awoke early on Saturday for the Gulu Go Green 5km and 15km race on a beautiful sunny day and a perfect way to start a Saturday morning.  Afterwards to indulged in fresh out of the oven cinnamon rolls at the Iron Donkey while planning the next race - a 21km trail run through the Mpanga Forrest on April 30th!

From Gulu, Julia, Dennis, and I took the long way home via Kidepo Valley National Park in north-eastern Uganda, bordering South Sudan.  With Fred and Sandra as our guides, we traversed the red dirt roads of northern Uganda. The scenery was beautiful, with small collections of huts along the isolated roads a stark difference from the crowded and commercial roads we traverse in southern Uganda.  The landscape in and around the park is absolutely stunning, and one of the most scenic backdrops we have seen thus far.  As the sun was setting behind the mountains marking the Uganda and South Sudan border, the savannah landscape glowed with incredible colors, dotted with herds of zebra, buffalo, Jackson's hartebeest, and Uganda cob.  Once we arrived at the Apoka Rest Camp, all five of us were laughing at our change in appearance, with hair, eye-lashes, skin, and clothes coated in a red-orange layer of dust.

As we settled in to camp, a buffalo was grazing in the fields nearby, while several jackals passed by our roaring camp fire.  The night sky was filled with stars, and otherwise the amazing sounds of the nocturnal animals coming to life.

The next morning we were up before the sun to explore more of the valley and its lustrous wildlife.  Kidepo is most known for its tremendous herds of buffalo, with over a thousand members in a herd, creating a thunderous rumble as they migrate through the savannah.  Near one of the largest herds, Fred spotted three young lions sleeping in the shade of a tree, too lazy from the heat to care about the thousands of buffalo nearby.


After a relaxing afternoon reading and watching a family of warthogs chasing their piglets around the camp (Julia was in heaven), we ventured to the Karamojong village.  As part of a way to teach others about their culture, as well as raise money for their village, the tribe welcomes visitors to tour their homestead.  In the homes, we saw dried sorghum and maize hanging from the ceiling, protected from bugs by mosquito nets (unclear if there were separate mosquito nets for sleeping under).  A woman taught us how to grind the sorghum against a block of stone in the home as a way to prepare bushera, the popular fermented beverage.  

Outside of the home we were shown the hut we noted the horns of a goat; if a man marries a woman and is happy with the marriage, he will buy the family of the woman a goat to be slaughtered in a huge feast.  The family will then display the horns as a badge of honor for producing a hard working woman.  After touring the goat shed and the grain bank, we were treated to traditional songs of the tribe, as well as a dance, with groups of men and women jumping high in the air.  This is another traditional custom to show others how high one can jump and that you are a hard worker.

Back at the camp, we again enjoyed a beautiful sunset and watched the sky transition to a dark backdrop full of shining stars, while a large buffalo came wandering through the camp.  We were joined by two wonderful people from UCSF who were working in Soroti Regional Referral Hospital for four months.  As Chris, a fourth year medical student, sat down next to us, he asked, "was that a huge buffalo that just walked by?!"

The next morning we took a walking tour, walking where antelope had been just moments before we scared them away.  Highlights of the walk were seeing the small details of nature, such as the antlions that trap bugs into a conical hole in the ground, the clean bones of an old buffalo, and discovering the only the scat of a hyena is white from the calcium of eating bones.

The rest of the day was another dusty ride home to Mbale, passing through villages set against the dry mountains, and the landscape reminiscent of the Arizona desert.  Men wore knitted top hats with a single large feather on the side, with a plaid fabric wrapped around them.  The women also wore the plaid fabric wrapped around, and had large necklaces made of tiny beads decorating their necks.  The landscape then began to change to one of green atop towering rocky mountains.  Yet another beautiful side to Uganda.

Southwest Uganda

January 14 - 21, 2017

In the wee morning hours of January 14th we landed at Kigale Airport; back in Eastern Africa.  We slept for a few hours before getting picked up by Divine, a friendly and ambitious Rwandan woman who volunteers for Shooting Touch (an NGO promoting education and leadership through basketball).  We headed north through the winding roads of the mountainous country to cross the most south-western border into Uganda.  Throughout the two-and-a-half-hour ride Divine shared some of the history and culture of Rwanda.  She was not even born at the time of the Rwandan genocide but was well informed, explaining the country's Genocide Memorial Day on April 7th and the week following, where the community discusses the events to ensure that it will never happen again.

As we neared the border we were greeted with gorgeous views of three large volcanic peaks - Gahinga, Muhabura, and Sabinyo - rising high in the sky, serving as a natural barrier between Rwanda and Uganda.  At the border we were picked up by Michael, a wonderful and attentive driver who took care of us for the rest of the week in south-western Uganda.  If anyone needs a driver in the area, contact me and I would be happy to provide his contact info - highly recommended.  After a month of constantly figuring out exchange rates and new languages, it was great to be back in a country which is so familiar.

Kisoro District Hospital, 2011

The nearest town to the border is Kisoro, which holds a special place in my heart because I was here as a fourth-year medical student. Twice yearly Dr. Jerry Paccione from Albert Einstein College of Medicine brings a group of four to six students to Kisoro to work in the district hospital and also pairs them with local village health workers on education projects in the community through the Doctors for Global Health NGO.  I was fortunate enough to participate in one of these trips.  The memories of my time here came flooding back: the restaurants where our group had many a night out, the veranda where we celebrated match day for residency, and the cute cafe called The Coffee Pot where a lovely German woman bakes amazing cakes, including one for my Kisoro bachelorette party in 2011!  

We settled in at the Virunga Backpacker Lodge and quickly set off for an afternoon hike to Lake Mutanda.  I had taken the trek many times during my previous stay in Kisoro, but six years having passed since the last hike made finding the paths a bit harder.  Along the way groups of kids would help to guide us if we veered off track, then asking for a pen, cookies, our water bottles, or anything else they thought we might have.  At times the hills would ring out with tiny voices shouting "Muzungu!" from all directions.

That evening we had a lovely dinner at Traveller's Rest, where the famous primatologist Dian Fossey made her second home.  During happy hour we began talking with a couple who were originally from Poland and now living in Chicago.  We joined them for dinner along with their travel guide, hailing from our own Mbale. He was shocked when we began speaking with him in his native Lumasaba language. 

The next day we were up before the sun to set out on an eight hour hike of Mount Sabinyo.  This is one of my all-time favorite hikes: you pass through thick bamboo forests with the occasional sound of golden monkeys overhead, moving on to trees covered with furry moss, and on to varied terrain as you continue on to each subsequent peak.  There are three peaks in total, the last of which requires you to climb up a series of ladders to maneuver the steep sides and reach the top where the Democratic Republic of Congo, Rwanda, and Uganda meet.  After a hikers' lunch at the top, it was time to reverse the trek, heading down, up, down, up, and finally down again to reach the base of the mountain.

There wasn't much time to rest as we made it back to Kisoro, grabbed our gear, and went north to Bwindi Impenetrable Forrest. Upon arriving at Rushaga Gorilla Camp just after sunset we realized that we had the entire lodge to ourselves - such luxury!  January 16th we celebrated my turning thirty-three by trekking to find the Eastern Mountain Gorillas!  We were designated to track the Bweza gorilla family, alongside a lovely couple from Australia and two hilarious travel guides from Adventrue, a Polish tour agency.  The guys, fully equipped with serious cameras and recording devices, were researching and gathering footage to promote an upcoming trip to Uganda for their clients.

The trek to see gorillas can vary based on which gorilla family you are assigned to, where the family has been found, and their movements throughout the day.  The trail to reach the Bweza family was anything but flat, with lots of peaks and valleys throughout the lush surroundings.  Bwindi is known as the Impenetrable Forest for a reason, as there are no permanent trails.  There are paths that are well delineated and others where the guide has to cut down branches with his machete to make it possible to pass.  After an hour and a half of hiking, we spotted a gorilla high in the trees.  We then went into the very thick brush to gain a closer perspective of the beautiful creatures. 

You might be asking yourself, "How is it possible to be so close to these wild animals?"  In order to research and better understand the gorillas, several families in different areas of the park have been habituated, becoming used to the presence of humans.  This process can take several years but once habituated, the gorillas don't mind respectful human presence. However, to minimize exposure, the families being tracked are rotated and the time spent with them is limited to one hour with the majestic creatures.  

While we were watching one of the male silverback gorillas munch on some leaves, a female who was close to us decided she wanted to move to another area nearby.  We were in her way so she gave an indication of wanting to move, then started going her way whether we were there or not. As we made ourselves small and ducked out of the way (general rule of thumb - do not run, whatever you do) she pushed passed us, as if we weren't there, grazing my leg. Everyone was fine, and I was touched by a gorilla - awesome!

As we continued moving to see more of the family, the gentleman from Australia got down on one knee and proposed to his girlfriend right in front of a large gorilla.  The tour guides' cameras swung around, capturing the moment with the gorilla in the background.  Talk about an engagement story.  For those of you wondering, she said yes!  After that moment of excitement we watched in awe as two young gorillas played and fought each other in the dirt, leaves, and on top of the sleeping adults.  Intermittently throughout their playing the young ones would show each other their strength by pounding their chest before lunging at the other to wrestle some more.

As our time was nearing the end, we noticed another large silver back enjoying some leaves.  One of the infants decided he had enough wrestling and swung down through the trees to join the feast.  It was a wonderful experience with such rare and impressive creatures.  Our hike back was filled with excited chatter, so we invited everyone to our camp for a drink and to review some of the photos, especially of the impromptu engagement photo shoot.  It was a lovely afternoon sitting on the veranda overlooking the heavy forest, making new friends, and reliving the incredible morning.  The Polish tour guides decided our lodge was much more cozy than their backpacker hostel so theymoved camps to join us for a fabulous birthday dinner at the lodge.

In the morning we left the beautiful Bwindi, slowly making our way east to Lake Bunyoni, believed to be the deepest lake in Uganda and second deepest in Africa after Lake Tanganyika.  Staying at the Bunyoni Overland Lodge, we had a gorgeous view of the lake and plenty of spaces to hide out and enjoy reading while overlooking the lake.  As the afternoon became slightly cooler, we hiked up to the Arcadia Lodge for a fantastic view of the island-filled lake.  The evening was spent enjoying the serene setting and watching the sun set behind the Mgahinga mountains in the far distance.

The following day we set off from the dock in a traditional hollowed-out acacia tree canoe to traverse the lake with Edirisa Tours.  Compared to fiberglass or plastic canoes, the traditional tree variety is incredibly heavy and requires a significant amount of effort to move.  After cruising the lake for a bit, we docked at one of the islands and hiked up the ridge, through a lakeside village, past the elementary school still closed for the Christmas holiday break, then on to a small bar, the walls of which were made of wood and filled in with bricks of dung and mud, to enjoy ubushera with some locals in the village.  Ubushera is a traditional fermented drink made of sorghum flour and ash that is very popular in the southwest of Uganda, much more so than in the east; definitely not sweet, and just a touch sour.  

The next stop was a traditional herbalist.  While he was organizing the local medicinal plants, children were wandering in the yard, seeing what the strange looking people were up to.  Once the kids were comfortable, they were in our laps, singing village songs.  It was then time for the lecture about the different plants and their preparations to cure common ailments.  It is always intriguing as a physician to see these traditional medicines, as much of our modern medicine is based on plant-derived compounds found in nature.  A short distance down the road, a woman who makes and sells crafts as a living taught us how to make bracelets out of local dyes and papyrus, all-the-while tightly sewing a small basket out of dried grass.  Once we were back on the water in the acacia tree canoe, we slowly made our way around a few islands, each with its own history and story, to arrive back at our lodge.  We took advantage of the waterfront tables to enjoy a lovely afternoon reading lakeside.

On January 19th we traveled from the lake to Mbarara, where we met up with fellow GHSP volunteers Sara, Laura, and Mark.  We enjoyed catching up on their travels over the break, and marveling at the fact that Dennis and I had a similar trip to Laura and Mark, only in reverse.  The rest of the afternoon was spent on a long drive to Kampala.  After taking care of some Peace Corps business for a couple of days, it was finally time to head home.  We hopped on the Y.Y. bus with music videos entertaining and blaring for the five hour drive from Kampala to Mbale.  As we picked up all of the luggage we had carried over the six weeks, we were glad to be back in our home away from home.  We were even greeted by several locals saying "welcome back" as we carried our gear through the streets.  Once home, it was time to prepare for the next adventure: teaching the second semester of students.

Zimbabwe, Zambia, Botswana, and a gorgeous sunset over Namibia

January 5 - 13, 2017

Where the Chobe River intersects with the Zambezi River in Southern Africa, there is a confluence of four countries: Zambia, Zimbabwe, Botswana, and Namibia.  Here you will also find a wealth of natural treasures, from the incredible Victoria falls shared by Zambia and Zimbabwe, to animals galore in Chobe National Park in Botswana near the border to Namibia.

Dennis and I arrived to Victoria Falls, Zimbabwe on the afternoon of January 5th.  The town is a tourist-centered area within walking distance of the falls.  As soon as we were settled into the N1 Hotel in town (recommended for budget travelers), we set off for afternoon high tea at the Victoria Falls Hotel.  The hotel was built in 1904, and the decor has not changed since.  Walking in to the hotel feels as if you have stepped back in time to colonial Rhodesia, the British territory encompassing present day Zambia and Zimbabwe and the eponym of the imperialist Cecil Rhodes, whose dream was to build a "Cape to Cairo" railway linking northern and southern Africa.  Part of this ambition included construction of the Victoria Falls bridge, which Rhodes instructed to be built "across the Zambezi where the trains, as they pass, will catch the spray of the Falls."  The colonial era loses its charm after reading books such as "King Leopold's Ghost" by Adam Hochschild, which details the extreme abuses and exploitation of the natives by the "explorers" and their royal benefactors.  As a modern day tourist, however, the hotel offers magnificent views of the bridge and the mist created from the thundering falls as it rises up above the gorge.  


January 6th was an adventurous day, starting with Dennis jumping off of solid ground for a 70 meter / 230 foot freefall during a gorge swing over the roaring Zambezi river.  I was very "happy" (read: petrified) to watch and snap photos on the side; no additional adrenaline rush needed.  The adventure activities take place near the Look-Out Cafe, situated high above the gorge.  After a relaxing lunch and reading amongst the green, we set off across the border to Zambia for the next exploit - swimming in Devil's Pool!

The short drive over the border brought us to the Royal Livingstone Hotel, a luxurious venue where former U.S. presidents have stayed during trips to Zambia.  A boat took us from the launch to Livingstone Island, where the famous missionary explorer David Livingstone first saw the falls. Once the group was dressed up in swimming gear, we braved the waters of the Zambezi to reach a natural pool situated atop the falls before the water plunges down 100 meters.  Fun fact that we discovered once in the pool: there are small fish that reside in the pool and like to bite your toes.  While the waters are moving past you over the edge of the pool, I found myself kicking just enough to keep the little fish bites at bay while simultaneously ensuring I would not propel myself over the edge.  Absolutely exhilarating experience.  Our swim back to the island included a magnificent view of the sky bursting with clouds from the humidity.  Dennis and I lingered in the waters for a bit longer to enjoy the serenity and astounding beauty.  On the island we enjoyed high tea yet again, except instead of tea we were served the refreshing Pimm's Cup drink while chatting with our fellow swimmers, hailing from the U.S., U.K., and Mexico.  

We were able to explore the full length of the falls the next day, first touring the Zimbabwe side of the rapids with a knowledgeable guide and lovely couple from the U.K., refueling with lunch and a Pimm's Cup at the Victoria Falls Hotel, then walking over to Zambia to marvel at the falls from the Knife's Edge buttress.  The falls span 1,708 meters, or over one mile in length and a vertical drop of 80 meters at the western Devil's Cataract to 108 meters at the center.  Spectacular.

That evening we cruised the Zambezi on a boat tour, enjoying the breeze on the warm day.  On board we met a lovely couple from Moscow whom Dennis impressed with his Russian, and the conversation later including more English for my sake all while admiring the birds, hippos, and crocodiles gracing the waterway.  That evening we enjoyed a gamey twist on Spanish faire at Lola's Tapas & Bar, with dishes including zebra, wildebeest, giraffe, impala, and, of course, sangria to wash it all down.  

On Sunday, January 8th we drove for an hour to cross the border into Botswana and on to the town of Kasane, located just outside Chobe National Park.  Of note, this day would have been my dad's 57th birthday.  I don't think he would have ever imagined that one day I would be crossing borders and traversing southern Africa on his birthday.  After tucking in to the Old House, a cute B&B on the Chobe waterfront, we enjoyed a boat tour on the river that divides Botswana from Namibia, watching hippos seemingly wearing grass skirts grazing and herds of elephants migrating to their much loved water.  A good way to celebrate the day.


Monday morning was an early start to explore Chobe National Park.  Before we even reached the gates we were greeted by a herd of elephants, with two juveniles testing each others' strength.  Once in the park, all the vehicles took off in one direction.  We followed suit and soon were viewing a leopard lounging in the trees immediately in front of us.  An amazing and lucky find!  

Throughout the day we saw several large troops of baboons, with the male calling out from the treetops to the rest of the troop below.  Being on a day-long drive through the park, when the animals took shelter in the shade from the heat of the day, we were able to admire the colorful flora and fauna of the lush green park, including the African bee eater bird, three lionesses, a family of warthogs, a giraffe in its awkward bend to the ground for water, as well as two young male giraffes fighting to test their power and might.  In the later afternoon we again encountered one of the lionesses we spotted earlier calling out to her hidden away cubs, letting them know that she was returning to the den.  We didn't find the cubs, but while in pursuit of the lioness we noticed a tree branch off in the distance with some oddly shaped branches, only to discover through the binoculars that it was in fact a leopard fast asleep in the trees!

Sleeping leopards aside, the highlight for me was in the evening hours when we encountered one of the largest herds of elephants we had ever seen - we were surrounded by 56 elephants scattered throughout the hillside.  With so many elephants it is incredible to experience the social dynamics of the species.  From the low grumble used to communicate to each other, the young ones playing, fighting, or even mock charging the vehicle, and to nature's drive to move itself forward with two bulls in estrus competing for the young female also in estrus.  Of note, Botswana is known for its enormous elephant population, with 130,000 elephants estimated in the country of 2 million, or 1 elephant per 15 people.  

That evening back at our B&B, the sky flashed a brilliant red, pink, amber, and variations of blue sky as the sun set across the Chobe River and over Namibia on the horizon.  A perfect end to the day. 

January 10th we were off to Maun, with just a short flight from Kasane.  Maun is the main jumping off point for exploring the Okavango Delta, marshlands teaming with beautiful water lilies in the waterways and herds of animals grazing on the surrounding lands.  That evening we checked into The Old Bridge Backpackers, with a bar-at-the-end-of-the-world feel. Our accomodations for the next few days consisited of a perma-tent located just off of the small river, complete with an open-air private bathroom offering an unobstructed view of the stars in the sky.  In the common area, with the sand underfoot and the pool table always lively, there was a chicken and two resident cats, one of which decided to make Dennis his new best friend.

Mother nature decided to show us what rainy season in Botswana really means by dumping significant amounts of rain overnight, continuing into the morning.  Despite the downpour, we decided to stick with our original plan of cruising the delta in a mokoro, a shallow dugout canoe, with a guide working to propel us along the shallow water using a ngashi pole.  We floated along, cold and wet, for an hour before the rain stopped and the sky slowly opened up to reveal its blue.  

Along the route, we pulled up on land and hiked on foot to see beautiful herds of impala, wildebeest, and zebra grazing so close in the grass.  To see the animals on foot with nothing between you and them is a very raw experience.  When animals were not in our immediate surroundings, our guide was pointing out the plants and their traditional medicinal uses, as well as burrow holes made by anteaters and later taken over by other wildlife.


Back at the camp we had a lively sunset dinner conversation with a former Peace Corps Volunteer in Botswana in the 1970s, who regaled us with stories of the area from his service, the incredible changes that had taken place, the people that he had worked with (and when we did a google search, many of whom are now top in their scientific fields!), and crazy adventures he had throughout Africa, including Uganda. 

The following morning we were again up before the sun to join a young German couple on extended holiday for a trek to the Moremi Game Reserve located in the midst of the delta.  After a gorgeous sunrise, the morning again threatened rain but we were fortunate once more that the clouds cleared, revealing the incredible blue sky.  In the park the rainy season showed its effects, with several large water holes full of mud taking up the entire road.  Thank goodness for 4-wheel drive!  On the way in we were informed of one group that had self-navigated through the roads, only to become stuck in the middle of the park and needing to spend the night in the car as no one was available to tow them out.  Yikes!

Fortunately thanks to our guide, Master (known as a master tracker), we navigated the roads just fine and found ourselves on the open plains of the grasslands.  While roaming the green landscape, we spotted a lone lioness in the distance.  When she arose to move, we tracked her until she led us to three more lionesses lounging under the brush.  What a find!  We were feeling so lucky to be able to track and find so many lions, when they suddenly all began to get up and walk slowly in a single file line through the grass.  We were certain they were on the hunt for food, and that one unlucky antelope in the distance was going to be brunch.  After a few minutes of tracking, however, we began to hear the same low grumble that we had heard in Chobe - they were calling their cubs!  Within a minute, 13 cubs came bounding out of the brush to greet the lionesses.  We sat and watched them for what felt like hours as they bonded, played, breastfed, and eventually found shade in the brush.  

With that, it was time to find a lunch spot.  We drove a little ways away from the lions, to plant ourselves right in front of a pond filled with hippos.  Definitely much safer, right?!  Hippos are known to be very territorial, despite their massive size move very quickly on land, and are the greatest animal threat to humans after malaria-carrying mosquitoes.  Awesome.  Throughout the lunch several hippos showed us that we were in their territory by opening their mouths in a giant yawn, revealing their massive teeth and powerful jaws that can snap you in half.  

The rest of the afternoon we found many variations of antelope as well as troops of baboons in the thick brush.  We also encountered a large military truck that was on its way to tow the stuck vehicle we had heard about earlier, only to become trapped in the mud itself due to the massive rains.  Double yikes!


As we drove out of the park, more and more animals seemingly appeared, including a turtle making its way across the road to more water, several bull elephants, and towers of giraffes migrating in the cooler evening hours.  We arrived back at camp just after sunset to enjoy one last meal under the stars.  

On January 13th we began our long 14 hour trek from Botswana to Rwanda, to bring us closer to our home in Uganda!

Recommendations for Travelers:
-We suggest our itinerary in reverse:  Arrive in Maun, explore the Okavango River Delta, and you can even do a longer camping trip, migrating up the delta and into Chobe National Park.  From Chobe, take a day trip over to Zimbabwe and Zambia to see the falls, and return the same day.  

-If spending multiple days near Victoria Falls, purchase the Kaza Visa, which allows multiple entries across the Zimbabwe and Zambia border.  The website states it is available in multiple countries, however other travelers told us the Kaza Visa was not available in Zambia.  We purchased ours on arrival to the Vic Falls Airport in Zimbabwe.


-According to the guide books, a great time to travel to this area is July or August.  It is the dry season in Botswana, meaning animals flock to the central Chobe River, thus increasing sight seeing of animals, but it is not so dry as to become too hot like in September and October.  It is also the time when the waters of Victoria Falls are full yet not so much so that they are obscured by their self-made mist.

-Zimbabwe has some significant economic instability, with the country undergoing massive inflation of its local currency to the point that the currency was eliminated and replaced with the US Dollar in 2008.  Because of this, everyone who had their money in the bank (instead of in a house, cows, or goats) lost all of their savings.  You will find many MANY men on the streets of Vic Falls (and Livingstone in Zambia, we were told) very aggressively hawking souvenirs starting with statuettes and progressing to selling you millions or billions in the now-defunct local currency.  Be forewarned that you will be confronted on the streets several times and by people that it will take saying no to a good 7 times before they will give up the pursuit.

-Skip the boat ride in Zambia - Chobe has loads more to offer.

-All-day game drives are long, with not many animals seen between 10am and 5pm.  Consider staying a few days to enjoy a few morning drives, reading in the afternoon, then heading out for sunset drives; it's a better way to enjoy the wildlife.  That being said, you never know what you will find at any time of day!

-Swim in Devil's Pool!  Absolutely amazing experience