KEMRI FACES building

Tuesday, May 1, 2007

current projects and documents

This is a resource and orientation blog site for residents and students visiting the FACES-Nyanza clinical sites in Kisumu, Suba and Migori, Kenya. We will include our reflections on the rotation, details about travel, housing and food logistics as well as all the current projects we're working on. Currently this blog site is maintained by UCSF residents in internal medicine, but we welcome residents and students from all departments and institutions visiting FACES from abroad to utilize and participate in it.



To see the current projects, which are updated regularly as Google live documents, you can go to www.gmail.com and log in to the email address: FACES.CME.projects@gmail.com with the password: karibu


Click on the “documents” link on the top left of the web page to view the list of documents. Click on each document to see the most recent version of it.


To be able to post blogs and edit the current projects, please contact sophy.wong@ucsf.edu to get the instructions for access and passwords. Please also include in that email request your name, institution, title or year in school, dates at FACES, and role at FACES.

visa for Kenya

[last updated 2007 Aug 9 by sophy]


-in advance (most reliable but not necessary): give it at least a month, need to send passport, 2 passport photos, visa application Form V, $50 for single entry up to 3 months, certified return envelope [kenyaembassy.com, check LA office]

-upon arrival: pretty easy and more reliable than in the recent past; during busy seasons and arrivals, prepare to wait at least one hour, have the above items ready ($50 cash and visa application from the airport - you don't need the Form V; photos may be needed but may not be), and beware of corrupt officials asking for bribes. If you get asked for a bribe, then ask them to speak to a supervisor. That should put an end to the bribe request.

travel to Kisumu / Kenya

[last updated on 2007 Aug 18 by sophy]

Summary:
You want to check for flights that go to Nairobi (NBO). British Air offers direct flights from SFO to London, then London to Nairobi. KLM offers flights from SFO to Amsterdam, then Amsterdam to Nairobi. There are also now flights from Paris.

From Nairobi you will either purchase a ticket there for a flight to Kisumu (40 mins) or take a taxi into the city and take a bus to Kisumu (8+ hours).

Contact Kimberly Bale <BaleK@globalhealth.ucsf.edu> at least a week before you leave with your flight information and plan for travel from Nairobi to Kisumu. Veronica Achieng will pick you up from the airport or bus station and arrange transportation to the FACES flat or the Pabari Cottages, depending on where you are staying.

*** More suggestions, updated 18 Aug 2007:

-prices for flights fluctuate dep on season, but expect to pay $1600-1900 for SFO to Europe to Nairobi and back. On off-season (Feb-April), you can find tickets as low as $1200. This is going to be the biggest expense on your trip. Purchase tickets to Nairobi, not directly to Kisumu. i generally call STA Travel, check in with them about pricing trends, and also check out British Air and KLM websites.

Suggestions: try the following online resources for your flight to Nairobi...

http://www.kayak.com - as a clearinghouse for most major online sites (thanks, Kate!)

http://atmtrvl.com/ - a local SF travel agent that Craig Cohen uses, call 415.627.0717

http://www.statravel.com/ - student travel agent, may have special discounts, best to call them for specials (800) 781.4040


Specific airlines that fly to
Nairobi:

http://www.britishairways.com

http://www.klm.com

http://www.virgin-atlantic.com


-bag limits are strict from London to Nairobi (one carry-on only, 2 bags at 25kg max each baggage limit) and from Nairobi to Kisumu (if you fly, 20kg max weight for checked bags *total.* they don't weigh your carry on unless it's huge. some airlines will allow you to fudge to 25kg if other people on the plane don't have much stuff). so if you are hauling a lot of stuff, i.e. more than 25kg, you should think about taking a bus instead.

-flights from Nairobi to Kisumu: most people have a half-day or overnight stay in Nairobi and have time to purchase their tickets when they get there. It's really easy to purchase there, and you almost always get a seat. If you prefer to have them in advance (pricing is similar online), you can try purchasing them online with Fly540 or Kenya Air. Their websites seem to work only intermittently, so i tend to purchase the tickets when i'm in Kenya. The flights should cost $40-50 each way on Fly 540. Kenya Air is much more expensive, at about $70-80 each way. There's another small company that also runs a plane shuttle- i forget what it's called, but the prices are comparable to Fly540. For all airlines, there are generally one set of flights in the morning, around 8 am, and one set of flights in the evening, around 6-7 pm.

http://www.fly540.com/

http://www.kenya-airways.com/

-if you need to stay overnight in Nairobi, some recommendations on safe places to stay (take a taxi and don't walk around at night, esp by yourself!):

budget ($5/night) - YMCA hostel: Y.M.C.A. Shauri Moyo Hostel, Ambira Road, PO Box 17073, Nairobi, Kenya, Phone : +254 (2) - 558383, Fax : +254 (2) - 728822

moderate ($40/night): Comfort Hotel, in the city centre: http://www.kenyacomfort.com/

luxury ($100/night): Fairview, out of city centre but gorgeous: http://www.fairviewkenya.com/

-bus from Nairobi to Kisumu: no baggage weight limits, so if you have a lot of stuff, you're up for an 8-hour adventure, don't mind being the only non-Kenyan on the bus, and want to save a bunch of money, you can take the $7 bus from Nairobi to Kisumu. There are a few bus operators, but Easy Coach is the safest and most comfortable (but the slowest). Matatus are much faster and cheaper, but they are more dangerous, and i think the university is discouraging people to take the matatus... personally, i also think that it's even less safe when you are carrying a lot of luggage as thefts are more common on matatus.

At the airport, get an official taxi (with an official taxi number on the window and door) and ask them to take you to the Easy Coach Nairobi station. It's different from the main bus station, which can be hellish chaos. Protect your luggage! Purchase your ticket there and wait for the next bus. Make sure you pee and get food before you board (there will be one or two stops only on the 8-hour ride). The bus may be hot and usually crowded, but since you will be at elevation, it won't be too sticky. Keep your bags on your lap at all times or if you stay awake, keep them overhead and watch them (don't keep them on the floor; they run the risk of getting knifed). Bags in the trunk area of the bus are generally safe because they are monitored by the bus staff, but nothing's ever guaranteed while traveling, regardless of plane or bus. Time on the bus depends on road conditions: 6 to 8+ hours. Try to give Veronica Achieng a call along the way so she knows when you're arriving: pay someone to use their cell phone or call at a rest stop "pay phone" - i.e. pay someone with a special landline to make a call.

Make sure Kimberly Bale knows how you're arriving to Kisumu so she can tell Veronica Achieng where to pick you up! BaleK@globalhealth.ucsf.edu


Update 11/27/07 by Kate

-Airlines that fly from Nairobi to Kisumu are Kenyan Airways (you can buy online in advance, but is more expensive, ~$105 one way). I booked in advance so I could minimize my layover in Nairobi and it worked perfectly - made the 8am flight after getting in on the 6am ft from London. Fly540 is cheaper & has a website, but I haven't tried it and am not sure how well it works. East African and JetLink are the other common options. Both are cheaper (about half the price of Kenya Airways), but I'm not sure about advanced online booking. You can try contacting a local travel agency (Let's Go Travel in Nairobi has been highly recommended) and trying to arrange your ticket through them before you get to Kenya. If you're going to arrange your transfer after arriving in Nairobi, be aware that last month not all flights were going daily and it was a little harder to just walk up and be sure there'd be a seat that day. May have changed by now, though.

- Also, for in-country it appears that if you have >20kg of stuff it's ok as long as it's in 2 bags, neither of which is more than 20kg.

accommodations

Currently residents and students stay at the FACES Flat for $60/week. Coordinate with Kimberly Bale and Veronica Achieng on the payment and for housing dates. Kimberly can be reached at BaleK@globalhealth.ucsf.edu and Veronica can be reached at

vachieng@kemri-ucsf.org



The FACES Flat is located 1 block south of the Hare Krishna temple off Butere Road in Milimani, behind the Milimani shopping row on Nzoia Road. It has a gray gate that allows cars through. The flat is on the top floor, closest to the street. Keep in mind that most drivers don't know the names of the roads in Kisumu, so it's best to say something like, “one block down the street from the Hari Krishna Temple in Milimani, on the left”



Updated 11/29/07 by Kate

To tell boda or tuk-tuk drivers where to go, I found no one had ever heard of the Hare Krishna temple. Much better was "the new flats on the street behind Xaverian Secondary School". Worked every time. The shops on Nzoia Rd are the Kilimani shops, but the neighborhood is called Milimani.

The FACES flat is pretty nice; it's a 3-bedroom place with 2 bathrooms (one opens off one of the bedrooms), living room and kitchen. The kitchen has a fridge, sink, and cooktop burners (no oven). There are pots & pans and dishes, so no worries about that. When I left there was a lot of staple food (rice, lentils) that were recently purchased; on your way to the flat from the airport Vero will likely take you to the supermarket, so hold off on buying that stuff until you see what's left at the flat. The living room has a TV & VCR with a huge DVD collection (not all of them work in the African-system DVD player, but there's enough to keep you occupied on slow days). If you bring your own movies, you will likely not be able to play them on the VCR but you can on your computer. The bedrooms have sheets & blankets, pillows & mosquito nets. There are a few towels in the flat, but I'd recommend bringing at least a quick-dry camping towel. If there aren't any big towels for you to use, you can always buy one at the Nakumatt.

At present there is NO internet in the flat, to get access you need to go in town to Oginga Odinga Rd (expensive for wireless). There is free wireless internet in the residents lounge on (I think) the 5th floor of the Imperial Hotel. There is also a coffee shop ("the Italian Coffee Shop") on the second floor of the Universal Mall at the end of the road leading to FACES (the mall where Tusky's is). The coffee shop is upstairs next to the movie theater, they will give you the password for the wireless and you can use it as long as you want if you're a customer. There is wireless at FACES, also, which was a bit unreliable when I first arrived. It's very slow for downloads, etc, so if you think you may need articles or references, put them on your computer before you go. The FACES wireless is quite slow during the work day, so I usually got there early to email, skype, etc. DEFINITELY bring your computer!!


rotation pocket guide

[last updated 2007 Aug 7 by sophy]

Download the complete rotation pocket guide here:

www.resister.info/FACES.rotation.pocket.guide.pdf



It includes the rotation schedule, weekly clinic schedules, rotation goals, FACES formulary, WHO staging, contact information, etc.

map


Download a printable PDF map of Kisumu and Western Kenya here:

www.resister.info/kenya.map.pdf

what to bring

In Kisumu, there are huge Target / Wal-mart-like department stores where you can buy most common modern household items (except your personal meds, glasses, contacts, modern electronics), so don't panic if you've left something at home. They are in Kisumu: Nakumatt, Ukwala, Tusky's... but not in Suba, so buy your wares before leaving for Suba if you're going there.

In addition to the usual stuff, here's what you can bring particularly for the rotation/FACES:

-laptop so you can do your work, develop PowerPoints, and get online without competing for a FACES computer while you're there

-your own equipment: stethoscope (for sure), pen light, reflex hammer, pocket hand sanitizer (it's really hard to find clean water to wash your hands with regularly); consider bringing an otoscope/opthalmoscope to donate

-donations: Sanford's HIV handbook, pharmacopias, stethoscopes, pulse ox (finger machines), otoscopes/opthalmoscopes, HIV textbooks - check in with Kimberly Bale on which ones they might have to bring, hand sanitizer, PDAs, digital cameras, white coats

Download a possible trip packing list here (this is one i developed generically for all of my trips abroad but is applicable especially to trips such as this):

www.resister.info/trip.packing.list.pdf