March 28, 2017 – A tragic birth and a visit to a boma….

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Nan doing her lecture on neonatal sepsis

Our day began early as it was Tuesday which is education day. Today, Nan was speaking about neonatal sepsis as it has been a topic of discussion since her arrival and was an area that certainly needed further clarification. The real issue here was when to proceed to an LP and how that would change management as our resources are far more limited than they are at home. We have no cultures here, either blood or CSF, though they are coming in September, and are critical when managing these patients. In the US, any baby less than 28 days presenting with fever has an LP done as part of their work up. That has not been the practice here and the issue really becomes how long of an antibiotic course these children receive and what are the doses, either sepsis or meningitis coverage.

Nan’s lecture

Somehow, Nan managed to find studies from various Tanzanian institutions that covered this topic perfectly and they were tremendously relevant considering where they were from. It had already been decided that it was not only impractical and resource consuming to do spinal taps on every neonate with a fever, but without cultures, there was also a significant question as to the information they would yield in this particular situation. She delivered an impressive lecture that provided an immense amount of relevant information with which to develop a protocol for FAME to use that would be appropriate for care in a resource limited country, though with a progressive attitude to continue improving the care here at FAME which is always the purpose of these exercises. There are always many questions that follow our lectures and this morning was no exception. Hopefully, the outcome will be that Nan will help to develop a practical and realistic protocol for neonatal sepsis and meningitis.

Chri evaluating an elderly woman with long standing myelopathy

Chris examining his patient with myelopathy

After her lecture (we did morning report beforehand due to a brief windows vs. Mac snafu) everyone began rounding in the ward while I went off to find Sokoine so we could get started on seeing patients that were already arriving for us. Chris rounded on his stroke patient with the team (the 90 year-old gentleman with a large left MCA territory infarction by clinical signs who was now nearly a week out) as he was still on the ward and hadn’t been eating well so had a feeding tube placed. After that, I was able to get Jamie and Chris started with patients and then went over to Ward 2 (maternity) looking for Nan as we had a third translator this morning to run three rooms seeing neurology patients.

Chris and Nan evaluating the little child with delay

Chris and Cliff evaluating a patient

Before I could reach Nan, though, Siana, the head nurse here, walked up to me with her phone to show me a photo that was of an anencephalic baby. When I asked her when the picture was taken she told me that she had just taken it in the labor room as the baby had just been born and was alive and crying. An anencephalic baby is one whose cranium and other parts of it’s skull and face have not formed properly nor has their cerebral hemispheres, but they do typically have an intact brainstem so are able to breath. I asked Siana to grab Nan from rounds and the two of us made a bee line for the labor room where we found one of the nurses attending to the mother and another nurse attending to the baby in the incubator.

Nan evaluating a young girl with seizures and developmental delay

A very happy patient with Nan

The baby was severely malformed and didn’t have a complete face nor cranium so that the majority of it’s brain was not enclosed. Worse yet, the baby was struggling to breath and would intermittently cry. It had a very rapid pulse and was clearly very cyanosis, though we had difficulty getting an accurate oxygen level as we had to measure it from the limbs which were not reliable. Nan took immediate charge of the situation, attempting to make the baby comfortable knowing that it didn’t have very long to live. She got an oxygen line even though there was no where to hook it up to on the baby, so we just allowed it to blow in her face in an attempt to help her breathing and make it less labored. Dr. Brad was in as well and assessing whether the mother wished to hold her dying baby or after it had passed as we would have to wrap the baby in something to make her more presentable to her mother. There was some confusion by the nursing staff as to whether the mother wanted to see her, but it was unclear if they had actually discussed it with the mother or whether they had made the decision for her.

After a bit, we were concerned regarding the babies labored breathing and didn’t want it to suffer any more than it already had, so we were all in agreement that we give it a small amount of morphine to ease her breathing and pain. The baby remained alive for perhaps an hour after that, slowly fading, but with a clear drive to remain alive as that is a very strong desire regardless of one’s situation. The baby finally passed quietly and the family was comforted. It was nothing the mother did to cause this to happen and it would be unlikely for it to happen again to them. It was a tragic end to her pregnancy and she had no warning prior to going into early labor and delivering the baby prematurely. But with the tragedy, we were hopefully able to offer a bit of comfort to the portents and the baby, however short its life was.

Our goat cooking on the fire

Boiling the organs

We had excellent patients today including several epilepsy patients and a four year-old child that Chris evaluated with clear developmental delay and who had seizures previously, but was no longer having them. We brought Nan in to help with the child, but there didn’t appear to be any regression of milestones so it was very likely another story of perinatal injury or anoxia. It was decided not to treat the child with antiepileptics as she wasn’t losing milestones nor having clinical episodes.

While Chris was seeing his patients today, Dr. Jackie slipped into the room to inform him that his patient who had suffered a stroke last week had died. Even though the patient was 90, it was still a bit of a shock as we had seen him that morning and there were no clinical changes. Chris finished with his outpatient and went over to the ward to find out what had happened and learned that family had been in the room with the patient and had just thought he was sleeping. By the time anyone realized anything, the patient had fixed and dilated pupils and there was no point in trying to resuscitate him here. Chris was rather surprised that there had been no code status  on the patient, though I explained to him that coding patients here can be very tricky as we don’t have an ICU or a mechanism to support patients for any length of time on a ventilator. Performing CPR for a witnessed arrest is one thing as they have a reasonable chance of recovering quickly, but trying this on someone who has been down for sometime with the likelihood of having suffered significant neurologic injury and would require long term recover is another matter altogether. Regardless of what this patient’s outcome was going to be, it’s never easy to have someone you’ve been caring for pass away so suddenly.

We had planned to visit a long-term patient of mine and her husband at the boma after work today and were able to finish a bit early to get on our way. Elias is a Maasai who met over four years ago when he brought his wife to me for seizures and she had never been treated before. We eventually transitioned her to lamotrigine (not an easy trick with someone living far away in a boma) and she has not only been seizure-free now for several years, but has also had several children without incident. The last two visits, he had expressed an interest in having me come to his boma for a goat roast to show his gratitude to us, but we have always run out of time to do this. I had told Sokoine last visit that I wanted to made sure this happened during our time here this month.

Slicing the goat meat along with Angel

So today was the day for our goat feast and we loaded everyone up in the Land Cruiser to visit their boma. We picked up a few gifts to bring as Sokoine says that you never visit a boma without something to give so we brought a bag of rice, a case of water and a case of soft drinks. The boma was on the other side of Mto wa Mbu and Lake Manyara which was about a 45 minute drive for us to reach the turn off. Alais met us there along with one of his neighbors who led us to the boma driving a motorcycle in front of us while Alais jumped in our vehicle. The drive was longer than I had anticipated and traveled along a thin trail the majority of the time and at times was more a cross country jaunt. We eventually reached his boma, an enclosed or six or so mud and dung huts. We drove our vehicle through the opening in the brush fence that enclosed the boma and when we arrived, all the children and wives came out to great us.

Two cute baby goats (not for immediate consumption)

Slicing the best tasting goat meat for the guests – Dr. Mike, Angel and Sokoine

It was amazingly tasty

Sharing the goat meat

They brought small stools and five-gallon buckets out for each of us to sit on. In addition to Chris, Jamie and Nan, we had also brought Sokoine and Angel along with Abbey so we had a large group of us. We sat around in the boma and presented them with their gifts before eventually taking a short walk to where they were roasting the goat for our dinner. Thankfully, they had already butchered the goat which was just fine with Jamie as she is a vegetarian and even though she hadn’t planned to eat, it was still nice not having to watch the poor goat before being cooked. It was being cooked on small stakes leaning over a fire and as we waited for the meat to finish, they were piling all of the organs in a bowl of water to boil as they waste nothing that is potentially edible. Even the head is roasted and eventually striped of all it’s meat.

Alais standing next to me

Once ready, they would take one of the various cuts and place it on a taller stake that allowed them slice chunks of meat off as we ate them. The first pieces were all a bit chewy and it was hard to tell what was meat and what was gristle, but it was tasty just the same. As time went on, though, the slices of meat became leaner and leaner and were pretty much irresistible, at least to my palate. The others were not quite as enthusiastic as I was and, because of this, they seemed to continue handing me the chunks of meat to eat, which was perfectly fine with me. It became a bit of a joke after a while as I kept saying “last piece” and they kept handing me more which I didn’t want to turn down so as not to offend anyone. Eventually, though, I had to step aside or I would have burst.

The scenery was amazing with nearby Lake Manyara shimmering in the setting sun and the lush vegetation of this area after the recent rains. As we walked back to the boma with the long shadows of the dimming light, it was never more apparent to me both the differences and the similarities of our cultures. Beauty and joy seem to transcend all as we give our thanks for the courtesy they have shown us here tonight in their home, in their land and in their world.

Their boma at dusk

March 27, 2017 – Back to FAME after surviving Lake Ndutu

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We were all exhausted after our incredible adventure over the weekend and went to bed earlier than normal I think. At about midnight, though, we had a tremendous thunder storm come through the area that lasted the entire night and into the wee hours of the morning. I think after our ordeal at Ndutu, we were all a bit gun shy and skittish of the heavy rains given what the roads become in very short order here, but the weather let up a bit in the morning long enough for us to walk to the clinic and then later in the morning the skies became clear with bright sunshine.

Chris evaluating a patient with Onaly

On the mornings where it’s rained all night, clinic is usually slow first thing, but today we had a number of patients already waiting for us. What we discovered, though, was that many of the patients had come from Arusha this morning, having driven the tarmac which is much more dependable than the dirt roads most patient use to get here from the nearby communities. Though Arusha and its surroundings is a city of probably a million people, there are no neurologists there and only one in all of Northern Tanzania at Kilimanjaro Christian Medical Center in nearby Moshi, and she is primarily dealing with hospital patients there so I’m not sure what type of outpatient practice she has. The patients that came this morning from Arusha were primarily of Indian descent as there is a very large Indian population in Tanzania who have been here for many generations after having arrived here in the 19th century as traders on the coast and in Zanzibar.

Jamie and Sokoine examining a patient

Patients seen today included a general smattering of the usual complaints including headache, back pain, extremity numbness and the such. One woman who saw Chris, though, brought an MRI with her that revealed an extra-axial mass of the right sphenoid wing compressing the right anteromedial temporal lobe. She was complaining of a right sided headache and the MRI had been taken at Muhimbili Hospital in 2015, though she reported having had a repeat MRI done within the last several months, also at Muhimbili, and that she had given a disc with the study to Frank.

Chris and Onaly evaluating a patient

Chris’ exam was very concerning as she now had right sided ptosis and impaired vision on the right that we felt was referable to the lesion we saw. Frank was out so we had the patient wait until he returned and reviewed the study on his computer. The report of the repeat scan did not describe the lesion nor did it suggest that they compared it to the original study and after looking at the scan we felt the lesion was still there and was responsible for her headaches and the change in her examination. We suggested that she return to Muhimbili, which is in Dar es Salaam and a day’s bus ride away, and we gave her a letter from us indicating that we felt she still had a problem and should see either the ENT who she had seen before or the neurosurgeon (of which there is only one in the country). As she had been seen numerous times there before we were certain that she had the means to make it there which is so often the limiting factor here as most everything has to be paid for and most often patients just don’t have the ability to do that.

Jamie and Sokoine examining a patient

Since this is our last week here, I had promised Daniel Tewa that we would stop by his home to visit with him before we left. We had agreed on today and it was also agreed in advance that he would not provide us with dinner, something that he loves to do because he feels that it’s an honor, but also something that I am sure is expensive for him and very time consuming. We went after work and probably arrived at his place around 5:30pm or so. The chairs and table were set up outside as they always are among the eucalyptus trees in front of his home. This is where he entertains groups of safari goers from the different countries, educating them about the history of Tanzania and the Iraqw people. His wife, Elizabeth, brought us delicious African coffee which is boiled with milk and really, really amazing, even if you’re someone who normally drinks your coffee black.

Chris and Onaly with a patient

As we began to discuss politics (always entertaining with Daniel), Elizabeth began to bring out additional plates containing sandwiches of cucumber, tomato and beef that were incredibly tasty and despite our objections considering his promise not to feed us dinner, he argued that they were merely snacks and couldn’t be considered dinner. When the plates of fresh fruit and avocado arrived, though, I think his argument was quickly falling apart which was of no concern to him as he continued to insist that we eat. I had asked him for some coffee beans to take back with me and insisted that I pay him for them as he usually gives me several, but I had asked for a few more for friends this time. It took some doing, but I was eventually able to give him some money for the coffee and I don’t think that he was offended. In addition to saying goodbye to Daniel and Elizabeth, we were also able to see his granddaughter, Renata, once again before we left and I look forward to seeing her again in October. I have seen her grow from a six year-old happy to eat her grandfather’s leftovers (an honor) to a now thirteen year-old doing great in school and a pleasure to have work with us at times. Her aunt, Bernadetta, had also worked with me at FAME several years ago before going off to college, so the family has been very close since coming here.

We came home from Daniel’s not quite hungry for dinner so stored all of our dinners (roasted chicken and potatoes) in a Tuppeware container for another night, though we’re running very short on remaining nights here. We have three more days of clinic and three more nights as we are planning to head to Tarangire National Park on Friday before arriving to Arusha later that evening. The residents will spend the night there and fly out on Saturday while I will be flying out on Monday. It always seems to go so fast when we’re here, but we’ve gotten so much in.

March 26, 2017 – An Adventure, Part 2….

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CAUTION – PLEASE READ THE PRIOR POST (PART 1) FIRST!!

We were now free of the deep mud by the marsh and as we drove along it was clear that the trails were not improving. Yusef decided to drive up out of the marsh area to what he hoped might be firmer and drier ground which was an excellent plan, but, unfortunately, the high ground had also been completely inundated with all the rain so there was little safety there. We had to keep up our momentum at all times which meant that it was pretty much of a slip and slide with the vehicle continually fish-tailing from side to side and mud flinging in all directions including the vehicle as we now had the top back up as the rains had stopped. In the distance, we could see a grouping of four or five vehicles near a tree and as we approached, still maintaining our speed so as not to get mired down again, one of the other guides motioned for us to slow down, which wasn’t really possible as we would become hopelessly stuck again if we did so.

Mother and child cheetah scoping out the horizon

As we passed them, we first saw what they were looking at which was the cheetah with four babies that we had seen the day before. The second thing we saw was the horribly wet area just beyond where they were and which was directly in our path with no hope whatsoever of avoiding it. The vehicle slowed and in the short moment it took for us to realize what was happening, our momentum had slowed and we were again stuck in the mud. Considering that there was no immediate rush to do anything, we watched the cheetahs for a bit as the mother seemed to be interested in hunting as there was a Thompson gazelle fairly close that might be good prey for her. She had her babies wait for her in a group, but they eventually began to follow her, apparently not wanting to miss out on anything. The gazelle eventually moved on and so the mother cheetah and her babies began marching off towards a heard of wildebeest in the distance.

Vehicles stuck at the cheetah tree

All four wheels dug in deep

This was our signal to get out of our vehicle and assess the situation that we were in which was not very good. We also realized that at least two of the other vehicles that had stopped to look at the cheetahs were also stuck in the mud. As we were outside walking around, the driver who had helped us get out previously came driving up and managed to avoid the softer ground so as not to also get stuck. He had his four wheel drive working and, although that was helpful, it didn’t prevent one from getting stuck in this mess as several of the other stuck vehicles were also operational 4×4’s. We were very much dug in and this time it was going to be a bigger chore to get us out. We tried digging and pushing, digging and pushing, but to no avail. He finally got out his recovery tracks, which are three-foot long steel plates with holes for traction that you can put in front or behind your tires to gain traction.

Everyone working to free the vehicle

Unsuccessfully trying to push it out

Using the recovery tracks and the pull strap, we were eventually able to move the vehicle a few feet before getting stuck again and we did this again and again until we finally had it out onto firmer, though still quite slippery, ground. All the while, other vehicles kept coming upon us and thankfully weren’t getting stuck as the ground was slowing drying some, one advantage of being stuck here for so long. We now focused our attention on helping some of the other vehicles out of the muck. One of them had all four tires dug in and it was going to be a real chore to get it out. It had a winch on the front that wasn’t strong enough to pull the dead weight of the vehicle, so it was eventually up to using our tow strap and situating another vehicle in front to pull. This still wasn’t enough to do the trick and despite Chris and I trying to convince the drivers that it was necessary to jack up all the tires and get plates under them (we now had two others from another vehicle that had stopped) so we wouldn’t be trying to lift the vehicle in addition to pulling it, they continued to make failed attempts at getting it out.

Further discussion

During all of this, everyone was out of their vehicles and I met a nice young man from Santiago Chile who was here on his honeymoon with his new wife. They weren’t one of the stuck vehicles, thankfully, but were instead helping out as their vehicle was doing the pulling. We were eventually successful in our urging them to raise each tire and after many, many tries over several hours, we had the vehicle out and, now, the only thing left was for us to somehow get back to camp without getting stuck again. Our plan had been to get back for breakfast around 8:30, though now it was after noontime. All of the vehicles stuck together riding back in the direction of the camps which are near the marshes so that if someone got stuck again we’d have help. The going was still quite difficult, though it was an exciting ride as the vehicle had to keep its speed while constantly fish-tailing back and forth. We had finally made it down to the marshes where we were heading in a different direction than the other vehicles which meant that we now had to go it alone.

The final push (and pull) to successfully get it out

A herd of wildebeest crossing the newly formed river

We crossed several smaller areas of water and then had to tackle a slightly longer stretch and as we felt our momentum slow to a stop in the middle of the stream, our hearts sunk as it seemed we were stuck again, this time in the middle of a deep stream with rushing water. Getting out here to push would have been a big mess and very likely unsuccessful. Yusef expertly rocked the car backwards and forwards in a number of successions and after over a half a dozen tries and several minutes was able to free us from the clutches of mother nature and we were again on our way. At one point, Yusef had gotten disoriented as to the direction of camp, a very uncommon occurrence for him, and, thankfully, I had my iPad with my navigation application that allowed me to locate us, our camp, and the correct direction that we needed to travel.

Two Maasai giraffe

We had several more crossings before reaching camp that were much less eventful, though still quite exiting, and we arrived at around 1pm. We were exhausted after our ordeal and I’m sure that Yusef was worse off than the rest of us. They had prepared breakfast for us which was still available and so we all washed up before enjoying a much deserved meal of eggs, crepes, bacon, sausage, juice, and toast. They had made lunch boxes for us that we would bring back and eat later.

A nursing baby wildebeest

A Maasai giraffe

By the time we left camp it was well after 2pm and I don’t think Yusef was very interested in tackling any more of these roads considering we still had a long way to get home which entailed driving over a number of miles of open plains before reaching the Serengeti Road that we’d take back to the Ngorongoro Gate. We packed up all of our stuff and decided to head out slowly, doing some game viewing as we did, rather than exposing ourselves to the potential for another long extrication that would easily put us past the closing of the gate at 6pm in which case we wouldn’t be able to make it out of the Conservation Area and would have to spend the night here.

A selfie on the road

Nan enjoying the scenery

It was an amazingly beautiful day as we traversed the Serengeti plains with scattered wildebeest, antelope, zebra, ostriches, and eland as we traveling. We eventually made it to the main road and headed back in the direction of Ngorongoro Crater. The sky was ominous in front of us with huge rain storms, lightening and even some rainbows. Given the distances we were traveling, the rainstorms miraculously passed in front of us before our arrival and we encountered their wrath in the form of some flooding along the road, but nothing that wasn’t manageable. It became clear to me, though, that we were going to be very, very tight on time and Nan guessed this in the seriousness of my face when she asked me how we doing on time and I told her it was a 50-50 proposition. Since we had patients the following day at FAME, we couldn’t really afford to spend the night on the crater rim, either financially or timewise.

Chris and Mike enjoying the scenery

Yusef continued to drive at a very fast pace and we arrived at the gate at 5:55 pm, with just 5 minutes to spare. Given that we had driven hours and miles that day, it was a real feat. We sat in the car as Yusef went into the office to check out. We were all breathing a huge sigh of relief and congratulating ourselves on having survived such an epic day, when suddenly, Jamie let out a scream. Her windows was rolled down only about six inches or so, but somehow a huge baboon had jumped deftly through the opening, bouncing off the front seat and ending up in the driver’s seat next to our lunch boxes which was obviously his plan and previously calculated.

Needless to say, being in the cramped confines of a car with a wild baboon, whose canines are quite intimidating, can be just a bit anxiety provoking and it had just the effect you would imagine. I grabbed a Coke Zero bottle by the end and jumped forward swinging it towards the baboon in a perhaps lame attempt to protect my residents and had Chris quickly open his door so the beast would have an easy exit. With a sandwich in his mouth and a chicken wing in his hand, he quickly turned and, just as deftly as he had entered, he exited back through the small opening in Jamie’s window and was gone. The last we saw of him he was eating the chicken wing sitting on the small wall in front of us and Chris snapped a photo for documentation purposes. After a short while and after a chance to have settled down, we were able to get out of the car to see what was going on outside.

The dastardly baboon with the chicken leg

Yusef had been gone for some time and when I walked up to where he was, he told me that we had underpaid for our stay at Ndutu, which I was sure we hadn’t and went through our receipts again to show that everything had been paid for properly. We had indeed taken care of everything, except in the earlier turmoil of the day, Yusef had forgotten to check out at the Ndutu ranger station, an apparently necessary step when camping there. Therefore, they had already entered in the computer there that we had overstayed and we would have to pay another night’s camping fee. I told the supervisor that it was obvious we hadn’t overstayed as I was standing right in front of him and, also, that I was not willing to pay the additional fee ($286!) regardless. This went back and forth several times and when I told him of the ordeals of the day we had had, he was a bit more sympathetic and said that if we had photos of our car stuck in mud, then he would consider waiving the fee. Thankfully, we had plenty, and he was willing to make an exception as long as we would send him the photos at that moment so he would have the supportive documentation to justify it. Jamie sent him two of her photos and we were eventually on our way back to Karatu after a very, very long day.

I’ve been to Ndutu in the months of March and April, but have never seen it that wet before, though I’m sure it wasn’t that unusual of an occupancy. Perhaps we were just lucky. Coming around the crater before the gate, we saw our third rainbow of the day and though it was felt that that was perhaps too many, I think it was just the right amount as they allowed us to survive each and every ordeal, including the baboon, and make it home safely. We ate dinner that night at home and were all amazed at the adventures we had this weekend. We had seen quite a number of animals and had lots of stories to tell back home to our friends when we returned. These are the experiences we will remember forever and have to tell our children and grandchildren.

March 26, 2017 – An adventure we’ll not forget, Part 1…

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The rain fell solidly throughout the night in a steady chorus against the fabric of our tent, though seemed to let up slightly in the morning. I remember lying in my incredibly comfortable bed beneath the soft sheets and warm comforter wondering about what the day would hold for us. Certainly, if it had been still pouring, it would be very unlikely that we’d head out into the bush as early as planned, but since there was a reasonable break in the weather, I got out of bed before 5:30am along with Chris and we decided to head over to the mess tent for our morning coffee before loading into our vehicle. IT was still pitch black outside and we clicked our outside light off and on several time to call for an escort. When no one came, I began to whistle hoping that someone would hear us, but to no avail. Finally, with flashlight in hand and swinging it from side to side like Leonard had taught me, we made our way to coffee praying that we weren’t being watched by a hungry lion or hyena. All morning before getting out of bed we could hear the soft roar of two lions just outside of camp as they were heading somewhere near the lake. Thankfully, it was not our morning to serve as lion fodder and we promptly sent an escort for the girls.

A bat-eared fox in the rain

I vaguely recall the camp manager’s comment when I mentioned the nightlong rain and we should have taken more heed at the time. He said “too much rain” as nonchalantly as one can, but was clearly prescient in his wisdom. We piled into the Land Cruiser in the dark and popped the top so as to stand in the cool early morning air as Yusef navigated along the paths we had driven in on yesterday afternoon. It was immediately clear that the rain we had received through the night had swollen the previously shallow waterways so that they were all now swollen to several times their previous size. Paths we had previously taken were now underwater and even if you could find something familiar, it would very quickly lead into one of the bursting waterways.

One of our several rainbows of the day, this one with a giraffe at the end

We forded several deeper bodies of water and eventually made it back to the small Marsh which is always a good spot to find lions. Jamie immediately noticed the tracks in the mud that Yusef identified as hyena and they were noticeably fresh leaving no doubt that the beasts were very close by and likely directly in front of us. As we came around the corner of the marsh, we immediately spotted the same lioness we had watched yesterday and she was dragging a freshly killed wildebeest up towards the brush. Even more exciting, though, was the fact that there were three hyenas following her very closely and it was quite clear that their intention was not to settle for seconds. As we drove closer we could see the recent kill clearly whose abdomen had been opened completely with all its viscera exposed. The hyenas backed off as we entered the scene and maintained their distance for some time, though eventually skittering into the distance beyond our sight having chosen to make their battle another time. I’m sure the lioness was thankful for our intervention as it saved her from what would have been a formidable battle as she would have had at least three hungry hyenas to take on and possibly more had reinforcements showed likely shown up with the sounds of the fight.

We watched her eating for a fair amount of time until she became either full or tired and dragged the carcass further up the hill into a thicket of brush where it was partially hidden and she could lie down somewhat protected from the rain that had now begun to fall again. Two other vehicles had pulled up to watch the lioness and they had come and gone while we remained to watch. We were now heading in the direction of the big marsh to look for other lions or whatever we could find. The amount of rain that had fallen overnight had completely filled the basins that we had easily driven through yesterday and the water was actually flowing in the direction of the Lake so that what were previously very drivable trails traversing the dry river beds and wetlands were now flowing rivers. We crossed several smaller tributaries flowing into the river, but now had to get to the other side to continue on which would mean a full on fording of the waterway. One of the other vehicles that had been with us at the lion kill drove down to the river side with us where there were tire tracks entering and in the distance, one could see tire tracks exiting the flowing mass of water. It was a long way across, but we knew at least that there had previously been a road underneath somewhere and it most likely connected between these two points of entry that we could see.

Not a good sign

We began the crossing with water splashing in all directions, up over our hood and to the sides in all directions. The Land Cruiser did what it was supposed to do, thankfully, and we drove across the river with waves departing from each side of the vehicle in an amazing demonstration of the utility of these vehicles. The other vehicle followed behind us and we both drove off with the satisfaction of having conquered at least one major obstacle this morning. We were now on the other side of the river and driving off in the direction of the big marsh. The roads remained passable, but were becoming more and more treacherous and, finally, at one point while we were in a particularly wet area, the vehicle began to spin from side to side leaving us eventually perpendicular to the road and pointing uphill with our rear wheels completely dug into the mud, spinning with no traction whatsoever. It was then that we discovered that our four wheel drive wasn’t operational as the transfer case, which is a push button activation with automatic locking hubs on this vehicle, wouldn’t engage. Not a good situation in these conditions.

Trying to jack up the vehicle

Stuck in the muck

We were helplessly stuck at the side of the marsh with the vehicle pointing uphill, the rear tires buried, and pure muck behind us. I recalled that this was nearly the exact location where we had seen one of the lionesses yesterday so this was certainly not a good place to try and walk out of on foot. Once again, it ran through my mind, just how I would explain this to the program directors at home that one or more of their residents had been eaten by a lion while on safari. It would surely put a damper on the future of the program. We would have to get to work to get ourselves out of this predicament and thankfully, I had brought my rubber boots which I changed into rather quickly and got out of the vehicle to assess the situation along with Yusef. It didn’t look very good, but we got to work pulling out our Hi-Jack, a very tall jack stand that allows you to lift your tires completely out of holes if needed. Unfortunately, we had no rocks to pile under the rear tires, a strategy that often works to improve your traction, so instead tried to pile downed tree limbs under, but it was all to no avail as the tires wouldn’t grip and there was no way we were capable of pushing the vehicle out.

Attaching the tow strap

Nan enjoying the scenery

As we sat pondering our dire situation, another safari vehicle showed up on the scene and stopped to help extricate us. After numerous additional tries of jacking up the vehicle, it was eventually decided to try pulling us out which would be a real task considering the orientation we were in and the fact that ground in front of us was also a bit on the slippery side giving less than optimal traction for the other vehicle. We initially unsuccessfully with a chain they had from their vehicle until we realized that we had the tow strap which I had given to Leonard over a year ago in ours. The two strap was longer than the chain and had the benefit of some elasticity to provide additional pull on the vehicle. After several tries, our vehicle was eventually freed to the cheers of all of us and it now sat on somewhat more firm ground for us to continue, that is at least for the moment.

Free at last!

Walking back from the scene of the crime

March 25, 2017 – Off to the Southern Serengeti to see the Great Migration…

Standard

March is the beginning of the low season for safaris as the longer rains are beginning to fall and with things more lush and green, the animals tend not to congregate as much near the water sources for easy viewing. This is true everywhere in Northern Tanzania, that is, except for the Southern Serengeti and Lake Ndutu, where one of the most amazing spectacles in nature occurs every year at this time. March and April are the high season for Lake Ndutu which is where you can find the largest concentrations of migrating wildebeest and zebra at any one time. Sure, the crossing of the Mara River into Kenya in the Northern Serengeti is pretty darn spectacular in August and September, but for different reasons and, in particular, watching the waiting Nile crocodiles pick off unsuspecting animals as they’re trying to reach the other shore. For shear numbers, though, seeing them in the south can’t be beat and this morning we’re heading down to one of the migration camps on the shore of Lake Ndutu where we’ll spend the night “glamping,” which is the new term for glamorous camping made famous at some music festivals on the east coast.

A Tawny Eagle

A vulture protecting its meal

We have plans for Yusef to arrive at our house at 5:45am for a departure of 6am that will put us at the Ngorongoro Gate at 6:30, right when they open. We have a several hour drive down to Ndutu and would like to get as much game viewing in as possible today before heading to camp later for dinner. We had packed our lunches along with a sandwich for Yusef, plenty of Coke Zero, cut up pineapple, a can of Jalapeño Pringles and some candy bars. Had we found ourselves lost in the Serengeti somewhere, we wouldn’t starve for at least three days with the supply of food we had.

A silverback jackal

Two strutting Marabou storks

Traveling around the rim of the crater once again was nothing less than spectacular as we first entered the clouds, but after a short while, the sun broke through and you could see down to the crater floor with it’s unique topography that is unequaled anywhere else on earth. We finally pass by the descent road as we leave the rim and begin dropping in elevation traveling by boma after boma in this very fertile and reasonably populace area. The views are just amazing and we are eventually down on what would be the Eastern Serengeti, passing by Oldupai Gorge, famous for the Leaky’s discover of oldest man here in the 1950’s, Oldupai George, otherwise known as Zinjanthropus. I am using the correct spelling of Oldupai, by the way, rather than the incorrect spelling of Olduvai that has been used every since the gorge was discovered back in the early part of the century before the Leaky’s. Oldupai, which is the Maasai word for a wild sisal plant that grows here, was what the gorge was originally named for. Oldupai is mecca or ground zero for anyone who has studied physical anthropology or the history of man. Interestingly, the river that runs through the gorge here dumps into Lake Masek and Lake Ndutu, our destination for today’s journey.

A migrating wildebeest

Homely, but graceful

The road we’re traveling is full of washboards and dust as we traverse the Serengeti plains here and make our way to the northwest until we reach a small turnoff that will take us southwest in the direction of Ndutu. All across the Eastern Serengeti there are herds of wildebeest and zebra spread out grazing as the rains have been generous in the recent weeks and there is plenty of grass to be had. After the turnoff we are essentially following tire tracks that make up the roads here through the open plains until we reach a region of taller shrubs and low trees through which we pick our route that presents the least amount of bumps to slow us down. We’re finally to the shores of Lake Ndutu where the going is mostly flat except for the occasional stream bed that empties into the lake and causes us to slow down briefly. There are flamingos on the lake that we stop to photograph as they squawk and mingle amongst themselves with some unknown agenda.

A small herd of wildebeest at a watering hole

An eagle in flight

We begin our game viewing by driving to the small marsh where we have seen so many things in the past including lion, cheetah and leopard, and in very short order we locate a sole lioness that looks a bit on the thin side and is making her way towards a large herd of wildebeest who clearly haven’t yet noticed her presence. She eventually moves into the tall grass that is situated on this end of the marsh where she begins to slowly move in the direction of the unexpecting herd. We situate ourselves up high above for a good vantage point to view any action and then break out our lunch while we sit and wait for her to make a move. We can see her head popping up occasionally in the tall grass along with a few hyenas who are obviously also hoping to benefit from a kill. Unfortunately, this wasn’t the time and as the wildebeest slowly move away, the lioness never makes a move and her opportunity vanishes as does ours and we eventually move on looking on for new sights.

Lioness in the high grass

On towards the big marsh, which is at the other end of the water way we’re following, where we find another lone lioness, this one resting atop a slope overlooking a watering hole, not far from where we witnessed four lionesses ambush a zebra herd seeking water two years ago. A young zebra was their victim then, but today, this lioness is not hunting which is probably a lucky thing considered there are two safari groups outside of their cars having lunch not far away.

Wildebeest looking for shade from the midday sun

We left the big marsh and headed out onto the plains in search of more cats considering the monstrous herds of wildebeest moving to and fro in long lines and occupying the horizon in every direction. Thousands upon thousands of them, many of the females with new calves that are typically born in Kenya and are older by now, but given the recent drought, many of the mothers have delayed their deliveries until the rains fell recently. The younger Wildebeest are much more attractive than their parents who have to be one of the homeliest looking animals I have every seen. I have called them “ugly” before, but have received grief from the others so have had to reconsider my critical assessment and finally settling on homely to be a bit more considerate.

Sisters

A more attentive lioness

In fairly short order, we were able to spot two groups of lions, one consisting of two lionesses and the other of two lionesses and one male lion, the latter who had a very coiffed ‘do with what appeared to be bangs. He was clearly no slouch, though, as he had his two women with him and I’m sure would have taken no slack from any of us had we decided to challenge him. After driving around for some time and marveling at the massive herds of “beesties,” we dropped back into the marshes where we were intercepted by two rangers who we had bumped into earlier when they were checking our permits and they now wanted to let us know about a cheetah that had been sighted not too far away. We sped over to the area where the cheetah was supposed to be and, although it took us awhile, we finally spotted it resting under a tree and not bothered at all by our presence. We watched for a bit as none of the others had ever seen a cheetah before and we were all by ourselves.

Our finely coiffed male lion

A very leary lioness

We eventually moved on to another wide open area where we spotted a cheetah in the distance under a tree which is usually how you find them resting in the daytime. Amazingly, as we got closer driving up we could see smaller cubs sleeping with their mother. They were the cutest little things, though much larger than some cubs I had seen here five years ago (that mom had five!) that still had their velvety coats of downy fur along their backs. They were all sleeping initially, but awakened intermittently to move around under the tree and interact in various states of consciousness, rolling over here and there, climbing on mom and grooming each other. We watched for sometime as they were all so adorable, but eventually moved on among the continuing herds of wildebeest while the sky began to darken with sheets of rain beginning to fall a short distance from us and moving in our direction. We were eventually caught by the grasp of the rain and were able to drop our roof in very short order so we wouldn’t be soaked, nor would our gear, as enough of the rain would have come in the vehicle to have taken care of each of those.

Our solitary cheetah

A simply gorgeous creature

It was only about 4pm and much earlier than we had planned to go in for the evening, but the rain was making it difficult to see much along the way so our game driving was done for the day. The drive to Mbugani Camp was uneventful and we pulled up in a pouring rain. I had stayed at this camp last year and it has a wonderful overlook of Lake Ndutu. The tents have running water, hot water with some advance notice, a shower, toilet and perhaps the most comfortable beds considering you’re in the middle of the Serengeti. We first sat inside the community tent with tables and couches while we waited to get our introduction to the camp and walked to our own tents. We were the only group in camp that night so we had the run of the place. The girls stayed in tent number one, while Chris and I were staying in tent number four, a few tents further away from the safety of the mess and community tents. Chris and I were definitely up for showers after the long day, so after a few minutes we got the go ahead from the staff that they were ready. Unfortunately, they were really “lukecool” showers, a new term we coined for a temperature that had little or no warmth, but less shocking than a straight on frigid shower that we’ve had on occasion here.

A young cheetah

We went back over the community tent after cleaning up as they did have WiFi there for us to check our emails and relax a bit. Jamie was napping, but Nan was there and, as the rain had stopped, she was walking around outside to check out our surroundings. I was typing away on my iPad when she said that she’d be back in bit, which just a funny ring to me and when I asked her where she was going, she calmly told me that she was going to walk down to the lake, perhaps a quarter-mile walk. Let me remind you that we’re sitting in the middle of the conservation area where we had just been watching lions stalking prey and hyenas stalking the lions. I quickly replied to her that she couldn’t walk to the lake for these quite salient reasons and the camp manager, who was also sitting in the tent at the time, suddenly took notice of our conversation as well. The beauty of this place often makes it easy to forget where we are at times and that around every corner lurks another part of the “real world” where we are no longer the top of the food chain.

Another young cheetah

Luckily, the rain had stopped for a long enough time for some of the firewood to dry so they were eventually able to get the fire pit going so we could watch the “bush TV” and relax a bit with the sun going down. Dinner wasn’t until 7:30, so we had plenty of time to enjoy the view and the wildlife between us and the lake, which at one point included a small herd of Coke’s hartebeest running, or really prancing, in front of us with their eyes reflecting in our torches, bouncing up and down, to and fro. They were apparently quite happy with the recent rain and were celebrating, or so we were told. When dinner was served, it was delicious butternut squash soup and then a buffet of amazing lamb, roasted vegetables and roasted potatoes. Jamie, being a vegetarian was served a stuffed roasted tomato that she said was quite delicious as well. I was quite happy with the lamb!

Mama cheetah with her four babies

A grooming session with mom and baby

We all relaxed a bit after dinner and then walked to our tents, with escorts, of course, considering the fact again of where we were and the constant danger of animals coming into camp during the night. There was a cool breeze after the earlier rains so a chill was in the air, but it was delightful, and sliding in under our thick comforters after a long day never felt better. We were planning for a pre-dawn start to our morning drive and were meeting in the mess tent at 5:45am for some coffee and chai and a 6am departure. We’d come back to camp for breakfast and then bring lunch boxes with us so as not to have to return to camp later during our game viewing. At least, that was the plan when we fell asleep, little knowing what adventures the next day would hold for us.