Today Michele and I traveled to the town of Webuye. We took the public transit system, which in Kenya, like many places in Africa, is based on the matatu. A matatu is basically a mini van that closely resembles a sardine can - boxy, usually rusty and without cushions, often smells like fish, and can really pack people in. On one of the rides today (since you almost always have to take various matatus to get where you're going if the destination isn't close), when the seats filled up the attendant pulled out some short wooden planks to span the aisle between seats so additional passengers could sit. At another point, the matatu was so full that three guys were hanging on to the outside of the van as it cruised along at about 40 mph. The basic rule of matatus is that they'll usually get you where you need to go, about an hour later than you expect. You walk up to a parked matatu that is going in your direction, sit inside, pay your fare, and then wait until the van fills up with passengers. Departure time is when the van is full. But the other rule of thumb is that they're cheap. Our trip to Webuye took four hours and involved three different matatus, and it cost us each five bucks. It's an experience, and actually pretty fun. For a little bit. Once in while.
Michele and I went to Webuye to meet the previous residency director from the Moi University family medicine training program. He is still part of the residency faculty (one of only four family docs on faculty), and is now working and teaching residents at the Webuye District Hospital. Moi had the first family medicine program in Kenya, started in 2005, and it is still going strong. Family med is pretty young here, and there is only one other program in Kenya, associated with Aga Khan University; and it is less than a year old. Our friend Megan from UCSF is now helping lead the AKU program, a private hospital based residency in the capital city of Nairobi. We learned a lot today about the benefits, challenges, and unanswered questions about family medicine in Kenya and Africa in general. We also had a very nice dinner of fresh garden greens, including the best tasting cilantro I think I've ever had, homemade Southern cornbread, and hot chocolate with amarula liquor. We are feeling pretty well cared for.