On the day of our departure from Lamu, Kenya Airways finally started flying off the neighboring island Manda so we luckily avoided another bumpy bus ride. We flew via Nairobi to the far western side of Kenya to the city of Kisumu. Situated on Lake Victoria in the Nyanza Province, it is home to the FACES program, a collaborative HIV clinic providing care in one of the hardest hit regions of Kenya. Residents from UCSF often spend a month at the clinic, so we went to Kisumu for me to get to know the program better. The town itself is small but has a sizable "downtown". The clinic moved into a new building three weeks ago. Before that they had been seeing patients in tents and makeshift shacks. My visit went well. First, the staff is cohesive and dedicated. Second, the work they are doing is impressive. The clinic serves more than 5000 patients so every day is incredibly busy. Most all of the patients who need antiretroviral medications actually have and are taking them. The staff does home visits to see ill patients and follow up on people who have been lost to care. They do a lot of educational work. They also have programs in two other areas in the province. I hope to spend more time with them again soon.
The day after I finished the site visit we planned to head to Kampala, Uganda to see another program and see the place we had called home for a few weeks in 2003.
So, Nima bought bus tickets and at 12:30 pm we went to the bus station expecting to get to Kampala by 7 pm or so. Well, we made it to Kampala but we got there late, at 12:30...... the next afternoon! So here's the story: we had arrived at the bus station about thirty minutes before the scheduled departure time and settled into the waiting room. We waited and waited and finally three and a half hours late, the bus arrived. No problem, we boarded and sat in the relatively comfortable seats armed with newspapers, magazines, and even head lamps to read at night. The road to the border (about two hours away) was not so bad and immigration went quickly. As we boarded the bus again, the sun was setting and the azan was being called from the the small town of Busia. So we get back on and start driving. The road on the Ugandan side was full of potholes and there was a slight rain falling. We eventually hit traffic and moved along slowly. Eventually the traffic got a lot heavier and we slowed to a stop. After 45 minutes it became obvious that we weren't moving anywhere. Soon word spread that the traffic went for kilometers and nothing was moving in either direction. By now it was past 10 pm. The bus driver turned off the bus and told us to sleep well. Everyone was amazingly calm. We relieved ourselves by the roadside, chatted with our fellow passengers (one of whom works in HIV care in Kisumu), and then climbed into our seats to try to sleep. Somehow we managed to get a few hours of shut eye and by the time the sun rose everyone was awake and ready to see what was going on. Turns out that the road just up ahead was even worse than what we had jiggled on - it was essentially mud. The night before a couple trucks lost control and slid across the mud, getting stuck and blocking the road. Now hundreds of buses and trucks were lined up in either direction for kilometers. 
By some magic, on a Sunday morning, as we were starting to talk about how many nights we'd spend on this bus, the road workers arrived and after three hours of work dug up enough earth with their giant Caterpillars to create two additional lanes. With some fancy and well organized maneuvering we ended up on our way. So we arrived in Kampala 24 hours after we had first arrived at the bus station in Kisumu, a little tired but also impressed by people's patience, the fast work of the road workers, and not stressed since we weren't on a tight schedule. Actually the night turned out to be pretty fun as everyone bonded, shared stories and food to pass the time and alleviate our hunger.The streets started coming back to us pretty quickly when we arrived in Kampala. So did the feeling of comfort that we had back 2003. It felt like very little had changed, even the restaurants that we had used as our landmarks were the same. We did note a significant increase in the traffic; the roads were now clogged all day all the time. We grabbed a taxi to the Red Chili Hideaway, a hostel we stayed in for our last two weeks in '03. Our few days here were mostly been about work. I had a chance to evaluate the sites where we rotated through as residents. I had a wonderful visit to the HIV clinic Reach-Out Mbuya. When we worked there the clinic ran out of a small room at the edge of a church. We couldn't do any tests so HIV tests and tuberculosis tests were sent to a nearby lab. We had just a few medications and definitely not any antiretrovirals.
We spent our days seeing patients in clinic and at home. Now the organization has grown. They have a nice clinic building, a lab, and antiretrovirals. They continue to have the other programs that make the care they provide special, like home care, a microfinance program, a skills training program for women, an education program for HIV prevention, a school fees program, and so on. It is a place that is still filled with an incredible amount of hope. I saw a few familiar faces. Nima's work (and mine when I returned) was working on the blog. We finally caught up!! In the evenings we ate good food. A couple of nights we had Indian which we always remembered as being wonderful in Uganda. We weren't wrong. Our favorite place is a small South Indian place called Masala near the National Theater where we had delicious dosas.
So now, as I write this last paragraph, it is just about one hour before we have to leave for the airport and the end of our journey. I can't even believe I just typed that. We'll add a reflection in a few days but before then I just have to say that we have been so lucky and we are incredible grateful.
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