Pumpernickel, one quarter of the way there…

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After an hour on the tarmac we turn off road and descend a steep dirt track that winds down in to the valley. We cross a small wooden bridge over the river, it doesn’t look strong enough to hold a child, never mind a mini bus and equipment van. The views are stunning. We have a 360º panoramic view of dense, lush green vegetation. Classic round mud huts with straw roofs are dotted throughout the landscape. Farmers are tending to goats, sheep and cows, donkeys and chickens roam the little pathways that intersperse rich fields with 6 foot high maize. We eventually track down the edge of a field and end up at a small dispensary that has USAID logos stamped all over it. This is to be today’s clinic site. The team head straight to work renovating the building in to a world class eye clinic and the patients steadily trickle in.

At times like this, in the midst of such perfect surroundings, I sometimes consider that the biggest disadvantage of ophthalmology as a speciality is the need to work predominantly in the dark. Here I am in a place that is hard to imagine real it is so beautiful, and I am cooped up in a small room, backed up in to a corner on a hard plastic stool, the slit lamp in front of me, laptop to my left, retinal camera and visual field machine on the table nearby and a heavy, black curtain over the window blocking out the outside world.

As the day progresses, nature calls and I venture out on a small walk to the nearest toilet (well pit latrine actually, I’ve yet to work anywhere with a toilet), around 80 meters from the clinic is a small wooden shack. As I approach, admiring the views around me, a phone stars ringing from within the toilet, it is the classic Nokia ring tone. I am so taken a back that I genuinely expect Dom Jolly and some camera crew to jump out at me. It just goes to show how widely mobile phones are now used, there may not be flushing toilets or electricity, but you can be sure to find wherever you are, someone has a mobile phone!

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We sit at the table with Daddy for breakfast.  “What does Daddy do Lucas?” “Eye Doc-tor, Peoples eyes better” I can see how proud Daddy feels sipping his morning coffee.  Being charming is a strength Lucas is developing almost inversely proportional to his eating ability, aside from licking the butter from the toast and leaving the rest, despite plenty of encouragement again he eats and drinks nothing, he asks to get down and finally we agree.

Whilst Andrew is having an adventure in the field Lucas is wanting his own adventures and not any of the necessities the day brings. I walk into Lucas’ room holding the tangle teezer hair brush and some conditioner, immediately he runs to the bed and slips down into the “tantrum” position, lying face down with his head in his hands and bottom in the air! I gently pick him up and begin the fortnightly struggle, I am thankful he is not a girl! (I think he is too!). Daddy regularly offers to give Lucas a haircut in his own balding style but I haven’t yet managed to trim his beautiful golden curls.

We settle from the trauma of hair brushing, Lucas shouts “nee naw” as he chases the tractor with a fire engine. We are heading up on to the roof for “pouring games” (we pour water from various containers in to others, often with food colouring so he can see how colours mix). I take out the daily sun cream to protect him from the midday equatorial sun, he slides down into the tantrum position with his reusable big bum nappy in the air, head on hands making a lot of noise.  Usually he is very good at sun cream (thankfully!) but not today, finally he gives up, giggles and I paint him white.

I think he must be tired, he has been up by 6.30am and sleeping at 9pm for the last two nights, with only a 30 minute snooze in the carry rucksack whilst I was marching up a hill on the way to Kate’s house in the baking heat. It may well be teething time again and it is certainly the familiar no sleep and irritability!  Coupled with an unfortunate encounter with a swing yesterday, he walked in front of it and was knocked flat by a flying foot to the jaw, right where there are more teeth coming through! Toddlers are wonderful, but can be tiring!

Lucas wakes from his much needed sleep, he comes for a cuddle then sets about racing his red and yellow cars. We sit for lunch sharing a soft juicy “ad-do-ca-do” mine I’ve made into a quick guacamole, Lucas’s has a little less spicing.  Along with the homemade crusty seeded bread he munches away followed by a juicy sweet mango bought this morning, perfectly ripe from the mkokoteni (fruit cart) we are both left with sticky fingers and juice all around our mouths.  We get down, get our things together and head out to the guesthouse 15min walk away to play on the grass, we chase doves, find geckos, spot red and purple flowers, tuk tuks, cars and run down the dusty road! It feels more normal although I haven’t relaxed to the point of letting him pick up any stick on the road after seeing a few too many men pee down there! At the guesthouse the sun is shinning, we giggle, sing, chase the ball, read under the table (for shade) and Lucas finishes the trip by picking a purple flower for Daddy, these are special moments to be remembered. My phone rings, it’s Andrew he’s telling me he  has had a bizarre experience on the way to the toilet…

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Recipe – Pumpernickel Bread

Ingredients:

Pre-ferment

30g rye flour

30g water

2g dried yeast

Final  dough

325g White strong bread flour

220g rye flour

20g cocoa powder

240g water

110g strong cold brewed coffee (filter)

The pre-ferment above

12g salt

3g dried yeast

65g molasses

25g sugar

120g butter unsalted

6g caraway seeds

Method:

1. Make the pre-ferment the night before by mixing ingredients altogether with a spoon and leaving at about 20ºC

2. The next day combine the white flour, rye, cocoa, water, coffee, pre-ferment salt and yeast mix with a dough hook for 3 minutes or knead by hand for a little longer, then add the molasses and sugar and mix for further 7 minutes.

3. Add the butter and caraway sees and mix until well incorporated.

4. Leave  to prove for 1 hour or until doubled in size.

5. Half the dough and flatten each piece slightly then fold in from either side, turn 90 degrees and repeat then fold round to make a loaf like shape and place in a floured bread tin, repeat for the second loaf.  If you don’t have two loaf tins you can make into a round to make a circle shaped loaf.

6. Leave to rise for a further 1 hour until a finger leaves an indent in the dough. Cover with cling film or plastic bag but be careful the dough will not expand to get stuck to the cover.

7. Place in the oven a 220ºC for 40 mins with  tray of water at the base of the oven to create steam.   After 20 mins turn down to 200ºC.

8. Remove from the oven turn out and place on a wire rack to cool.

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Ginger Shortbread Biscuits and no Coffee…

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“What fresh juices do you have?”

“We have mango”

“Great, we’ll take one mango juice, and do you have brewed coffee?”

“Yes, how many coffee?”

“Two please, do you have any vegetable samosas?” (A usual Kenyan ‘biting’ aka snack!)

“Ok, two coffees and I will check with the chef about the samosas”

We take a seat on the nice lawn outside the guesthouse, its lovely and so well kept.   This is the top rated accommodation in the area so we thought we’d check it out for an afternoon and have a breather before another busy week commences.

After running in the hot sun with Lucas, rolling the green ball down the hill and chasing the tractors over the tap, we certainly feel ready for a coffee and juice, we wonder where the order has gone.

55 minutes later, a waiter turns up with a pot of hot water, 2 sachets of Nescafe and a carton of juice. Not quite what we had in mind. We enquire about the samosas.

“Chef has made you pancakes”

“But we didn’t ask for pancakes… are they pancakes with vegetables inside?”

“No, they are fried pancakes, plain”

This conversation drags on whilst in the background, just across the fence, a boy is being continually beaten and is screaming. We try to block it out but it keeps on going. It is the neighbouring house and the parents are being so heavy handed it is making us nauseous.

We decide to cut our losses and head home for real coffee on the roof and some relative peace.

We have questioned many times, is it a communication problem? Are we asking anything too different from the norm here? We are the visitors (or aliens as immigration call us!)  But we have come to realise that poor service is everywhere and widely accepted.  We spent much of the first few months incredibly frustrated at scenarios like this, not because we didn’t get what we ordered but because Kenya has so much to give as a country, it has so many resources to produce incredible food, coffee!! and service.  Our view point has somewhat changed, not to one of acceptance, which seems to be the usual survival mechanism, nor anger, but a desire to demonstrate that things can work here and mediocrity need not be the norm. We find it encouraging that the poor service in so many places not only frustrates us but all our Kenyan friends.

We really hope that by modelling Jamii Bakery-Cafe as a place of excellent quality, service and courtesy, it will inspire other places around to raise their game. We have an important meeting at the end of this week regarding staffing and live in hope this is something that can be done.

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Monday’s clinic is in a corrugated iron church, full of character and life. We connect a 50 meter extension cable to the local dispensary, the nearest electricity point and commence the days work as the queues grow.

We have recently employed local guides to help us find more people. So far this seems to be working really well. We give them the list of study patients a few days in advance and incentivise them with a reward for each study patient that is brought to the clinic and completes their examination.

I hear the roar of a motorbike outside. Stew the app designer has arrived to the GPS location I sent him. He observes the phone being used to test some patients and finds a dusty corner to whip out his laptop and make some modifications. A small crowd gathers to watch this mzungo man (whiter then me!) tapping away at a laptop. Within an hour an improved version of the app is working – some great progress is being made.

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Recipe – Ginger Shortbread Biscuits

Ingredients: Makes about 20

200g unsalted butter softened

100g castor sugar

260g plain flour

40g rice flour or corn flour

½ tsp ground ginger

Pinch of salt

50g chopped crystallised ginger

Method:

  1. Beat the butter until it is very soft then beat in the sugar.  Best to use slightly softened butter that is not straight from the fridge.
  2. Add all the other ingredients and with your hand bring all the ingredients together to form a dough.
  3. Wrap the dough in cling film and place in the fridge for 30mins.
  4. Pre-heat the oven to 170°C.  Slightly flour the surface, place the dough on the surface and slightly flour the top of the dough and rolling pin then roll out to 1cm thick and use what ever shape cutters you feel like to cut out.
  5. Place on baking parchment and bake for 12 mins ish.  They should be just showing the very first signs of browning as you take them out.  I was putting Lucas to bed whilst baking these ones…always a challenging combination but resulted in slightly darker biscuits, still yummy though!
  6. Let cool on the tin(approx 15mins) until firm enough to transfer to wire racks.

The corrugated iron church was today’s examination centre, a fair number were waiting when we arived

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Inside the church we get the kit out and get going

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Pork Pies and Adjustable Eyes…

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The queue looks endless, I slide back the dark curtain that keeps us in semi-darkness away from the window. What seems like hundreds of faces peer back at me. Head down again and on with work. Our advance teams have excelled recently and records are being broken for attendance. We amazingly managed an 80% follow-up of the people seen here almost 6 years ago and along with all our study patients, many other people with eye problems (and other ailments) join the queue to be seen.

The team work really well, almost non-stop until it gets dark. Apart from a short pork-pie and chapati break there is little opportunity to stop.

Now the pork pies deserve a special mention. I am a man who appreciates a decent Melton Mowbray from time to time, but this was something else. The melt in the mouth crust with sweet, and perfectly seasoned pork was delicious. I could have eaten ten and regret having shared them with the rest of the team. They were a big hit and a completely new concept for everyone. I’m not sure anyone had had a pie before so this will have set the level of expectation on the humble pie pretty high! One for the bakery I reckon…

As we see the last of the study patients we begin helping out our amazing clinical officer by seeing some of the long-waiting crowd. A young man in a wheel chair describes familiar symptoms to me, he is short-sighted and is really starting to struggle. A quick eye exam rules out anything more serious. From our treatment box I whip out one of the 50 pairs of donated adjustable glasses and we try them on him. I wish I’d recorded a video. As the dials were turned adjusting the level of correction, his face changed in perfect harmony with the adjustment. As the optimum prescription was reached his smile broadened to a wide grin. The lenses were locked in place and we sent him home a happy man.

In start contrast, the next person in the queue was a young mother with a 2 year old boy. Although almost exactly the same age as Lucas, he was almost half his size (and Lucas is not particularly big), a smiling little man who was unable to stand or even sit. From his history and examination it appeared he had cerebral palsy and it was heartbreaking as little could be done to improve their situation. Were the same child in the UK he would have been surrounded by support services and opportunities, but not for this boy. This is the raw reality of our lives in Kenya, at times we feel so fortunate to be able to help some of the people we come across, but with equal, if not greater measure, is the pain that comes from knowing at times nothing can be done, despite the hope some have that somehow we can fix everything.

Study patients who’ve had eye drops await for their pupils to dilate so they can complete the examinations

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The queues gather outside

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Another patient benefits from adjustable specs, a crowd gathers to watch them being tried on

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Pork pies are something I have never baked before, I always feel excited about baking something when I’m learning a new process or different technique, so although I’m not a big fan of meat it was really satisfying making hot pastry, the hot dough ball is very relaxing in your finger tips ahhhh!  Oh and the left over filling made great meat balls, my two boys were very happy!

Actually I couldn’t quite complete the process as I couldn’t find any gelatine but I can save that bit of excitement for another day!

In between picking up imaginary baby rabbits cuddling them, having the baboons round for lunch (also imaginary) and chasing a little blue tractor named Lucas then backing up with my trailer so the sheep can go into the field I was updated with encouraging news of progress in the field.

One of the pieces of land our anonymous donor is in the process of purchasing was found to have problems. Unfortunately  the owner was trying to sell it twice so the paperwork didn’t match up.  However the other parcel of land so far has a consistent paperwork history with a couple of remaining checks including whether the land has been assigned as reserve, woodland or is involved with road planning, in any of these circumstances the land could be taken off you at any time so not a good purchase.  We are really hoping the next part of the process goes well as the parcel is in a fantastic location.

We went on a visit with the bakery’s architect to the one and only  (that we know!) stone oven in Nakuru, they were using eucalyptus wood, commonly known as blue gum, the most widely grown tree for fuel in Kenya. Ensuring a sustainable wood source is on the priority list, along with local and reliable providers of coffee beans, tea leaves and wheat. The research and planning continues…

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Recipe – Pork Pie

Ingredients:

Pastry:

480g all purpose flour (Its all we have here) or 200g plain flour and 40g strong white

100g unsalted butter

120g lard – (I used 120g butter as I couldn’t find lard)

200ml boiling water

1 egg beaten, to glaze

Filling:

1 large onion

300g boneless pork loin

100g unsmoked back bacon

3 eggs boiled

salt and pepper

1 chicken stock cube

(100ml boiling water and gelatine sheet)

Method

1. Pre-heat oven to 190°C.  Sieve the flours into the mixing bowl and add the cold cubed butter then rub in with your finger tips.  When a breadcrumb consistency make a well in the centre.

2. Put the lard or butter into a pan and melt, the remove from the heat.  separately dissolve the salt in the boiling water then add to the lard and stir to combine.  Pour the hot mixture into the well in the flour and using a wooden spoon gradually mix the flour into the liquid.  Continue mixing until a dough has formed.

3. Tip the dough onto a lightly floured work surface and work quickly into a ball.  The dough should be glossy and still warm.

4. Roll the dough out to 3mm thick and cut 12 circles out just to be just slightly too tall to fit a muffin tray, then cut 12 circles for the lids, work quickly or the cold dough may crack.

5. line the muffin tray with the round pieces of dough and chill along with the lids.

6. To make the filling put the pork, bacon, onion, parsley and seasoning into a blender and gently hard boil the eggs for about 6minutes.  Fill each muffin case about 1/3 full, place a 1/4 of an egg minus some white part on the meat, then cover with further filling and gently compress.

7. Brush the edge of each pastry case with the beaten egg, place the lids on and compress with a fork all the way round.  using a piping nozzle make a steam hole in each lid and brush with more beaten egg.  place in the oven for 40 minutes.

8. Remove from the oven and let cool.  Mix the stock cube with boiling water then whisk a soaked gelatine sheet into the stock.  Pour a little into each pie and place in the fridge overnight to set.

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