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Archive for the ‘Africa’ Category

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So we’re back in the US.

What a year. I’m so grateful to have had the chance to travel to all these countries and experience so much. We saved and planned for years so that we could hike the Annapurna Circuit, ride a camel, see the Acropolis, pet a koala, and eat amazing food from all over the world. I took some really fun cooking classes in Japan and Thailand and learned a decent amount of basic Italian. Scott learned how to ride a scooter. We both learned how to cross crazy busy streets (make eye contact with the drivers, walk slowly and steadily instead of running across or stopping suddenly).

One of the best parts was meeting people and hearing their stories. We met a fascinating Nepalese man who had married a Japanese woman and had run a Nepalese restaurant in Japan before coming back to Nepal to run a Japanese restaurant with his wife. A couple of women in Barcelona drove up to us by the sidewalk and offered us a ride just because we looked lost. We shared an apartment with a friendly Italian couple who cooked us dinner. An American who spent half the year in his cabin in Maui and the other half in Nepal making a documentary gave us a ride in his SUV.

And of course it was great to meet up with friends in Paris and Naples and visit family in India, Thailand, and Korea.

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Even as we came across puzzling differences like people in some countries who didn’t really use maps (even taxi drivers, which made it hard when they didn’t already know where a place was), ultimately our travels were an affirmation of how similar we all are. We all need people to love and be loved by. Everyone likes to laugh. A smile can go a long way when you don’t speak the same language. And we all need food and shelter, except that many of us are so used to having it that we hardly ever think about it. Sometimes we used squat toilets and stayed in some questionable hostels in Nepal and India, but that was a complete joke compared to the extreme poverty that afflicts so many in those countries. Almost all Americans are more fortunate than the majority of people in the world. Yet it’s so easy to complain and envy some people while forgetting about others. It’s easy to buy a cheap shirt for $5 without thinking about why it costs $5. It’s easy to forget about the massive amounts of trash that we create when we just have it taken away instead of seeing it accumulate in the neighborhood.

I hope that this year of travel has brought a little more perspective and mindfulness to my life. Probably one of the biggest changes for me was becoming vegetarian. Kind of funny that I once claimed that I could never marry a vegetarian because I love eating meat. I’m sure there will be plenty more occasions in my life when I will eat my words. There’s a chance I could change my mind if the U.S. starts treating its farm animals a lot more humanely, but factory farming is just utterly wrong on so many levels. And at some point last year I decided that it’s wrong for me to support that kind of suffering just because I like how meat tastes.

One of the best things about the year was just having time for myself, especially precious after 3 years in residency with frequent 80-hour weeks. With more time to just sit and think and reflect, I have a better sense of who I am. I became interested in unconventional blogs like Mr. Money Mustache and Miss Minimalist. I usually read mostly fiction, but I found myself devouring nonfiction last year. Some of my most eye-opening favorites were:

Daniel Kahneman’s Thinking, Fast and Slow

Steven Pinker’s The Better Angels of Our Nature: Why Violence Has Declined

Jonathan Haidt’s The Righteous Mind: Why Good People Are Divided by Politics and Religion

I also really enjoyed Joshua Foer’s Moonwalking with Einstein: The Art and Science of Remembering Everything, Jon Krakauer’s Into Thin Air: A Personal Account of the Mt. Everest Disaster, and Charles Duhigg’s The Power of Habit: Why We Do What We Do in Life and Business.

You’ll notice a lot of social psychology in there, which my husband happens to have gotten a Ph.D. in, but he didn’t seem that interested in reading or discussing them with me. If you read any of these, though, I’m happy to discuss them with you!

Anyway, I’m glad to report that we have come back safe (no need to worry, Uncle Ty), and I figure it’s a good sign that our marriage survived being together constantly for an entire year. The only regret I have is that we weren’t more social and didn’t book more accommodation that would have given us more interaction with other people.

After all the moving around, I’m looking forward to settling down in one place for a while and putting down some roots. It’s been strange to come back and experience sticker shock in the US, though – we’re wondering what happened to the 1 euro baguettes and 1 euro cappuccinos we saw in Europe, and we swear that US grocery store prices are way higher than we remembered. We’re still figuring out what happens next as we find jobs and hopefully start earning money instead of just spending it, but I think we’ll eventually travel again at some point, just a little more slowly. It’s funny how even after a year of travel, there are still so many places we want to see, like South Africa, Patagonia, Jordan, Greek islands, Sicily, the UK, and huge countries we’ve never been to (China, Russia, and Brazil).

As for this blog, this is my 105th post, and probably my last, although it’s possible I will revive the blog to post about other trips in the future. If you’ve been coming to this blog from http://www.scottandnina.com, that domain name will be discontinued by the summer – the permanent link to this blog is https://purplmarsh.wordpress.com. I wish everyone a wonderful new year as we finish this chapter and start the next one.

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RTW Trip Summary

Length: 348 days

Continents: Europe, Asia, Australia, and Africa (if you count Egypt)

Number of countries: 25 (28 with Vatican City, Monaco, and San Marino)

Favorite country: Italy

Favorite mode of transport: a scooter in Vietnam and Indonesia

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Favorite food:

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Italy

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Thailand

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India

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France

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Indonesia

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Japan (dishes above from my cooking class)

Best drinks: coffee in Italy and Vietnam, cardamom/masala chai in India, beer in Czech, wine in Australia

Best hike: 12 days on the Annapurna Circuit in Nepal

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Thorong La Pass at 17,769 feet

Worst hike: Mt. Ngauruhoe in New Zealand, aka Mt. Doom from the Lord of the Rings movies

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Really steep, and we stupidly started going up the scree (1 step forward, 2 steps back) instead of along the ridge. Plus we lost each other at the end.

Favorite animal encounters:

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Australia – You won’t find animals like kangaroos, duck-billed platypuses, and echidnas anywhere else in the world. Scott’s favorite Australian animal is the wombat on the left (or else his koala neighbor); mine is the Tasmanian devil on the right.

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Riding camels in India

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Hanging out with penguins in New Zealand

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Caring for elephants in Thailand

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Monkeys galore in Nepal, India, and Indonesia

Most impressive structures:

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Taj Mahal

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Temples in Bagan

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The Parthenon in Athens

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Pyramids of Giza

Favorite museum: Te Papa Tongarewa in New Zealand

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I think the British Museum could have beaten Te Papa if we had had longer to spend there, and the Louvre was a close runner-up.

Prettiest cities:

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Kyoto

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Venice

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Ghent

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Paris

Number of times robbed: 0

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…unless you count the cookie monster in India

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Whoa, We Saw the Pyramids

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Scott and the Sphinx

From Istanbul, we had toyed with visiting other parts of Turkey like Cappadocia, but since it was mid-November we instead decided to buy tickets at the last minute to warmer Egypt. We spent four days in Cairo gawking at the Pyramids of Giza and stuffing ourselves with cheap, delicious food.

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It was pretty darn cool to see the only one of the Seven Wonders of the Ancient World still remaining. It’s crazy that the Egyptians built these pyramids over 4000 years ago. Or maybe it really was the aliens…

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In front of the Pyramid of Khafre

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Passageways lined by steep ladders led deep underground to the tombs where mummies and treasure used to lie. And I got to say, “I’m in a pyramid!” (We have a weird running joke where I say, “I’m in a fort!” when in a fort)

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We also took a picture of touching the Pyramid of Khufu in the same way that we saw dozens of people do at the Taj Mahal. We told ourselves that we did it ironically, but I think we’re just dorky and found it funny.

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Picture of the street from our hostel window

Scott loved being in Egypt. It had been a long time since we had been in a developing country, and it reminded us a lot of India. Scott enjoyed the vibrancy of life in Egypt, but I quickly grew tired of Cairo’s crowds, traffic, incessant honking past midnight, blow-your-nose-and-it’s-black pollution, and shysters who kept trying to wring Egyptian pounds out of us. I think what Scott especially loved with all his cheapskate frugal heart were the amazing food prices, some of which were on the same level with India (i.e. even cheaper than southeast Asia). The picture above shows the chain restaurant Gad across the street from our hostel, which we must have gone to at least five times.

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There we got falafel sandwiches (pita bread filled with falafel, veggies, and tahini) and fuul sandwiches (with mashed fava beans similar to how Mexicans prepare refried beans) for 1.25 Egyptian pounds each. Considering 1 dollar is worth a little over 6 Egyptian pounds, that meant each sandwich cost 20 cents. And this was at a pretty nice restaurant, so I imagine it’d be even cheaper as street food. Our first night in Cairo, Scott ordered three sandwiches there after already having eaten dinner on the plane, and I tried to stop him from buying so many, but he said he had to order three because they totaled 60 cents, and he just couldn’t pass that up. To his credit, he did manage to finish them, although he was pretty stuffed afterward.

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The fresh pita bread was delicious. We constantly saw people on bicycles carrying large trays of pitas on their heads from the ovens where they had just been baked to the street stands where they would be sold.

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We stuck our heads into one shop where they were churning out fresh, hot pitas hoping to buy a couple. One guy immediately decided to give us a tour around the shop and showed us every step of how they were made. He had pretty decent English, but he used the phrase, “My name is,” to mean “The name of this is,” and so he pointed out different objects in the shop as “My name is oven,” and looked at me and asked Scott, “My name is wife?”

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We were given some tea, too. Afterwards, we were offered pitas at 2 Egyptian pounds per pita, which we knew was at least ten times the normal price (Scott had bought 4 or 5 pitas for 1 pound at a stand the day before), but when a massive overcharge is still 30 cents a pita, we were happy to buy a couple and give the guy a little extra for showing us around.

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Another popular Egyptian dish that we liked was kushari, which is macaroni, rice, lentils, and chickpeas topped with tomato sauce and fried onions with a splash of something spicy. Not terribly exciting, but hearty and filling and a nice vegetarian option – look for big metal vats to find where it’s sold.

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We also loved the mango ice cream from a dessert shop across the street from our hostel. It was chock full of real mango and wonderfully creamy. I have to say that it even rivaled Italian gelato, except that two scoops of this stuff in Egypt cost less than a dollar.

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In addition to food, the huge bazaars sold everything you could possibly want to buy, but I found it a little scary to navigate through the crowds. A lot of people tried to pass through the narrow lanes carrying large loads on their backs or carts, and the way they announced their presence was to hiss like a snake from behind. If I didn’t hear it in time, I could get knocked around by a bunch of bulging blankets.

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But hey, at least I didn’t get run over by a truck full of blankets. Egypt was an exciting way to spend the last week of our trip before we went back to the comforts of home. Since we had such limited time in Cairo, we didn’t have a chance to visit its huge Egyptian Museum, but at least we had an overnight layover in London before going home, and we got to spend a whirlwind hour in the British Museum, which has a completely ridiculous Egyptian collection. Not only did they have a crazy number of mummies and giant Egyptian heads and sculptures, they also had the Rosetta Stone. And seeing the Parthenon sculptures there was pretty neat after visiting Athens. After way too short of a time in London, Scott flew to Grand Rapids to be with his family while I flew to LA to be with mine. I’ll write more soon on what it was like to go on a trip like this and how it feels to be back home.

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Reflections on Tanzania

I’ve talked about the fun, cool things I did in Tanzania, but I’ve barely touched on the month that I spent there working in a tertiary care hospital. I thought about tweaking and posting the 3-page reflection piece that I wrote in order to receive the second half of my travel grant, but I wasn’t sure whether some of the things I had written would be appropriate to post, so you’ll get the abbreviated, PC version here.

It was one of the hardest, valuable, and intense things I’ve ever done. I’m really glad I did it, but I’m still processing and figuring out what to do with all I experienced. I expected to see saddening things like congenital heart disease that could have been repaired in the U.S. but not in Tanzania, but what I didn’t expect were children dying of dehydration in a tertiary care hospital with plenty of IVF. I had done plenty of international medical electives before, but they had all been in the outpatient setting, and this was completely different. I don’t think I really grasped before how difficult it can be to improve medical care in a developing country. I think I vaguely figured that if they had more money it would be better. But there was so much more than that. Their system of medical education, the different cultural beliefs among doctors and patients, the relationship between doctors and patients, infrastructure, capability to fix broken machines or order more reagent in a timely fashion, access to health care, socioeconomic status, resources concrete and abstract. Someone had donated a CT scanner to them, but it had been broken for months, and they lacked the resources to fix it. I’m interested in incorporating international medicine into my career an as yet undefined way, but this was overwhelming. I saw physicians who had worked there for years and made some great changes, but still had so far to go. I didn’t see any easy fixes. Who am I to judge, anyway, since our current healthcare system in the U.S. is pretty messed up, too? We spend much more money on healthcare than other developed countries, yet our outcomes are often worse. I came away with lots of questions but not many answers.

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Unhappy feet

First, a little background. One of the reasons I didn’t go into internal medicine was that old people’s feet gross me out. I didn’t want to deal with the yellow toenails and musty smell of ordinary old-people feet, let alone the deep ulcers that diabetics can get. Yes, babies poop and vomit, but babies also have a fresh baby smell, and their hands and feet are really cute.

I’ve also been lucky enough to be generally pretty healthy and have never needed to go to the ED, never sprained let alone broke anything. But lately my feet have been acting up. It all started in November 2009 when I got my right foot trapped between two rocks while trying to cross a beach with giant waves in Hawaii (also the same day I got engaged and Scott ended up with a huge scar on his arm from trying to help me, but I digress). It got scraped up, and despite my best efforts at keeping it clean while camping, it got infected. Cellulitis, to use the medical term, that required a week and a half of antibiotics. Ok, fine, I now have a faint scar on the top of my foot, no biggie. Except a year later, while in Peru, I got some bug bites on my right ankle and leg that developed into giant blisters that wept yellow fluid and my right foot got really swollen, presumably from the fluid that hadn’t been able to drain out of the blisters. I think my feet don’t really like tropical environments.

Cut to Tanzania, when after the quick descent from the top of Mt. Kilimanjaro, I end up with a few “black toes,” which is apparently pretty common after hiking Mt. Kilimanjaro. Subungual hematomas, to be more precise, essentially a bruise where the blood collects underneath the nail. Normally not a big deal, but if it does get big enough, it can cause some pressure to build up underneath the nail and can get rather painful. To relieve the pressure and pain, you can poke a hole in the nail to let the blood drain out. The subungual hematoma underneath my right big toe wasn’t that big, but after a couple days, started to become really swollen and painful. Finally, Anna persuaded me that she should trephinate (poke a hole) in it while we were hanging out at the open-air bar in Hotel Tilapia, a beautiful upscale hotel in Mwanza. We went to her room and she grabbed a lighter and paper clip. She heated up one end of the paper clip with the lighter and then placed it on the center of my toenail, but even after about 20 attempts and a visible depression in the nail, she still hadn’t made it all the way through the nail. We then discovered that it’s better to heat the paper clip by holding it near the top of the flame instead of the bottom, and after a couple attempts with this technique, she was through! It didn’t hurt, but when I felt the paper clip go through, I instinctively yelped and jerked my foot up, then sheepishly told the startled Anna that I was fine, just surprised. What was also surprising is that most of the fluid that came out (about a tablespoon’s worth, which doesn’t sound like a lot, except imagine it building up underneath one toenail) was not really as bloody as I had expected it to be, but more yellow or serosanguinous. It also drained quite a bit of fluid in the next few days as I walked around the hospital in Mwanza in flip-flops and a Snoopy bandage covering the gauze dressing. I’ve decided that after my right foot cellulitis, the lymphatic drainage in my foot is all messed up so that every time I get any sort of injury to that foot, I build up a bunch of lymph fluid that can’t drain properly except through blisters and holes in my nails. I’m only in my 20s, too, so imagine the foot problems I’ll have 40 years from now. That’s what I get for being so anti-feet.

Apparently my toenails also grow really slowly. I expected a couple of them to fall off by now (they’re dead once a subungual hematoma is big enough, and new toenails should grow in their place), but they’re still hanging out on my toes despite the sides being detached. So I’ll probably be missing some toenails during my wedding this summer. I don’t know if that’s going to stop me from wearing flip-flops underneath my wedding dress, though.

Look, you can see the hole in my big right toe!

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Karl, Anna, and I went on safari to the Serengeti and Ngorongoro crater for 3 days and 2 nights, and it was awesome, just packed with cool animals, some of whom we got to see right next to the car or crossing the road in front of us. One of the best things about it was that there were tons of baby animals, and somehow the baby version of ugly animals just became even more adorable (ahem, baby warthog).

Baboons with baby
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Giraffes
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Leopard with her cub
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Birds grazing on hippo grazing
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Zebras with babies
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Anna and Karl with mongooses in the road
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Pregnant hyena with wildebeest in the background
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A lot of wildebeest
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Cheetah having a drink by the side of the road
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Water buffalo looking grumpy
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Zebras cuddling
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Rhino
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Warthogs with baby
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Elephants with babies
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Movie of lions eating a zebra



Our guide was kind of clueless but funny. Every time we’d see an animal for the first time, he’d stop and recite stiffly, “Lion. Lifespan: 15 years. Weight, male: 200 kg. Weight, female: 150 kg. Gestation: 4 months,” as if he’d memorized a chart with that information and couldn’t possibly add any verbs or turn it into a discussion or tell us anything other than lifespan, weight, and gestation. He managed driving the uneven roads and talking into one or more of the 3(!) cell phones he carried or the radio that the drivers in the park used to communicate with each other at the same time with aplomb, but as soon as we tried to ask him a question, he got flustered and would have to stop the car, have us repeat it a few times, and then usually give us a good answer in pretty good English once he understood what we were asking.

Being in the Serengeti and Ngorongoro crater was amazing, but I would not recommend the safari company that we used. It was managed by a foreign businessman who provided the worst customer service. He neglected to tell us that lunch on the first day was not included and so we’d have to pack our own, despite us starting at 9 a.m. Even though he had told us the previous day that “all meals were included,” he absolutely refused to budge on providing it for us, despite it being a couple bucks and us already having forked over way too many hundreds of dollars per person. We camped both nights, and they provided sleeping materials that smelled like cat urine. Seriously gross. When we called him about it, his only response was that the sleeping bags were washed after every trip. Thanks, but either clearly not true, or some creature decided to urinate on the bags after you washed them or on the sleeping pads that were never washed. We talked about moving to a nice lodge for the second night, but he wanted $270 extra for the privilege, and we could not stomach the thought of giving this guy any more money. So the second night we used the same camping stuff, except our flustered guide found a half-full small container of strawberry spray in the Jeep that looked like it’d been sitting there for 2 years, sprayed it on the sleeping bags, and it actually helped a decent amount. Now it smelled like the cat who had peed on our stuff had drunk very sweet strawberry juice beforehand? And besides, the campsite the second night was absolutely gorgeous overlooking the Ngorongoro Crater.

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So there were some bumps in the road (causing two flat tires, too, but fortunately we had two spares on the back of the Jeep) and going on safari is really expensive ($200 per person for park fees alone), but man, seeing those animals up close like that was unbelievable.

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A Really Big Mountain

Unfortunately, we didn’t stay in Zanzibar as long as I would have liked because we were off for Kilimanjaro the next day. Anna had convinced me that it would be a good idea to hike up Mt. Kilimanjaro, Africa’s highest peak at 5895 meters . We did the 6 day Marangu route, and for the three of us they provided a guide, two assistant guides, three porters (one of whom also served as our “waiter” during meals), and a cook, since we were too wussy to carry much of anything besides water ourselves.

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Every night, we slept in huts that were surprisingly nice. Simple but functional with a Norwegian aesthetic, furnished with mattress pads and pillows, solar panels sometimes provided electricity at night, and flush toilets were provided at most of the campsites. They plied us with hot beverages constantly because they wanted us to stay well hydrated, and the meals were decent, usually involving several courses and certainly much fancier than anything I’d make camping by myself.

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The first part of the hike was beautiful. We walked through lush rainforest, stopping to say hello to a group of blue monkeys eating dinner, and then wound through alpine meadows onto grassland.

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The third day was a rest day at Horombo Hut (3720 m), when we did a short hike to Zebra Rock, relaxed, and enjoyed the scenery.

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The fourth day was when the landscape started to look more barren and alien and when we started to really started to feel the altitude. Before this, we had noticed that we got out of breath more quickly, but by the time we arrived at Kibo Hut (4703 m), even bending over to tie a shoe or turning over in bed caused us to hyperventilate. Unlike the previous pretty wooden huts, Kibo hut was a cold concrete block surrounded by rocks, dirt, and scree. I had a headache and very little appetite, but we tried to eat dinner and go to bed early before waking up at 11:00 p.m. to start the final ascent. Unfortunately, I wasn’t able to sleep at all, but I dragged myself out of bed to put on two pairs of socks, three bottom layers (long underwear, warm pants, and Goretex pants) plus gaiters for the scree, and four layers on top (Merino wool, fleece, Gore-tex jacket and a down parka), along with ski mask, hat, scarf, and gloves.

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We started hiking at midnight in the dark, headlamps lighting the way. On the previous days, there had only been one or two guides hiking with us, but tonight, all three went up with us. It wasn’t pretty anymore. Even in the daytime, all you could see was a very steep slope of dirt and rocks. The guides advised us just to look at the feet of the person in front of us and focus on following each step. I had planned to eat frequent snacks while hiking, but I hadn’t anticipated that chewing would make me so out of breath, nor how the nausea would come and go in waves. It wasn’t long before the guide offered to take my backpack and I eagerly accepted. Even gulping down water meant that I would have to breathe quickly afterwards to make up for it. It was cold and dark and exhausting. I alternated between slow, deep breaths and shallow, quick breaths, uncertain which was providing me with more oxygen since both techniques left me feeling oxygen-deprived. About two hours in, Anna decided to stop and turn back. She just wasn’t enjoying it and didn’t like the feeling of not being able to breathe. A guide escorted her back. Karl and I trudged along, stopping frequently to catch our breath. At about 5 a.m. I hit a wall. Absolutely no energy. The little bit of water in my canteen had frozen so I poured in more from the insulated water bottle in my backpack. One of the guides stayed with me while the other guide continued with Karl (who ended up making it all the way to the top). I had thought it difficult before, but now I could only take a few steps before I had to sit down. What should have been a half hour more became two hours as my guide dragged me along. The last part was even steeper over boulders, but finally I stumbled onto Gilman’s Point.

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People around me smiled and high-fived elatedly, but I just sat, unable to move or speak. After about 15 minutes, I was able to take out some food and water to force myself to eat. Another 15 minutes and I was able to snap a picture or two and get one off-centered and blurry picture of me by the sign marking Gilman’s Point. The guide suggested we go on to Uhuru peak, a 2 km walk to the other side of the crater rim, 200 m higher and the true high point of the mountain, but I absolutely refused. I could barely put one foot in front of the other. We instead made the long descent down, sliding down the scree now that it wasn’t frozen as it had been on the way up in the middle of the night. We made it down the rest of the mountain in about a day and a half, eagerly looking forward to the hot shower and cold beer we enjoyed as soon as we made it back to our hotel.

So was it worth it? It’s not something I would have done had I not already been planning to go to Tanzania for work, and I don’t think it’s something I would have initially suggested as part of our itinerary. I don’t really feel the need to make it to the highest point in Africa just for bragging rights (and I have no regrets about not making it all the way to Uhuru Peak). Anna was interested, and since I do like hiking and probably wouldn’t return to Tanzania, I went along. It’s definitely quite expensive (park fees alone were $635 for the 6 days), a lot more than some other cool hikes like the Inca Trail and the Annapurna Circuit in Nepal. On that last ascent in the middle of the night, instead of a burning desire to get to the top, I mostly felt a masochistic curiosity…how far could I push my body? I also felt an extreme awareness of my body and breathing that was strangely meditative despite the misery. For hours, all I could focus on was stepping forward and breathing, without room for anything else in my mind. I can’t remember another time in my life when I’ve been able to clear my mind like that on my own, despite halfhearted attempts at reading about and practicing meditation. And the rest of the hike was certainly beautiful, and I enjoyed hanging out with Anna and Karl. Overall, I’m glad I did it, but it’s not something I’d wholeheartedly recommend to someone else.

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