Archie in Africa II

I'm indulging myself a bit and writing a sequel to my earlier blog entry on recent medical work in Africa.

I've now been here for 10 weeks and have finished working at the Shree Hindu Mandal Hospital (SHMH), Dar es Salaam. The SHMH is a private hospital and in theory is very good with lots of clever gadgets, an intensive care unit (ICU) and other magic. The reality is that no one knows how to work the gadgets and the ICU is just an air-conditioned room with a working door. If you find yourself in Tanzania - and sadly probably a lot Africa - I would suggest that if you're a bit ill (e.g. malaria, manflu, hangover) you will probably be ok, but if you are actually quite poorly you will need to keep your unwell wits about you constantly. If you need surgery, just get back home any way you can. Is this a little racist? Am I being bit of a tit? Certainly not. Here's why.

I'm sure there are some great Tanzanian doctors - I don't want to condemn them all - but here is a story of the most spectacular surgical cock-up. It's more of a 'balls-up' actually:

I was on duty looking after the post-surgery patients, on this occasion a 50 yr old gent post-prostatectomy, I should add that this procedure has nothing to do with testicles (for the docs: in tanz they do an open lower abdo procedure not turp). Patient was doing well but on examination had a rather mysterious bandage over his balls. So I had a look and I found just the one testis (for the docs: men normally have two). So this was not expected. I had a thoughtful scratch of my chin - after carefully removing my gloves, of course - and looked to see if his notes could shed any light on this unusual finding, before cautiously questioning the patient... He too clearly expected his full package intact but had no idea this was not the case (!!!). So I re-examined him. Again. And again....until he was as confused as I was. I then went to see the surgeon.

This unforgivably incompetent surgeon had done the wrong operation. The poor patient was not only left with his original problem but had a crown jewel removed for fun. I don't know what will become of this but I know the surgeon is trying very hard to wash his hands of the affair and I very much doubt the unfortunate, paying patient will ever feel satisfactorily compensated. Nightmare!

So we should all be grateful for our health system in England that, at least, attempts to be just and ethically run, with fewer scalpel wielding maniacs. For anyone that has had or will have an op in England, you should be reassured by the impeccably high standards of our surgeons. They do a great job and I'm grateful for that. If I was my Uncle Paul Keeling I'd call the whole thing "marrrrrrrrvelous."

I'll be back in Blighty on Saturday. Hurrah! What an adventure it's been. While being here I've seen near-extinct rhinos in Ngorongoro Crater and witnessed lions devouring an elephant in the Serengeti. On a $10 snorkelling trip in Zanzibar (thanks for the tip Kate!) we had a snorkel and the way back intercepted some impressively leaping dolphins. Not content with watching, I promptly leapt in front of their sine-wave trajectory and had a splash with this rather intimidatingly curious and numerous pod of monsters. 38 in total. Surely there are only a few places where such fantastically wild opportunities present themselves?

Thanks for all the support and kind words over the past 10 weeks, it's been a blast but I'll be glad to be back (just in time for the World Cup), and start the long adjustment to normality.

THE END

Comment
Hey Archie, Great story and poor old chap with one ball. Yes, thank mankind (the European variety), for the wonderful world we live in.

Posted by: george | June 06, 2014 at 07:50 PM

Archie in Africa

Having just finished my medical degree, at that Keeling favourite the University of Bristol, I've taken the opportunity to stretch my legs a bit, get a tan and work abroad.

I have been doctoring in rural Malawi travelling to extremely poor, mud hut style villages. I've treated lots of malaria and other exciting tropical diseases. Since then I've come to Dar es Salaam in Tanzania, via some pretty cracking beaches, and now work in a hospital where my patients now come to me and not the other way round. With death looming everywhere, the value of life here is much lower than back home and it's been a challenge to see so many of my, often young, patients pass away. But there have been some happy endings too. And overall the experience has been a positive one.

(The medicine here is complex as it is fascinating. But probably less fascinating to the reader. I am sending a private catalogue of medical intrigue to Dr Trev and can, of course, forward this to anyone else who has interest).

On a lighter note there truly is so much to tell, in particular this extraordinary journey. I feel this 'Greek Tragedy' of mine will amuse more than any tale of daring and chivalry would. (Of which there have been loads, of course.)

Getting from Nkhata Bay to Dar es Salaam, with my pal Sam. Vast distances we're talking. So my first mistake was to step onto a tiny, Fred Flintstone-style minibus for such a titanic journey. Now in Africa they have most painfully bad habit of waiting until every inch of bus is full of paying passengers before they can leave. This time we waited 3 hours before even starting this marathon test of endurance. The bus was so crammed full that people were sticking heads and limbs out windows to avoid folding in half. African resilience is astounding. And of course this wasn't just a human bus, we were also transporting chickens and goats. Obviously pissing and shitting everywhere. And throw in a few infants, also pissing and shitting everywhere. And then the music came on. Now I actually happen to quite like African music but this is another terrible African habit: they put it on so loud that you hear nothing else. This otitis-inducing sound would not be turned down once throughout the whole dam journey.

So finally after 3 hours of fannying about the engine turns on and we leave. Marrrrvelous. Except we don't really leave as we've spent so much fuel on the speakers that after 45mins we have to turn back to town, refuel and start again.

So finally we leave.

It's no ones fault that the roads are so bad, but no one cared less than our driver who would send his stupid bus soaring to a cacophony of screams every 100 yards whenever he accelerated into the numerous giant pot-craters that lined the road. Going at 70mph+ on a 'motorway' this game of his backfired and eventually we flew majestically off of the road (into dense African jungle, no less) to an ensemble of screams and accompanying appropriately mad music. Thankfully, we landed the right way up. But the axle had snapped in half. It was the middle of the night and we were in the middle of nowhere. Now we had to contend with the possibility of being eaten by a lion and, more likely, by a thousand mozzies. However, in a quite impressive, but anxious, mere 5 hours later we were fixed and on the road again.

Next. Any chance of sleep was ruined not only by the enduring music but also by a stroppy elderly lady (plus child) who, in the mayhem, had moved next to me. Not only did she keep changing her clothes, quite explicitly, she also insisted on lying down and making a little bed on my shoulder and lap. My frustration/exhaustion/lack of linguistic skills was no match for her powerful African attitude and I could only be English: polite and annoyed.

What terrible journey wouldn't be complete with out a terrible traffic jam? On reaching Dar es Salaam, we had the biggest, African migration-style traffic jam. Motionless for hours in baking African sun. Any air-con?? Don't. Be. Silly!

We did eventually arrive of course. But our predicted 12 hour journey had become a colossal 28 hours of minibus.

So there you have it - the worst journey ever. I hope you enjoyed that story, I certainly didn't.

Seriously though as a beginner in Africa I must confess that, minibuses aside, I have genuinely fallen head over heels for the two countries I have visited. Forgive the cliche but to anyone who has never visited, it is a beautiful beautiful place in geography, culture and people. It is a marvellous alien world that is only undermined by a lack of infrastructure and leadership. But in Africa's wild unpredictability it also lends itself a truly unique opportunity for adventure. I have certainly had a few. And I haven't yet been to the Serengeti (going in 12 days).

With Dad, Polly and Fred visiting South Africa this year, Dr Trev sorting out Zambia and probably other expeditions I'm unaware of, I feel this is an exciting year for Keelo-African relations.

Amen to that!

From Africa with love

Archie.

Comments
Amazing! Hope you're having a great time, I'm very jealous! If you get the chance to go over to Zanzibar, definitely go-lovely lovely beaches and an oasis in the craziness of Africa!
Enjoy the rest of the trip! X
Posted by: Kate | May 20, 2014 at 08:18 PM

Keep having an amazing time and I look forward to news from the Serengeti. Tom
Posted by: Tom | May 13, 2014 at 08:41 AM

Great tale, keep the bush telegraph's drum beating. c
Posted by: Paul | May 12, 2014 at 02:28 PM

Not just a doctor then. Hoping Africa leaves you idle enough to write another chapter. x
Posted by: david | May 12, 2014 at 10:33 AM

fantastic!

Posted by: george | May 12, 2014 at 10:08 AM

Paddock Wood Half Marathon

Van ran the Paddock Wood Half Marathon yesterday – Sunday 30th March – and did all 13.2 miles in 2.24 – her target was 2.30 – and so was really pleased, but ... she hated the whole thing and cried at the end in pain – sadly, no one was there to see her cross the line, so we'll have to take her word about the tears. She got a wonderful medal at the end of it all which made up for the pain and distinct lack of any mother’s day card from her attentive boys.

Thanks from her and the charities all you nice sponsors helped, St Michaels Hospice and the Bodiam church St Giles. You raised £1,500! Anyone who meant to but forgot can still do so here.

http://uk.virginmoneygiving.com/VanessaKeeling

Comment
Bravo van!

Posted by: Archie | May 08, 2014 at 07:19 AM

New Year and new challenge

Slightly pathetic to only be running a HALF marathon but I am not a runner and so that is the challenge - 13.1 miles on Sunday 30th March.  it is a way to raise some much needed money for 2 charities both incredibly close to my heart.  St Michael's Hospice is the most amazing place, full of love, positivity and lots of humour.  Two thirds of their funds rely on donations and fund raising, I know first hand what an extraordinary place it is and am priveleged to spend half a day a week there.  The other charity is St Giles' Church, Bodiam - one of those beautiful old churches at the heart of the village, welcoming anyone and everyone.  I can assure you that the money will go towards the building and not the church hierarchy.

If I have asked you before to sponsor me, please ignore this as I am fully aware of the amount of 'asks' everyone gets.

http://uk.virginmoneygiving.com/VanessaKeeling

Thank you in advance -  Van xxx

What I saw in the shop today


I popped down my local Turkish supermarket today and look what I saw. The owner, Omar Ben Salaad I think he said, swore they only contained crab meat, so guess what you are getting for Christmas?

Crab meat all round
ööööööööööööööö

Comments
Quite by accident I found myself on your (and your family)Posts complete with all the archive material that was most interesting.I was born in Silvertown (London) in 1927, emigrated to New Zealand with my fiance in 1949 My beautiful talented fiance became my wife in 1952. We then emigrated to Australia where I now live on my own following the demise of my wife 8 years ago. This is one of those unusual contacts that some times happen in life . So, it's hello to you George Keeling from George Keeling.
Posted by: george.j.l.keeling | June 18, 2014 at 04:39 AM

Fantastic find!! Save on postage and just send a torn off scrap of the label with 'Karaboudjan' written on the back xP

Posted by: Paul | December 11, 2013 at 09:14 AM

did the owner tell you to make way for him because he is the most respected man in Baghar? sidi
Posted by: Tom | December 11, 2013 at 11:24 AM

Family meeting

While we were in Berlin Harry, Archie and I decided it would be fun to organise another get together for the family and this will happen on 2nd November. Harry is fixing for Hurlingham to accommodate us for lunch. The idea is that people can turn up there from about 1200 and then have lunch (details to follow but everyone will need to pay for themselves). Then we can generally mill around and enjoy ourselves. Please let Harry know if you will be attending so he can make a booking. His computer / iphone was not working properly last night, hence me sending this message. Look forward to seeing as many as poss on the 2nd. Tom
Harry: 07725 329107 harry.keeling@rolls-royce.com

Comments
Slight alteration to the plan:
The event has been shifted to the evening and will be at Dad's (Simon's) house. More details will follow, but it will start from 19:30.
Please let me know on harry.keeling@rolls-royce.com if you want to come so I can get an idea of numbers.
Harry
Posted by: Harry | October 09, 2013 at 02:36 PM

I hear that 7 of the 8 brothers are so poor that they can not afford £50 for a very good charity. So they probably won't turn up.
I can help! If they give me their bank details I will send them each a £100 out of my Nobel prize money. Email me here: higgs@higgs.boson

Hottest News Ever - We're off to the Stars

Yes. Ever. Since mankind began. It turns everything upside down, it has been mankind's dream since we first looked up at the stars.

Today I learnt three things. Two are personal and I love them both, the third, well, I do not understand why it has not been headlines worldwide. Sorry Syria, you are boring.

New Scientist reports that NASA are working on a 'warp drive'. Yep, what Captain Kirk uses to power the USS Enterprise. The research is led by Harold 'Sonny' White and he plans to start experiments very soon. It will exploit a loophole in Einstein's law of General Relativity.

So, if they are right, we will be able to

  • Travel to Mars in 5 minutes
  • Go to Alpha Centauri and come back in one year
  • Send probes to the centre of the galaxy to check out all that dark matter
  • Find a nice planet to stick all the bad guys on where they can live unhappily ever after

Spread the word!

Lucky Bad Boy Arthur B Gibbs

Or is that Arthur Godfrey Fossett Gibbs?

Altogether there were 247,061 officers in the British army in World War I; 164,255 survived.  There were probably a good deal less who survived three years. Arthur Gibbs did not shirk his duty. He could not even shelter behind his bath because some other lucky chap was carrying it.

So he was very lucky. But why was he never promoted?
And oddly he remained a lieutenant all that time (1) when officers were famously dying like flies, . (What was the life expectancy of a junior officer?) I have only found one point in his letters (p 207) where he ever sounds disgruntled. He wrote: "Perhaps it is just as well that I don’t write much on those occasions: if I did you might get permanent depression from reading what I should write, and I might be court-martialled for writing exactly what I thought about the staff and all their work."

But I reckon he told the staff what he thought of them and all their evil stupid work and the grand children of Queen Victoria, the Russian tsar, the German kaiser and the English king were evil and stupid (2). What cousins would slaughter their friends and countrymen for a ridiculous theory of attrition?

So he never got promoted. My opinion of the Gibbs branch has up-ticked enormously. They make the Keeling lot look like pussies.

Arthur Gibbs knew and did what was right, even when everybody was against him.  I followed his example all my life. I'm very proud and pleased that I have found a new hero and that he's my grandfather.

Here's the plate he somehow gave me after he died. I suppose that is something heroes can do. Cool.

Robert and Trevor have or had similar plates to these.

I will give mine to whoever of AGB's descendants does as well as him. I might have to leave one of you to be the judge.

Notes
1) Brave Lucky Boy Arthur Gibbs was temporarily promoted to Captain for four weeks, then demoted. He was quite annoyed about that. (p 393 of the letters, he was sort of promoted Aug 16 1918)

2) From 'The Better Angels of our Nature' by Steven Pinker & Wikipedia. The Flynn effect the substantial and long-sustained increase in both fluid and crystallized intelligence test scores measured in many parts of the world from roughly 1930: "If a teenager now went back to 1910, he or she would have an IQ of 130". Reversing that, the Russian tsar, the German kaiser and the English king as measured now would have IQ's of about 70. They would have to be kept in special care.

Comment
My own take is this – an educated guess and no more:
1) Survival: I am nor sure one can approach the likelihood or otherwise of survival of an individual purely on a statistical basis. There will have been plenty of lieutenants who were on active service in France who had relatively safe jobs, such as ‘embarkation officers’, lieutenants in charge of transport animals, and those in the artillery to take some examples. In Arthur’s case I believe that his job in charge of the proppers, repairing trenches night in night out, was undoubtedly dangerous – the march up to the front line was itself hazardous and being in the front line trenches in need of repair must have had its own separate hazards in addition to the normal ones of sniper and artillery fire. However, I would expect an analysis to show that his job was relatively safer than that of his colleagues who had to lead reconnaissance missions into no man’s land and also assaults ‘over the top’. If one looks at the History of the Welsh Guards by Dudley Ward one sees that most of his contemporaries in the Battalion were very severely wounded or killed in the typical manner of the slaughter – shrapnel from high explosive and whilst carrying out some form of reconnaissance or assault.

2) the lack of promotion (he would have started as 2nd Lieutenant and been promoted to full Lieutenant) I think reflects the size of the body of men under his direct command. Therefore, insofar as he continued to do the same job of commanding the proppers on their nightly visits to repair the trenches, promotion was not going to come his way. Also, presumably, there would have been an expected quota of 2nd Lts., Lts., and Captains within a Battalion. I cannot recall the circumstances of his temporary promotion to Captain, but it often happened when there was simply a shortage of survivors to occupy the relevant quota.


Posted by: Howard Palmer QC | July 29, 2013 at 01:52 PM

Immigration advice please!

Hello

Does anyone know anyone who works in immigration law or might know anything about the workings of the Canadian visa system?

I'm moving to Canada for a year in September (if all goes to plan) with my boyfriend who's got a job in Montreal and we have a couple of questions about the visa application process that we cannot seem to get answered by the internet - or by the infuriating automated Canadian embassy helpline service.

If anyone knows anyone who might know anything, we'd be really grateful for some advice.

Thanks, and love to you all

Poppy

xx

Ralph Keeling and Dad

Paul spotted this branch of the family first, in the Economist yawn and David said he had "heard of Charles David". The clan lives on!

I would have picked it up sooner if I paid more attention to my beloved New Scientist and if it came by Transporter Beam.

Atmospheric scientist Ralph Keeling explains the importance of measuring a CO2 concentration of 400 parts per million at the observatory his father set up
The Mauna Loa Observatory in Hawaii has reportedly recorded a carbon dioxide concentration there of 400 parts per million for the first time. How significant is that?
It's a psychological milestone. Every year in the last few decades, CO2concentrations have been going up by about 2 ppm per year. Those changes go unnoticed but people pay attention to round numbers. It gives you a bit of perspective on how far we've come – a bit like turning 40, or 50.
So how far have we come?
Before the industrial revolution, we started at about 280 ppm. 100 years ago, levels had risen to around 300, and they crossed 350 in the late 1980s. We think the last time concentrations were as high as 400 ppm was between 3 and 5 million years ago, when the world was much warmer.
What did Earth look like 3-5 million years ago?
It had much higher sea levels, forests extended all the way to the Arctic Ocean, and there was almost certainly a lot less sea ice. Today, sea ice is melting rapidly, and in the last decades we have seen the tree line moving north into the Arctic tundra.
Are we in a climate danger zone?
In my view, yes. At 400 ppm, we've perturbed Earth enough already that things could unfold that will be catastrophic.
We passed 400 ppm for the first time last year, above the Arctic. What is special about the Mauna Loa record?
It's the one record that has high resolution going back to the late 1950s – when my father set it up.
Why did he start tracking CO2 at Mauna Loa?
In the early 1950s, he was at the California Institute of Technology studying carbon in rivers. As part of that, he developed a way to measure CO2 in the air. He discovered that if you measured concentrations in a sufficiently remote place, you almost always got the same number. That was unexpected. Previous work suggested CO2 levels were more variable, making measurement very difficult. The realisation that there was a stable background level meant the challenge of measuring the increase might not be so great. You simply had to go to a place far enough from contamination and track it over time. The Mauna Loa measurements came later, beginning in 1958.
When did he first see a steady rise in CO2 – what is now known as the Keeling curve?
The early days at Mauna Loa were fraught. Power outages meant the measuring instrument had to be shut down for weeks. It would come back on reading a different level. He thought there should be a stable background, but concentrations were fluctuating. It was only when he'd gathered a year of data that he realised there was a seasonal cycle.
So levels may drop below 400 ppm again?
Crossing from below to above 400 will play out over years, partly because there is a natural up and down with the seasons. But this time next year it will be higher still. In a couple of years we'll never get below 400 again.
This article appeared in print under the headline "One minute with... Ralph Keeling"

Lionboy in Bristol - EXCELLENT

Three cheers and more to Poppy!! Last night Siobhan and I took Imogen and Flora with two of their friends to see Lionboy in Bristol. It was EXCELLENT and we all had a wonderful evening. The show was great fun and brilliantly produced by the Assistant Producer (Poppy). The evening was all the more fun because Poppy was able to meet us with her boyfriend Rob and after the show took us all backstage and let us walk the boards and rub shoulders with top members of the Complicite team. This was in spite of the fact that there was a press evening with all the national newspapers there. Thank you very much Poppy and keep making shows and entertaining the crowds! xxTom

Belated cricket news

Captain Paul tries to put the blame on George:
"My deepest apologies for not having provided a live feed direct from the pitch in Sedlescombe straight into to your [George's] apartment in Berlin.  I would have called of course, but what with you opting to drop off the grid in terms of telephones, I was foiled in my efforts!

As Simon said – we won.  In fact we won handsomely.  After a fine lunch provided by Mum and Dad at the the Brickwall hotel, and with a much missed sun burning high in an extraordinarily (for recent UK weather) clear sky, we won the toss and put the village into bat.  After some early stubborn resistance, the village fell apart under a sustained seam attack from our very professional and disciplined line up of attack bowlers.  They were all out for 137.  In response and after a small wobble right at the top of our order, the Keeling batting held firm and we raced past their total with the loss of only 3 wickets and with more than 15 overs to spare.  All agreed it was excellent to be able to repair to the pub early, for general merry making and celebrations."

Did anyone else see this? Has anyone heard of him before?

From the Economist May 11th:

Environmental monitoring
Four hundred parts per million

The only good news about the Earth’s record greenhouse-gas levels is that they have been well measured

CHARLES D. KEELING, mostly known as Dave, was a soft-spoken, somewhat courtly man who changed the way people and governments see the world. A slightly aimless chemistry graduate with an interest in projects that took him out into the wild, in 1956 he started to build instruments that could measure the proportion of carbon dioxide in the atmosphere, a scientific topic which, back then, was barely even a backwater. In 1958, looking for a place where the level of carbon dioxide would not be too severely influenced by local plants or industry, he installed some instruments high up on Mauna Loa, a Hawaiian volcano. He found that the level fluctuated markedly with the seasons, falling in northern summer as plants took up carbon dioxide and rising in northern winter as dead foliage rotted. And he found that the annual average was 315 parts per million (ppm).

62 years and they still love it!


Happy anniversary Mum and Dad.
Comments
Thank you George! We have had a very happy day with Trevor and family, now we are on our own again and returning to our normal routine of sleep! Lol Mum, (Dad is already in the land of Nod)

Posted by: jenifer Keeling | April 21, 2013 at 03:43 PM