CHAPTER 10 AMREF Flying Doctors, Kenya (1963- 1967)
Michael Wood, while running a surgical practice in Nairobi often flew to help doctors at small peripheral mission hospitals. This vision to help “peripheralization” (my label) of health services became the organization AMREF. (African Medical Research Foundation) and its better known title FDS (Flying Doctor Services or “Flying Docs”). Mike procured a Mobile Medical Unit as a ground vehicle for getting health services farther out into rural areas. When my tour with the Tanzania Health Service was finished (mid-63) we spent leave time in US. The most important event of that time was a Lane Family Reunion in US. Back in Nairobi I became director of AMREF’s “Mobile Medical Services”. The purpose was to provide basic clinical care to populations who lived “beyond the dispensary”. In Nairobi Betty and I built a family-size home later known as the “Chalet” for its resemblance to Betty’s childhood home in Switzerland. Our kids attended Nairobi schools. For secondary schooling the boys were at Prince of Wales School and Carolyn attended Kenya High School otherwise known as the “Boma” (for its circular layout (like a Maasai kraal). Dan spent the last two years at RVA. One of the most important single events of this era was the celebration of Kenya’s achievement of “Uhuru” and the inauguration of Jomo Kenyatta as President in 1963. In 1966 for family reasons I left AMREF’s extensive safari life and went into private practice in Nairobi for two years 66-67.
- Lane Family Reunion in US
- The Chalet in Nairobi
- Work with AMREF Flying Doctors
- Kids’ schooling
- Nairobi Baptist Church
- Mann Research
- Private Practice
- Lane Family Reunion at Grand Hotel in Alabama 1963.
This was a major gathering of Mortimer and Mary Lane and their seven offspring with spouses and all their grandchildren (35 of the latter). It was held at the Grand Hotel at Point Clear, Alabama. Fifty years later in 2013 the reunion was repeated at the same venue. This time the numbers had grown greatly, though Morty and Mary were gone. Our son Dan was involved in that second event, especially researching and explaining the Lane family genealogy. The first Lane had arrived in Massachusetts from England about 1638.
2. The Chalet in Nairobi
In May ’63 when we knew were soon to move to Nairobi we began to look for a permanent home there. This was six months before independence, so there was a great deal of political and financial uncertainty. Capital investment was considered a gamble. Nevertheless, we were inclined to trust Jomo Kenyatta (the obvious kingpin) for democratic leadership in the inevitable independence. We bought a parcel of land in a higher part of Nairobi, hired Richard Hughes a British architect and put out bids for the house he/we designed. At that time there was little construction going on. To our surprise the winning bid for construction came from a small British firm, named Lang. Asian owned firms were usually more competitive. I wondered if Lang Co. had cut their profit to a minimum just to keep their skilled crew intact pending better times. They, Lang, went on to become one of the largest construction firms in the country. Our house site was on a hillside overlooking a valley which had been the site of Kenya’s original coffee plantation. In the near distance was downtown Nairobi and in the far distance, on a clear day one could see the snows of Kilimanjaro. My middle childhood home Lasit, had been on the foothills below those snows. Our Nairobi home later came to be known as the “Chalet” its roof line and balcony was designed in the style of Betty’s childhood chalet home in Switzerland (Chalet Gumfluh). This new home was spacious enough to enable us to enjoy hosting a variety of missionaries and development workers in from their far-flung projects. We often hosted small groups from Nairobi Baptist Church and AMREF.
We had a lot of input into the design of our new home. Betty had spent a decade of her youth in a large, traditional chalet at Chateaux d’Oex (see Chapter 2) in the mountains of Switzerland. I was born and educated at Kijabe on a 7,000’ shelf on the eastern wall of the Great Rift Valley. So “outlook” was an important factor in our choice of plot and of house design. The plot was on a fairly steep slope, so the view was unobstructed by any housing below us. We overlooked the city of Nairobi and beyond that the plains of Masailand and beyond that the snows of Kilimanjaro. We enjoyed a cumulative fifteen years in that house. It lent itself to a large family, and also in later years to a variety of friends involved in the development world.
- UHURU Kenya
While we had much involvement in UHURU (independence) celebrations in Tanzania (at rural Monduli), we were just spectators in Kenya’s UHURU celebrations in 1963. But the pageantry was there in full force. My impression was that the African public mood was benign and positive, not negative as in “GO HOME Brit!!” Much of course depended upon Jomo Kenyatta’s persona.
- Work with AMREF
Sir Michael Wood and AMREF
Michael Wood started his career in Kenya as a surgeon. After a few years he returned to UK to specialize in plastic surgery. His mentor was Sir Archibald Macindoe, the “father” of modern plastic surgery. Macindoe’s rise to fame and his eventual knighthood arose from his work with RAF Spitfire fighter pilots who had been severely burned in fiery aerial combat with Nazi Messerschmidts in the “Battle for Britain”. Mike, after completing his training under Macindoe. returned to Kenya to resume his surgical practice. He took up flying and began to do voluntary stints at remote mission hospitals. This avocation eventually became AMREF the “African Medical and Research Foundation” (or colloquially “Flying Docs”). This, I believe was the basis for his knighthood. Partner founders of AMREF were Sir Archie Macindoe and an American plastic surgeon Tom Rees. During my internship at Albany Med. Mike (Wood) came to visit a plastic surgeon there, Dr Macomber. The two had met in Kenya when Macomber was there hunting. Out of this visit came an offer for me to join AMREF. Mike’s wife Elizabeth Wood was born in a remote part of Congo. She was a granddaughter of the renowned cricket star-turned-missionary C.T. Studd. She has written a beautiful memoir titled “A Fly in Amber”. Mike wrote an account of AMREF titled “Go an extra Mile” and a philosophical book titled “Different Drums”.
A good friend of Mike’s and of AMREF was Imre Loefler a surgeon in private practice in Nairobi. In addition to his skill with the scalpel, he was also skilled with the pen. He was a very good writer and illustrated his surgical papers with lucid drawings. He was an expert and enthusiastic pilot and devoted much time to flying out to small mission hospitals to provide his surgical expertise. He attended me once surgically.
But before I joined AMREF full time I was seconded i.e. loaned to serve the Tanganyika (then) colonial medical service as District Medical Officer, Maasai District. I may have been the only US citizen in the British Tz. colonial service. This era is covered in Chapter 9.
AMREF’S Mobile Unit
Mike Wood was a visionary in many ways. He had a heart for the missionary doctor who was often fresh out of medical school, faced with surgical problems far beyond his training or experience. Mike set up a rota of 2-3-day fly-in visitations to small remote mission hospitals, bringing skilled surgeons to provide such doctors with intense training and moral support. Mike wanted also to extend the reach of modern general medicine to more remote areas. With the generous financial support of western donors he created the Mobile Unit. It was designed in US, so was relatively over-sophisticated. But it did get the ball rolling. The unit contained a then-novel Picker Polaroid x-ray/xerograhy machine for simple studies.
While I was District Medical Officer at Monduli the actual mobile unit (a large van on a truck body (see above photo) was based at my home. During that time, the van was of great help in the Mann Cardiac Research. It was also the traveling base for our (AMREF) MCH studies of Gogo children. This study was in collaboration with Dr Joe Taylor, Director of Mvumi Mission Hospital. Joe was a multi-task genius who initiated numerous medical developments in a variety of fields, a notable one being “Sight by Wings”. Dr Taylor’s connection with AMREF, Nairobi was facilitated by a radio network. One day, at Mvumi I was high in a baobab tree mounting a 20′ pipe to hold the outer end of an antenna. A visiting American medical student was helping me. He was a real New Yorker, who had grown up in an affluent neighborhood called Sutton Place South, near the UN. I called down asking him to bring up a tool. He was slow in getting up the tree. He finally exclaimed “Roy, this is the first time in my life I have ever actually climbed a tree!”. In later years he became very adept at climbing the tree of success in the medical profession.
My work with AMREF sometimes took me to Uganda conducting various training activities. This was during the dictatorship of Idi Amin, so things were often uncertain.There were many road-blocks, manned by an uncertain variety of people in uniform. One day I was running a TOT course in the east side of Kampala. I left the course for an errand to Makerere Medical School on the other side of town. On the way back I was stopped at a road block. A big, sinister-looking soldier leaned in the window and said “Hello Roy”. My first, panicky thought was that I was on some hit-list, not uncommon then. Then I realized that he was just reading my TOT course name-tag.
We held several TOT sessions at Kagando Hospital in far western Uganda. The Medical Director was Rob Morris MD, son of long-term friends Philip and Mollie Morris. Philip had been one of the “big guys” at RVA when I first started there in the ’30s. He was an opthalmology specialist and one of the founders of the organization Sight-By-Wings.
On the eastern side of Uganda we were spectators to the warfare between fierce tribesmen and the government. The tribesmen did not like the government interfering with their very traditional cattle raiding.
- Kids’ schooling and family life
Prince of Wales School
In advance of our move to Nairobi, Dan switched from S. Michaels and St. Georges (in Iringa) to the very British Prince of Wales School in Nairobi. The school was starting to become multi-ethnic about that time. Dan was later joined there by brother David. The two of them were among the very few “Yanks” there. They did not appreciate the strict “British Public School” regime (as oft caricatured in movies). But both managed to take away from there some valuable lessons and good memories. With American higher education in mind Dan spent two years at the US-oriented Rift Valley Academy. There he played rugby against his former team mates at Prince of Wales.
Westlands Primary School.
David, Carolyn and Marilyn attended here. It was very mixed racially. The curriculum was typically British. While there the kids were involved in school plays. In addition they had kid parts in a major city production of “Oz”. Meanwhile Betsy and Gini were at nearby Westlake Kindergarten. That area is now a major commercial complex known as Westlands. In 2013 The Somali Islamic terrorist organization al-Shabaab staged a massacre/raid on a supermarket there.
For two years I was in private practice, partnering with Dr Ian Batey, a Brit. The Bateys were very much into horses, so while Ian and I practiced medicine our families often wove adventures together with horses. Marilyn had always been very keen on horses, so this was a boon for her. Marilyn’s daughter, Arlene has followed in her footsteps. She earned a BS in Equestrian Studies and a Certificate in Equine Massage and then ran a stable “LaCasarena” in Arusha, Tanzania. Currently 2017 she has just successfully completed training as a Vet. Tech in South Africa.
Watamu on the Coast
While living in Nairobi we occasionally took vacation time at the coast on the Indian Ocean. A favourite place was Watamu, near Malindi. The snorkeling over the reef was splendiferous. The Gedi ruins bespeak a long-ago Arab dominance of the area. Nowadays, the entire coastline with its beautiful beaches has become jammed with all sorts of tourist attractions, some of dubious merit. There has also been some offshore oil exploration, though no “finds” have yet been reported.
- Nairobi Baptist Church (NBC)
Nairobi Baptist Church
We attended this church because it was evangelical and very diverse in make-up. It was Baptist in origin, but completely independent of the “denomination”. The Pastor when we first came was Tom Houston with his wife Hazel. Tom was a very dynamic thinker and preacher. He was good at “applied theology”. He set the tone, followed by his successor pastors of conservative evangelical theology matched with candor in applying Christian principles to civic affairs. Tom attracted a significant following of University people, both tutors and students. Among the former were the Sales the Etheringtons and the Thairus. Tom was also a friend of John Stott (a prominent British theologian) who often visited Kenya. In 1970s Tom Houston moved to California as International Director of World Vision. He is now retired in Oxford but maintains a thoughtful, timely ministry through his newsletter “Fly on the Wall”. One of the pastors who followed Tom at NBC was Mutava Musyimi, a Kenyan. He followed Tom’s example of candor in his preaching. This put him in political disfavor with the Moi regime and for a short time he went into “hiding”. He went on to head the Christian Council of Kenya and then joined Parliament. He is said to have had considerable influence in the drafting of a new constitution for Kenya. This is a difficult task, with a parliament having such kleptocratic tendencies.
- Mann Research 1963-67
I facilitated research by Prof. George Mann of Vanderbilt Univ. Med. He was trying to document the lack of cardiovascular disease in this milk and meat-eating, carbohydrate-shunning people. Mann was able to document the relative absence of cardiovascular disease among the Maasai. But the limited study did not reveal any cause-effect relationships. Our research site was deep in the bush of the southern part of Maasai District in Tanzania. Our campsite overlooked a dam which attracted a variety of wildlife, including elephant in families. When they stood in the water drinking they created waves across the surface which lapped at our campsite.
In 1967 before leaving for US I helped George Mann with another research exercise in Masailand. This was in Loliondo, Tz. a rather remote area in the north of the district. Part of the study involved telemetry technology, then in its infancy. We put transmitters on some men and hoped to record their geographical peregrinations. But, unfortunately the electronics failed us. But, mechanical pedometers on the men’s ankles showed that their “just hanging around the area”, for some individuals, clocked up to 20-mile totals in just 24 hours. Each man’s reward for cooperation was a fine whetstone for sharpening his sword (panga). We also studied cholesterol levels in pregnant women. Their reward for cooperation was a nice half gallon aluminum milk bucket. Our Loliondo hosts during this exercise were Dave and Eunice Simonson. We also were on long-time good terms with the Catholic mission folks there.
- Private Practice
In 1965 I left AMREF to join Dr Ian Batey in private practice in Nairobi. This was quite a change. Many of my patients were embassy or big-business types. The emphasis switched from diseases of poverty to diseases of affluence. I did take time out occasionally to participate in AMREF activities. One was a flight to Lake Turkana, with Frau Semmler to secure the body of the manager of the Lodge. He had been murdered by Somali Shiftas. Another trip was to facilitate Prof. Mann’s research in the Loliondo area. And another trip was to help in a study of the ElMolo tribe on Lake Turkana.
Another unusual diversion was to another part of the “NFD” (Northern Frontier District). There was a “water well war’ with Somali “Shifta” (bandits) around Loyengelani on the east side of Lake Rudolph (later Named Turkana). The Goanese manager of the Lodge, Guy Poole had been shot dead at the lodge and the Italian driver of the supply lorry was shot dead a few miles south. I flew up in the AMREF plane with Frau Leonora Semmler, a prominent supporter of AMREF. There was little to do other than collect the manager’s body for return to Nairobi for forensic study. The “Shifta problem” remains to this day. The Shifta are ethnic Somalis who consider the northeastern half of Kenya territory as belonging to Somalia. They reject the boundaries imposed by Western powers. They overlap somewhat in outlook with the “Shabab” jihadis who have carried out several mass atrocities in Kenya (2013).
Bill Atwood was a Democrat appointee as US Ambassador to Kenya. He was very laid-back and popular with young Kenyans. Prior to Kenya he had been Ambassador to Guinea. From that experience he had written a book “The Reds and the Blacks”, about US-Soviet tensions in Africa. The book came out during his appointment to Kenya. One paragraph in the book intimated, very gently, that Jomo Kenyatta had been a bit naive on some political issue. For that reason, the book was banned in Kenya. We liked the Atwoods and I once paid a house call on one of their kids. When his term was up a number of us gathered to see them off at the airport. For that occasion, I made a jocular sign which read “DON’T go home Yankee”.
Enroute back to the US in 1967 we traversed Europe. We took a one-day boat trip on the Rhine River out of Cologne. It included the usual scenic “highlights” seen on travel TV. This excursion did not, regrettably, traverse the Remagen bridgehead where I had crossed the Rhine twenty-two years before during WWII (see Ch. 3).