We went and visited Kwale, a relatively small community of Duruma and Digo in Eastern Kenya. I’ve been to so many of these African towns that I’m honestly somewhat bored. Five years ago, I might have been more excited. Perhaps I’m just tired.

People speak Swahili here. For real. In the rest of Kenya, Swahili is a language to connect disparate tribes, Kenyans happily mangle and make a mess of Swahili, but it does its job well enough. Here, I’m struck that even the kids speak Swahili, something you never see in other parts of Kenya.

I keep running into people who don’t speak anything but Swahili forcing me to communicate as best I can with my limited vocabulary. Fortunately, it’s all easy to understand out here.

But, to be honest, it’s quite boring out here. Life is fairly content, it lacks all of the huge and obvious problems of economics and health that persist in the rest of Kenya, and the ubiquity of Islam makes is a safe and tranquil place, if one is willing to ignore the oppressive patriarchy.

We spend the day at the hospital, meeting person after person. I’m growing agitated. Lunch is being pushed back later and later. I’m so bad at this, but its necessary and everyone is well meaning and kind.

Why are we doing this? All of Kenya’s problems are a failure of government. It’s not fashionable to say, but you can’t help but be annoyed when people spin the tired old narratives of colonialism and corruption. You guys voted these assholes in.

We finally get to lunch. I order pilau (mixed rice and beef) and some fried goat, knowing that it will be quick and we can be back on the road. Since he’s not paying, our Kenyan host orders to most expensive thing on the menu, the thing they never have prepared, the thing you have to wait an hour for. It’s hard not to be annoyed, but you just let it slide.

People are telling me what a great President Moi was, claiming that everything was ok during his reign. It was at the beginning, thanks to his predecessors, but his awful policies pushed Kenya to a horribly repressive one party state and spurred a complete collapse of the Kenyan economy, leaving the mess for his successors to clean up. In politics, timing is everything.

Now the entire health system has been devolved to the provincial governments. I’m thinking this is going to become a disaster of epic proportions. While the devolution of powers to local governments makes some sense in diverse and fractured Kenya, health problems usually don’t recognize political boundaries. A failure of health policy in HIV and malaria infested Nyanza could have devastating effects for Nairobi.

We’ve stopped in a tiny market center in the middle of nowhere. I say “shikamoo” to an old man, a respectful greeting reserved for elderly people. He asks me for 20 schillings. I’m having fun saying “shikamoo” to people younger than I am. It confuses the hell out of them.

The area is partially semi-arid and partially forested. Elephants come out of the national park and wander through the streets, I’m told. Baboons rifle through the trash. The areas close to the forest are doing better than the other areas, but there’s no real economy out here and the wildlife and igneous terrain prevent people from doing any substantial agriculture out here. The houses are in great shape, some even have power, but there’s malnutrition everywhere. The markets are mostly devoid of decent food outside of bags of rice trucked in from other areas. There are signs of American food aid and a World Food Program truck passes us.

A Japanese group is doing a survey on diet and malnutrition. It’s explained to me, but I think it’s pretty stupid. We already know that a lack of food causes malnutrition. They say they want to help. While I’m listening, though, I’m thinking that it’s a colossal waste of time and money. Perhaps it might be more helpful to come up with a better plan.

I realizing that this post is full of complaints, but here not every day is full of wonder and excitement.

We get dinner. It’s nyama choma (BBQ) again. I’m not disappointed but the conversation turns to Japanese academics. I can’t help but remark that I find a lot of it horribly uninteresting. I’m not sure why many of these groups do projects here, and even less sure what the tangible results will be, outside of raising the domestic status of ineffective Japanese researchers. Public health research really has to do one of two things. Either it should push science forward, or provide meaningful public health services to developing countries. The projects that are being described to me fail on both points. My anxiety level is high.

It’s time for me to stop complaining, though complaining is healthy and sometimes leads to substantive change. I’m getting ready to go to get some Ethiopian food at one of my favorite spots in Nairobi, Queen Sheba, which is run by Ethiopian refugees who fled the war there some years ago. Fortunately, it’s not expensive, unlike other places in Nairobi. See, the complaints never stop.