You think WE have a health care crisis? Let’s talk about northern Kenya.

Nalemusekon Pakir, 70, and two sons

70 year old Nalemusekon Pakiro sits calmly on a wooden bench outside the district hospital in Lodwar. Afflicted with tuberculosis, he just walked more than a hundred miles from his village to get help for his severe coughing fits. It took him two weeks.

9 month old Ettir Arupe dangles in a baby sling while his frightened-looking mother waits at a window for medication to treat his malaria and diarrhea. She walked through the night to get here.

Frail and in pain, Rhoda Nalibikai lies on a makeshift traction bed propped up at one end by a couple of metal cabinets.

Residents wait for drugs at Lodwar Hospital

Each day, crowds of sick swamp the grounds at Lodwar, And each day, the tiny staff does what it can. Often, to their frustration, it just isn’t enough.

Lodwar is the only hospital serving the arid, scrub-covered region of Turkana, home to half a million people. A recent drought has brought extra hardship to the widely scattered goat and cattle-herding tribesmen living in clusters of reed-covered huts. The ever-present dust triggers lots of eye and respiratory problems. But there just aren’t enough drugs to go around. Conjunctivitis is easily curable with eye drops. In the U.S., we drive to the corner pharmacy. Here, people slowly go blind.

Like many regions in Africa, Turkana suffers from a high AIDS rate. Hospital officials say one out of every ten patients here is HIV positive. But at Lodwar, the refrigerator that stores anti-AIDS drugs is on the fritz, so the hospital’s supply is threatened.

Drug storage room at Lodwar Hospital

The filling machine in the dental clinic is broken. So is the physical therapy equipment.

And on and on.

It’s a daily onslaught for the hospital’s staff. Three doctors, one part time surgeon and a part time gynecologist handle 200 patients a day, cases which range from severe infections to amputations to gunshot wounds suffered in cattle raids. Since there are no specialists, doctors sometimes have to guess their way through complicated procedures they’re not familiar with. “You have to do it yourself, because if you don’t do it, look at the alternative”, says Dr. Lokoel Gilchrist, the hospital’s chief medical officer.

Dr. Lokoel Gilchrist, Chief Medical Officer at Lodwar (on right)

In Rhoda Nalibikai’s case, there was no orthopedic surgeon to treat the broken femur she suffered in a fall. The staff put her in a cast, but her fractured bones aren’t coming together properly. It would cost $800 for her to see a specialist in a different city. For people who live off thinning goats and gnaw on palm nuts when they’re hungry, that kind of sum is inconceivable.

The government picks up the tab on drugs for all children under five. But adults have to pay. Even a buck or two for anti-malaria pills can be beyond the means of patients here. As we toured the hospital, a small boy popped up and led us to an elderly woman lying on a bench in the waiting area. He said she couldn’t afford the $3 fee for admission to the hospital. Dr. Gilchrist ordered her admitted for an ultrasound exam to analyze the pain in lower side. If a patient can’t pay, he says, a hospital committee makes a quick decision on whether his or her condition is serious enough for free treatment.

But by far the hardest scene at Lodwar is the starving kids. Drought and disease have decimated livestock and jacked up food prices. On the day we visited, 60 families with “moderately” malnourished children sat in the heat and dust waiting for help. And the hospital was treating 14 cases of severe malnutrition. We found 22-month-old Shemmy sitting on an examination table as his mother Eunice looked on anxiously. Shemmy is doing better after being put on formula followed by a high calorie mix. Much of the food relief is provided by international charity groups. But recently the supply has been on again/off again, according to Ewoi Bengdunn, a clinical officer. And many infants are already in bad condition when they’re born. “If a mother is malnourished, automatically that child will be born malnourished,” says nutritionist Regina Keitany.

The people who make it all the way to Lodwar are the lucky ones. Most Turkanas living in remote villages haven’t ever seen a doctor or a dentist. There’s an outbreak of polio—60% of the district’s residents still haven’t received basic immunizations. And many are still ignorant of the dangers of AIDS—a huge problem in a place where men have multiple wives and families. With so few physicians and nurses available, Dr. Gilchrist is hoping to put some villagers through a 4 month crash course on how to treat the most common problems such as malaria and eye infections. But he says the government isn’t willing to fund that program.

Still, Lodwar hospital is a place of hope…an oasis of care in a vast dustbowl of suffering. And none of the healers are giving up. “Here at times you are alone,” says Dr. Gilchrist. “What you do is you fold up your sleeves and get to work.”

{For more information, contact the Turkana Basin Institute http://turkanabasin.org/contact}

At the airstrip in Ileret, near Lake Turkana

It’s here that a group of researchers with strong ties to Long Island are chipping away at the secrets of early man.

Our host is Dr. Richard Leakey, son of Louis and Mary Leakey, who rocked the scientific world with discoveries of million year old human fossils and footprints. A few weeks a year, Richard Leakey teaches at Stony Brook University. But most of the time, he, his wife Meave and daughter Louise are busy unearthing fresh discoveries at a cluster of scattered dig sites.

Leakey is a soft-spoken burly man with twinkling eyes and shocks of white hair. He’s got a quite a story—not just as a scientist—but as a bold reformer who has bumped up hard against the infamously corrupt Kenyan government. Leakey once ran the Kenyan Wildlife Service, creating an elite security force to protect elephants from poachers. He became the second most powerful official in Kenya, only to be drummed out of the government twice.

Dr. Richard Leakey

These days, Richard, Meave and Louise are running the Turkana Basin Institute in conjunction with Stony Brook. It’s a research center and guest house for teams of scientists studying the many treasures in these fossil rich sands.

Fossilized tortoise shell

Louise Leakey showing fossils

The Leakeys showed us a room with shelves packed with animal skulls dating back 3 million years. But the real prizes are the “hominids”. Meave brought out a small tupperware container and carefully removed its contents, which included several small skulls of human ancestors that lived 1.8 million years ago. The Institute just discovered two additional fragments from the same era. They may prove critical in unravelling some of the longstanding questions about human origins.. “It’s taken us a substantial step closer to understanding the Homo lineage,” Richard tells us.

Meave Leakey

The Leakeys are also breaking fresh ground by building a thriving relationship between scientists and the people who live here. If you’re a paleoanthropologist, the last thing you want are herds of goats and cattle trampling over fields of precious fossils. The Leakeys reached out to the Dassenatch and Turkana tribes, convincing them that the scientific riches beneath their feet are a part of their history and heritage. Kids learn about fossils in local schools, and at the base in Ileret there’s a play “dig” site. “They get to see what fossils are,” says Louise. “And the children really love it.”

Turkana children pounding palm nuts

These days are tougher than usual for the people who carve out a hard-scrabble living here. Drought has hit them hard. Normally they’d sell goats for maize, but the goats are dying off because of drought and disease,” explains Ikal Angelei, a young Turkana woman who will be studying public policy this fall at Stony Brook. People are forced to rely on food brought in by the government and relief agencies, plus whatever else they can find. At a nearby Turkana village, we found a circle of kids pounding palm nuts to make them easier to gnaw on. Hunger is an everyday factor for these children, who help with chores such as hauling water and walk to school more than 10 miles away. “When there’s no food, it’s hard to go to school not knowing whether you’ll have lunch,” says Angelei.

Turkana mother and child

But the nearby Turkana Basin Institute has made a big difference. TBI and the Leakeys  have raised a hundred thousand dollars in the past year to improve local schools.  They extended a water pipeline from TBI’s base on the west edge of Lake Turkana into the village we visited. The institute recently brought in a group of dentists to treat villagers, and a team of surgeons has expressed interest in helping also. Even more importantly, TBI employs 40 to 50 locals directly. Many have learned marketable construction skills. They raised the lab buildings and dormitory from scratch, even making bricks from rocks and gravel gathered by nearby villagers. “It’s so easy to make a really significant difference here,” says Lawrence Martin, TBI’s director.

Carving hope for the future while unlocking secrets from man’s distant past. In the harsh, baked scrubland of Northern Kenya, it seems like a very good deal.

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The pack of zebra drinking in the pond began to stamp nervously as they sensed danger. Suddenly, a lioness emerged from a line of bushes. The herd bolted, but the big cat had already spotted her victim—a lone zebra who had unwisely strayed from the group. Keeping her eyes locked on her target, she put on a burst of blinding speed. None of us breathed as predator and prey splashed across the pond and streaked right by the front of our safari truck. A few seconds later, it was over–the lioness got in a couple of swipes, but the terrified zebra managed to pull away.

Lion Attacks Zebra

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Just another day on the Serengetti.

Elephant herd viewed from safari vehicle

A few million years ago, a cluster of volcanoes belched out mammoth clouds of ash which settled over thousands of square miles in what is now Tanzania and Kenya. In time, the ash became a flat sea of grassland broken by a handful of low hills and the eccentric shapes of trees like the flat topped acacia and the fairy tale-like baobab. Much of it is now protected forever in a series of national parks.

It’s paradise for exotic creatures most of us only see in zoos. Free to roam in the wild, they’re entirely different.

A family of elephants lumbering along a shallow river…the graceful, slow-motion lope of giraffes…vast meadows dark with bull-like wildebeests…a pack of hippos motionless in a pristine lake…a leopard resting on a tree limb…a clan of baboons grooming each other….ostriches that seem to float over the plain on their long, powerful legs.

There’s a lot of dust, and a lot of bouncing around in a cramped safari vehicle. But there are so many payoffs.

Fourteen of us traveled to East Africa in a group organized by friends from SUNY Stony Brook. Our trip began in Arusha, at the base of Mt. Kiliminjaro in Tanzania…and wound its way northward up over the towering walls of the Ngorongoru crater, across the Serengetti and up into the Maasai Mara preserve in southern Kenya.

Lioness "chilling" on side of road

Rule number one: Don’t get out of the truck. There are fast-moving things with sharp teeth out there and they aren’t afraid of people. Instead, the roof on the van swivels up, allowing you to stand and click away in complete safety.

Rule number two: Get a really good guide. We had one. Usiah, a burly, 30-something Tanzanian with decades of experience had an inexhaustible knowledge of every flora and fauna we encountered. And uncanny eyesight to go with it. He could spot the tail of a leopard dangling in a tree from hundreds of feet away.

There were a lot of electrifying moments, and some surprising insights too. Try this factoid at happy hour: When mating, male lions are called upon to perform every fifteen minutes for five days. No wonder they’re called the “king of beasts.”

Another revelation came as we watched a baby elephant who had fallen behind the herd and couldn’t see its mother. He charged around in circles, squealing with fright, ears waving. Mom noticed and patiently trundled back to collect him. She gave him a nudge, and he nestled up to her, snorting with relief. Hey, forget your species: Being a parent is being a parent.

On most nights, we stayed in well-run lodges built on former plantations. Protected campsites are also an option. The food was good—mostly recognizable Western fare—and the soft-spoken staff eager to please. But even in a resort hotel, you’re acutely aware of the wildness of the place. We saw elephants and zebras wandering right outside our windows. And in one hotel, guests were not allowed to walk back to their rooms at night without an escort.

Here’s something else to put on your must-do list, if you ever go: A balloon flight over the Serengetti. It starts at the crack of dawn. You huddle in the morning chill as a propane burner shoots towering flames into the balloon. Then the basket shudders, the ground drops away–and suddenly you’re drifting in silence over the treetops as antelope scamper below you. The finishing touch: An outdoor champagne breakfast!

Serengetti Balloon Ride

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Our group was led by Dr. William  Arens, a professor at Stony Brook’s anthropology department who’s spent decades in rural Tanzania. So the trip included some people-watching too. At one stop, we visited a village of the Maasai tribe. The Maasai are goat and cattle herders who live in clusters of acorn shaped thatched huts. The men have multiple wives who do most of the work, and families measure their wealth in terms of livestock. We got a lively Maasai welcome including some traditional Maasai dances.

Maasai Welcome Dance

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5-year-old Nura, AIDS orphan

Bill also took us to a sobering place: The Watoto Care Orphanage—a place for children whose parents have died of Aids. With all those radiant little faces and bright laughter, it’s hard to tell their lives are filled with tragedy. 5-year-old Nura jumped into my arms and screamed with delight as I swung him around. The kids eagerly devoured the candy and played with the small toys we brought. There are two other AIDS orphanages in the same area.

Another reminder of East Africa’s struggles: At a gas station near the Tanzania/Kenya border, hungry children thrust their hands through the windows of our van. We emptied half our lunchboxes to feed them.

East Africa wrestles with a panoply of third world problems: Drought, hunger, unemployment, lack of medical care. Even for a group of L.I.’ers on a safari vacation, the signs of that are everywhere. But the people here are wise enough to have carved out places of wild beauty where creatures of all sorts are allowed to play out their lives without interference, exactly as they have for countless centuries. It’s a place well worth experiencing.

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By Pat Dolan

It’s the kind of story that twists you up and exhausts you.

If you’re a parent—like me—you can’t help but be moved by the site of 4-year-old Leo talking to his mommy’s picture.

His mommy is Joanna Bird. She was 24 when she was brutally stabbed to death in March, allegedly by her ex-boyfriend—who is also Leo’s father.

The case is a major story because cops are under fire for allegedly failing to arrest Leonardo Valdez Cruz when he barged into the home of Joanna’s mom, where Joanna slept in her mother’s bedroom each night because of how terrified she was. Police brass are disciplining half a dozen officers for misconduct in the case.

Prosecutors are also taking heat. The family’s attorney says the Nassau D.A. could have kept Valdez-Cruz in jail for an earlier assault against Joanna, but failed to argue for that in a crucial pre-trial hearing. The D.A.’s office contends it was powerless to do anything because Joanna didn’t want to testify.

It’s all going to wind up part of a very large, very messy lawsuit soon to be filed against Nassau County by the Bird family.

But here’s another question: How many other Joanna Bird stories are out there? Does the criminal justice system do a poor job of protecting vulnerable women?

It wasn’t hard to find other women with horror stories. Just a few phone calls to local domestic violence counseling agencies.

One Suffolk mom of two who was too terrified for us to use her name showed us a pile of police reports and orders of protection. Her ex roughed her up, followed her to the homes of friends, and in once incident slit his own throat and wrote angry messages on the walls in blood. On at least one occasion, she says, cops saw her husband at the house in clear violation of an order of protection—and failed to arrest him. Other times he was held overnight and released on his own recognizance.

“I was horrified. I was scared for myself and my children,” she told us.

Turnstile justice. Her husband beats her up, he’s released the next day, and she gets a court order that states he can’t do it again. And possibly a stint in a “batterers treatment program,” which one counselor told us has a notoriously high washout rate.

“Mostly for the victim it means she doesn’t really have a period of safety where he is behind bars for any length of time, so she could maybe make a plan on what she wants to do or move to another location,” says Ruth Reynolds of the counseling agency VIBS.

So the message to battered women is this: Report your spouse, and he’ll be out the next day— angrier than ever. Is she going to dial 911?

“It’s a bad message all the way around. The court is not taking its own order seriously, the batterer acts with impunity, and the survivor is perhaps less likely to engage with the system,” says Patty Jo Newell, director of public policy for the New York State Coalition Against Domestic Violence.

To be fair, many women don’t want their violent hubbies thrown in jail. It means having to do without his paycheck. Given a choice between stopping the beatings or feeding her kids, she chooses the kids.

Nevertheless, it’s hard to find an expert on this issue who doesn’t favor stiffening penalties for d.v.-related assaults and violations of orders of protection.

What does all this say about the criminal justice system? For one thing, notes Reynolds, prosecutors don’t represent the victims, they represent the state. Bail is set to make sure an accused person doesn’t skip out on his trial. The goal is not necessarily to ensure the victim’s safety.

So that’s where the Island’s domestic violence agencies come in. VIBS, Brighter Tomorrows, the Retreat, the Nassau Coalition Against Domestic Violence and its counterpart in Suffolk all provide assistance and arrange for shelter for victims. You can find their Web sites and hotline phone numbers here.

Joanna Bird was an ambitious, hard working mom of two. She wanted to pursue a career in law enforcement. Perhaps her death will make law enforcement more sensitive to vulnerable women like herself. Lives could be saved. When Leo grows up, maybe he’ll be proud of that.

The full Justice for Joanna special series