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The village of Ihwagi, Kenya, sits in the crowded countryside about 50 miles north of Nairobi, a few miles from Karatina. In March 2008, it was a patchwork of green—small plots of vegetables, light green tea fields, broadleaved banana palms that leaned over small grassy yards. Men in work clothes on the roadside pushed sturdy bicycles up hills, with bundles of vegetables or tan nipia grass tied to the back rack. A middleaged woman in a worn but colorful dress trudged uphill, balancing a white plastic bucket on her head with one hand. Small groups of goats wandered the roadside.
Andrew Githeko was returning to his hometown in the central Kenya highlands to do the work of a disease detective. Because he lives and works hundreds of miles away in western Kenya, Githeko had not yet had the chance to visit clinics and hospitals here to talk to health care workers. Such visits, he says, are the best way to uncover clues about emerging diseases.
Here, more than 1,600 meters up in the Mount Kenya foothills, malaria had never been a problem. If malaria was spreading even here, 1,600 meters up in the Mount Kenya foothills, then global warming was contributing, Githeko believed. His plan was to visit dispensaries (community health clinics staffed by nurses), school clinics, and regional hospitals, where he'd speak with nurses and doctors to find out if malaria had taken hold.
On a bumpy dirt road, Githeko stopped on a bridge over a steep valley. Below was a riverbed dozens of feet wide filled with boulders the size of basketballs. A small stream dribbled along at the bottom—the Ragati River. Githeko shook his head. "This was a huge mountain stream," he said sadly. He swept his arm to indicate the whole valley and the grassy banks above it. "It used to flood here all the time." But since he was a kid, there has been a population explosion in the region, and 10 times more people live in the Mount Kenya region now than a half century ago. They're drawing the river down, but that's only part of the problem. Eighty percent of the glaciers on Mount Kenya have also melted. "The mountain is drying up," he said.
Githeko spotted a stone entranceway on the side of the dirt road. A large sign sat next to the entranceway, handpainted in large red letters: Gatei Health Centre. He parked on the lawn in front of the clinic. A few feet away was a small onestory building with ruststained cinderblock walls and a corrugated tin roof.
Githeko got out of the Land Cruiser as two women appeared at the door. One woman was bigboned, in a lavender skirt, matching top, and beaded necklace; the other was shorter, with almondshaped eyes and smooth skin the color of dark chocolate. A bespectacled man in a white lab coat joined them. Githeko walked over and greeted them. "I'm Dr. Githeko," he said, then paused. "From KEMRI."
The woman in lavender, Margaret Kariuki, identified herself as the district public health officer; the shorter woman, Susan Wangiki, was the clinic's lab technologist; the man in the white coat, Bernard Gikandi, was a nurse. The Gatei Health Centre was the first stop for sick locals. Githeko chatted with the health workers for a few minutes in English, one of two common languages in Kenya, about Githeko's roots in the area, the brandnew university campus up the hill, the famous cool weather of the area. "This place used to be very cold," Githeko said. "Mmm," Margaret murmured in acknowledgment.
Githeko explained his intention to investigate the impacts of global warming. "You know global warming?" he asked. They all nodded. He told them he had come to see what global warming is doing to malaria. Githeko told them of malaria mosquitoes his team had found in nearby Naro Moru in 2005. "We were told that Karatina had a lot of malaria," he said.