Category Archives: General

Healy Pass (mostly)

Before all the snow started coming in Alberta this weekend, we went out near Sunshine Village ski resort yesterday and headed up to Healy Pass. We got ‘mostly’ to the pass before the snow was getting too deep and we were post-holing it on most steps so we decided to turn around just a few hundred metres from the top. We only had our microspikes and not our snowshoes since it would be easier to run back down. It was cloudy most of the day anyways so it was hard to see the mountains in the distance anyways. Still an 18 km day in the mountains with over 600 m of elevation! 20 cm of snow on the way for the mountains today so we were lucky to get this day in.

Healy Creek at lower elevations.

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Healy Creek as we move higher up.

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Amanda thinking the snow is getting deep as we head up towards the pass.

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Amanda running down in knee-deep snow!

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Thankful for the microspikes, but could have used the snowshoes up top.

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Total distance: 18280 m
Total climbing: 831 m
Total descent: -832 m
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Bourgeau Lake

Last Sunday we headed up to Bourgeau Lake again. We’ve done this trip a few times now and really enjoy it each time. It’s a fairly gradual climb up to the lake and then a nice quick run back down for 15 km total. There was too much snow to go up to Harvey Pass this time. It was also getting dark quite early as the sun was tucked behind Mount Bourgeau at only 1:30 pm after the time change. We got new microspikes this year and put them to good use as there was quite a bit of snow on the trail just a few kilometres into the climb. Scenery was stunning as always!

Sun burning off the clouds.

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Amanda in action watching her steps.

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Heading towards the lake.

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Bourgeau Lake.

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Forgot to take a selfie at the lake but remembered part way down.

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Total distance: 15439 m
Total climbing: 1130 m
Total descent: -1130 m
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Grizzly Ultra 50 km

For the second year in a row, I ran the Grizzly Ultra 50 km yesterday at the Canmore Nordic Centre. It wasn’t pretty, but I finished it again which is all that really matters. My legs are feeling alright today considering what they went through yesterday. Big thanks to Amanda for cheering me on after each leg of the race and keeping me going! (She also had a good run leading off with a 14 km leg for her team.)

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Total distance: 51663 m
Total climbing: 1779 m
Total descent: -1772 m
Download

Travel Update

Sorry for not posting an update before now. My iPhone was out of commission for a little while due to water damage from our Chamonix-to-Zermatt adventure. First it wouldn’t work at all, then after a couple of weeks in a rice bag, it would only work when plugged into the wall. I replaced the battery at the end of last week and now it’s working again!

Enough about the iPhone. Here are some quick updates:

Pictures: We didn’t travel with computers so I can’t sort/edit any photos until we are back in Canada. I go back to work right away but will do my best to get some posted soon.

Haute Route: We made it! Chamonix to Zermatt in 11 days. We covered a total of approximately 160 km by foot and somewhere between 10,000 to 12,000 meters of vertical! We are feeling good though and have managed a few more hikes and runs since then.

Zermatt: After finishing, we spent four days in Zermatt. Lauren (Amanda’s sister) and her fiancé Paul joined us for the weekend and we did a great hike with wonderful views of the Matterhorn (the mountain on the Toblerone chocolate bar).

Grenoble: We spent last week in Grenoble with Lauren and Paul. It was a mixture of low key, relaxed days with some hiking thrown in.

Tuscany: Amanda’s parents have now joined us and the six of us are currently having a “tough” week at a villa in Tuscany. Lots of relaxing by the pool and we ate lunch today at a local winery. Amanda and I have been getting out for a run each morning before it gets too hot.

That’s all for now! More updates soon (either later this week or when pictures are ready when we get back home).

Haute Route

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I thought I would post some information here about what we are up to so people have a place to get the details.

What are we doing?

We are going to attempt to “run” from Chamonix to Zermatt – Mont Blanc to the Matterhorn. The route we are taking will likely be somewhere between 160-180 km and we are aiming to finish in 11 days. Each day will be between 15-24 km and will vary in difficulty based on changes in elevation. The map to the left will give a general idea of our route, but it could vary depending on conditions, how we are feeling, etc.

Why are we doing this?

We are not completely sure ourselves!?!? All we know is that three years ago we had a great time doing the Tour Mont Blanc and this trip promises to be more of the same. Since we have been doing more trail running over the past year, we thought it would be fun to give a multi-day run a try. But, our main goal is to have fun and be safe, so if that means hiking instead of running at times, that’s what we’ll do!

Information for those interested in following along:

Map and Messages:
https://share.delorme.com/ASkinn (password to access the map is: hauteroute)

We hope this works! While we are running, our new GPS device should send a location data point every 10-20 mins. We will also try to remember to send a message each night, from the GPS device, which will appear on the map. If we forget to send a message one night, or have technical difficulties, please do not worry about us. We will update everyone when we can.

Talk to you all soon! We will try and post here when we can as well but we don’t expect to have reliable or regular internet service for the next couple of weeks.

Andy and Amanda

Still Alive!

I know I haven’t posted much here in a while. It’s mainly because most of my “spare” time right now is spent studying.

We did get away for a night on the weekend to see Craig Cardiff again in Wakefield. Always an entertaining show.

I have been trying to run in the mornings before work as much as possible and some longer runs on the weekends. The plan is still to run the Ottawa half-marathon on May 27. Today I also signed up for the Powderface half-marathon trail race in Bragg Creek, Alberta on July 14. Hopefully I will be able to adjust to trails, altitude and elevation change.

More soon!

Back to Iqaluit!

This picture was taken last year near the end of my stay up in Iqaluit, Nunavut. Due to some last minute cancellations and other sequences of events, the hospital in Iqaluit needed a Pediatric resident for a week from February 5-13. Since I really enjoyed my time up there last year, I decided to go for it! It will be the exact same time of year as last time, so I know what to expect from the weather. Pack the long johns!

Forward

When trying to come up with a title for this post, I considered Moving Forward, Forward Thinking and Forward Progress. All of them seemed to capture part of what I wanted to write about, so I settled on simply Forward and using the other titles as headings. As the word may suggest, this post will focus on the year that has just passed and a look ahead as I go forward.

Moving Forward

While Amanda and I enjoy many different physical activities, the one that has served as a common theme for the past few years has been our interest in running. 2011 was a particularly interesting, frustrating and rejuvenating year in running for me. Early on, I was running and just trying to stay warm in temperatures below -30 degrees Celsius while spending a month up in Iqaluit, Nunavut. When I returned, I got into training mode for the Ottawa Race Weekend where I completed my second marathon in a span of 7 months. Race day was a mixture of emotions. Of course, I was thrilled to have finished my second marathon and improved on my time. The frustration was that I was unsure if I had bilateral stress fractures in my feet, just sore overused muscles, or something more serious that may signal the end of my young running career.

After taking time off from pounding the pavement, I knew I would have to start slowly again and rebuild in order to avoid that feeling in my feet from coming back. After lots of rest, walking and stretching, it was time to attempt running again. It was also time for a bigger shake-up. All of the downtime led me to read even further into barefoot running. It seemed like as good a time as any to give it a shot since I would be having to “start over” again anyways. I was not willing to go “all the way barefoot”, so I settled on a pair of Merrell Trail Gloves to be my new minimalist barefoot shoes. It was great to have my feet truly feel the ground again and slow but steady, I have built back up to about 12 km over the summer. It was also a great way to see the streets of Gaborone, Botswana, and even a trail run in South Aftica. Definitely rejuvenating!

Moving Forward. In 2012, I hope to continue building on the new form I have learned over the past 6-7 months in the barefoot shoes. I plan to do more trail running, especially in the summer when we move back to Calgary. The plan now is also to keep slowly building my distance and run the half marathon at the end of May in Ottawa. There is also a trail half-marathon just outside of Calgary in July that I would like to try. Depending on how my feet are holding up, I’ll likely add a few more goals to close out the summer of 2012.

Forward Thinking

Amanda and I were extremely fortunate to travel as much as we did in 2011 and experience many different people and cultures. It also gave us a lot of time to think about our beliefs, values and what is truly important to us. I have written before about us trying to minimize the “stuff” in our lives, and I’ve recently discussed that people should be treated fairly for the work they do.

Forward Thinkng. Moving back to Calgary in July will give us a chance to rethink some of these things again. How big of a house do we really need? How much of our “stuff” do we really need to move? Should we buy things for the 1 or 2 times a year we might need them, or should we figure out how to get by with what we have or rent / borrow what we need in those rare instances? Perspective on these things changes when you see how little some people have as well as living out of a suit case for almost four months!

As part of the process of minimizing, we have already given away quite a few of our things to local charity. We have also started posting a number of things online for sale. Of the things we have given away or sold so far, I can’t say I’ve missed any of them yet!

Forward Progress

In some ways, the biggest thing happening in 2012 is something I don’t always talk about but will try and elaborate on a bit here. Three and a half years ago we moved to Ottawa for me to start my Pediatrics residency. As part of that program, I was fortunate to be able to spend 16 weeks working in the health care system in Botswana. It was very different than working in Canada, but kids are kids and I do love my job. There are frustrations working anywhere in the world when it comes to health care, but the kids don’t know any of this. They just want to get better and we do our small part to try and help them.

This year will mark the end of this time in Ottawa. In May, I have a series of exams to become a certified pediatrician in Canada. These exams are known to be quite difficult and will require me to put a focus on studying for the next four months. In July, the next chapter of my training begins as we move back to Calgary and I start a Pediatric Gastroenterolgy Subspecialty Fellowship training program. What’s another two or three years?!

I am reading a book right now about training for ultramarathons,1 Relentless Forward Progress. I think the title also sums up the fact that I am currently completing my fifteenth year of post-secondary education! Who needs a real job anyways!

All the best to everyone! Move forward and have a successful 2012!


  1. Not committing to anything, but maybe a potential long term running goal of mine. 

Back it up!

As we head towards the holidays, lots of pictures will be taken and lots of memories made. This will be one of my boring blog posts, but as you will see, it is something I believe pretty strongly about. Think of it as and early gift for the holidays!

Many people have different ideas when they think about backing up their files. There are different levels of backup and I try and break it down to the following:

  • If I accidentally delete a file, how easily can I get it back?
  • If my hard drive fails, how long until I am back up and running?
  • If my computer is lost, stolen or damaged, do I have a copy of all my files?
  • In the most extreme circumstance, if my house were to burn down, would I lose all my photos? 1

If you can already manage each of those situations, then congratulations. You can stop reading now and be happy knowing that you are well backed up. For the rest of you, if you can hang in there a little longer, I hope to show you that it’s not that hard to be ready for each of the above scenarios.

Here is my complete backup strategy:

  • Mac OS X Lion – The latest edition of the Mac operating system includes a versioning system that lets you go back in time to older versions of files or retrieve filed that are accidentally deleted. It’s a good first step but most wouldn’t even consider it to be a true backup. All the files are stored on the same hard drive, so if your computer is lost or damaged, so are all the versions of the files.

  • Time Machine – The easiest routers to setup are the Airport Extreme and the Time Capsule. The Airport Extreme allows you to plug any hard drive into its USB port and use it as a Time Machine backup. The Time Capsule is even easier in that the hard drive is already built in. Once you set this up, every hour, any Mac on your network will automatically backup your hard drive to the Time Machine disk. You don’t need to remember to do anything, it just happens. This is the minimum amount of backup anyone should have since if you lose anything on our Mac, it’s on the Time Machine disk. If you get a new Mac, or your old one is lost or damaged, you can restore the new Mac using the information on the Time Machine disk. This restore takes time though, so I would suggest you take other precautions to be up and running even faster. Also, in the unlikely event that the Time Machine backup becomes corrupt at the exact same time as you need it for a restore, then you will be wishing you had another strategy in place.

  • Dropbox – You can get 2 GB of storage on Dropbox for free, and increase it based on referrals. 2 Or you can pay for more space. I usually suggest that people keep their “active files” on Dropbox. This means any folders with files you are currently working on or need access to on the go should be in Dropbox. For some people, this might be all files besides photos and music, for others it might be everything. It all depends on your workflow and how often you access old files. The advantage to this is that now your files are accessible from any computer over the web. If your computer becomes unusable, you can use another computer to continue working, especially if you are facing a deadline.

  • SuperDuper – This is a Mac only utility and I’m not sure if there is an equivalent for other systems. With SuperDuper, you make an exact clone of your hard drive that is bootable. What’s the difference between this and Time Machine? A bootable backup means you can plug the hard drive into any other Mac, boot off the external drive and you have your exact system back up and running. Some people run this every night, so if their hard drive is damaged, they can immediately be back to where they were the night before. And since you’re using Dropbox, any changes to your active files will also stay up to date. Since I store everything in Dropbox, I personally run SuperDuper every 3-4 weeks or after making big changes to my photo library. You need to decide how often to run SuperDuper based on your individual usage patterns.

  • Multiple Backups – Don’t just make one clone of your hard drive with SuperDuper. Buy two hard drives. Keep one at work, one at home and switch them every month. This way if your house burns down, there is an off-site copy that will never be more than a month behind. Obviously, you can keep theses drives up to date more often depending on your level of comfort and how much you are willing to lose. The key is whatever interval you pick, set a recurring alert in your calendar to remind you to do the backup on a regular basis. Also, try booting from your backup every once in a while to make sure they work.

  • Online backup – This is the final step, keeping your files safe from a natural disaster that simultaneously wipes out your backups at home and work. (You never know!) There are many services out there depending on your level of paranoia. Personally, I would recommend keeping as many files in Dropbox as you can. Then, for the other files, I would use a combination of Arq and iCloud.

  • Arq – This allows for a similar strategy to Time Machine as above, but the backup goes to Amazon’s S3 servers which provides redundant backup around the world. You can chose which folders get backed up to S3 and you pay only for the storage you use. I use S3 for all my photos, and pay around $3 per month. The latest pricing is about $0.14 per GB per month. The initial setup of S3 isn’t difficult, but it is not exactly Mac like. Setting up Arq on the other hand is extremely easy and well worth the one time cost of the application.

  • iCould – Until this past week, I did not have all my music backed up online. I simply had too much music and I didn’t think the time required to upload it all to S3 was worth the time or money to store it all. But, this week, Apple released iTunes Match in Canada. For $27.99 per year, all of my music is backed up to iCloud and accessible from all my devices. The advantage to iTunes Match is that it only uploads files that aren’t in the iTunes store, even if your original files aren’t from iTunes. For me, this meant that less than 20 per cent of my music actually had to be uploaded which is a huge savings in time and bandwidth compared to backing it all up to S3. For the convenience of accessing the music from all of my devices and knowing its all backed up online, it is worth the $27.99 per year.

  • iOS 5 – If you haven’t updated your iPhone or iPad to iOS 5, do it now. The latest operating system allows for automatic backup to iCloud each night when your device is plugged in. No thinking involved. If the device gets lost or stolen, you can restore your new device online and nothing is lost.

Thanks for hanging in to this point! So, now you might be thinking, it will cost money to by hard drives and it will take time to set all this up. But I think you just need to ask yourself one question: If you were to lose your computer today, and lost all your photos, how much time and money would you be willing to spend to get all your files and photos back? When put in that situation, it would probably be a lot more than the time and money it would take today to protect everything. Just a thought.


  1. I stress photos here because for most people, these are the files that if lost, are truly irreplaceable. 
  2. Full disclosure – the link to Dropbox is a referral link. If you sign up after clicking through this link, we both get more space on Dropbox. 

Taylor Lake, Gatineau Park

Photos: Taylor Lake

After all of our African adventures, it is easy to forget that there are many places right in our own backyard for more adventures!

This past weekend was Amanda’s birthday. I booked us a yurt at Taylor Lake in Gatineau Park. We had never hiked out and stayed overnight in Gatineau Park prior to this weekend, so we figured it was a very Ottawa thing to do.

The ground was lightly snow covered which meant it was better to move away from our barefoot shoes, and put on the hiking boots. There was some soggy parts on the trail, so we were both glad we made that choice. The hike was only 6-7 km before we reached Taylor Lake Yurt. Bunk beds, wood stove for heating, propane stove for cooking, candle light – what more could we ask for! I’m glad Amanda likes to do the same outdoor activities as I do. There were a few people at work that were glad I wasn’t getting them birthday presents!

Aside from one minor scare with the carbon monoxide detector going off 1, the hike and overnight stay were uneventful. Just a nice relaxing evening and a great way to celebrate Amanda’s birthday.


  1. There were warnings that leaving the wood stove door open could cause the carbon monoxide detector to go off. We didn’t think we had it opened for too long, but the detector didn’t agree. After we opened the doors for a couple of minutes and reset the alarm, there were no further issues or scares. 

Artists should get paid

As many of you know, Amanda and I try to eat organic and fair trade as much as possible. Not only is it healthier, but it also raises personal awareness for what is going into our bodies as well as ensuring that the farming practices are safe for the workers. Most importantly though, fair trade means that workers are adequately paid for what they do.

So what does this have to do with artists? In a similar way, one could say that artists should be paid fairly for what they do. Artists can be writers, poets, musicians, film makers, actors, software developers, etc. By thinking about artists in terms of “fair trade” it raises some interesting issues. Many would argue that music has gotten worse over the years and maybe an album shouldn’t be worth $10 or a song shouldn’t be worth 99 cents. What music is “worth” is something we all need to consider. Instead of then illegally downloading those songs or albums, maybe we should ask if we really need that song in our music collection in the first place. After all, if we are saying that we wouldn’t even pay 99 cents for a song, it can’t really be worth keeping, can it?

The same argument can be made for movies. Many people say they download movies illegally because DVDs and Blu-ray discs are too expensive. If we really feel that buying the movie is too much money, and we don’t even want to spend the money to rent it on iTunes, perhaps the movie really isn’t worth watching.

To put this another way, if we were to start limiting downloading music, movies, books and television shows to legal downloads, where the artists get paid, it is true that we may have to become more selective in what we chose to download. For some, being selective would be a necessity, if only for financial reasons alone. But think about how much more time might be available to do other things by downloading less. Plus, those artists that you do chose to support become that much more special and you know you are supporting the artist to continue producing content that you are willing to buy.

Am I the poster child for what I just wrote? Absolutely not. I feel that I am part way there in that I do my best to support the musicians that I listen to the most or that are my current favorites. I also try to support these artists by attending their shows when they play locally. But there are many songs that I listen to often enough that should have been worth a 99 cent investment at some point.

Here are some suggestions to ensure artists get paid:

  • Music – Buy music direct from the artist whenever possible. Musicians make more money if you buy from their websites directly. iTunes is a great choice as well, especially from a convenience stand point. If one of your favorite musicians is in town, buy a ticket to the show to support them even further.
  • Movies – No more illegal downloads. I don’t have time to watch that many movies so when I do, I will use Netflix or iTunes to legally watch them and support everyone involved in making the movie. A great side effect of this is that if we stop supporting all the bad movies coming out of Hollywood, maybe they will stop making them!
  • Television – We don’t currently subscribe to cable and in general, we only watch one or two shows at any given time. The big issue with television shows is there are some shows that are not available on iTunes or aren’t available in Canada. For shows like this, there is often no choice but to obtain them by other means. But I will try to look for shows on Netflix and iTunes first.
  • Software – The majority of software I buy now is on my iPad or iPhone so the only way of installing it, without hacking the device, is through the legal App Store. The Mac App Store is also making installing legal software extremely easy.
  • Books – iBooks and Kindle versions of books are readily available. Between the two choices, you would be hard pressed not to find what you are looking for.

If the reasons above aren’t encouraging enough to consider fair trade for entertainment, maybe taking a look at a recent story about a new site will provide a bit more incentive.

Getting rid of “stuff”

Since Amanda and I have returned from Africa, one of the general themes we keep discussing is how much “stuff” people in North America tend to have – us included! I think that there are a lot of things that we thought we needed, but when you are away and don’t have those things, perspective can change. As we move into the season where people generally accumulate more “stuff”, I thought I would share some of the tips to de-clutter that Jason Robillard posted on his barefoot running website. He draws a lot of parallels between living a minimalist lifestyle and barefoot/minimalist running. You can expect more posts on similar themes in the future.

  • Get rid of extra unused clothing. Go to your closet. Turn all hangers around so they’re facing the opposite direction (hook on the backside of the rail.) When you wear an article of clothing and wash it, return it to the rail normally. At the end of one month, you’ll know which clothes you’ve worn and which clothes you haven’t by the hanger position. Donate half of the clothes that were untouched.
  • Do the “35 items” challenge. Each day for one week, select five items around your house that you do not use. Place them in a pile somewhere in your house. At the end of the week, donate the pile to a local charity.
  • Do a week-long “zero growth” activity. If you buy anything during the week, you must get rid of something of approximately the same size and/or value. The goal is to stop accumulating new stuff.

Feel free to leave any other tips and ideas in the comments!

Botswana-Baylor Fun Run

What better way to spend our last day in Africa than by participating in the Botswana-Baylor Fun Run. All proceeds are going towards completion of the new Adolescent Center. There was both a 5 km and 13 km event.1

In what we now refer to as being typical Africa, we ran down the streets, often struggling to figure out which way to go next. We had heard the roads would be closed, but what that really meant was that a police car would lead the way. However, as runners became more and more spread out, this meant we got further and further from the police car. As such, the other cars on the road didn’t really seem to notice or care that the roads were closed so we often had to deal with the passing cars as well!

Amanda decided that she was going to enjoy the day and instead of pushing too hard for 13 km, a distance she hasn’t run in quite some time, she would run the 5 km. When I finished the 13 km, she was there waiting for me at the finish line. After a minute or two of catching my breath, I asked her how her race went. A big smile appeared and she said, “I think I won!” She was convinced she must have made a wrong turn somewhere, but the organizers confirmed with her that she had in fact won the 5 km event.

When they were making announcements, they had draws for door prizes and presented medals to the top 3 finishers for the 13 km event. There was no mention of the 5 km finishers. We asked one of the other organizers that we knew about it. She found out that the sheet of paper where they had written down the names of the top 3 finishers for the 5 km had been lost. This meant that, unfortunately, they would be unable to hand out medals for the 5 km event. Again, typical Africa!

All in all, a great morning and a great way to spend our last day. We have a long stretch of traveling ahead of us this evening, so hopefully the exercise this morning will help us sleep on the flights!


  1. These distances were approximate. My Garmin said 11.7 km as I was crossing the finish line of the 13 km event. But it doesn’t really matter! It was just great to be out supporting a great cause! 

Cell phones in Botswana

I know it’s hard to believe from the guy who collects shiny objects from a particular fruit company, but this has been my cell phone for the past 16 weeks:

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Nothing fancy. Previously used. Had to relearn how to type using T9. But it works.

I got this phone from a friend, but Amanda bought a similar cell phone for 99 Pula which is the equivalent to ~$15 Canadian. A pay-as-you-go SIM card for the phone cost 10 Pula (~$1.50) and came with 10 Pula credit (so it was essentially free). Depending on the time of day and who you are calling, it costs about 1 Pula (~15 cents) for a minute of airtime or 4 text messages. You can buy top-up cards from street vendors in 10 or 20 Pula denominations or you can add more money at the cell phone shop. (If you didn’t already think so, this really makes cell phone contracts in Canada look like a real rip-off!)

As a result, everyone in Botswana has a cell phone. And I truly mean everyone. Even people that don’t have running water going into their homes will have a cell phone. It also means that text messaging is the primary way people communicate. A study at the children’s HIV clinic is trying to leverage this and use cell phones as a way of educating children about the importance of taking their HIV medications. They are also using text messaging as a way of sending direct reminders that it is time for their next dose.

While it may seem fairly advanced that everyone is using a cell phone, unfortunately, cell phone etiquette is virtually non-existent. Phones will ring and people will talk everywhere including movie theatres, restaurants and offices. I have seen residents and staff physicians sending text messages while in the middle of a conversation during morning handover. I have even seen someone answer their phone and start talking while sitting in the chair directly beside someone giving a Powerpoint presentation!

As much as I would like to say that I like the simplicity of my cell phone here in Botswana, and it has reminded me how little you actually need to communicate, I would be lying if I didn’t say that I’m looking forward to being back on my iPhone full time when we are home in a couple days.1


  1. To clarify, my iPhone would have worked just fine here, but while we have overall felt very safe, we haven’t wanted to carry anything valuable with us on a regular basis. I also did not want to have to use my iPhone as my primary phone at the hospital. As a result, the iPhone was used over wifi only and the above cell phone became my regular phone for phone calls and text messages. 

More Hospital Thoughts

I know I haven’t had too many posts about life at the hospital in Botswana. I have been finding it hard to write about work for a few reasons. First, in Canada, it is typically discouraged to be overly public about day to day work in a hospital since it is very easy to cross the confidentiality line. Second, I have never really written about work on my website in the past. And third, once settling into a routine at the hospital, things started to feel more normal and as a result, particular things on a day to day basis didn’t seem post worthy. Instead, I’ve decided to write about a few themes that have come up. I am also aware that this post may come across as negative, but I’m hoping that it actually just illustrates some of the differences and challenges I have faced during my time here in Africa.

Efficiency

Things just don’t happen as quickly in Africa as they do in other parts of the world. People will often say that they like the laid back attitude in Africa, but unfortunately, this doesn’t always work in a heath care setting. Things that should take a short time, inevitably end up taking longer and as a result, everyone has to adjust. One of the doctors here early on told me to think of it as “everyone drops a level”. What he meant by this, is compared to working in medicine back home, everyone is being asked to do things they would not normally have to do. So there are specialists acting like general paediatricians, paediatricians acting like residents, residents acting like medical students, and so on. While thinking like this does not make the day any more efficient, it does point out the idea that everyone is doing things they are not used to having to do. So, everyone needs to help out.

Early on in my stay, I was told that the quickest way to ensure that a patient gets an X-ray done is to go along with them. So off I went to the X-ray department. When I arrived, they asked me if I had brought the request form with me. I told them it had already been sent earlier that morning. The person disappeared for a long time before returning to say that they were sorry, but the form could not be found. My reply to this was that it was no problem, I would just fill out another form. Silence for a moment. Then I specifically asked for another form to which I was told that they did not have any request forms in the department so I would have to go back to the ward to get another one. That’s right, the radiology department does not have their own request forms. From that point on, I realized that when going to radiology, I should also remember to bring some extra forms even if I was sure they should have already received the original.

Ownership

For the most part, I would say that everyone at the hospital back home takes ownership for their responsibilities. This is obviously most important with respect to nurses, medical students, residents, and physicians taking ownership for their patients. This means, if a medical student or resident is assigned to a patient, they should know absolutely everything about that patient, even more than the attending physician. If there is something with that patient that is not going according to the daily plan or expectations, it is up to the person assigned to that patient to make it right and/or make others on the team aware of the situation.

While working here in Botswana, I have noticed in particular that blame is often passed on to others. More often than not, these others are people who are no longer working that day or people who cannot be specifically identified. I have also noticed that in general, there is a lack of formal sign-over of patients to the night team on-call. While these things do not happen all the time, they do definitely occur more often than back home and goes back to a general feeling that people are not taking ownership of the care of their patients.

Communication

Communication has been a challenge on several levels. The most obvious is that most people from Botswana speak Setswana. This does pose some issues on a daily basis, but not nearly as many as more broad communication issues.

Again, this is a generalization, but I have found that most people do not offer information. It is always work to get the information you need. If a lab result is not yet available, a phone call to get the result is the first place to start, but the lab rarely answers the phone. When they do, they will often say that the test has not been done yet, which of course, I already know, as that is the reason I am phoning. Asking when the test is planned to be done usually yields no further information as the person who is supposed to do the test is invariably away at the moment or they cannot find the sample. Again, this goes back to the ownership problem discussed above.

One morning a nurse came to me saying that a boy’s father had just arrived and was wondering where he could find his child who was admitted to our ward. I asked the nurse if the boy had gone for his CT scan and she did not know the answer. After looking for his chart on the ward and not finding it, not an unusual situation, we presumed that he must still be at his CT scan with his chart. I then asked the nurse if she could accompany the father to the radiology department so that he could be with his child.

A few moments later, the nurse was back and I could see the boy’s father at the far end of the ward. She said she actually found the boy playing outside, and he remained outside. I asked if he had his CT scan and she replied that she didn’t know. I then asked her if she could find out for me. A few minutes later, she was back and said that she still did not know since the boy’s father had just arrived so the father was unaware if the scan had been done. Since the boy had been scheduled for his CT scan that morning, I told the nurse that it was very important that we find out if it had been done, so off she went. More minutes later, she was back and said that nobody in the radiology department was answering the phone so she still didn’t have an answer for me. I then reminded her that the boy is 8 years old, so we could just ask him as he should know if he had a CT scan that morning. She told me he was outside playing so she could not do that at that time. In the end, I had to walk outside with her to find the boy and ask him myself. Turns out, he did have his CT scan already, so all was good in the end, but it took a lot of effort in communication to find that out.

System Flaws

I started making a list early on in my stay about system flaws since these are things that conceivably could be changed. I was not very stringent about keeping the list though, and there are too many of these things to remember right now, but the following list will highlight a few of them.

  • The spare oxygen tank on the ward is constantly empty despite there being a form attached to it that is signed off each day as being checked and full.
  • When ordering tests at the lab, an order is automatically cancelled if the same order has been placed within 24 hours, even if a new sample is being sent. This makes it very difficult to monitor lab results since for each new sample within 24 hours, there needs to be a conversation with the lab. Often by the time the sample is actually processed, a new person has started their shift in the lab, and the conversation is forgotten so the repeat sample is just cancelled anyways.
  • There is no ward clerk so the printing of forms and collecting lab results and X-rays becomes everyone’s responsibility. Of course, when everyone is responsible, no one is responsible. (Back to ownership, again.)
  • The blood gas machine uses special cartridges that only last one week. It should be easy to predict how many of these are needed in a month since they are changed weekly, and therefore, can be ordered accordingly. But, for some reason, we are almost always out of cartridges.

Closing Thoughts

As stated in my initial paragraph, the point of this post was not to be negative towards the health care system here in Botswana. It was intended to point out some of its differences and the challenges I have been faced with during my 16 weeks here. I am sure that I will notice more differences when I’m back inside the now not so familiar walls of CHEO, and I really do think that there is something to learn from each of these. I am also sure that in the coming days and weeks, there will be much more reflection by both myself and Amanda about how these 16 weeks in Africa have changed our outlook in both our work settings and our personal lives. I will try to post more of these thoughts so we can all learn from them.

Great Travel Camera – Panasonic GF2

A few people have asked about what camera we have been using while on our trip, so I thought I would write up some of the details.

Before we left for Africa, we knew we were in the market for a new camera. We previously had a small Olympus point-and-shoot that we really liked since it was small enough to put in a pocket and durable enough that it didn’t need an additional case. So it was always ready. The one downside to it was the image size that was produced. We were able to print anything up 5 x 7 and it looked fine, but once we got above that, pictures became grainy.

We also both realized that since we were carrying our iPhones with us everywhere, we already had a simple point-and-shoot camera on us all the time, so the old Olympus was being used less and less. Therefore, the question became, what is out there that is better than an iPhone 4 camera, but easier to carry around than an SLR? We also wanted a camera that would always be ready like our old point-and-shoot.

I had numerous email, Skype and Google Talk conversations with my cousin Chris, which could be summarized by the following points:

  • “the best camera is the one you have on you”
  • not going to a DSLR for traveling is a smart choice
  • make sure the camera shoots RAW
  • buy either a Panasonic GF-1 or GF-2

It was that last point that Chris kept coming back to. No matter how many times I tried to only take the first three points into consideration, he practically insisted that I only buy a Panasonic GF-1 or GF-2. He admitted to being biased when it comes to cameras, but I’ve seen his work and know that he knows a thing or two about cameras.

So, we took the leap and purchased a Panasonic GF-2.1 It is definitely more of a camera then we have ever had before, but its size is definitely manageable. It is also very rugged and durable. We usually just have the camera hanging around our neck or in a small backpack without any other case to protect it, except for a lens cap. So it definitely meets our criteria of always being ready. It is also a significant step up from the iPhone 4 which is important since we didn’t want to carry another camera around if the pictures would turn out exactly the same as pictures from the phone camera we would already be carrying.

I knew nothing about the camera before talking to Chris, so here are some points for those interested in getting one:

  • the Panasonic GF-2 is based on the Micro Four Thirds System developed by Panasonic and Olympus
  • it has an interchangeable lens system with many different lenses available, but it still very much feels like a point-and-shoot with more options available if you know how to use them
  • although the lenses are different than on a DSLR, apparently there are adapters if you ever do need a particular lens for something (I will talk more about our setup below)
  • depth of field makes a huge difference in the quality of photographs
  • if you are moving up from a point-and-shoot, it is definitely a camera you can grow into

As a final note, here is our setup for what we used for our entire trip to Africa:

  • Panasonic GF-2
  • Panasonic 14 mm f/2.5 lens – this is a fixed lens which means all zoom is by foot.2 This is the lens that came with our kit. There is an option to get a 14-42 mm lens instead.
  • UV Filter – we put this on the lens the moment the camera was purchased and it hasn’t come off since
  • 2 memory cards – 8 GB (holds over 500 RAW images) and a 4 GB for backup
  • Extra Battery – the battery life is much better than our old point-and-shoot, but it was still nice knowing we had a spare, especially out hiking or in the bush
  • international plug adapters to charge the batteries
  • no additional case, just the supplied lens cap and a cap keeper
  • standard SD card reader
  • all photos were taken in RAW only, at the largest setting, Adobe RGB
  • Flickr to upload the photos
  • WordPress to host the blogs

Chris, thanks again for your camera advice. We continue to love the camera and are extremely happy with the decision! If you have anything else to add or corrections about things above, feel free to comment below.


  1. The GF-1 was no longer being sold in stores, and I didn’t have enough time before leaving on our trip to search one out on eBay. The GF-3 was actually just about to be released so there were plenty of good deals on the GF-2. I have not used or seen a GF-3, but a good review is here
  2. We opted to keep the camera footprint small and stick with just a fixed lens which meant if you wanted to zoom in closer, you had to move your feet. I will admit that some photos were cropped a bit afterwards if we couldn’t physically get close enough, to a lion for example! 

Erongo Mountains

Photos: Erongo Mountains

November 4, 2011

We started the journey back to Windhoek, but made a planned detour at Usakos (about 90 minutes from Swakopmund) and headed 30 km north to Ameib Ranch. It is a small guesthouse nestled in the Erongo Mountains with hiking trails on site. We arrived early so had time to drop off our things and head out into the mountains for most of the day.

The first stop along the trail was at Philipp’s Cave. Inside the cave, there are rock paintings in the wall including one famous in Namibia, the white elephant. We got there just in time as there was a brief rain shower but we did not get wet in the cave.

We then headed to Bull’s Party which is an area containing many large boulders, many of which appear to be standing on edge in ways defying gravity. Each turn provides new and impressive views of crazy rock formations (hopefully some of this comes across in the photos).

Overlooking Bull’s Party is Elephant Rock which gets its name since it looks like the head of an elephant. We followed the path around back and headed up a steeper section requiring chains an ladders at points which led to the top of the rock and a panoramic view of the area. The climb up was only a 150 meter elevation gain, but some parts where quite steep and narrow, bringing back memories of the movie 127 Hours! 1

We headed back to the guesthouse, had a bit of time to cool down by the pool, then a delicious buffet dinner. Another great day in Namibia!

November 5, 2011

We woke up to great weather in the Erongo Mountains. After a filling breakfast, we hiked west from the ranch past the dam with great scenery of new peaks and valleys. The rock formations remained outstanding and it seemed like we could almost take a photo with each step.

We saw more wildlife during today’s walk. Plenty if antelope were running around and a troop of baboons peered down at us perched atop one of the many rock cliffs. Unfortunately, we did not come across any of the giraffes in the area, but we did our best to try and spot them.

It was much warmer than yesterday, so it was good that we needed to hike early in the day before taking transport back to Windhoek. A short stop at a coffee shop in Usakos and then we were on our way.

We ate at a Cameroonian restaurant called La Marmite. We shared a delicious beef curry and vegetables in a peanut sauce. Definitely one of the better meals we had in Namibia and a great way to spend our last evening.

We stayed at The Cardboard Box for our last night in Namibia. It is a backpackers that many stay at while in Windhoek. On a Saturday night, unfortunately that meant that many of the guest stayed up quite late at the bar area making the 5:30 am wakeup call the next morning even more difficult. On the plus side, the room was cheap!


  1. Not to worry, no boulders fell during our climb. Amanda and I each completed the hike with two arms intact! If you haven’t seen the movie, sorry for the spoiler. 

Sandwich Harbour

Photos: Sandwich Harbour

November 3, 2011

Sandwich Harbour is a former port about 100 km south of Swakopmund. There are a couple of old houses that are now in ruins, but otherwise there are no remnants of this being a commercial harbour. We had heard that the scenery was beautiful so we booked a tour with Turnstone Tours. We were lucky to have the company’s owner, Bruno, as our guide.

Most of the driving to get to Sandwich Harbour is a long the coast and through sand dunes. There is one stretch of beach where the large dunes of sand literally meet right up with the ocean. This doesn’t leave much room for vehicles to pass so the day must be carefully planned around the tides. It is also essential to have a good 4×4 vehicle and plenty of off-road experience – neither of which we have!

In the morning, we parked the vehicle up on a sand dune and had a fantastic walk up to some of the taller dunes in the area. The panoramic views were amazing and sitting atop one of the dunes, it definitely felt like you could just slide down into the ocean of you wanted to. We then walked back to the vehicle (glad that Bruno remembered the way), and had a delicious salad for lunch with coffee and cake for dessert.

After lunch, the tide was low enough that we could pass through to Sandwich Harbour. We then has another nice hike up to the highest point there before taking a different route down and following the ocean back to the vehicle. I don’t really know how to describe the sights of the day besides saying that the large dunes looked like mountains and the pictures will not do it justice. It is a very beautiful part of the world that we were privileged to see and Bruno definitely made the day one of the highlights of our trip to Africa.

I should also say a special thank you to everyone at Meike’s Guesthouse for making our stay in Swakopmund so relaxed and enjoyable. Meike in particular was extremely helpful in helping us with all the planning for the week. I think she made it her personal challenge to ensure our stay in Namibia was memorable after hearing that our plans would have to be altered due to forgetting our licenses.