I originally wrote this as one monstrously long entry, but have decided to post it in two pieces to save you considerable eye strain. Please enjoy, and stayed tuned for Part 2 tomorrow. –M

My primary workplace sits just over the invisible, unofficial borderline that separates the “local” and “tourist” regions of my district. If you walk 20 minutes in one direction, you will find resorts of mind-boggling opulence. Guests are happy to pay hundreds of dollars USD each night for sublime Indian Ocean views and think little of laying down more for a perfectly chilled cocktail than the average laborer makes in a week. If you walk 20 minutes in the other direction, you will find villages where one household in ten has a bed-covering net to prevent malaria, where wells are unprotected from contamination and routinely test positive for fecal bacteria. You will find homes where 2 of the family’s 4 children have died from preventable disease before the age of five years. You will see women who are trying their damndest to educate a brood of children with the proceeds from selling bananas at a roadside kiosk. We have a dedicated clinic staff, as well as more than a dozen layman volunteers who serve to encourage their neighbors and friends to seek out things like vaccinations and treatments for tuberculosis. Nonetheless, the work is slow, and often feels darkly Sisyphean.

One of the oddest features of the intersection between local and tourist is the number of people who come rolling through my clinic as a stop on their vacations. Yes, my clinic. They roar into the main yard in white SUVs, dropping off plastic shopping bags of adhesive band-aids and nearly-expired drugs with labels in foreign languages (some of which are used, and some of which are accepted graciously before being dumped into a drawer somewhere never to be seen again.) They openly point at too-thin babies (aside from being rude for obvious reasons, pointing at a person has a very stark cultural distastefulness, and can be associated with witchcraft.) They take pictures of seriously ill patients curled up on the wooden benches in the waiting area, then shove their $300 camera phones back into the pockets of their skin-tight booty-shorts. They brush past well-spoken, uniformed medical professionals to gawk at the pit latrine toilets and reaffirm their expected narrative of the “African” experience.

I know they mean well. I do. It is through meetings like these that our clinic can sometimes find a donor willing to fund new microscopes or improvements to the birthing room. Some visitors are patient, thoughtful, and respectful. And there are DEFINITELY instances wherein infusions of foreign money or goods can serve to boost a long-term, sustainable goal. But even if I set aside the “donor syndrome” issue, it rarely strikes me as anything other than self-important (“Look at all the good we’ve done!”) or blatantly disrespectful (photographing sick people? SERIOUSLY?) If I may borrow a phrase from Salman Rushdie, it’s poverty porn. For a few months, during the low-season, we receive a total respite from this experience. But then high season returns, and every week or two, another group shows up.

High season: the period of the year during which Europeans and (to a lesser extent) Americans abandon their chill, soggy homelands for the warm, welcoming embrace of the Kenyan coast. They begin to trickle in around July, rush forth in torrents by late October, and then depart abruptly the first week April, as though they all simultaneously remember they left the gas on and forgot to put the cat out. For the duration of our rainy season it’s a veritable ghost town outside the local areas. Peaceful, if not always convenient (example: the local grocer stops stocking peanut butter altogether until it becomes a reliably-selling item again. Boo.)

A number of my Kenyan friends and neighbors look forward to high season like it’s one giant, seven-month Christmas holiday. I can scarcely overstate the economic impact it has on my region: hundreds upon hundreds of jobs are created, from hotel staff and house help to tour guides and turtle watchers. Service, entertainment, and environment-related industries boom. Much of it pays rather well. People have money in their pockets, so school fees get paid and long-delayed doctors’ appointments are attended. Plus, more attention is given to infrastructure issues like sewage and electricity – a good sign that the deluge is about to begin is when you see teams of temporary government employees scoping out and setting fire to the unlicensed trash pits that spring up in every neighborhood.

It also coincides with the directional shift of seasonal winds, clearing the beaches of seaweed and improving conditions for the small-scale fishing that has long been an economic and nutritional staple in this area. The price of fish drops, allowing more families to access this lean, healthy source of protein in gluttonous quantities. Meanwhile, fisherman still make more money, because they’re moving more product to more people (tourists have an insatiable appetite for seafood – and it’s hard to blame them; it’s difficult to find fresher, tastier fish in the world. In my humble opinion.) Furthermore, most of it is hand-harvested by small crews in wooden boats, the way it’s been done since time immemorial, so one doesn’t even have to wrestle overmuch with the environmentalist concerns of massive trawlers spouting pollution and devastating area fish populations. Everyone is happy (except, possibly, the fish.)

Of course, even setting aside the renewed enthusiasm for poverty porn, not every side-effect of tourism is positive. Some of the jobs created are not entirely reputable. Drug use is shockingly common both among locals and foreigners, particularly among young men. The number of people involved in the production, movement, and monetization of heroin and marijuana skyrockets.

Similarly, teachers notice an uptick in the number of female students quietly dropping out of school, or disappearing from their homesteads. If you ask them, they’ll tell you they have a job as a waitress, or a cook’s help, or that a cousin knows a tourist family who needed a house girl. But in truth, many of these girls are looking to help their families make ends meet by joining the ranks of the world’s oldest profession. While many of the adult women who support their families this way have demonstrated in surveys an above-average knowledge of HIV and resulting trends towards consistent condom use, this often doesn’t translate to youth. They may lack a solid educational foundation about their personal risk for infection, or feel disempowered to demand protection from clients. Also: they’re often paid extra to go without.

Notice I didn’t say “young women.” I said “girls.” And I mean “girls,” some as young as eleven or twelve. Although some efforts have been made to combat it, this area of the Coast remains an international hot spot for child prostitution and human trafficking.

Crime also goes up slightly, as an influx of wealth can yield an influx of muggings, but this hasn’t really been a problem in my particular area. (On a personal level, it also doesn’t hurt that I’m rarely out after dark, and most of the people in my neighborhood know me to some degree.) Still, tourists quickly discover that if they leave their beach bag unattended while they nip back to the bar to refresh their cocktail, it probably won’t be waiting for them when they return.

Continued tomorrow with part 2