South African Road Trip

Knysna heads

I have been quite blog-lazy and engrossed in my holidays. I am not sure if bloggers are supposed to write whilst travelling… I think I fail spectacularly at this, but probably have more fun on my holiday. Anyway, we just returned from two weeks in South Africa. We were in desperate need of some first-world luxury (such as food-choice and shops) so we headed off to the Garden Route and Cape Town.

This part of the world is spectacular and reminded me so much of home. Stunning coastline, lush forests, wildlife galore… That said, the section of SA that we travelled certainly is a little microcosm of the continent – perfect for what we needed but probably not for those wanting a true African experience.

Foodie heaven

Getting our foodie and consumer fix was a prime focus and we were not disappointed. Fresh, local, seasonal produce abounds and the food quality is perfection. We stuffed ourselves silly dining on all the cuisines that we cannot readily get here in Tanzania. Italian, Japanese, seafood, Thai and lots of modern contemporary food. It was pure heaven and incredible value for money. From a T1 perspective this could have been a nightmare, but I managed to guesstimate carbohydrates and bolus correctly 90% of the time. The other 10%, who cares, that’s what holidays are for. Not only were we excited by the cafes and restaurants, but we wandered supermarket aisles in awe of all the food choices that we are no longer accustomed to. I think we have been in Tanzania too long!

Plummeting sugar up Table Mountain

After spending the night in Port Elizabeth we stayed at Addo-Elephant Park to get a taste of Southern Africa’s wildlife (some we literally tasted - whoops). Then we headed along the coast through surfer heaven Jacksons Bay, Plettenberg Bay, Tsitsikamma forest, Storm’s River National Park, stunning Knysna, ostrich capital Oudtshoorn, Franschoek wine-region and then on to beautiful Cape Town. Along the way we hiked, explored rock-pools (my FAVOURITE past-time), visited markets, beaches, went caving (made more difficult trying not to crush my meter stuffed in my bra!), visited the southern tip of the continent, ate… ate… ate…  All food, accommodation and activities were amazing value due to the plummeting rand (sorry South Africa).

Cape Town

Cape Town was such a pleasant surprise. It is modern and funky and there is so much happening. We found it safe and easy to get around. The shops and waterfront are modern yet have lots of character with excellent markets. Climbing Table Mountain was stunning, despite me needing to munch fruit and sweets most of the way because I forgot to adjust my basal insulin the night before (for non-T1s reading this - yes, it is very complicated!). At the top we were in icy cold cloud and wind, then the weather turned and we got the view and sunshine. It was in Cape Town that we ate the best Japanese food of my life and shopped up a storm. We managed to replace our holey underwear and shoes that have lasted us through our first two years in Tanzania. Exciting stuff.

Amazing holiday, exactly what the soul needed.

So, Type 1s reading this, what I want to know is this: Overnight travel is consistently extremely challenging for me and my blood sugars. The lack of sleep and small meals seems to make my sugars go extremely high to low, and makes what is already unpleasant an even worse experience. How do you manage this? Any tips? 

Safari - Lions, elephants and hypo snacks

Happy place! 

Many people ask why we moved here, but for us, the opportunity was a no-brainer. We are wildlife obsessed, and the chance to live here meant safari, and Tanzania is where you want to be for animals. I think I am now the world expert on going on safari with T1D!

Here in Arusha, we are at the gateway to Northern Tanzania. Kilimanjaro is to the East, and the Serengeti to the West.  Forested Arusha National Park is a 1 hour drive from our house, elephant-rich Tarangire National Park 1 and a half hours, beautiful Lake Manyara National Park 2 hours and the famous Ngorongoro Crater 3 hours away. All the cliche African wildlife experiences can be had here on a Friday night weekend getaway...  I still have to pinch myself to believe that we live here. Oh I should have warned earlier, this is a major brag post!

Wildebeest migration. 

Living here we have three options for safari; self-drive, guided or fly. I am incredibly spoiled in that I have been able to tag along with Jarrod on his flights and overnights to the Serengeti. We have stayed in little tents, luxury tents, lodges... The great thing about Tanzania is that none of the camps are fenced, so seeing elephants or hearing lions and hyena outside your tent is all a part of the experience. I will never forget my first African camping trip; I made the mistake of offering to watch our friends baby and kids while the others set up the tents... I felt very vulnerable sitting with a squealing baby and chatty kiddies, knowing lions could be somewhere nearby in the darkness! Shining your torch around... lots of eyes reflect back, hopefully zebra and impala.


Of the challenges I have had to face going on safari, the biggest has to be hypo snacks. Sleeping in a tent, luxury or not, they are strict on the no-food policy, and for good reason. One of my friend's cars was smashed open by a hungry elephant who could smell fruit in the vehicle! This is a tricky one to get around, so my tip is to pack a plastic, seal-able tuppaware type container for any snacks. Keep simple plain snacks in your tent that don't smell too sweet - such as plain crackers and sweets (no fruit or meat). Glucose tabs would probably be a good option here (ugh). Give any additional snacks to the kitchen to store for you to collect at the beginning of each day. Or pack in the car, again, in seal-able containers.

Refrigeration of insulin and glucagon is another challenge. I think it's wise to travel with glucagon - you are in a very remote place. If you are with a safari company, many of their cars have a little fridge. If we are self-driving we have a cooler box with frozen bottles. For longer trips we are looking at investing in a Engel fridge. Jarrod is very keen to get one of these for my insulin... but I think he is mostly excited about a new gadget.

Mama cheetah and cubs. 

Another thing that struck me was be prepared to get stuck. I don't think this happens too often, but you do hear about cars getting stuck in the mud overnight, or even lost for several days (one of our guides rescued a group that had been lost for 2 days!). When I heard this I felt so vulnerable, and realised that I need to be responsible for always having my own food supply in the event that this might happen. Others might last a couple of days without food... I am not sure what would happen to my diabetic body. As such, now I always make sure I have a couple of full packets of decent crackers, dried fruit, nuts, juice boxes and biltong (dried meat).

If you plan on safariing, get used to injecting with the bumpy roads known as the "African massage." Let's just say I have become an expert at pinch, look away and stab. Not cool.

My last tip is to communicate. My husband Jarrod enters some kind of a state of safari frenzy and never notices if I am chowing down on sweets. I need to get better at telling him that I don't give a **** about that baboon riding a zebra right now, because I am busy hypo-ing. All things to learn! Another thing I learnt is that self-driving and having a huge male lion walk past and make eye-contact, about 2 meters away, causes a massive release of sugar into the blood-stream! My electric window was not fast enough.

This is such an amazing place. Sometimes I wonder what we are doing here... am I am crazy depriving myself of easy access to medical care, support and technology? Then I remind myself of the incredible things we have seen and done, and how much more we have to see, and it is so, so worth it.

Check-Ups in Nairobi - Getting Care in East Africa

Land border crossing between Tanzania and Nairobi - legitimate excuse for
procrastinating an endo appointment right? 

Last week I traveled to Nairobi, Kenya, for my first big check-up since being in Tanzania, and since being diagnosed. Unfortunately the checkups and advice needed for my diabetes care isn't easily accessible in Arusha. I had one appointment with the endocrinologist at the hospital here, but the long queues of forlorn people outside his door made it clear that it would be difficult to get much of time in the face of such overwhelming need. As such, it is necessary to travel to Kenya for what I need.

High security in "Nairobbery." 

I had heard the private health care in Kenya is world-class, and on the advice of colleagues, booked to see the endocrinologist at the Aga Khan University Hospital in Nairobi. The Aga Khan Hospitals are funded by the Aga Khan, the philanthropist leader of Ismaili Muslims. The service funds hospitals in Kenya, Tanzania (Dar es Salaam), Pakistan, India, Uganda and Tajikstan, and aims to support low-middle income earners in developing countries. I was so impressed by the care I received and I have heard expats saying that it surpasses what they would receive in their home countries. My consultation was only $35 and while this unaffordable for most people in the region, it is significantly cheaper than I would face in the private system at home. The hospital had gardens for patients and was very clean and modern, the staff were friendly and all services and appointments efficient. My endocrinologist was thorough, knowledgeable and kind, and she allayed all my fears and nerves about my first big check-up.

While the drive to Nairobi from Arusha is less than 300km, I had been advised to take a shuttle bus to avoid driving in Nairobi's infamous traffic and to save border crossing issues with a private car. This was a good tip given the navigation and terrifying driving in Nairobi. 8 hours travel for 300kms for an endo appointment is longer than I would like... but it is better than many people in the world have access to. While waiting around for tests and appointments I made the most of Nairobis modern shops and food, stocking up on supplies such
 as decent shampoo and cooking ingredients.

So to summarise my first big check-up as a diabetic - terrifying, adventurous, and oh yeah, terrifying again. I was a bundle of nerves, self-judgement and anxiety for weeks leading up to this. Other T1s, do you all find it so nerve-wracking?! At least in the future I know I can reward myself with Nairobi food and shopping, seems only fair right? X

I was pretty happy when we found an Asian
restaurant... #small things. :)

When you have been in Arusha for a year and a half,
even Nairobi is a foodie holiday. 

The "African massage" is not so great for diabetics.
Trying to psyche myself up to jab on bumpy African
roads is always fun, but I am becoming an expert.  

Tumbili. Diabetes Monkey.

The Zanzibar Red Colobus monkey is unable to process sugar, like me!

It is official. I have a new favourite animal. Not only are they adorable with killer hair-dos, they, like me, cannot process sugar.

I was lucky enough to visit Jozani Forest which was the best thing I did in Zanzibar. Not only do I love forests of any description, but it was so unlike any place I have been before. The forest is humid, lush and teeming with life, with immense mangroves that you can explore via a boardwalk. It is the largest remaining stand of forest on Zanzibar and an essential habitat for so many creatures, from land to ocean. The National Park authority works with local communities and it seems to be a real success story in ecotourism supporting local enterprise and conservation. One initiative is teaching local people to farm butterflies which are purchased from them for the butterfly park and sale overseas.

The forest is home to endangered Zanzibar Red Colobus monkeys. Sadly, because of the small habitat and threats due to road traffic, these monkeys are listed as endangered. The Colobus around the walking trails are used to visitors, so unlike the Black and White Colobus in Arusha, you can get close without disturbing them. I was  delighted when my ranger guide informed me that they only eat leaves and unripe fruit because they cannot process sugar! While I use insulin to get around this, they eat charcoal to help process trace amounts of sugar. In that moment I wished desperately I could communicate with the monkeys to lament our bodies and their sugar processing abilities. The cruelty of living in a forest with jackfruit and mango abounding and we cannot eat it without medical intervention! I found my kindred animal.

This monkey gets me. How I feel when I'm hypoglycemic... or hyperglycemic.

Beautiful Vine Snake in Jozani Forest.  

Kuandaa. To Prepare.

Travel, holidays, exploring, new places… Love it. I am in Zanzibar writing this and having an incredible time. However I will get to that later.

Today I feel the need to share/moan/laugh about the preparation that occurs when a T1 diabetic travels. When I was diagnosed, I was due to depart for Tanzania only 6 weeks later, so I was thrown into the challenges of travel right from the beginning, and for this I feel somewhat grateful.

The key is organisation and preparation. Organisation of supplies, and preparation for the worst.

Here is photo of my medical supplies for this week in Zanzibar. It pretty much says it all. This is the day to day equipment I need to stay alive for one week, but going away, I need doubles or triples of everything, just in case something is lost/stolen or damaged. I always lay everything out one or two days before departure, and triple check I have everything. Travelling in developed countries this is not such an issue, as replacements are possible, however the lack of easy access to medical supplies in developing countries deems this necessary.

Ready for anything! Type 1 diabetes supplies for 1 week away.

Perhaps I overthink things, but I also consider natural disasters, political unrest, transport delays. For everyone else, getting stranded somewhere probably means a bit of discomfort. For a T1 diabetic who has lost their insulin or sugar, it’s a lot more serious. There is no need to let these worries prevent you from doing anything, but I believe it pays to plan for a worst case scenario. In addition, I always wear my medic-alert bracelet and an ugly medical wrist-band when travelling. There are so many unknowns being in this part of the world, and you are not always with people who know you. It is just better that people can easily see that you have a medical condition for if you are in an accident.

I really think that I should be allowed excess baggage on medical grounds, however I’m not so sure they will go for it. Maybe next time I fly I will ask and let you know. For any T1s reading, I will make a list of travel tips soon. For anyone who doesn’t have to carry this amount of medical equipment with you everywhere you go, feel grateful next time you are packing your bag and trying to organise your toiletries!