Hello... I apologize for not writing more, but one of the less fabulous things about Micronesia is that internet is pay-by-the-megabyte. Needless to say, I spent a lot of money on internet and wasn't able to access 'fancy' websites often.
So.... I will just give a brief synopsis. My research with Island Food Community of Pohnpei was fine. I did a qualitative project, which left me to fend for myself, basically. More help on logistics (transportation, etc) would have been appreciated (and probably granted had my project been quantitative). Oh well. My village was an hour away and had to be reached by a 4-wheel-drive vehicle. I only made it out there 4 times, unfortunately. (And it was a struggle to get those 4 times.) I completed the project, but I do not think it is thesis-quality, so I will write up a report but not plan on using it for a thesis. Conducting the interviews in a different language was too much for my first time carrying out a qualitative project. However, I learned A LOT and am so grateful for the opportunity.
Some of the great parts about the trip... I got to swim with manta rays. Awesome. We did a lot of snorkeling. The boat trips to outer atolls were really, really enjoyable. We spent a night on one of them and it was so neat. Hikes to waterfalls were slippery and trying experiences. :) Rewarding, too, of course. The place was just beautiful, but it took getting into a boat and seeing the island from the water to realize the incredible nature we were living in.
Michael Jackson died while we were in Pohnpei and I was actually sick that weekend, so while the other researchers were out exploring, I watched Michael Jackson tributes on TV all day laying in bed. That was special...
Leaving was much more difficult than I had expected. Because it is such a small island, going to the airport is a big deal. A plane comes and leaves once a day (Continental Micronesia). Entire families and friends will go to the airport to see people off. I wasn't prepared for it to be an emotional experience and couldn't look back when walking to the plane. Met some pretty special people.
Well, I guess that is all for now. More to come at the GFE presentation. Ha.
Hope everyone had good experiences - enjoyed your posts. What an amazing group of people you are. Look forward to seeing you back in Atlanta and wishing everyone a safe trip back.
Love,
Kaleigh
Tuesday, August 11, 2009
Tuesday, July 28, 2009
Meryl is return
Heidi and I picked her up at the airport.
http://www.youtube.com/watch?v=_L4fltWl9-A
Heidi said leaving a bag unattended in an airport in Israel is a good way of having it exploded by security.
Jeff
http://www.youtube.com/watch?v=_L4fltWl9-A
Heidi said leaving a bag unattended in an airport in Israel is a good way of having it exploded by security.
Jeff
Saturday, July 25, 2009
Home
Hello,
I left JoBurg Thursday evening and arrive in the US Friday evening . It took about 27 hours. I watched a lot of television and movies and the food was pretty good. I flew Virgin from JoBurg to London. Richard Branson was on the flight and went around greeting his customers.
I'll keep blogging to cover some experiences and thoughts I didn't get to while abroad. Such as, the most disgusting thing I ever ate, almost, two days ago.
A nice woman at work makes a corn porridge for breakfast and brings it to work. She would make an extra portion for me sometimes so I could have an authentic SA breakfast. It was good with lots of sugar and milk. By coicindence on my last day of work (I think! I hope it wasn't a treat for my last day) she had brought in another authentic SA food. It some kind of insect or grub. I don't even know.
I'm pretty into food and you have to eat weird things to have street cred as a food enthusiast. There were a few African people at the table in the break room and they were sampling the fried insect. Here I am contemplating one. It's pretty big. And disgusting.
Here I am nomming on a grub. I didn't want to eat that whole thing so I bit off a third. Then I held it in my mouth for thirty seconds. The outside was kind of flaky and crunchy and the inside seemed goey. I couldn't chew it. I wanted to, but I couldn't get past the thought, if I start chewing on this, I'm going to be chewing on bug guts.
So I spit it in the trash and moved on with my life. (center below the napkin)
I left JoBurg Thursday evening and arrive in the US Friday evening . It took about 27 hours. I watched a lot of television and movies and the food was pretty good. I flew Virgin from JoBurg to London. Richard Branson was on the flight and went around greeting his customers.
I'll keep blogging to cover some experiences and thoughts I didn't get to while abroad. Such as, the most disgusting thing I ever ate, almost, two days ago.
A nice woman at work makes a corn porridge for breakfast and brings it to work. She would make an extra portion for me sometimes so I could have an authentic SA breakfast. It was good with lots of sugar and milk. By coicindence on my last day of work (I think! I hope it wasn't a treat for my last day) she had brought in another authentic SA food. It some kind of insect or grub. I don't even know.
I'm pretty into food and you have to eat weird things to have street cred as a food enthusiast. There were a few African people at the table in the break room and they were sampling the fried insect. Here I am contemplating one. It's pretty big. And disgusting.
Here I am nomming on a grub. I didn't want to eat that whole thing so I bit off a third. Then I held it in my mouth for thirty seconds. The outside was kind of flaky and crunchy and the inside seemed goey. I couldn't chew it. I wanted to, but I couldn't get past the thought, if I start chewing on this, I'm going to be chewing on bug guts.
So I spit it in the trash and moved on with my life. (center below the napkin)
Thursday, July 16, 2009
Kruger
I went on safari in Kruger National Park with Waverly and her friend from the US, Miranda. On Wednesday we went to Nelspruit, a major town near to the park. Thursday morning we awoke at 5am to get to Kruger for a morning drive. The driving is done in safari vehicles, a cab in front for the driver and 3 or 4 raised bench seats that are open except for a canvas roof. It was very cold and windy most of the time in the vehicles and especially in the morning. The driver for our first game drive in Kruger is the driver for the hostel/safari company and the rest of the game drives were by safari guides.
We entered Kruger and the first thing we saw was impalas. There are lots and lots of impalas in Kruger. The driver even told us, we don’t need to stop long, you will see many impala. The way game drives are done is to drive around in the safari vehicle trying to spot animals. There aren’t viewing areas you can go and see a wildebeast or whatever, you just drive around and hope you see something. Watering holes are likely to have animals like waterbucks or impala, but we saw the more “exciting” animals in the bush. If you see something you tell the driver to stop and if he sees something, he will stop. The drivers are really good at spotting animals. It was always exciting when the driver stopped because we knew there was something to see we hadn’t spotted. When the vehicle would stop we would crane our necks from side to side and I would ask Waverly “what is it? What is it?” Sometimes the guide would just look off into the distance intently for a bit but most of the time there was an animal we hadn’t spotted. Twice he spotted giraffes, once in dense brush off the road and once in a tree line over a mile away that we would have missed.
After the first impala’s we saw we drove more and I spotted a lone impala off in the distance framed by foliage. I was proud of my animal spotting skills but this would end up seeming kind of silly compared to what we saw in two and half days. At that time, we didn’t know what to expect and it can vary a great deal. People at work had told me about going and not seeing any cats, so I knew that was a possibility.
Then, we passed another vehicle headed towards us and they said they had been following a lion. The animals walk on the road a lot so that is an easy way to spot them. Later we saw an incredible picture of that lion sitting in the road.
The first exciting animal sighting was two rhinos, a parent and smaller rhino. The guide told us that white rhinos have the babies walk in front and black rhinos have the babies walk in back of the herd. Then he said “where do white people hold their baby?” “And, where do black people hold their baby?” That is how you can tell whether you are seeing black or white rhinos. We never saw rhino herds and there are mostly white rhinos in Kruger, so it was not the most useful explanation.
Then we went to camp to have breakfast. We were staying in tents in Pretoriuskop, in the southern part of Kruger. I invented a sandwich at breakfast, toast with peanut butter and jelly and cheddar (It was to have lots of calories and protein. Of the pbj family, it was better than peanut butter and banana, not as good as pbj and bacon). Then we went on another game drive. On safari, you mostly are either eating or on a game drive. We saw more impalas including two males that were fighting. They were rubbing their horns together but not very vigorously, so it looked more like they were flirting. Impala’s look delicate and soft, even the guys. Then we saw our first zebras. I really like zebras. They are like funny horses. Their neck fringe stands straight up so they look punk. There were some impalas and zebras and wildebeests hanging out in a field by the road. Later the guide told us that animals like to hang out with animals tougher than them, so they don’t have to worry about predators as much. For those animals wildebeat>zebra>impala. Sometimes there is low grass near the road, which is good for sightings. Tall grass and trees are worse. The most exciting part of the mid-day game drive was seeing elephants. There were three elephants way off in a grassy depression leading away form the road. At the time, we didn’t know if those would be the only elephants we saw, so it was great.
Then we broke for lunch at one of the rest areas. A guy from Europe was with us and he warned us about trouble monkeys. Those are monkeys that hang around the rest areas and try to take loose items or food from vehicles. I thought that was a fun concept to bring back to the US. “I can’t find my keys, maybe a trouble monkey took them.” Every meal we had on safari was great. Breakfast was pastries, the aforementioned sandwich, yogurt, fruit salad, cereal, etc. Lunches were sandwiches, salad, and very delicious curry potato salad or macaroni salad. Dinners were cooked over a camp fire. Marinated chicken the first night and beef stew the second night, with pap and rice, respectively. Pap is a South African dish made of corn flour. There was a lake near the rest area and we saw our first hippo there. Hippos bob up and down in the water, from fully submerged to sticking their nose out, so you don’t see very much hippo.
It sounds super exciting when condensed, but on safari there are long stretches of driving when you don’t see any animals. Sometimes, we went an hour or two at a time only seeing impalas or something way off in the bush.
That night we had a night drive. We went out at about five as the sun was setting. Right outside of camp we saw our first baboons. They were crossing the road in front of us. There was a baby baboon riding on it’s mothers back which delighted Waverly and Miranda but I missed it. On night safari, there are bright flashlights in the vehicle and you shine them out to the sides and use the lights and headlights to try to spot eyes in the dark. I think we mostly spotted animals in the lights without actually seeing their eyes. Night drives are good for seeing cats and we hadn’t seen any cats yet. The night guides were different from our day drivers and they were incredible at spotting animals. As the sun was still going down they saw a rock antelope on a rock face way off in the distance. The drivers also spotted a chameleon on a tree (while we were doing about 20 mph and in the dark!) and we saw a bush rabbit. We also saw a few owls. Mostly I am using correct names but if I don’t know the right name, I just append “bush.” Bush rabbit, bush squirrel, etc.
I have a bunch of black pictures from the night drive from trying to take pictures at night of animals in dense bush. The first cat we saw was a leopard. It was walking towards us on the road and then it turned away and walking away about level with the vehicle. I have a picture of its butt. I think the second exciting animal we saw was a hyena. It was about 20 feet away and not moving. It was gazing at the ground and didn’t seem to care that we shining a light on it and talking. I really like hyena faces and I’m glad I got to see a hyena. Then we saw two lions. One was a girl lion and they both might have been, I’m not sure. They were very close to the road. I think when we first stopped they were only 15 feet away. It felt a little bit dangerous. They moved away from us but stopped about 25 feet away for a bit. I think lions are a bit overrated, because you usually only seem them briefly and at night. It’s also fun to see elephants playing or impalas bouncing up and down over brush, but when you go to Kruger people are really concerned with seeing the big five (lion, elephant, rhino, leopard, water buffalo). The big five comes from hunting and if you are sightseeing, then zebras or giraffes might be more fun than water buffalo but not as good for bragging if you are a hunter. A bit later we saw a third lion walking parallel to the road and roaring. The Euro guy had done an impression of the lion he saw and it was like that. Low and short and not very loud, Ruuur, Ruuur, Ruuur. The guide thought he was looking for his lion ladyfriends.
It was pretty cold our first night in Kruger. We had hot water bottles to snuggle with and we used them for the morning drive the next day too. I think of day two as elephant day. First we went and looked at a watering hole that was empty except for a few hippos. Two young hippos were playing, sticking their jaws out of the water and on each other. Then we saw a few waterbucks. Waterbucks have a white behind. The guide explained that waterbucks sat on a toilet seat that had been painted so they have a white U shape on their butt. Then as we were cruising along the road a pack of wild dogs approached in the opposite direction. Wild dogs are very rare, I think only cheetah’s have fewer numbers in Krueger. They are splotchy black and tan and white and about the size of a coyote. There were about seven of them and they didn’t seem fierce at all. Some went by on the road, close to the vehicle and some veered off into the bush. Wild dogs are thought of as intense predators because they will bring animals down in a pack and start eating while the animal is still alive.
Then we went and saw the watering hole where the battle at Kruger took place. It’s on youtube, but I can’t get the link from my work computer. There were lots of Waterbucks there and I was hoping there would be a lion-croc fight over one of the young ones but it didn’t happen. Then we saw about three zebras. I asked the guide how many zebras he would see at a time since we hadn’t seen more than four and on tv I have seen large herds of zebras. He said nine or ten was the most zebras he would see in Kruger. Then we drove for another hour or so, seeing a bush lizard, before we saw about fifteen zebras right by the road! There was a kid zebra and a teenage zebra dude and a bunch of adults. That was one of my favorite sightings.
Then we saw an elephant pretty close to the road eating a bush. After that we saw water buffola completing the Big Five. ***old dudes*** Next we went and looked at a creek bed. In one direction there was a rhino off in the distance. In the other direction there was a giraffe way off in the distance. I have a picture that looks like a loch ness monster picture because the giraffe is so far away and it has the same head shape. Nevertheless, we crossed off giraffe from our list of animals to see.
Then we stopped for lunch. There were lots of trouble monkeys at lunch. When the group next to us finished eating trouble monkeys came and scavenged their leftovers. Then the trouble monkeys went to our vehicle. I had to shoo five monkeys off our vehicle trying to get into our bags. As we were pulling out of the parking lot I saw that there was a minivan with an open window and monkey was going into it.
We saw a lot of elephants after lunch. We were driving thought high bushes and I saw some dark shapes behind bushes. Just as I thought I should say “stop” to check if they were animals we got a clear view of another elephant between two bushes. There were three or four elephants eating leaves as they wandered away from us. The guides had told us to stay low in our seats and not lean out because animals will react to a human shape and not to talk too loudly. One of the elephants shook his head at us and the guide told us that he was irritatied with us. We moved on and saw a lone elephant pretty fast. That elephant shook his head even more angrily. He wanted to kill our safari vehicle. Our guide told us elephants had charged him but he didn’t get give details about what happened. Shortly after that we saw two groups of elephants. One groups was next to a concrete cylinder with water in it. One of the elephants was sticking it’s trunk in and then spraying water on a child elephant. One of the smaller elephants was trying to get his trunk in the water but he couldn’t reach.
We moved on from the elephant area and drove for a bit before seeing some cars stopped on a bridge. The bridge was a bit narrow so cars were backed up and the first person we asked didn’t know what there was to see. When we pulled forward more someone told us there was a leapord in the dry creak bed. That was the only cat we saw during the day time. It was lying in the shade of a tree and didn’t move during the time we were looking at it. That was it for day 2 and we went back to the camp.
This was the giraffe day. The guide had an incredible sighting of a giraffe and zebras way off in a tree line. Then we saw giraffes not too far away in trees and bushes. There were two. The way the head sways as they walk is fun and I like the horns. The giraffes looked at us, which was nice. A lot of animals either ignore us or move away.
Jeff
Tuesday, July 14, 2009
Sapa (Ron)
After the two posts my Jeff and Heidi I tried to think about an event here that had a similar bearing on my humanity and I can honestly say I have not had that experience (thankfully). My experience here is that Vietnam is a very peaceful country with wonderful people. The closest I had was a political discussion about a progressive citizen who was imprisoned for speaking out against corruption of the current government. It was not even a debate as my co-worker was agreeing with me that this man's imprisonment was improper.
On a more happier note, I have found one of my favorite places on this earth. Sapa, Vietnam. Sapa is a little town northwest of hanoi in the nothern mountains of vietnam that is surrounded by ethnic minorities who live their very traditional lives in small villages scattered amongst the rice paddies.
I booked a tour with handspan tours which was the best investment for this trip. The guide we had was wonderful. He grew up in Sapa so he was very knowledgeable of the area and the people. The hotel was simply amazing. Here is the view we had.
The group of people I had most contact with were called Black Hmong. Others in the region are Red Dau, Day, Tay, Flower Hmong, and Lu. At times it's very difficult to tell the difference as an outsider but each group has slightly distinctive clothing.
Here is a Black Hmong mother and her baby. They hike EVERYWHERE so all young children are carried on their back.
This is Cat Cat Village (Black Hmong). As you can see the village consists of small houses usually in a valley scattered around rice paddies.
This is from the second day hike to Lau Chai village. As you can see from the pictures it rained. In fact it rained the entire time I was in Sapa and I still left feeling like it was one of the most magical places I have ever been to.
One of the main reasons why I felt Sapa to be so wonderful is the people I met there. Everyone is trying to sell you something as the town and surrounding area is a tourist attraction. It is a mixture of hilarity and anger as you continually say "no" to someone who continues to ask "you buy from me?"
But the younger children speak very good English and are eager to practice. They are very outgoing and sometimes just want to get to know you. Here is a picture of a couple girls my group and I spent time talking to.
These two girls were hilarious when together. Just simply amazing people.
If anyone travels to nothern Vietnam you absolutely must take a trip to Sapa. The small town is beautiful in itself, hiking along the villages is a great way to spend the day, and the people are utteraly unforgettable.
Highlight of my trip so far.
On a more happier note, I have found one of my favorite places on this earth. Sapa, Vietnam. Sapa is a little town northwest of hanoi in the nothern mountains of vietnam that is surrounded by ethnic minorities who live their very traditional lives in small villages scattered amongst the rice paddies.
I booked a tour with handspan tours which was the best investment for this trip. The guide we had was wonderful. He grew up in Sapa so he was very knowledgeable of the area and the people. The hotel was simply amazing. Here is the view we had.
The group of people I had most contact with were called Black Hmong. Others in the region are Red Dau, Day, Tay, Flower Hmong, and Lu. At times it's very difficult to tell the difference as an outsider but each group has slightly distinctive clothing.
Here is a Black Hmong mother and her baby. They hike EVERYWHERE so all young children are carried on their back.
This is Cat Cat Village (Black Hmong). As you can see the village consists of small houses usually in a valley scattered around rice paddies.
This is from the second day hike to Lau Chai village. As you can see from the pictures it rained. In fact it rained the entire time I was in Sapa and I still left feeling like it was one of the most magical places I have ever been to.One of the main reasons why I felt Sapa to be so wonderful is the people I met there. Everyone is trying to sell you something as the town and surrounding area is a tourist attraction. It is a mixture of hilarity and anger as you continually say "no" to someone who continues to ask "you buy from me?"
But the younger children speak very good English and are eager to practice. They are very outgoing and sometimes just want to get to know you. Here is a picture of a couple girls my group and I spent time talking to.
These two girls were hilarious when together. Just simply amazing people.If anyone travels to nothern Vietnam you absolutely must take a trip to Sapa. The small town is beautiful in itself, hiking along the villages is a great way to spend the day, and the people are utteraly unforgettable.
Highlight of my trip so far.
Wednesday, July 8, 2009
Because Jeff brought it up...
My 'worst thing I've seen' isn't what I saw, but rather what I heard.
A couple weeks ago Adi and I were waiting outside her apartment building waiting for her roommate so we could all walk to a Shabbat dinner. With open windows we heard this really loud cracking and clanking in her neighbor's second floor unit followed by screaming. We soon realized the dad was whipping a child with his belt in the room right above us. It was horrifying how long it went on for. We waited several minutes for her roommate and, with the beating still going on, left for our dinner.
I asked if we should call the police, and Adi was hesitant. She knew that the neighbors were Lebanese and because they helped Israel during the Lebanon War (2006), they were allowed to live in the country. Apparently abuse is common among this group - a stereotype, I know. While she wanted to help, she said that it can be dangerous for her to report them if they were to find out it was her, and decided that for her safety it would be best to ignore it. I should say too, Adi is a nurse, and incredibly compassionate... to me it spoke volumes about the complexity of this situation when she was reluctant to get involved. The neighborhood is a little rough, but clearly there are social, political, and cultural dynamics here that I don't understand.
This was by far my worst experience, the kind that challenges your being and leaves a knot in your stomach, and ironically it's something that I could just as easily experienced in Atlanta. It was a terrible feeling to know that a child was being relentlessly beaten, hearing the foreign shouting and piercing cries, and to not have the ability to do anything about it. I guess I'd like to think that if I were confronted with a similar situation in the US, I would feel safe enough to intervene... hopefully I'll never have to find out.
A couple weeks ago Adi and I were waiting outside her apartment building waiting for her roommate so we could all walk to a Shabbat dinner. With open windows we heard this really loud cracking and clanking in her neighbor's second floor unit followed by screaming. We soon realized the dad was whipping a child with his belt in the room right above us. It was horrifying how long it went on for. We waited several minutes for her roommate and, with the beating still going on, left for our dinner.
I asked if we should call the police, and Adi was hesitant. She knew that the neighbors were Lebanese and because they helped Israel during the Lebanon War (2006), they were allowed to live in the country. Apparently abuse is common among this group - a stereotype, I know. While she wanted to help, she said that it can be dangerous for her to report them if they were to find out it was her, and decided that for her safety it would be best to ignore it. I should say too, Adi is a nurse, and incredibly compassionate... to me it spoke volumes about the complexity of this situation when she was reluctant to get involved. The neighborhood is a little rough, but clearly there are social, political, and cultural dynamics here that I don't understand.
This was by far my worst experience, the kind that challenges your being and leaves a knot in your stomach, and ironically it's something that I could just as easily experienced in Atlanta. It was a terrible feeling to know that a child was being relentlessly beaten, hearing the foreign shouting and piercing cries, and to not have the ability to do anything about it. I guess I'd like to think that if I were confronted with a similar situation in the US, I would feel safe enough to intervene... hopefully I'll never have to find out.
Tuesday, July 7, 2009
The worst thing I saw today
In the HIV section of a case report form “mom refused testing.” The child was one year old.
Most of the CRFs don’t have any extraneous writing, it is just boxes checked or lines filled in. Still, a lot is apparent about HIV testing in South Africa. People definitely are not testing when they should be. Stigma and denial must be huge factors, as well as worrying about having access to treatment if diagnosed.
I am only seeing cases with invasive pneumococcal disease, which is itself a warning sign about HIV status. Sometimes, a patient will have wasting and candidiasis or TB and candidiasis and the box is checked that they refused testing. Sometimes there is a CD4 count, which indicates the doc thought there was HIV and is going to try to treat the patient without acknowledging that they have HIV.
Sometimes I see a narrative through CRFs. Someone has the box checked for suspected HIV and they have AIDS defining illnesses but they refused testing. Then, three months later, there is another set of CRFs and they are positive.
Jeff
Most of the CRFs don’t have any extraneous writing, it is just boxes checked or lines filled in. Still, a lot is apparent about HIV testing in South Africa. People definitely are not testing when they should be. Stigma and denial must be huge factors, as well as worrying about having access to treatment if diagnosed.
I am only seeing cases with invasive pneumococcal disease, which is itself a warning sign about HIV status. Sometimes, a patient will have wasting and candidiasis or TB and candidiasis and the box is checked that they refused testing. Sometimes there is a CD4 count, which indicates the doc thought there was HIV and is going to try to treat the patient without acknowledging that they have HIV.
Sometimes I see a narrative through CRFs. Someone has the box checked for suspected HIV and they have AIDS defining illnesses but they refused testing. Then, three months later, there is another set of CRFs and they are positive.
Jeff
Friday, July 3, 2009
Bara
I like my women like I like my hospitals. The largest in the Southern Hemisphere.
On Thursday I visited Chris Hani Baragwanath Hospital. Bara is the main hospital serving Soweto, a black area that abuts the southwest of JoBurg. It was a separate municipality until 2002 but now Soweto is considered part of JoBurg. There are clinics in Soweto, but if you need a hospital for something serious, or you can't pay very much (or at all) you go to Bara. The hospital gets 150 000 inpatients and 500 000 outpatients per year and 160 gunshot wounds a month (1).
Aside from being really really big, Bara is unlike any hospital I have ever seen. I have only seen hospitals in America, where they are usually squareish buildings with a lot of concrete. Bara has lots and lots of one-story buildings as well as two larger buildings and a variety of sizes in between. The largest building is about 11 stories. The wards are mostly 1 story and they are scattered around the middle area of the grounds. There are brick buildings, concrete, tin roofs, and a variety of colors. There are small buildings scattered around between the wards. Some of them are restrooms, some have doctor’s office, some sell halal food.
I was at Bara to learn about the GERMS-SA surveillance and burden of disease. The Group for Enteric, Respiratory and Meningeal Disease Surveillance-South Africa (GERMS-SA) does surveillance for a variety of disease that are associated with HIV positive individuals. HIV is one of the risk factors for invasive pneumocococcal disease generally, as well as for serotype 19A specifically, which I am working on. Bara has about six surveillance officers for adults and 1 for pediatrics, all women. In SA, nurses are called nursing sisters. Sadly, male nurses are not nursing brothers. When diseases under surveillance by GERMS-SA are identified in the hospital laboratory the surveillance officers go to the patient to ask for consent to have that person be a part of the surveillance.
The sisters told us that finding patients and consenting them can be tricky. Older patients may be illiterate. Sometimes it is hard to locate patients in such a large hospital. Patients with cryptococcus are often experiencing cognitive difficulties. People may abscond. We couldn’t locate a patient and the sisters thought he might have absconded. People may be transferred to the step-down hospital before the sisters have time to see them. People may be unclear about what they are consenting to because they want to be treated and so want to approve everything. This happens with HIV testing as well. GERMS-SA wants to identify HIV positive individuals. Sometimes patients “consent” to HIV testing. Then when asked if they want to receive the results, they don’t.
The first patient we saw was a child. The mother was there and so the surveillance officers were collecting information from the chart and from talking to the mother. They want to know things like vaccination record, temperature on the day the CSF isolate was collected, does the child live with siblings under 18, has the child been hospitalized recently, etc. If the patient is a child, surveillance officers will check when family members visit so they can talk to someone.
While walking to the next patient we had a fascinating discussion about HIV treatment. People will often see a traditional healer, either instead of seeking treatment or in conjunction. This occurs especially in HIV positive individuals with Cryptococcus as the mental effects may seem to be a curse from someone else or spirits and also may affect judgement. The doctors try to incorporate the traditional healers into the health plan and people will come with their healer to the doctor. Also, we learned that people sell anti retroviral drugs to drug dealers. ARVs can cause hallucination even if taken correctly so people will grind them up and smoke them for fun (2). About this time we passed a condom lying in the gutter. Oh JoBurg.
Then we looked for a patient in one of the adult wards. He wasn’t where they expected so they did a bit of investigating. They knew where he had been admitted and so they could check the night counts and what the computer system said about transfers. They weren’t sure if he was transferred to a different ward and it wasn’t noted or if he absconded. The wards are segregated by gender. This seemed strange to me because I don’t think of US hospitals as segregating by gender but I guess they do. We do it by room but their wards are one giant hall so it’s the same idea. It just felt different because it isn’t stated in the US, only one gender but room, but I guess that’s the policy. I asked a sister about it and she said privacy is important and “you wouldn’t put a lion in a room with a lamb.”
The next patient we saw was an HIV positive individual with Cryptococcus. The patient (TP) was experiencing cognitive effects so TP had been admitted to the hospital. TP had ARV medication but hadn’t been compliant with the treatment. Both interviews by the surveillance officers were in languages I don’t speak so they would have to explain what was happening. TP wasn’t clear on the importance of taking medication and possibly TP’s counseling when TP was diagnosed with HIV was not adequate. TP wanted to know about buying ARVs but that would be very expensive and they would be free at the hospital. Sometimes people that are HIV postive are in denial or don’t want to talk about their status because of the stigma so the sisters will talk to them about treatment without talking about their status. It was sad to see TP because TP was very nice and the sisters were trying to impress upon TP to take TP’s medicine and TP didn’t seem to be getting it. One of the doctors told us if TP wasn’t complying with his treatment he would be sent to the step-down hospital and then discharged because they need the bed available. One of the people with me on the site visit was an MD from London and she said TP would probably relapse and die from crypto if TP didn’t take the medicine for that.
Then we went to the morgue where the sisters sometimes go to check about paperwork. There was music playing a bit loudly in the morgue. The sisters told us that is to keep the spirits cheerful.
There is a building at Bara for prisoners that require medical treatment. Also you see people with orange jumpsuits and wrist and ankle chains being escorted around the grounds. We went to an HIV clinic next and it was pretty crowded. The waiting room had about 30 people in it including a prisoner. It is an obstacle to testing and treatment that the HIV care is pretty centralized in Soweto. It can be hard for people to get the Bara.
The sisters were very friendly and worked hard. It was great to see where my dataset has come from and what data they have trouble collecting. I asked one how long she has worked at Bara and she had been there 4 years. She said she enjoyed her job and it is interesting but it is hard because so many people have HIV. She said ARV treatment wasn’t helping very much because people get sick before they are started on ARV. I think the CD4 count has to get below a certain number before ARV is started. In the 80’s mortality at Bara was similar to a hospital in the US but now it is much higher. It can make treating patients seem futile. I was a little concerned with some aspects of the data quality after seeing the sisters. For example, they mentioned that they round age up. If I have a date of birth, I use that. If not, I go with the indicated age.
Then I went on pediatric rounds. I have been on rounds once before, at the ICU at SF General. That tine, there were a few people dying, a lot of people with trache tubes that couldn’t talk and seemed pretty miserable, etc. Although yesterday we were seeing sick kids, it was still kind of cheerful, compared to SF. In one room, there was a dad laughing as his kid held a Gatorade bottle for his dad like a bottle. The rooms were painted brightly with lots of images on the walls. There were usually parents with the kids and sometimes there were siblings too. The kids all had infections of some kind and antibiotic resistance is often a problem.
In one of the wards I vaguely noticed something on the ground but it didn’t register because hospitals often have miscellaneous equipment scattered around. The doc mentioned how it is hard to do infection control and pointed. I realized it was a sink on the ground that was ripped out of the wall. Everything was a bit grubby and the doctors talked at times about having trouble getting certain (expensive) medicines, but they seemed very competent and able to treat the kids.
Jeff
1. http://www.chrishanibaragwanathhospital.co.za/bara/article.jsp?id=161
2. http://www.aidshealth.org/news/in-the-media/no-turning-back-teens.html
p.s. I retracted my earlier post about hearing gunfire (in the comments), but I should say it on the front page too. It was just a loud noise. Although a friend of a friend was shot in an attempted carjacking near to where I live. She survived.
On Thursday I visited Chris Hani Baragwanath Hospital. Bara is the main hospital serving Soweto, a black area that abuts the southwest of JoBurg. It was a separate municipality until 2002 but now Soweto is considered part of JoBurg. There are clinics in Soweto, but if you need a hospital for something serious, or you can't pay very much (or at all) you go to Bara. The hospital gets 150 000 inpatients and 500 000 outpatients per year and 160 gunshot wounds a month (1).
Aside from being really really big, Bara is unlike any hospital I have ever seen. I have only seen hospitals in America, where they are usually squareish buildings with a lot of concrete. Bara has lots and lots of one-story buildings as well as two larger buildings and a variety of sizes in between. The largest building is about 11 stories. The wards are mostly 1 story and they are scattered around the middle area of the grounds. There are brick buildings, concrete, tin roofs, and a variety of colors. There are small buildings scattered around between the wards. Some of them are restrooms, some have doctor’s office, some sell halal food.
I was at Bara to learn about the GERMS-SA surveillance and burden of disease. The Group for Enteric, Respiratory and Meningeal Disease Surveillance-South Africa (GERMS-SA) does surveillance for a variety of disease that are associated with HIV positive individuals. HIV is one of the risk factors for invasive pneumocococcal disease generally, as well as for serotype 19A specifically, which I am working on. Bara has about six surveillance officers for adults and 1 for pediatrics, all women. In SA, nurses are called nursing sisters. Sadly, male nurses are not nursing brothers. When diseases under surveillance by GERMS-SA are identified in the hospital laboratory the surveillance officers go to the patient to ask for consent to have that person be a part of the surveillance.
The sisters told us that finding patients and consenting them can be tricky. Older patients may be illiterate. Sometimes it is hard to locate patients in such a large hospital. Patients with cryptococcus are often experiencing cognitive difficulties. People may abscond. We couldn’t locate a patient and the sisters thought he might have absconded. People may be transferred to the step-down hospital before the sisters have time to see them. People may be unclear about what they are consenting to because they want to be treated and so want to approve everything. This happens with HIV testing as well. GERMS-SA wants to identify HIV positive individuals. Sometimes patients “consent” to HIV testing. Then when asked if they want to receive the results, they don’t.
The first patient we saw was a child. The mother was there and so the surveillance officers were collecting information from the chart and from talking to the mother. They want to know things like vaccination record, temperature on the day the CSF isolate was collected, does the child live with siblings under 18, has the child been hospitalized recently, etc. If the patient is a child, surveillance officers will check when family members visit so they can talk to someone.
While walking to the next patient we had a fascinating discussion about HIV treatment. People will often see a traditional healer, either instead of seeking treatment or in conjunction. This occurs especially in HIV positive individuals with Cryptococcus as the mental effects may seem to be a curse from someone else or spirits and also may affect judgement. The doctors try to incorporate the traditional healers into the health plan and people will come with their healer to the doctor. Also, we learned that people sell anti retroviral drugs to drug dealers. ARVs can cause hallucination even if taken correctly so people will grind them up and smoke them for fun (2). About this time we passed a condom lying in the gutter. Oh JoBurg.
Then we looked for a patient in one of the adult wards. He wasn’t where they expected so they did a bit of investigating. They knew where he had been admitted and so they could check the night counts and what the computer system said about transfers. They weren’t sure if he was transferred to a different ward and it wasn’t noted or if he absconded. The wards are segregated by gender. This seemed strange to me because I don’t think of US hospitals as segregating by gender but I guess they do. We do it by room but their wards are one giant hall so it’s the same idea. It just felt different because it isn’t stated in the US, only one gender but room, but I guess that’s the policy. I asked a sister about it and she said privacy is important and “you wouldn’t put a lion in a room with a lamb.”
The next patient we saw was an HIV positive individual with Cryptococcus. The patient (TP) was experiencing cognitive effects so TP had been admitted to the hospital. TP had ARV medication but hadn’t been compliant with the treatment. Both interviews by the surveillance officers were in languages I don’t speak so they would have to explain what was happening. TP wasn’t clear on the importance of taking medication and possibly TP’s counseling when TP was diagnosed with HIV was not adequate. TP wanted to know about buying ARVs but that would be very expensive and they would be free at the hospital. Sometimes people that are HIV postive are in denial or don’t want to talk about their status because of the stigma so the sisters will talk to them about treatment without talking about their status. It was sad to see TP because TP was very nice and the sisters were trying to impress upon TP to take TP’s medicine and TP didn’t seem to be getting it. One of the doctors told us if TP wasn’t complying with his treatment he would be sent to the step-down hospital and then discharged because they need the bed available. One of the people with me on the site visit was an MD from London and she said TP would probably relapse and die from crypto if TP didn’t take the medicine for that.
Then we went to the morgue where the sisters sometimes go to check about paperwork. There was music playing a bit loudly in the morgue. The sisters told us that is to keep the spirits cheerful.
There is a building at Bara for prisoners that require medical treatment. Also you see people with orange jumpsuits and wrist and ankle chains being escorted around the grounds. We went to an HIV clinic next and it was pretty crowded. The waiting room had about 30 people in it including a prisoner. It is an obstacle to testing and treatment that the HIV care is pretty centralized in Soweto. It can be hard for people to get the Bara.
The sisters were very friendly and worked hard. It was great to see where my dataset has come from and what data they have trouble collecting. I asked one how long she has worked at Bara and she had been there 4 years. She said she enjoyed her job and it is interesting but it is hard because so many people have HIV. She said ARV treatment wasn’t helping very much because people get sick before they are started on ARV. I think the CD4 count has to get below a certain number before ARV is started. In the 80’s mortality at Bara was similar to a hospital in the US but now it is much higher. It can make treating patients seem futile. I was a little concerned with some aspects of the data quality after seeing the sisters. For example, they mentioned that they round age up. If I have a date of birth, I use that. If not, I go with the indicated age.
Then I went on pediatric rounds. I have been on rounds once before, at the ICU at SF General. That tine, there were a few people dying, a lot of people with trache tubes that couldn’t talk and seemed pretty miserable, etc. Although yesterday we were seeing sick kids, it was still kind of cheerful, compared to SF. In one room, there was a dad laughing as his kid held a Gatorade bottle for his dad like a bottle. The rooms were painted brightly with lots of images on the walls. There were usually parents with the kids and sometimes there were siblings too. The kids all had infections of some kind and antibiotic resistance is often a problem.
In one of the wards I vaguely noticed something on the ground but it didn’t register because hospitals often have miscellaneous equipment scattered around. The doc mentioned how it is hard to do infection control and pointed. I realized it was a sink on the ground that was ripped out of the wall. Everything was a bit grubby and the doctors talked at times about having trouble getting certain (expensive) medicines, but they seemed very competent and able to treat the kids.
Jeff
1. http://www.chrishanibaragwanathhospital.co.za/bara/article.jsp?id=161
2. http://www.aidshealth.org/news/in-the-media/no-turning-back-teens.html
p.s. I retracted my earlier post about hearing gunfire (in the comments), but I should say it on the front page too. It was just a loud noise. Although a friend of a friend was shot in an attempted carjacking near to where I live. She survived.
Tuesday, June 30, 2009
Happy 4th of July!
We have upon us what is arguably the best holiday ever -- the 4th of July!
So, what's everyone doing to celebrate this weekend?? Are you celebrating with other Americans, hosting a BBQ, or bringing yard games and fireworks to the locals? Whatever it is, take plenty of pictures and we'll have a story and picture posting blitz on the 5th! Pictures with American flags get extra props!
Happy 4th!
So, what's everyone doing to celebrate this weekend?? Are you celebrating with other Americans, hosting a BBQ, or bringing yard games and fireworks to the locals? Whatever it is, take plenty of pictures and we'll have a story and picture posting blitz on the 5th! Pictures with American flags get extra props!
Happy 4th!
Monday, June 29, 2009
Grananda
First of all, Granada = heaven. It is my favorite place so far in Nicaragua, and I feel slightly guilty saying so because it is very touristy (aka lots of gringos, different foods, streets are clean) but it was really beautiful. It is the oldest Spanish colonial city in Central America and there were great churches and cathedrals. This is us at a lookout over a lagoon that connects to Lake Nicaragua. (Still not sure how a lagoon is different than a lake but enough to look it up). Don't let this picture fool you, we were hotter than ever, it was over 100 and I was sweating sunscreen!
Fabulous market where Allison secured her hammock.
Happy Hour! Two mojitos for $1.25. You know what that means.
Cathedral. For the Jesus lover in all of us.
Time is running out and I am sad! Only a month left. I was going to travel up Central America but those damn Hondurans are having a coup so I think I will instead go down Costa Rica and Panamá. Maybe dabble in Columbia. Mwhahaha.
Tourist in Hanoi (Ron)
I thought I would add some pictures and comments from the tourist sites that I've visited in Hanoi. Most of these I saw a few weeks ago but some were just this past weekend.
This Hoan Kiem Lake, one of the multiple lakes in Hanoi but the most popular being right in the center of downtown.
A refurbished section of Hoa Lo prison. Originally constructed as a prison to hold Vietnamese political prisoners fighting against French occupation it is commonly known as the famous prison where US Soldiers were held during the "American War" as it's known here.
The Temple of Literature is the first "university" of Vietnam established in 1076. It has stone tablets with the names of its doctoral graduates.
I enjoy the Night market better in Hanoi than in other places. It's more of a gathering place for a nice walk than the Ben Thanh market in Ho Chi Minh City (Saigon) where you are treated as a walking wallet.
Speaking of "Uncle Ho" here is his final resting place and Ba Dinh square. The sheer size of this open area is hard to describe. In one of the most crowded cities I have seen, this large open area is just stunning.
My project is coming along fine. Two months just isn't a lot of time to get even basic research done in my mind, but I think what I'll collect will be helpful to ACS and hopefully to the organizations here.
This upcoming weekend I'm going to travel to Sapa which is a nothern mountainous region where many ethnic minorities live. Hiking along the rice paddies from village to village sounds like a great way to spend my weekend in attempt to get away from city life.
This Hoan Kiem Lake, one of the multiple lakes in Hanoi but the most popular being right in the center of downtown.
A refurbished section of Hoa Lo prison. Originally constructed as a prison to hold Vietnamese political prisoners fighting against French occupation it is commonly known as the famous prison where US Soldiers were held during the "American War" as it's known here.
The Temple of Literature is the first "university" of Vietnam established in 1076. It has stone tablets with the names of its doctoral graduates.
I enjoy the Night market better in Hanoi than in other places. It's more of a gathering place for a nice walk than the Ben Thanh market in Ho Chi Minh City (Saigon) where you are treated as a walking wallet.
Speaking of "Uncle Ho" here is his final resting place and Ba Dinh square. The sheer size of this open area is hard to describe. In one of the most crowded cities I have seen, this large open area is just stunning.My project is coming along fine. Two months just isn't a lot of time to get even basic research done in my mind, but I think what I'll collect will be helpful to ACS and hopefully to the organizations here.
This upcoming weekend I'm going to travel to Sapa which is a nothern mountainous region where many ethnic minorities live. Hiking along the rice paddies from village to village sounds like a great way to spend my weekend in attempt to get away from city life.
Sunday, June 21, 2009
Pacific (Kaleigh)
Hi!
I may have mentioned that Pohnpei is kind of a boring place… well, the massive Pacific Ocean that surrounds it most certainly is NOT boring. We almost died today and I am not exaggerating. Lois’ husband, Konrad, took us to Ant Atoll (an outer island about 25 miles from Pohnpei) on his small fishing boat. On our way to Ant Atoll, we did some snorkeling first. It was the most impressive coral reef. I cannot even describe it. This is one of the best places in the world for seeing such sights and now I know why. It was just tons and tons of coral reef (a wall) that spans an entire island. Kim took some underwater pictures, so hopefully I will steal some from her eventually. Alyssa saw a couple of reef sharks (Konrad said we probably would), but I didn’t see them... they were far below us.
We arrived at Ant Atoll, an uninhabited island, and it is exactly what people picture when you think of deserted tropical island… turquoise waters, sandy beach, palm trees. It was incredible and untouched. The only animals on the island are things like birds, salamanders, and lots and lots of hermit crabs. We ate lunch there (pasta salad with mangrove crab, basil spaghetti, boiled eggs, and pineapple) and then napped under some trees. We also did a little bit of snorkeling, but there wasn’t a whole lot to see except crystal clear water and sand. However, we did see a little coral reef with an eel in it. Supposedly there are a lot of stingrays where we were, but we didn’t see any.
Then it was time to head back to Pohnpei. We were in unprotected waters and the wind was extremely strong and we encountered choppy 6 foot waves. The boat got airtime more times than makes on comfortable and it started pouring. At first we thought it was fun, and then it started getting scary. It just got worse and worse. Eventually I had to get a bucket to take water out of the boat. It was very, very scary. Luckily Konrad is a good boat driver. :)
Well, that is about all we did today. It is 8:15 and we are in bed. (It was a big day. )
By the way, I am back to my ORIGINAL research project, which is probably best because I had put a lot of work into it and was prepared to do it. We will see how it goes.
Take care,
Kaleigh
I may have mentioned that Pohnpei is kind of a boring place… well, the massive Pacific Ocean that surrounds it most certainly is NOT boring. We almost died today and I am not exaggerating. Lois’ husband, Konrad, took us to Ant Atoll (an outer island about 25 miles from Pohnpei) on his small fishing boat. On our way to Ant Atoll, we did some snorkeling first. It was the most impressive coral reef. I cannot even describe it. This is one of the best places in the world for seeing such sights and now I know why. It was just tons and tons of coral reef (a wall) that spans an entire island. Kim took some underwater pictures, so hopefully I will steal some from her eventually. Alyssa saw a couple of reef sharks (Konrad said we probably would), but I didn’t see them... they were far below us.
We arrived at Ant Atoll, an uninhabited island, and it is exactly what people picture when you think of deserted tropical island… turquoise waters, sandy beach, palm trees. It was incredible and untouched. The only animals on the island are things like birds, salamanders, and lots and lots of hermit crabs. We ate lunch there (pasta salad with mangrove crab, basil spaghetti, boiled eggs, and pineapple) and then napped under some trees. We also did a little bit of snorkeling, but there wasn’t a whole lot to see except crystal clear water and sand. However, we did see a little coral reef with an eel in it. Supposedly there are a lot of stingrays where we were, but we didn’t see any.
Then it was time to head back to Pohnpei. We were in unprotected waters and the wind was extremely strong and we encountered choppy 6 foot waves. The boat got airtime more times than makes on comfortable and it started pouring. At first we thought it was fun, and then it started getting scary. It just got worse and worse. Eventually I had to get a bucket to take water out of the boat. It was very, very scary. Luckily Konrad is a good boat driver. :)
Well, that is about all we did today. It is 8:15 and we are in bed. (It was a big day. )
By the way, I am back to my ORIGINAL research project, which is probably best because I had put a lot of work into it and was prepared to do it. We will see how it goes.
Take care,
Kaleigh
Saturday, June 20, 2009
Settled in Southern Israel (Heidi)
I've become quite comfortable here in Beersheva and have settled into a nice working routine. During the week I'm at the Medical Center writing about comparisons between the Incident Command Systems (ICS) in Israel and Atlanta. It didn't take long to learn that comparing these two was like comparing apples and pumpkins... So I've made a few changes in the topics I'm looking at and will hopefully be able to generate something a little more practical. This week I'll also be switching my focus a little and looking at the role and development of resilience within the communities here. I'm really looking forward to this and hopefully will be able to use some aspect of this for my thesis.
I've taken the train back up to Tel Aviv and Netanya (up by Haifa), to attend two separate hospital preparedness events. Both were excellent supplements to the military drill I saw my first week here and provide a good background for learning more about mass trauma hospital response. Photo descriptions: The hospitals keep protective suits for their staff for use when patients come in from explosions that occur during wartime or a suspect blast. The decontamination showers are outside the hospitals here, much different from the US where decon takes place at the sight.
I can't say enough about the people I'm working with. They have done so much to make sure I'm taken care of and are really looking after me. Before I arrived my supervisor here put me in contact with one of her graduate students, Adi, which has made it really easy to find things to do and meet people. It seems every night I am invited with her friends to play volleyball, ultimate frisbee, swimming, or repelling. I have found this an excellent chance to get to know "true" Israeli life, especially that of young people here. Plus, they have group meals it seems every night, and they're making sure I'm getting to try all the traditional Jewish food. I could post dozens of pictures of the amazing food here! The Friday feasts are really spectacular and this past Friday we had one that was really traditional with the prayers and separation of meats and milk. Very cool. Photo descriptions: Getting ready for a night of competative foosball... playing volleyball (I've never played when it's this hot)... one of the many delicious meals, this night there were 13 people that brought dishes! 
Last Tuesday was Student Day, and so they had a big 24 hour music festival. Most of the artists sang in Hebrew, but it's pretty amazing how you don't need to understand the words to sing along with the chorus! The whole thing was really fun and it was great to get out and enjoy a little Goldstar-the main beer in Israel. Here's a picture from the festival.
Unfortunately I haven't done much sightseeing -- I've been in Israel for 3 weeks and haven't even visited Jerusalem! How sad is that! Part of this is due to the fact that public transportation doesn't run on Friday afternoons or Saturdays... so it's a bit of a planning dilemma when I'm working all week (the work week here is from Sunday to Thursday), so I'm definitely glad I gave myself a couple weeks at the end to travel. But it's great knowing locals because they have cars and know all the secrets: next Saturday Adi and some friends are planning a morning climb up Masada so I can see the Dead Sea at sunrise, and there's also a 3 day hiking/camping trip at the Sea of Galilee in the works, where I'll get to stay at my first kibbutz! Photo descritptions: I realized I haven't posted any pictures of the area -- just preparedness stuff! So, here's Tel Aviv from the Jaffa side... the Jaffa port is one of the oldest ports in the world, apparently it's referenced in the Bible and was constructed around the time of Alexandria... OK, so India had feral dogs, here cats are absolutely everywhere. Everytime you walk by a dumpster they scatter like crazy. I'm tempted to pet them but I'm sure I'd get infected with a few hundred diseases...
I've taken the train back up to Tel Aviv and Netanya (up by Haifa), to attend two separate hospital preparedness events. Both were excellent supplements to the military drill I saw my first week here and provide a good background for learning more about mass trauma hospital response. Photo descriptions: The hospitals keep protective suits for their staff for use when patients come in from explosions that occur during wartime or a suspect blast. The decontamination showers are outside the hospitals here, much different from the US where decon takes place at the sight.
I can't say enough about the people I'm working with. They have done so much to make sure I'm taken care of and are really looking after me. Before I arrived my supervisor here put me in contact with one of her graduate students, Adi, which has made it really easy to find things to do and meet people. It seems every night I am invited with her friends to play volleyball, ultimate frisbee, swimming, or repelling. I have found this an excellent chance to get to know "true" Israeli life, especially that of young people here. Plus, they have group meals it seems every night, and they're making sure I'm getting to try all the traditional Jewish food. I could post dozens of pictures of the amazing food here! The Friday feasts are really spectacular and this past Friday we had one that was really traditional with the prayers and separation of meats and milk. Very cool. Photo descriptions: Getting ready for a night of competative foosball... playing volleyball (I've never played when it's this hot)... one of the many delicious meals, this night there were 13 people that brought dishes! 
Last Tuesday was Student Day, and so they had a big 24 hour music festival. Most of the artists sang in Hebrew, but it's pretty amazing how you don't need to understand the words to sing along with the chorus! The whole thing was really fun and it was great to get out and enjoy a little Goldstar-the main beer in Israel. Here's a picture from the festival.
Unfortunately I haven't done much sightseeing -- I've been in Israel for 3 weeks and haven't even visited Jerusalem! How sad is that! Part of this is due to the fact that public transportation doesn't run on Friday afternoons or Saturdays... so it's a bit of a planning dilemma when I'm working all week (the work week here is from Sunday to Thursday), so I'm definitely glad I gave myself a couple weeks at the end to travel. But it's great knowing locals because they have cars and know all the secrets: next Saturday Adi and some friends are planning a morning climb up Masada so I can see the Dead Sea at sunrise, and there's also a 3 day hiking/camping trip at the Sea of Galilee in the works, where I'll get to stay at my first kibbutz! Photo descritptions: I realized I haven't posted any pictures of the area -- just preparedness stuff! So, here's Tel Aviv from the Jaffa side... the Jaffa port is one of the oldest ports in the world, apparently it's referenced in the Bible and was constructed around the time of Alexandria... OK, so India had feral dogs, here cats are absolutely everywhere. Everytime you walk by a dumpster they scatter like crazy. I'm tempted to pet them but I'm sure I'd get infected with a few hundred diseases...
Friday, June 19, 2009
The Good and The Bad (Ron)
I haven't posted in a while partly my own doing and partly because I felt too sick to leave my bed.
So the beginning........
A few weeks ago I was notified by my work that they would be holding a journalist training seminar on how to write effective tobacco control stories. The 2 day conference was to be held in Ha Long which is about a 3.5 hour drive from Ha Noi. So I thought to myself, what a wonderful opportunity to visit Ha Long Bay the weekend before and begin the conference the following Monday. So I booked overnight passage on the SS White Dolphin. Here's a picture of it's little cousin - my boat was another floor bigger.
Ha Long Bay was absolutely beautiful. It was simply amazing to see the limestone rock formations sharply extend from the water which is turned a very pretty green due to the dissolved rock. Everything is so calm with the exception of all the other boats touring the bay but when you have some free time it's truly a relaxing place to be.
The trip itinerary was a little touristy for my liking but we did explore "Surprise Cave" (ask me why it's a surprise and I'll show you the picture), hike one of the islands and kayak a smaller enclosure.
Pretty much the entire time was a relaxing boat cruise on the bay. I ate great seafood and met some really nice people as well.
The conference was likewise a really enjoyable time. Even though I did not understand a word of what was being said without the translator it was successful in that I gained some insight for my work here on Vietnamese media. I met and talked with some newspaper reporters, and TV correspondents - all of these contacts will help in the future when I need some insight into their tobacco control efforts.
Through a work friend I was invited into the home of a local family (the toddler son did not like me), drank beer and ate squid by the bay, and enjoyed pleasant conversation into the evening.
Even the 3.5 hour return bus ride to Ha Noi was enjoyable.
But if the universe is a zero-sum game, I certainly paid for it in the following days.
I made it in to work Wednesday morning noticing that it was hotter than most days (it really was) but that when I made it inside the office I was continuing to sweat. To make matters worse, we had run out of bottled water and a new shipment wasn't due for a few hours. I toughed it out but was feeling pretty bad with some lower back muscle pain. I thought it was due to dehydration, but after 3-4 bottles of water and lunch I decided that I wasn't feeling well enough to work throughout the day. I told the office that I was going home but would likely return tomorrow.
I made it home but by this time I was really burning up. Sure enough the thermometer was beeping with a temperature of 100.5. I monitored it throughout the day and it steadily climbed to 102 before plateauing. Then on came the headaches and diarrhea. Sadly this continued for another 3 days. I literally left my room a total of 3 times in five days all of which to go buy small amounts of food and large amounts of water.
This was the most sick I have felt in a long time.
When I finally recovered, I made it back to work just in time to be the butt of jokes pertaining to H1N1 and the American.
So the beginning........
A few weeks ago I was notified by my work that they would be holding a journalist training seminar on how to write effective tobacco control stories. The 2 day conference was to be held in Ha Long which is about a 3.5 hour drive from Ha Noi. So I thought to myself, what a wonderful opportunity to visit Ha Long Bay the weekend before and begin the conference the following Monday. So I booked overnight passage on the SS White Dolphin. Here's a picture of it's little cousin - my boat was another floor bigger.
Ha Long Bay was absolutely beautiful. It was simply amazing to see the limestone rock formations sharply extend from the water which is turned a very pretty green due to the dissolved rock. Everything is so calm with the exception of all the other boats touring the bay but when you have some free time it's truly a relaxing place to be.
The trip itinerary was a little touristy for my liking but we did explore "Surprise Cave" (ask me why it's a surprise and I'll show you the picture), hike one of the islands and kayak a smaller enclosure.
Pretty much the entire time was a relaxing boat cruise on the bay. I ate great seafood and met some really nice people as well.The conference was likewise a really enjoyable time. Even though I did not understand a word of what was being said without the translator it was successful in that I gained some insight for my work here on Vietnamese media. I met and talked with some newspaper reporters, and TV correspondents - all of these contacts will help in the future when I need some insight into their tobacco control efforts.
Through a work friend I was invited into the home of a local family (the toddler son did not like me), drank beer and ate squid by the bay, and enjoyed pleasant conversation into the evening.
Even the 3.5 hour return bus ride to Ha Noi was enjoyable.
But if the universe is a zero-sum game, I certainly paid for it in the following days.
I made it in to work Wednesday morning noticing that it was hotter than most days (it really was) but that when I made it inside the office I was continuing to sweat. To make matters worse, we had run out of bottled water and a new shipment wasn't due for a few hours. I toughed it out but was feeling pretty bad with some lower back muscle pain. I thought it was due to dehydration, but after 3-4 bottles of water and lunch I decided that I wasn't feeling well enough to work throughout the day. I told the office that I was going home but would likely return tomorrow.
I made it home but by this time I was really burning up. Sure enough the thermometer was beeping with a temperature of 100.5. I monitored it throughout the day and it steadily climbed to 102 before plateauing. Then on came the headaches and diarrhea. Sadly this continued for another 3 days. I literally left my room a total of 3 times in five days all of which to go buy small amounts of food and large amounts of water.
This was the most sick I have felt in a long time.
When I finally recovered, I made it back to work just in time to be the butt of jokes pertaining to H1N1 and the American.
Wednesday, June 17, 2009
Melville
I haven't been writing very much about work because it is not very exciting. Using a computer, meetings, learning lab techniques. So, travel writing.
Over the weekend I went to visit Waverly in Melville, which is a neighborhood in JoBurg (hi Waverly!). Firstly, I called a cab to pick me up at the compound. Lots of people who live in JoBurg don’t know where Sandringham is. It’s also called “Jewish” because it’s an area where Jewish people live. Cabbies mostly know where Sandringham is, but then they don’t know where the NICD is. There aren’t really address numbers in the area I live, so you can’t locate 1 Modderfontein Rd by trial and error. You have to know where NICD is. So, of course, the cabbie can’t find me and I have to explain things I’m near, like Sandringham HS and the Elfin Lodge (old people home).
Finally, he finds me, and great, we are off to Melville, which is near Witz University (the main university in JoBurg). He must not be very good at being a cabbie because we get comically, comically lost. Literally, driving in circles and stopping over and over to ask people where Melville is. This seems crazy to me, it’s one of the neighborhoods in a city you are a cabbie in. And other people didn’t know either! We passed through the worst area I’ve seen in JoBurg yet, which was fun to see while uneasy in a cab. It may have been Hillbrough, one of the two places you are definitely not supposed to go, ever. Razor wire even more everywhere than normal, people passed out/sleeping in a park, and it just felt dangerous. A ride that should have taken 30 minutes took an hour and a half instead. The cabbie was nice and he really was lost and not doing the scam-the-foreigner routine. He didn’t charge me much more than it should have cost without the impromptu tour of JoBurg (200 rand, rand is 8 to 1 with dollars).
I arrived eventually and met up with Waverly and we went exploring in Melville. We heard so much about how dangerous JoBurg was before leaving that it felt weird for me just to be walking around on the street. Also, I had spent about three weeks in the compound without leaving except to go to the mall a few times, so being outside around people and stores was making me a bit giddy. We wandered around the residential area in Melville while getting slightly lost in search of a café with internet. There was a reverse vampire effect, where we had to be home before the sun went down because I had my laptop with me.
Finally, he finds me, and great, we are off to Melville, which is near Witz University (the main university in JoBurg). He must not be very good at being a cabbie because we get comically, comically lost. Literally, driving in circles and stopping over and over to ask people where Melville is. This seems crazy to me, it’s one of the neighborhoods in a city you are a cabbie in. And other people didn’t know either! We passed through the worst area I’ve seen in JoBurg yet, which was fun to see while uneasy in a cab. It may have been Hillbrough, one of the two places you are definitely not supposed to go, ever. Razor wire even more everywhere than normal, people passed out/sleeping in a park, and it just felt dangerous. A ride that should have taken 30 minutes took an hour and a half instead. The cabbie was nice and he really was lost and not doing the scam-the-foreigner routine. He didn’t charge me much more than it should have cost without the impromptu tour of JoBurg (200 rand, rand is 8 to 1 with dollars).
I arrived eventually and met up with Waverly and we went exploring in Melville. We heard so much about how dangerous JoBurg was before leaving that it felt weird for me just to be walking around on the street. Also, I had spent about three weeks in the compound without leaving except to go to the mall a few times, so being outside around people and stores was making me a bit giddy. We wandered around the residential area in Melville while getting slightly lost in search of a café with internet. There was a reverse vampire effect, where we had to be home before the sun went down because I had my laptop with me.
After dropping off valuables at home we went out to dinner. There are about 7 blocks between the main street Waverly lives near (Main Street) and the night-life street with bars and restaurants we were going to (7th). This is not something I would think twice about in the States, but Waverly and I have to get into an involved discussion about walking 10 minutes at night. How late we should stay out. And what to do if we see people walking towards us or hanging out on the street. And whether we should go on the slightly shorter street or the busier street that is a bit longer. And, etc. (Safety meeting that emphasized how scary foreign countries are, and JoBurg especially, mission accomplished). I got my wallet ready to hand over to a mugger by removing half of the money and my ID.
For dinner we went to a Chinese/sushi place. Things are cheaper in JoBurg so we had a fantastic meal with sushi, multiple courses of Chinese food, beer, desert and tea for about $10 each. We had Windhoek, which I like more than Castle, the main beer in SA. Windhoek is less bitter and a bit sweeter. They are both lagers. Draft beers are about $1.50.
For dinner we went to a Chinese/sushi place. Things are cheaper in JoBurg so we had a fantastic meal with sushi, multiple courses of Chinese food, beer, desert and tea for about $10 each. We had Windhoek, which I like more than Castle, the main beer in SA. Windhoek is less bitter and a bit sweeter. They are both lagers. Draft beers are about $1.50.
After dinner we took a pre-mugging photo so we could have before and after photos if we got mugged. Then we walked around 7th avenue and looked at the bars.
(pre mugging photo)
I liked how Rat’z looked so we went there. It had a great atmosphere; dark lighting, eclectic art on the wall, and good music (US 90’s music ).
It was a bar I would be happy to find in the US. Because I like to be as authentic as possible (and getting drunk in strange and dangerous countries is wise) I had the Melville Rat. Blue curacao, pinapple juice, Malibu, Archers.
Walking back to Waverly’s was a bit tense because it was later (11 pm) and if we were going to be mugged this is when it would happen. We crossed the street at one point because there were two guys ahead, but otherwise it was uneventful. We smelled pot a few times in Melville while walking on that street.
The next day we went to bookstores and ate Indian food for lunch. The Indian food was a disappointment after the Chinese the night before because it didn’t come with a bunch of courses and it wasn’t as delicious. Walking back after lunch I had a moment of disconnect with reality. This was a perfectly normal day to have (book shopping, Indian food) but I am in Africa, and in Johannesburg specifically, which is a completely bizarre place for me to be living. And it still feels completely routine after just a day in Melville. There are kids that hang around the mall begging, but otherwise I could forget I was in a foreign country.
Jeff
p.s. I know some of you don't know Waverly. She is BSHE and doing community research about religion and sex.
Tuesday, June 16, 2009
That's that... (Liz)
The last several days of limbo have finally come to a close.
After initial warnings emerged around Nigeria, the Carter Center reported nothing out of the ordinary in Owerri. Carter Center and CDC are still sending personnel to the area. This is in contrast to information from Professor Dan Smith at Brown.
With these conflicting viewpoints, it's been difficult for me to make an educated choice. So I wrote the following in a letter to the director of my host organization in Nigeria:
"I'm really curious to know your take on everything. My primary interest is to be mainly an asset over a burden to you and your organization. Have these circumstances turned me into more of a liability than a help for CYDI?
In the event that I do not come to Nigeria, I have an alternative option available. Your comfort level with the situation will determine whether I come to Owerri or go to the other location."
This morning, I received a reply:
"First, I am really sorry that you have to be in such a difficult position right now. I realize that a lot of time, money and effort were put into making this trip possible. My colleagues and I are also devastated because this is the first time CYDI would be getting a student from Emory. It means a lot to us, and we have been looking forward to this trip.
Unfortunately, the situation in Owerri is not safe for you to come. This is my candid opinion.
You will recall that these kidnappings started, a few years ago, as a result of the protest in the Niger Delta area (River, Bayelsa and Delta), and the targets were expatriate staff of oil companies. We never had problem in Imo State. Infact, CYDI had students fro, Brown University in 2007 and 2008, which was at the peak of the crisis.
However, since the trouble spilled over to Imo State it has become an all-comers game.
These kidnappings have no political agenda, it just a way of making money. Their targets are random. They have kidnapped people across all ages (babies, children, teenagers, parents and grand parents), and across all sectors (civil servants, businessmen, teachers, lecturers, etc). Sadly, lives have been lost while people are being kidnapped or rescued. Infact things got worse when Imo State Government passed a bill making kidnapping an offence punishable by death.
While I agree that you will, definitely, be an asset to CYDI, I am worried that we shall be looking over our shoulders until you leave in August. I do not scare easily, but this kidnapping stuff is way above my head. I have lived all my life in Owerri, which has always been a peaceful town and I have my ear to the ground. The vibes are not good. People are hungry and angry. The new government has knocked down shops, relocated street businesses, and banned the use of motorcycle for transportation (in bid to make Owerri the cleanest city in Nigeria). Many people have lost their means of livelihood in the process. Most of the younger ones now resort to kidnapping, since it yields a higher return than armed robbery (this is based on the confession of a kidnaper that was caught a few weeks ago). Infact, last week, four students of Imo State University were arrested in Anambra State where they kidnapped a 4-year old boy. Yes, it is that bad.
Carter Center may not have experienced these problems, and I am not aware of the level of protection they offer to their expatriates. But, I am aware that other expatriates (construction workers, oil, hoteliers, etc) all move with Military or Police escorts. CYDI can not afford that level of protection, and even if we did, it will only draw attention to us that we have a valuable asset. Honestly, this is a catch 22 situation.
Right now I will not advise you to come. Dan Smith took the right decision. Infact my friends in the Mass Media and the Police Force tell me that these kidnappings are going on daily, and ransom is being paid quietly. However, only few, high profile, cases make it the press. I cannot afford to let anything happen to you."
This confirms that I will not be getting on a flight to Nigeria on Thursday.
I've been on the phone with different individuals all morning to explore the alternative option of Zimbabwe. Yesterday, with Nigeria still up in the air, I received a promising message from my Zim contact in the States:
"Sounds like a great opportunity to me if you are not able to go to Nigeria. I would think it would be the best of the two options anyway, since you have the relationship and entry points already there. If you try to go do something new in Nigeria in just a few months, you wouldn't get to know the culture/build relationships with the people as well as you already do in Zim. I think we could send a letter through the Fairfield email since they pick it up regularly and ask them to take it up to the VCT explaining what you want to do. Then they could reply on their own or through Linda
....
Let me know what you decide and what I can do to help you get back to Zim if that ends up being the avenue you take.
After initial warnings emerged around Nigeria, the Carter Center reported nothing out of the ordinary in Owerri. Carter Center and CDC are still sending personnel to the area. This is in contrast to information from Professor Dan Smith at Brown.
With these conflicting viewpoints, it's been difficult for me to make an educated choice. So I wrote the following in a letter to the director of my host organization in Nigeria:
"I'm really curious to know your take on everything. My primary interest is to be mainly an asset over a burden to you and your organization. Have these circumstances turned me into more of a liability than a help for CYDI?
In the event that I do not come to Nigeria, I have an alternative option available. Your comfort level with the situation will determine whether I come to Owerri or go to the other location."
This morning, I received a reply:
"First, I am really sorry that you have to be in such a difficult position right now. I realize that a lot of time, money and effort were put into making this trip possible. My colleagues and I are also devastated because this is the first time CYDI would be getting a student from Emory. It means a lot to us, and we have been looking forward to this trip.
Unfortunately, the situation in Owerri is not safe for you to come. This is my candid opinion.
You will recall that these kidnappings started, a few years ago, as a result of the protest in the Niger Delta area (River, Bayelsa and Delta), and the targets were expatriate staff of oil companies. We never had problem in Imo State. Infact, CYDI had students fro, Brown University in 2007 and 2008, which was at the peak of the crisis.
However, since the trouble spilled over to Imo State it has become an all-comers game.
These kidnappings have no political agenda, it just a way of making money. Their targets are random. They have kidnapped people across all ages (babies, children, teenagers, parents and grand parents), and across all sectors (civil servants, businessmen, teachers, lecturers, etc). Sadly, lives have been lost while people are being kidnapped or rescued. Infact things got worse when Imo State Government passed a bill making kidnapping an offence punishable by death.
While I agree that you will, definitely, be an asset to CYDI, I am worried that we shall be looking over our shoulders until you leave in August. I do not scare easily, but this kidnapping stuff is way above my head. I have lived all my life in Owerri, which has always been a peaceful town and I have my ear to the ground. The vibes are not good. People are hungry and angry. The new government has knocked down shops, relocated street businesses, and banned the use of motorcycle for transportation (in bid to make Owerri the cleanest city in Nigeria). Many people have lost their means of livelihood in the process. Most of the younger ones now resort to kidnapping, since it yields a higher return than armed robbery (this is based on the confession of a kidnaper that was caught a few weeks ago). Infact, last week, four students of Imo State University were arrested in Anambra State where they kidnapped a 4-year old boy. Yes, it is that bad.
Carter Center may not have experienced these problems, and I am not aware of the level of protection they offer to their expatriates. But, I am aware that other expatriates (construction workers, oil, hoteliers, etc) all move with Military or Police escorts. CYDI can not afford that level of protection, and even if we did, it will only draw attention to us that we have a valuable asset. Honestly, this is a catch 22 situation.
Right now I will not advise you to come. Dan Smith took the right decision. Infact my friends in the Mass Media and the Police Force tell me that these kidnappings are going on daily, and ransom is being paid quietly. However, only few, high profile, cases make it the press. I cannot afford to let anything happen to you."
This confirms that I will not be getting on a flight to Nigeria on Thursday.
I've been on the phone with different individuals all morning to explore the alternative option of Zimbabwe. Yesterday, with Nigeria still up in the air, I received a promising message from my Zim contact in the States:
"Sounds like a great opportunity to me if you are not able to go to Nigeria. I would think it would be the best of the two options anyway, since you have the relationship and entry points already there. If you try to go do something new in Nigeria in just a few months, you wouldn't get to know the culture/build relationships with the people as well as you already do in Zim. I think we could send a letter through the Fairfield email since they pick it up regularly and ask them to take it up to the VCT explaining what you want to do. Then they could reply on their own or through Linda
....
Let me know what you decide and what I can do to help you get back to Zim if that ends up being the avenue you take.
I am sure the kids and everyone at VCT would be so happy to see you (and we don't want you to be kidnapped)"
With this optimistic reply, I called Suzanne Mason at the Global Health Institute. She responded positively that GHI would probably support a change in project site. IRB seems equally flexible. I will have to take a few steps to confirm the switch. But overall, Emory appears to be on board.
Now for the bad news...
I got on the phone with Delta to cancel my itinerary. The Delta representative provided different information from the original person I talked to last week. Apparently I can change the dates on my ticket, but not the locations. I called back to confirm this with another representative.
With one useless ticket and visa to Lagos, I have about $1300 left from the original $3000 GHI grant. So I have a couple of options. Either I can start all over and book a flight from Atlanta to Harare. This will cost me upwards of $2300, meaning I would be out $1000. Or I can try to book through the Lagos airport. Flights from Lagos to Harare are still pretty steep at around $1200 - $1300. It would also mean a day or two of hellish travel through multiple ports. But, if I'm strategic enough, I might just be able to get all the way to Harare on GHI money.
So that's where we are now. Still better than being kidnapped. :)
With this optimistic reply, I called Suzanne Mason at the Global Health Institute. She responded positively that GHI would probably support a change in project site. IRB seems equally flexible. I will have to take a few steps to confirm the switch. But overall, Emory appears to be on board.
Now for the bad news...
I got on the phone with Delta to cancel my itinerary. The Delta representative provided different information from the original person I talked to last week. Apparently I can change the dates on my ticket, but not the locations. I called back to confirm this with another representative.
With one useless ticket and visa to Lagos, I have about $1300 left from the original $3000 GHI grant. So I have a couple of options. Either I can start all over and book a flight from Atlanta to Harare. This will cost me upwards of $2300, meaning I would be out $1000. Or I can try to book through the Lagos airport. Flights from Lagos to Harare are still pretty steep at around $1200 - $1300. It would also mean a day or two of hellish travel through multiple ports. But, if I'm strategic enough, I might just be able to get all the way to Harare on GHI money.
So that's where we are now. Still better than being kidnapped. :)
Micronesia - Kaleigh (super long)
Hi!
Warning – this is very long – I probably won’t write often, as it is a lot of effort and expensive to use the internet. –
I am writing this from the Island Food Community of Pohnpei building, where I am working. I will email it when I go to the Telecom building later (it is the only place where we can get on the internet). The Telecom building is air conditioned, so we love it. (It is very, very, miserably hot here.) The Telecom building also has couches and a flat screen TV with usually CNN or ESPN on, so it is an enjoyable place to be. It kind of resembles a bank (with tellers who deal with phone services and internet rather than currency).
Kim and I are living together in a hotel (for 2 months) called Nara Gardens. It isn’t as nice as it sounds. It is quite old and run down. There is no airflow and it smells of mold, is dirty, etc. We were hoping for a home to house-sit, but it doesn’t look as though it will work out with dates and all. I’m really happy that Kim is here.
There are two other public health students (female) working with IFCP this summer. Sueko is from Japan but attends Johns Hopkins. She is one of the sweetest people I’ve ever met. We met in Honolulu and stayed in a hotel together and began our journey to Pohnpei at 3:30 am together. Alyssa is from the University of Arizona. She did Peace Corps in Zambia.
My research project will take place in two rural villages. It was originally going to be qualitative but it has changed and is now going to be quantitative (a questionnaire about how often certain foods are eaten). I think this is better, although I may no longer do my thesis on this. Instead I might just write a report or something for IFCP. I want my thesis to be on high-quality data collection and I don’t know how well this will work out – I would also like my thesis to be qualitative.
We spend all day right now (before research starts) at the IFCP with our supervisor, Lois. We have met state and federal health officials the past two days (today we drove to the federal capital – Palikir – we live in Kolonia – the biggest city). We also get to go to numerous events that the IFCP is invited to, which might be fun. The first is this afternoon.
As far as first impressions of Kolonia, Pohnpei… the town reminds me of a miniature Fort Cochin in Kerala, India. It is kind of like a fishing town. It is along the water and the landscape is beautiful. It is kind of boring though, I’ve not seen anything unexpected yet. It is not crowded. The people here are very nice, which is enjoyable. I feel pretty safe. Even though we are on an island, it doesn’t sound as though there are many (if any) safe places to swim (water quality, currents, etc). We have pretty much already walked around the whole town… multiple times. Kim and I went for a walk last night along the causeway and next thing we knew, we were at the airport.
The food here is…. Interesting I guess. They eat a lot of tuna sashimi (the raw fish), which I love. But I am trying not to eat it every day… we have already been advised to get de-worming medications upon our arrival home. (Fabulous.) Apparently it is likely that we will get worms while we are here. Other foods are breadfruit – which is eaten like a potato. The food environment is basically a combination of local, Japanese, and American food (sometimes all at the same place). There are many varieties of banana… ranging from some which are used like a potato to those that are eaten with ice cream (I, of course, like the ones eaten with chocolate chip ice cream – a dessert Lois’ husband made for us).
I had a good time this afternoon and evening. We went out to a ‘marine park’ for a Peace Corps event that IFCP was participating in. It is a camp for girls who just graduated from 8th grade and it teaches them how to care for themselves, the environment, etc. Very neat. They stay overnight in traditional huts next to the ocean. It is beautiful there. We went swimming in the ocean. Afterwards, we had a dinner of local foods in a large community hut and the food came on a woven basket/plate, you eat sitting cross-legged and with your hands. The fish were fully intact (on one side). It was a good time.
I think I’ve written enough for a book now, so I will close.
Hope everyone is doing well. Look forward to seeing you back in Atlanta. Kaselehlie (hello, good bye, and other greetings in Pohnpeian).
Warning – this is very long – I probably won’t write often, as it is a lot of effort and expensive to use the internet. –
I am writing this from the Island Food Community of Pohnpei building, where I am working. I will email it when I go to the Telecom building later (it is the only place where we can get on the internet). The Telecom building is air conditioned, so we love it. (It is very, very, miserably hot here.) The Telecom building also has couches and a flat screen TV with usually CNN or ESPN on, so it is an enjoyable place to be. It kind of resembles a bank (with tellers who deal with phone services and internet rather than currency).
Kim and I are living together in a hotel (for 2 months) called Nara Gardens. It isn’t as nice as it sounds. It is quite old and run down. There is no airflow and it smells of mold, is dirty, etc. We were hoping for a home to house-sit, but it doesn’t look as though it will work out with dates and all. I’m really happy that Kim is here.
There are two other public health students (female) working with IFCP this summer. Sueko is from Japan but attends Johns Hopkins. She is one of the sweetest people I’ve ever met. We met in Honolulu and stayed in a hotel together and began our journey to Pohnpei at 3:30 am together. Alyssa is from the University of Arizona. She did Peace Corps in Zambia.
My research project will take place in two rural villages. It was originally going to be qualitative but it has changed and is now going to be quantitative (a questionnaire about how often certain foods are eaten). I think this is better, although I may no longer do my thesis on this. Instead I might just write a report or something for IFCP. I want my thesis to be on high-quality data collection and I don’t know how well this will work out – I would also like my thesis to be qualitative.
We spend all day right now (before research starts) at the IFCP with our supervisor, Lois. We have met state and federal health officials the past two days (today we drove to the federal capital – Palikir – we live in Kolonia – the biggest city). We also get to go to numerous events that the IFCP is invited to, which might be fun. The first is this afternoon.
As far as first impressions of Kolonia, Pohnpei… the town reminds me of a miniature Fort Cochin in Kerala, India. It is kind of like a fishing town. It is along the water and the landscape is beautiful. It is kind of boring though, I’ve not seen anything unexpected yet. It is not crowded. The people here are very nice, which is enjoyable. I feel pretty safe. Even though we are on an island, it doesn’t sound as though there are many (if any) safe places to swim (water quality, currents, etc). We have pretty much already walked around the whole town… multiple times. Kim and I went for a walk last night along the causeway and next thing we knew, we were at the airport.
The food here is…. Interesting I guess. They eat a lot of tuna sashimi (the raw fish), which I love. But I am trying not to eat it every day… we have already been advised to get de-worming medications upon our arrival home. (Fabulous.) Apparently it is likely that we will get worms while we are here. Other foods are breadfruit – which is eaten like a potato. The food environment is basically a combination of local, Japanese, and American food (sometimes all at the same place). There are many varieties of banana… ranging from some which are used like a potato to those that are eaten with ice cream (I, of course, like the ones eaten with chocolate chip ice cream – a dessert Lois’ husband made for us).
I had a good time this afternoon and evening. We went out to a ‘marine park’ for a Peace Corps event that IFCP was participating in. It is a camp for girls who just graduated from 8th grade and it teaches them how to care for themselves, the environment, etc. Very neat. They stay overnight in traditional huts next to the ocean. It is beautiful there. We went swimming in the ocean. Afterwards, we had a dinner of local foods in a large community hut and the food came on a woven basket/plate, you eat sitting cross-legged and with your hands. The fish were fully intact (on one side). It was a good time.
I think I’ve written enough for a book now, so I will close.
Hope everyone is doing well. Look forward to seeing you back in Atlanta. Kaselehlie (hello, good bye, and other greetings in Pohnpeian).
Saturday, June 13, 2009
sudden change of plans...maybe (Liz)
My flight to Nigeria is on Thursday (June 18). Whether or not I get on the plane remains to be seen.
This past Thursday (June 11), I read the following in an email from the director of my host organization:
"Liz I have some concern regarding ur trip. I do not know if you have heard of the recent kiddnapping in the Niger Delta area in Nigeria? Well the situation has been extended to Imo State. Yesterday, I got a call from Professor Daniel Smith of Brown University cancelling his trip with his student to CYDI this year. They were meant to arrive on May 11. This will be the first time, since 2002, that CYDI will not have an intern from Brown University. Will we are disappointed, we recognise thier genuine concern.
Sincerely, I think you need to evaluate the situation and reconsider the trip. Things are not safe right now in Owerri. Will CYDI needs you this summer, we are also concerned about ur safety.
I also think you need to discuss the situation with Professor Kate Winskel."
Since reading this, I've been communicating with Kate, who has spoken to Deb McFarland and Roger Rochat. She also got in touch with Dan Smith, the Brown professor. After their conversation, she sent this to me:
"I just spoke with Dan Smith. His in-laws are in Abia State (adjacent to Imo) and that’s where he does his research. What’s going on there is a spate of ransom kidnappings by criminal gangs copycatting those that have become fairly commonplace in the coastal regions of the Delta in recent years. This phenomenon is not isolated to South-East Nigeria – it’s nationwide (I’ve even heard that these kidnappings are becoming more common in Kenya…). Dan relies heavily on advice from his in-laws and, on the basis of their advice, has gone to Nigeria repeatedly when the State Dept would have advised against it. This time, his in-laws are saying don’t come because of it’s not safe to do so in light of the kidnappings – and he’s taking their advice very seriously. It’s clear that Abia State is worse than Imo State (Benjamin apparently wasn’t aware of a problem until alerted to it by Dan). Dan had been taking a Brown student to work with Benjamin in Owerri, but didn’t comfortable about the student going when he had decided not to go to Abia State, an hour away, for security reasons."
Deb has friends at the Carter Center,which has an office in Owerri. We are waiting to hear back with their assessment of the situation. I am meeting with Kate on Monday to discuss. At this point, the decision may be out of my hands. Emory and GHI might step in and decide for me.
If the choice is left with me (which I doubt), I have two conflicting schools of thought. Having planned this trip for months, there is the inclination to go anyway. But, I have also been on the other side, telling someone not to go somewhere and really knowing what I was talking about. I generally depend on the advice of locals and do not take their warnings lightly. I have made it clear with the director of the organization that if this situation turns me into more of a burden as a liability than an asset, I would rather not go. Plus, there is the whole kidnapping thing... Kate was specific to point out that kidnappings don't always go as well as planned and sometimes end badly. Being a young, female American, I could be a clear target, especially considering that I will be one of the only white faces in Owerri.
So I'm currently preparing myself for any conclusion. I want to be ready to leave on Thursday, but am quickly putting together backup plans.
I've written an email to my contact in the States, who I worked with in Zimbabwe. This is part of the letter:
"If I do not go to Nigeria, then I am suddenly without plans for the next two months. But I like to see it as a potential opportunity. I called Delta Airlines yesterday and learned that my ticket is non-refundable. However, if I cancel my itinerary before the flight date, I will have a monetary credit with Delta (minus a $250 penalty). I could potentially use this to help fund a flight to Zimbabwe.
It has been well over a year since I've seen Zim. I have wanted to get back, and have even had moments of regret that I wouldn't be going this summer.
I may be able to convince Emory that this would be a logical alternative. My continuing relationship with Zimbabwe allows for a promising access point. Trying to build a program from scratch in any other location will be difficult in a short time period. But my history in Old Mutare provides a convenient template. I was intending to perform a program assessment for a community-based HIV organization in Nigeria. I could easily shift this into a formal evaluation of the VCT. I would conduct a series of confidential, voluntary interviews with both personnel and clientele. This could be very beneficial to the clinic, because I could provide documentation of strengths, weaknesses, and recommendations for future development. As a funding source, this would be very helpful for me to also have."
When I suggested this option to Kate, she initially laughed and said "You've got to be joking?" (something about my knack for picking volatile environments...) But, after hearing me out, she started to come around. So we'll see.
As of now, I don't know what to expect. Nigeria, Zimbabwe, somewhere else altogether.
Either way, this summer just got a lot more interesting...
This past Thursday (June 11), I read the following in an email from the director of my host organization:
"Liz I have some concern regarding ur trip. I do not know if you have heard of the recent kiddnapping in the Niger Delta area in Nigeria? Well the situation has been extended to Imo State. Yesterday, I got a call from Professor Daniel Smith of Brown University cancelling his trip with his student to CYDI this year. They were meant to arrive on May 11. This will be the first time, since 2002, that CYDI will not have an intern from Brown University. Will we are disappointed, we recognise thier genuine concern.
Sincerely, I think you need to evaluate the situation and reconsider the trip. Things are not safe right now in Owerri. Will CYDI needs you this summer, we are also concerned about ur safety.
I also think you need to discuss the situation with Professor Kate Winskel."
Since reading this, I've been communicating with Kate, who has spoken to Deb McFarland and Roger Rochat. She also got in touch with Dan Smith, the Brown professor. After their conversation, she sent this to me:
"I just spoke with Dan Smith. His in-laws are in Abia State (adjacent to Imo) and that’s where he does his research. What’s going on there is a spate of ransom kidnappings by criminal gangs copycatting those that have become fairly commonplace in the coastal regions of the Delta in recent years. This phenomenon is not isolated to South-East Nigeria – it’s nationwide (I’ve even heard that these kidnappings are becoming more common in Kenya…). Dan relies heavily on advice from his in-laws and, on the basis of their advice, has gone to Nigeria repeatedly when the State Dept would have advised against it. This time, his in-laws are saying don’t come because of it’s not safe to do so in light of the kidnappings – and he’s taking their advice very seriously. It’s clear that Abia State is worse than Imo State (Benjamin apparently wasn’t aware of a problem until alerted to it by Dan). Dan had been taking a Brown student to work with Benjamin in Owerri, but didn’t comfortable about the student going when he had decided not to go to Abia State, an hour away, for security reasons."
Deb has friends at the Carter Center,which has an office in Owerri. We are waiting to hear back with their assessment of the situation. I am meeting with Kate on Monday to discuss. At this point, the decision may be out of my hands. Emory and GHI might step in and decide for me.
If the choice is left with me (which I doubt), I have two conflicting schools of thought. Having planned this trip for months, there is the inclination to go anyway. But, I have also been on the other side, telling someone not to go somewhere and really knowing what I was talking about. I generally depend on the advice of locals and do not take their warnings lightly. I have made it clear with the director of the organization that if this situation turns me into more of a burden as a liability than an asset, I would rather not go. Plus, there is the whole kidnapping thing... Kate was specific to point out that kidnappings don't always go as well as planned and sometimes end badly. Being a young, female American, I could be a clear target, especially considering that I will be one of the only white faces in Owerri.
So I'm currently preparing myself for any conclusion. I want to be ready to leave on Thursday, but am quickly putting together backup plans.
I've written an email to my contact in the States, who I worked with in Zimbabwe. This is part of the letter:
"If I do not go to Nigeria, then I am suddenly without plans for the next two months. But I like to see it as a potential opportunity. I called Delta Airlines yesterday and learned that my ticket is non-refundable. However, if I cancel my itinerary before the flight date, I will have a monetary credit with Delta (minus a $250 penalty). I could potentially use this to help fund a flight to Zimbabwe.
It has been well over a year since I've seen Zim. I have wanted to get back, and have even had moments of regret that I wouldn't be going this summer.
I may be able to convince Emory that this would be a logical alternative. My continuing relationship with Zimbabwe allows for a promising access point. Trying to build a program from scratch in any other location will be difficult in a short time period. But my history in Old Mutare provides a convenient template. I was intending to perform a program assessment for a community-based HIV organization in Nigeria. I could easily shift this into a formal evaluation of the VCT. I would conduct a series of confidential, voluntary interviews with both personnel and clientele. This could be very beneficial to the clinic, because I could provide documentation of strengths, weaknesses, and recommendations for future development. As a funding source, this would be very helpful for me to also have."
When I suggested this option to Kate, she initially laughed and said "You've got to be joking?" (something about my knack for picking volatile environments...) But, after hearing me out, she started to come around. So we'll see.
As of now, I don't know what to expect. Nigeria, Zimbabwe, somewhere else altogether.
Either way, this summer just got a lot more interesting...
Sunday, June 7, 2009
My Introduction to Emergency Management (Heidi)
As I mentioned in my last post, this past week I had the opportunity to watch as the newly founded NEMA (Israeli equivalent of FEMA) conducted it's largest national drill ever. Quite possibly the most intimidating and amazing experience I've had! Here are some of the more interesting events:
First, it was me and these guys. Yeah.
They had a school prepare for a missile attack - so they sounded the siren and had the kids go into missile/bomb shelters.
After that they pretended as if a missile had struck the building and children were trapped inside - so they sent rescue crews in (and up) to get them and had EMS triage. These kids were awesome.
Another day they showed us a resilience facility - so they showed us how they help displaced individuals and what they do for stress relief.
Then they took us to a collapsed building - they had demolished it before we got there and put dummy dolls in there to show us their search and rescue response.
The last day they pretended there was a car bomb and so they evacuated 6000 people from 9 buildings in downtown Tel Aviv - and we watched.
At the very beginning of the drill I met two FEMA guys who really took me under their wing. After the drill we took a trip to Caesaria to see the Roman ruins.
I'm now in Beersheva. I'll be writing up findings from the drill and collaborating on research to work that our Center is working on. Should be fun!
First, it was me and these guys. Yeah.
They had a school prepare for a missile attack - so they sounded the siren and had the kids go into missile/bomb shelters.
After that they pretended as if a missile had struck the building and children were trapped inside - so they sent rescue crews in (and up) to get them and had EMS triage. These kids were awesome.
Another day they showed us a resilience facility - so they showed us how they help displaced individuals and what they do for stress relief.
Then they took us to a collapsed building - they had demolished it before we got there and put dummy dolls in there to show us their search and rescue response.
The last day they pretended there was a car bomb and so they evacuated 6000 people from 9 buildings in downtown Tel Aviv - and we watched.
At the very beginning of the drill I met two FEMA guys who really took me under their wing. After the drill we took a trip to Caesaria to see the Roman ruins.
I'm now in Beersheva. I'll be writing up findings from the drill and collaborating on research to work that our Center is working on. Should be fun!
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