OH GEEZ

So…yeah, BUSY BUSY BUSY basically. That's all. I am taking time out of my packed schedule to write this because it seems like relevant procrastination.

So I was in Nairobi the past couple of days, so that I could meet with the head of epidemiology at the Department of Veterinary Services. I even briefly met the Director of Veterinary Services for Kenya, and he told us stories about the good ol' days when Veterinary Officers in remote districts could pretend to be doing work when they weren't. It probably seems like the meeting was a really big deal, and it was sort of, but I went with two of the Kenyan vets that I work with, and basically they are all buddies because there is only one vet school in Kenya and every vet therefore knows every other vet and all of his or her business (77 newly minted vets graduated last year, and apparently that is a huge class). Anyway, they weren't as excited about immediately implementing my mobile technology disease surveillance in every district as I would have hoped, but they did want to make sure that the information we collect gets to the local Veterinary Officer, possibly monthly, which sort of defeats the purpose of real time reporting but ANYWAY we'll see what actually happens. They are, on the other hand, piloting digital pen technology for notifiable diseases as well as mobile phone reporting for "zero reports" where they do active surveillance to make sure that certain diseases (like Rinderpest, which was recently eradicated) is actually not there. The mobile phone based syndromic surveillance that we are doing with ADSARS would do a third and separate thing, which is allow for timely surveillance of not-necessarily-notifiable diseases as well as emerging diseases.

I also had the opportunity to observe arthopod collection in the slum of Kibera, which basically involved following around a guy with a ghostbusters-type backpack vacuum cleaner mosquito catcher through the narrow streets and open sewers and into people's homes. The demographic surveillance they are doing in Kibera is equivalent to the study in the rural area near Kisumu, except it is about as urban as you can get. The part of Kibera that we were in is predominantly Luo, so they speak Dholuo, which is just like being in the field out here so it was quite an interesting contrast. The houses we went into were filled with a lot more stuff than I had imagined would be the case, but it made me realize that the difference between rural poverty and slum poverty, in a certain sense, is that by moving to a slum you have the potential for electricity sometimes, and to own a TV and furniture with cushions, and have a water tap nearby, and what you give up is a relatively clean environment and the ability to grow food to eat. Obviously that is a simplistic description of a very complex social phenomenon but it expresses my first impression, I guess.

But the primary reason that I am so busy, besides everyone freaking out about getting stuff done by the end of the year, is that we have some very important visitors next week and I have to do a presentation on ADSARS to try to convince them to collaborate with us. While in Nairobi, I also got to meet with our newly appointed head of Zoonoses at CDC Kenya (previously lab director), and he is awesome, and he loves ADSARS, and he has a ton of suggestions and can convince the lab people that this is a priority so that maybe we can actually get some lab tests to happen…and also next week when he's in Kisumu will find time to talk to me about my life plans and potentially making things happen in order for me to not just abandon this project while it's just getting going. So we'll see! But anyway, in addition to the important people, I'm supposed to be in Bondo for the third and final stage of the participatory epidemiology study Sunday through Thursday, plus Darryn and his ex-boss Sarah will be around and I'm submitting abstracts/papers for conferences, and writing about ADSARS for CDC's Global Disease Detection yearly newsletter by Monday! I'm also going to travel back to Nairobi with the whole group of visitors December 14 - 17 which is practically tomorrow, and then it probably wouldn't make sense for me to come back to Kisumu just for the weekend before flying to the US on December 22 so basically that means I'm leaving practically tomorrow. DOES TIME EVEN MAKE SENSE?

But it is just as important for me to mention that I ate Lebanese food in Nairobi and it was basically the best EVER EVER EVER and I ate at least 4 platefuls and then had leftovers for breakfast and why can't Kenyan food be more like Lebanese food?

Kenyan Thanksgiving

As you may know, one of my favorite recipes ever is Potato and Kale Enchiladas from Veganomicon, which I'm excited to say I was successfully able to make (Kenyan fusion style) for Thanksgiving Potluck Part 2. I'm even more excited to be eating the leftovers for breakfast right now, along with Silk soy milk that a friend bestowed on me after her parents brought it all the way from Pennsylvania, and pistachios roasted with salt and lemon. Kenyan fusion style means cassava instead of potato, sukuma wiki instead of kale, cashews instead of pumpkin seeds, and a friend's homemade tortillas/chapattis. The non-Kenyan part is the delicious spiciness and lack of cornmeal. I bought the cassava when I was out in the field the other day, and for $.75 got probably 5 kg of awesome fresh cassava, so also had to find another cassava recipe, and although I thought long and hard about making this, and following carefully the directions at the end:

• 25 After eating, wash your hands and take your plates to wash
  
• 26 After washing, keep them in the safe place and rest for some minutes in order to allow your food function well into your body.Here you may call it a day
  

I decided that garlic and lime (all small sour citrus fruits are called lemon here, actually, regardless of how dark green they are) would be the best ever, because honestly why isn't everything garlic and lime flavored, and made this one.

All the food brought by everyone else was obviously delicious too, although I didn't try the locally raised turkey, which apparently costs way more than chicken because people around here don't really eat turkeys so much as use them as guard dogs. But the adventure of the day was jackfruit. Every morning, Steph and Jo and I sit and wait for the shuttle to Kisian under a jackfruit tree, and wonder what tragedy would occur if the fruit fell off the tree. We finally got up the nerve to ask the staff at the hotel whether we could have one, and they were nice enough to give us one for free (no one here eats them, although you can see them for sale in Uganda). We called it a baby and carried it around, letting it stink up the car while we ran some errands, and later on Ricky showed us how to prepare it. The slimy stickiness got everywhere and we made some of the fruit into smoothies but overall were unable to handle the sickly sweetness, but we did have fun shooting the seeds at each other. If it had been an unripe one, I would have tried this recipe...

Our jackfruit baby/small child

As for real Thanksgiving (on Thursday), I worked all day which was very eventful, since everyone goes on leave pretty early in December and therefore freaks out at the end of November about all the things that need to be done by the end of the year, for example transitioning the entire Human Morbidity Survey from PDAs to smartphones in 4 weeks… Also apparently in the Nairobi KEMRI/CDC office they take off both Kenyan and American holidays but here we only get Kenyan ones. Then I attended a potluck with lots of high ranking CDC and Walter Reed people, and the cultural differences between civilian and army health research organizations was glaringly obvious, so John the statistician decided that his next job should be writing an awkward style sitcom about CDC and Walter Reed employees in Kisumu. I'll let you know when it comes out.

Getting Settled

Jambo,

So I arrived in Kisumu Monday night and have since been settling in, getting a new phone and internet connection and hanging out with the people living in the same house as me. It has been excellent so far, although I haven’t done any work yet other than one (3 hour long) meeting with my mentor. Tomorrow we are going out to the CDC base at Kisien and I’ll get to meet the people I’ll be working with. There are also a bunch of people doing work in a place called Kisii so be ready to be super confused with me. For tonight, I’m going to read up and think through some project ideas to be prepared for tomorrow and hopefully visiting the places will make the first steps easier to pull together in my mind.

I’m staying in a house where I rent a room and everyone shares the kitchen, the first night I arrived a Dutch girl named Masja who was leaving the next day cooked a bunch of salads for everyone, potato salad, pasta salad with and without tuna, and green salad. She also made a ridiculously garlicky mayonnaise/yogurt sauce to eat with bread. Linda, also from the Netherlands, is vegetarian so that has been helpful so far. On my way over I was concerned about the transition back to eating eggs and cheese but it has been okay so far, and since I was super hungry the night I arrived eating salads made with a bit of mayonnaise was okay and the garlic made the sauce I mentioned basically amazing. I avoided the hard boiled eggs that were on the side, though, still don’t think I’m up for that after last summer’s eggscapades. Last night I cooked some lentils and rice which turned out okay, and I shopped and bought the food including getting tomatoes, onions and sukuma wiki (greens) from a small vegetable stand at the market in town.

Besides the food, the transportation here has been a good experience. There are of course boda bodas, bicycles with seats on the back, plus motorbikes which are similar, and tuk tuks which are almost as fun, but lead to a very bumpy ride on the fairly bad road to the house where I’m staying. I had my first ride on a motorbike boda boda today, which, don’t worry, didn’t go very fast on the dirt roads and there are good handholds and I held on VERY tight. It also bounces with the bumps better than a car or tuk tuk, it seems. In a couple of weeks I might take a matatu up towards Mpala for a short visit, in order to get out of the big city when the referendum vote on the new constitution occurs.

The referendum is a huge deal, but I have been unable to find good information on what exactly is involved in the new constitution that has been passed by parliament that the people are voting on whether to accept. There seem to be phrases like “abortion is allowed to save the life of the mother” and “every person has the right to marry a person of the opposite sex” involved, the full interpretation of which is unclear to me... Right now there seems to be a rally going on in the park visible (and super loudly hearable) from the rooftop bar where I am using free wi-fi.



It’s partly in English, so I occasionally catch snippets, and there seem to be musical intervals between speakers. I haven’t figured out whether they are “yes” or “no” supporters, but apparently the majority of people (especially in this area) are in support of the new constitution, and the prime minister and president support it as well, although it would eventually supposedly limit some of their or their successors power through the imposition of term limits and maybe some other regulations. So, the only thing that seems like it might lead to unrest is if some high up people that claim to support “yes” somehow rig the election to have “no” win, which would be pretty slimy. The thing is, apparently, that even though this vote has nothing to do with tribal differences, tribal stereotypes are so ingrained that dissatisfied people will make their dissatisfaction about tribes and that could potentially lead to violence targeted at other tribes.