Lyonnaise is much better than Mayonnaise

Hello everyone,
I apologize for the extremely long delay in posting. There have just been so many better things to do!!

For the past week, I've been in Lyon, France at the International Conference on Animal Health Surveillance. I got to do my first ever conference oral presentation, and luckily got it over with within just a few hours of the conference beginning. For the rest of the time I have been enjoying the conference, which was held in a pretty amazing chapel, and not eating the incredibly fancy but undoubtedly meaty hors d'oeuvres that were served (for example, there was some tiny pita bread filled with an unidentifiable substance, and they were held closed with TINY CLOTHESPINS! and balsamic vinegar and soy sauce and such things were served in small pipettes. It's so modern.)

One of the people I met at the conference was the Principal Investigator for that participatory epidemiology study I helped out with a while ago - and after discussing some stuff with him it looks like we will finally move forward with writing that up! Hooray.

Otherwise, this fountain fairly accurately represents how awesome Lyon is. Lyon is a goddess riding four mythical (their hooves have weird claws) horses with steam coming out of their noses. Although the city's claim to fame is being the gastronomic capital of the world, my desire to not eat veal or mussels has limited me somewhat. But tonight I ate at a great vegetarian restaurant (Zone Verte) which is right around the corner from the hotel. They serve only fresh, local, organic food and they serve it on wooden trays which fit perfectly into slots on the table. It is fun.

So the week before the conference, I was busy hanging out at the coast with Christina, who came up from Lesotho to visit! Vacation is hard work and I had barely any time to practice my presentation. For example, we visited the Gedi ruins in Watamu. It's a cool place - a Swahili city that was active from the 13th-17th centuries.

We also visited the amazing and empty beach (it's low season because it's rainy season so there is some seaweed) and played in the water a lot.

The sand is very white.

It was awesome. That's all.

I think I didn't know before how much I like the beach. We went snorkeling and it was like swimming in an aquarium, so many fish!! Amazing. Will have to come back during November when the sea is a bit calmer and you can find dolphins.

One of the most amazing things about Kenya is the incredible range of ecosystems and cultures and landscapes. Lyon is amazing too, as I mentioned. Traveling is awesome but I have been feeling torn between really wanting to actually live in a place (an amazing place, hopefully Pullman lives up to that standard next year...) and wanting to keep seeing new places. Perhaps the solution is to take reasonable length vacations interspersed with having one place to go back to. Something to work towards in life I guess!

Easter birthdays and weddings

Pascal the tuktuk driver was born on Easter, like me. Unlike me, he celebrates his birthday on Easter regardless of when it happens to fall, and claims to not actually know the correct date. Apparently he said "My birthday has never been at the end of April before!"

Most people here don't have birth certificates and may also take some liberties with their age and their birthday. A friend told me about twins that she knows - on the official government ID of the brother, it says he was born 5 years earlier than his twin sister. Either people don't know, or don't really care about their exact age. This kind of disregard for facts reminds me of my primary pet peeve [bigger peeves, such as rampant corruption, are not included...] about Kenya - which is that people don't care about how things are spelled! People spell their names differently at different times, which I can accept as personal choice, but this trend also spills over into the set up of our lab database and other places where data matching is essential. It kind of makes me twitch.

In other news, this past weekend I traveled to Ruma National Park, "the last home of the Roan antelope [in Kenya]," which is an incredibly beautiful park south of here. To get there, we drove north around Winam Gulf and took the ferry across to Mbita. Somehow they manage to fit about 9 cars on a fairly small boat, along with a lot of people, bags of charcoal, motorbikes, wooden poles, and just about anything you can think of. Luckily the ride is only 45 minutes and there aren't too many hippos or crocodiles out in the center of the lake...


The ferry ride is awesome, though, and we got to see a different perspective of the lake. Kenya has about 6% of the whole of Lake Victoria, most of which is a gulf that is frequently clogged with water hyacinth and which is full of schistosomes.


Once on the other side, the lake opens out and looks more like an ocean, with little waves and a huge blueness that is a really nice contrast to the brown and green lake that I'm used to seeing.

Ruma is a cool park - although it rained heavily on us when we drove through the first time. We say an enormous group (tower) of giraffes standing out in the rain, probably 35 of them.


We stayed at the Kenya Wildlife Service banda which is a self-catering cottage, and we did a lot of self-catering...we brought enough food for several armies. But we had an excellent time sitting on the terrace and enjoying this view over the park:


We were inspired to go to Ruma because a friend from the UK was getting married to a Luo man out there in his rural home, which is so close to Tanzania that as kids they would just ride their bikes across the border. The wedding was really fun, although we had to run away from the reception early before a huge storm blew all the tents over, and we possibly severely insulted the hosts by not shoving food down our throats as we ran away. Oops. It was exciting to see a wedding with such a fun mix of Western and African traditions - although the bride wore a white dress, the groom, groomsmen and bridesmaid were all decked out in colorful Kenyan fabric.

This week there is another long weekend - Monday is off for May day or some bank holiday or something. Perhaps I will take another exciting trip! But with all the traveling (conference, etc.) I have planned for the month of May, it seems I only have 7 weekends left in Kisumu. The past 9.5 months have just flown by...

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.

Kisumu is almost Atlanta

Yesterday was awesome. So far my experience has been that I just feel relaxed and happy consistently when I am in Kenya. At Mpala, it was true, and here as well so far. I’m not sure if this is just a contrast with being at college and therefore not being stressed…so that “real life” in the US would be like this as well. Not that I was unhappy at Princeton, but anyway, the point is that yesterday I felt very happy and excited.

I went into work at CDC/KEMRI in Kisien for the first time, and Darryn showed me around and introduced me to some people I’ll be working with, and we spent basically the whole day attempting to get FrontlineSMS forms to work on one phone. We had about a billion little problems that led to this taking literally all day, most of which were ridiculous and involved switching sim cards around a ton of times, and spending an hour trying to figure out the number for one of the sim cards, and using VPN to access online help forums. In any case, even though it was a silly thing, it felt great to be working on something related to the project and to be problem solving, step by step, and then in the end to get it to work. Another thing that was just great was the atmosphere. In one of the offices downstairs, there are two clocks on the wall, one for Kenya and one for Atlanta. There is a strong sense of this really being a CDC field station. I think it is subtle, and I might not notice it if I didn’t have a sense of what CDC Atlanta feels like, since the vast majority of the people that work there are native Kenyans and the lifestyle is Kenyan, with a canteen where you can get tea and mandazi or samosas for your morning break. People here are working on malaria, HIV, tuberculosis, rickettsial diseases, zoonoses, basically everything, and the buildings are relatively high security. You have to have an ID card and they look in the car to make sure everyone belongs before they let you drive in, just like in Atlanta. You have to use a prox-type key to open all the doors, or from the inside you have to press a button to magnetically unlock them. Everyone is super friendly and really interested to hear about other people’s work and obviously also doing amazing work themselves. One woman who I’ll be working with is named Alice, she’s a Kenyan and she is a vet, and working on her PhD now, and she is studying rickettsial zoonotic diseases, Darryn and I talked to her a bit about trapping ticks and identifying them. I like her a lot even after just a brief meeting, and not just because she studies interesting things, haha.

I’ve been really lucky to get shown around by the people that live in the house I’m staying at as well as by Darryn and his girlfriend Nat, who is determined to get me introduced to anyone who is anyone in town, from the good tuk tuk drivers to the guy who makes the cakes at a certain restaurant, who apparently does special orders as well. I guess it hasn’t been very long but I’m really looking forward to getting on my feet and knowing my way around and not being new anymore, especially in terms of my project. For now (as in, on the first day) it has been mostly learning from Darryn about what is in place and what is feasible and now I have an enormous list of goals that each seem to need to be accomplished before any of the others can be done. I guess I’ll be working on a lot of aspects simultaneously and hope that it all comes together and works out. I also need to get better at explaining what I do to people, which I guess really requires knowing…but it has frequently been “okay so you are working on the animal health surveillance project, so what exactly is your role?” and the incredibly vague and unsatisfying answer is “yes, the project, yes, all of it…”