Things That Make Me Happy

Since the last post was long and depressing, these are current pictures that make me happy.

Cute Children 1

Cute Children 2

Snowflake Marshmallows in Cocoa...Martha Stewart



Purple Moonlit Nights

Troubleshooting to Take Off

Even though sometimes it doesn't feel like it, I am technically here for my Master's practicum. Throughout the entire process of searching for a practicum we were all told to not expect anything, that some practicums turn out badly, etc, etc. So while I was open-minded, I, of course, did have some expectations. Turns out, working abroad here is not meeting a single one of them. Lets take it from the top.

Disclaimer: Everything I am about to say, even if negative, is not a reflection on the organization, the people, the country, etc. it is merely the experience that I am having. Other people are having wonderful times...

The associated study: I approached the study team in September of 2008 to work on this project...and after 8 months of applying for funding, talking the project over with the staff, meeting with people at Hopkins about the project, etc. etc. I had some money and a confirmation from the investigator team that this would be a good experience for me and that there was lots to work on regarding the project because it was new.

The project was supposed to officially start in May, then June. I was asked to come at the beginning of July, but due to commitments in Baltimore, I opted to go in August. Although I did not have IRB approval before I left Baltimore, I was told right before I left that there would be some kinks to work out on the surveillance system and I would be helping with some project management duties. When I got to BG, the project still hadn't started and after being told oh, 4 days, oh 3 more days, oh 2 days...I got frustrated and did some travelling - Sylhet, Nepal, a visit to the fieldsite, etc.

During this time, there wasn't much for me to work on. I had helped with the surveys prior and although I went to the office every day asking to help, I was told I couldn't help with anything.

This taught me three things: 1. Make sure that before you leave, you know exactly what the stipulations of your job will be, when it will start, and what the responsibilities of the host organization will be if that doesn't work out (e.g. will they find other work for you?). 2. Be as candid (but polite!) as possible when discussing problematic issues and what can be done about them so that everyone involved is happy. 3. Don't rely on anyone but yourself.

The main reason I was so frustrated with the project is that every three days, the start date would get pushed back...for two months. And at first, I thought it was actually every three days, but apparently that had been happening since May and I just didn't know. Maybe naively, I thought it would really be in three days and so put off making any plans - e.g. getting a Bengali tutor, finding another project, finding a gym...If I had been more up front with how frustrated I was earlier, they could have been more upfront with me about how little they knew about when they were going to be ready to start - they honestly didn't know because it depended on the construction of their office (something that wasn't necessarily conveyed to me as such). More of my frustration wasn't that I wasn't doing anything, it was that I didn't know when I would be doing something - I was unprepared for all the waiting...And waiting...I didn't have a back-up project, I had wrapped up all my work in Baltimore, my med school apps were in and being processed, etc. etc. And there is only so much your adviser's can do from other countries. If I had known of the delays, even before I left, I could have opted to stay in India and travel or spend time with family and they could have emailed me when they knew a particular day and I would have flown in the next day. Granted, I think the project team was under the naive understanding I was - that it would actually start in three days (I'm not sure how much I believe this, but I think they had convinced themselves of it). Eventually I tried to find other projects, lots of bureaucracy is involved with everything and it didn't work out at the time... All these experiences I can use in the future

Eventually the project started and I would try to help, but again, was told there was nothing I could actively do. Although I was disappointed (this isn't what I had been told prior to coming), I still did learn a lot from just observing and asking questions (e.g. how project's are run, field visits, the fact that you have to check up on everyone about everything, troubleshooting). I still do learn a lot...

My personal project: the first fieldsite visit, I chose an interviewer, who although did not have experience in this type of work, spoke three of the tribal languages, very good Bangla, and moderate English (she had spent some time in Australia). We discussed the stipulations of her job and what she would do and etc. etc. And then she came to Dhaka to get trained (in Bangla just to make sure there were no communication issues). While I thought that would be enough - my training, the Bangla training, some practicing - it, unsurprisingly, wasn't. Although that is all the training we received at Hopkins, I couldn't really translate it to the here. I spent an extra three weeks practicing 7 hours a day with my interviewer on how to probe and elicit detailed answers to posed questions. By the end of it, she had it (!) - at least while she was talking to me. And during that time we also got our ethics approval to start (another side point: know when the holidays in your country are - the local approval was delayed by about three weeks because of Eid and then Durga Puja - timing I was again uninform

Over the course of the past month and a half and interviewing, I have learned the benefits and challenges of who you choose as an interviewer, which is really beneficial for future work and the development of future protocols and any future job I get - all for the future. Main challenges I've had: language barriers, ethnic associations, and training. I appreciate ethnographic/anthropologic/public health research so much more in these respects. I have also learned the differences (implicit responsibilities and expectations) between working in the West and working here. That has been another challenge all in itself - showing up to work on time, timeliness of turnaround on materials, how many hours are in a work day, bureaucracy, etc.

The latter stuff I was not prepared for. And it has been the biggest challenges for me. I am a 23 year-old women in a Muslim country where everyone is older than me. Although I do get added (?) respect for being from Hopkins and from America, ethnically I blend in quite well and so the expectations of who I should be are very different - basically, I shouldn't act like a white Western person, even though I am. Having to motivate workers is hard for me since I am so personally motivated - how do you evoke that passion and desire in others? Having to set rules and boundaries to those older than me is difficult and upsetting - again, that goes with implicit expecations in the West. Having to "reprimand" people when they are doing things inappropriately is even more difficult - I've never really been reprimanded by a boss, so I also don't know how to feel about it and the best way to go about it. I have definitely made mistakes and I have definitely learned from them, but it's not something I ever thought I would be exposed to and something I was completely unprepared for. I suppose a learning experience for everyone involved.

There have of course been some other bureaucratic issues and mistakes and disappointments and cries and yells, but nothing that is probably appropriate for a public blog.

Other projects: Eventually I did get some other projects through some convoluted ways and I will detail them in later posts...

Next time: the results of my interviews...thus far

Thoughts and Observations of the Day

Thoughts
1. If everyone keeps telling me that monsoon season is over, why does it rain everyday?

2. If you are going to put an army in place to monitor the safety of foreigners, shouldn't they be able to communicate with the foreigners?

3. I don't understand rickshaw-wallahs who are chain smokers. I want to do a study on their lung function - does biking all day cancel out the effects of tar?

4. In the middle of a village with no cell phone or radio reception, I heard Aqua's Barbie Girl. And the tribals sang along to the chorus....

My Fieldsite and My Life's People Thus Far

When I first arrived at my fieldsite, it was a breath of fresh air. Bandarban is on the Southeast nub of Bangladesh in the Chittagong Hill Tracts. The area has had its political ups and downs, some of which I will detail, but suffice it to say that the area is mainly full of indigenous populations. In Bandarban alone there are 11 or 12 (I can't remember) and others groups are dispersed around Bangaldesh. Bandarban is full of trees and relatively clean-smelling air. It has rain and mist and dirt roads and women and walking and cows in the streets and PIGS - it has PIGS people. Dhaka is crowded and congested and smelly and by the following pictures, you can see why it was amazing to get here.

I can't remember whether I have briefed you on the larger project, so I will do it again. It's an active surveillance study for the next three years and every week, they will randomly take 12 people and take blood slides to test for malaria (via RDT, PCR, and microscopy). It's the first active surveillance study for malaria in Bangladesh and a previous study showed a parasite level of around 8% during non-rainy seasons here, which is almost as high as some African countries. If you know about malaria: P. falciparum (the worse kind) is most prevalent here and of the CHT (Chittagong Hill Tracts - the surrounding region), Bandarban has shown higher rates. The entire project staff here is tribal people - the 12 fieldworkers for communication reasons, but even the entomologist and the data analyst, who both have university degrees. The medical officer has lived his whole life here and the project manager was brought in special for this project. They are from 4 different tribes I think, which is great because they work with about 6. And most people, even the villagers, know at least one language and Bengali...

The time I spent here in September is useless to detail, except to say that I was welcomed warmly by the fieldstaff, the project manager (Jacob), the medical officer (Chai), the entomologist (Sumit), and the data manager (Annie). We even went on a couple "sightseeing" tours - to a temple and to a small waterfall and did all the prerequisite stuff like meeting people at the hospital we would be recruiting people from and getting
"permissions" from the chief of health something-or-other. It was also the opening of the office and I came down with the PI, so there were lots of celebrations, invitations to dinners, visits to the field, etc. etc. However, since I didn't have IRB approval yet, I couldn't actually do real things.

Bandarban is a major city within the area, so it's not as remote as I thought it would be. That's both a positive and a negative. I wanted a more remote experience and while this is remote, I can take a bus back to Dhaka overnight or a two hour ride to Chittagong and an airport. However, it is nice to have civilization sometimes. And there are wonderful friends there....who I will detail now.

Alison: former Dhaka roommate, Fogarty fellow, and trying to solve the problems of cholera in a lab

Taher, Murshid, and Taibur: three Bangladeshi boys who work in Alison's lab who explain to us the workings of this country and why we shouldn't say some of the things we do...

Muraly: Canadian expat doing some sort of business where he sells things to people...

Lameck: Kenyan boy studying for his MPH at the BRAC School of Public Health

Tarik: Egyptian (?) expat also doing some sort of business here - either with phones or telecomm...or are those the same thing?

Evelyn: second former Dhaka roommate, Fogarty fellow, and involved in many many projects trying to solve the problems of Bangladesh...

Khoshal: other ICDDR, B intern, Dutch medical student, studying Gullian-Barre syndrome

Meghana: other ICDDR, B intern, US medical student from Buffalo, trying to get people to wash their hands

So those are the major people involved in my Dhaka life. All wonderful.

And I think that is probably enough catching up for today. Soon to come: my feelings on conferences, Eid, Durga Puja, my project, Hallowe'en...

The Way You Look Tonight

I loved everything about Nepal and it is definitely on my list of places to visit/work in the future. I would have loved more time to explore the country and the culture, but I suppose for now I will have to do it vicariously through L. and books I've ordered online, waiting for me in Niagara...

Other things I loved about Nepal was the fact that Nepali women are just so damn beautiful. Of course saris make all women look majestic, but there was something about their facial structure and their ethnic ambiguity (to me) that added an extra layer of awe...they weren't Indian, or Tibetan, or Bhutanese, or anything...but you could see resemblences of all of it in them. I know it's naive of me to say they are ethnically ambiguous because they are obviously Nepali, but not having known many Nepalis I try to abstract from the people I do know...Even the modern women were fashionable - with their henna and kajol paried with 3-inch stilettos and cute hair - totally different from Bangladesh...

Even more other things I loved...chai. BG doesn't make chai, they have tea from tea bags and thats about it. It makes me sad. But here, there was a warm milky smoothness of a good pot of chai - the fragrance of cloves and cinnamom wafting through restaurants and the oh-so-magnificant taste of cardamon as it rests in your mouth. For a coutry that produces 10 million pounds of tea a year, you think BG would have gotten the splendor by now...but still people ask me "why do you like milk tea so much?" I cry.

Day 6: Bodnanth and Leaving...

The Bodnanth stupa is one of the largest stupas in Nepal and has tons of Tibetan influence. Om mani padme hum (a mantra to the Bodhisattva of Compassion) is everywhere...chanted...written...it's in the air. Not much to say about this other than it was really big and I don't have pictures of it for the same reason. Once I get my computer back, I promise to update everything with lovely pictures.

After spending some time wandering, having tea, and buying a thanka painting, I returned to the hotel, had some chai and made my way to the airport. K. had to renew his visa, so had returned to Kathmandu alone earlier. I didn't know if it would be granted in time and I didn't know if I would see him on the plane...luckily and after the plane waited specially for him, he made it (!).

Flying home was an adventure in itself. I was probably the only girl in coach and was sitting alone among Nepali workers heading to Malaysia and Saudi Arabia for work. Another highlight was that we got to see Mt. Everest - rising from the clouds like something you would see in a Disney movie - completely unreal and some sort of etherial plane for higher beings. I mean it just looks like a snow-capped mountain, but really, when have you seen a mountain that is higher than your at-full-altitude plane (well, maybe YOU have).

The moment we stepped into Bangladesh, I missed Nepal - the cool breeze, the presence of women, the Hindu/Buddhist culture, and the lack of smell of defecation...oh well, we were back.

Day 5: to NamoBuddha and Back...

Our second day at Dhulikhel began with the early morning sunrise. As I was saying, since we came at the end of the monsoon season, everything was misty and cloudy and foggy and any other synonym you can think of for that. However, although we awoke to a very misty morning, for about an hour, the sky cleared up and we caught a view of the Himalayas to the north (the ONE picture I salvaged...). Apparently in October/November, you can see the whole range of the mountains...I.have.no.words.

Pictures cannot capture the beauty of this scene.

After breakfast, we headed out on a hike to NamoBuddha - a temple approximately 3 hours away from where we were staying. The stupa is a pilgrimage site, mainly for Tibetan pilgrims on their way to Lumbini, the birthplace of Buddha. Although little is actually known about the temple, legend has it that, centuries, ago, there were three princes who love to hunt in these hills, which were overrun with tigers (see origin of the word Dhulikhel). One day, three princes were out hunting and the youngest prince found a very ill tigress nursing her cubs. Seeing the tiger on the verge of death, the prince offered himself up as food, sacrificing his life.

The hike to NamoBuddha was a winding footpath through eons of corn fields and up and down hills. We passed two villages and small groups of children on their way to school, as well as men with huge baskets of maize and women carrying enormous bundles of kindling on her head. Often, the groups of children we passed would yell out, "One pen!" After being very confused, someone told us that often when tourists come and they pass the children, their hearts break and they want to give these poor children something. And most of the time, the only thing people have in their bags/purses/etc that they are willing to part with is a pen, so the children have collections of pens that the tourists give them on their walks. While this was probably an over-dramaticized telling, it may be true.

On our leisurely walk, we befriended a French girl who was travelling alone and who brought us to a Tibetan monastery for lunch. The monastery was HUGE - much larger than the one K. and I found in Pokhara. Lunch there was amazing. We sat in a section marked visitors, removed from the rows and rows of monks, ranging from notice to beginner. There were maybe 150 monks in total, some carrying their own bowls, some with saffron cloth added to their maroon robes, and some just shuffling in with their friends and giggling - I assumed each had to do with how senior they were. One monk led hypnotic chanting through a microphone and once the bell range, younger monks came around serving everyone our of huge metal buckets. From the time we were served to the time the end-of-meal chanting began, to me, felt like 10 minutes, but I am sure it was at least 30 minutes. People had scarfed their food and I was still slowly eating - it was delicious, but I'm just slow.

After lunch, we trekked down to NamoBuddha. The temple was simple, surrounded, as always, by a prayer wheel and at the end of a footpath lined with Tibetan prayer flags. Spending some time just soaking it all in, we then headed back to Dhulikhel.

Getting back, we realized that we had missed the last bus back to Kathmandu. Through much finagling, we were able to procure a taxi for a reasonable price. Within 15 minutes of our ride, the car broke down after the decent from the bumpy hill. Despite this being the "only" taxi in the city, another car mysteriously appeared and we were able to make our way to Bodhnath, another Buddhist site, and a wonderful hotel with HOT water (!)