Oct 5th
Ngambo and I have been singing hymns in the back PCR room - lots of fun! I will sing "How Great thou Art" in English and then she sings it in Nyanga and Bemba. And its so beautiful, i love listening to it. She always wants me to sing high -she says "sing hiiiiigh it is niiiiice". Its funny b/c im never comfortable singing for others in my singing voice, but for ngambo, i dont even have one fiber in me that feels self concious - i feel completely myself around her... and she wants to hear everything, and then she wants to hear it again. And then she says you sing and i will be behind you, meaning she will join in, in harmony but then sometimes she doesnt and i stop and shes like im coming im coming! I keep singing and she still doesnt and shes smiling and she says, I just wanted to hear you sing. Ngambo is really funny because when she is laughing at something, she can't talk...at all! We were laughing the other day and some guy came in to ask us about the machines and she was like "ohh noooo" and just put her papers in front of her face and they were shaking. I had to try to be serious and talk myself, so that turned out as explaining the ampli-prep while laughing, i was happy to even just get a fragment of a sentence out and soon the man that came was laughing with us, my eyes were watering I was laughing so hard. Later on that day I was going to take an alternate route to the kitchen so as to not bump into the same guy again, and Ngambo was like, "you are leaving the room? walk this way!" and I was like why this way? and she was like "I want to see you pass that man, I wish to see your faces" haha she really is a funny one.
Zambia has been so wonderful. to tell you the truth sometimes i cant sleep at night because i am so happy and i just lay in my bed on top of my sheets and stare at the glow of the curtain in my room. Sometimes i walk home from work and i just don't know how to thank God enough for this. You know the people here, you don't hear "I feel like this" statements, or like " I am upset because..." you don't hear those things at all. You just see people with their families and friends, living communally and sharing anything they do have. I believe they have a strength others haven't have the opportunity to have elsewhere where people don't have to worry about what they will eat the next day. I played this Gospel version of the U2 song "I still haven't found what I'm looking for" for Ngambo one day and she must have listened to it on repeat, probably 15 times before we had to go home from work. There is one line that is my fav, "I believe in the Kingdom Come, then all the colors, bleed into one, you know I believe it. But I still haven't found what I'm looking for" I like how they dont say he knows what he is looking for, but he knows he hasnt found it yet, and he knows it has not come yet, because in his inner most hearts he knows there is more than these human pleasures. And looking past these human characteristics, our colors bleed into one, we are all the same, and it makes me think of Ngambo when we compare skin colors and she says she likes the hairs on my arms and wants them (yes she says this, and when i asked why on earth do you want my arm hair, her repsonse is, because I like hair and I don't have any on my arms, it's nice to look at you know) i think about how we look differently on the outside and the way we talk and form sentences is different, how there are so many differences in our upbringing, but how we are both so similiar on the inside it's scary.
Also, I have been visiting the Kalingalinga school a lot and reading to grades 2-5 on lunch breaks once a week. The kids are great and i am still learning how best to try to explain some things in the book to them, because I can see how some of the word choice is definitely hard to understand if English is not your first language. Also, I made spanikopita for the people in the lab so everyone could try it. People are always giving me some of their African food and so I wanted to show them some of my cultural background as well!
We went camping about 45 minutes from my house friday night! There was a music festival, and it kind of reminded me of halloween with the decorations(and choice of music in some cases haha) It was really cool. There was a camping site and then we walked to the festival. It was so incredibly dusty however, the toilets had cornstalk type things around them and the whole place was encased in that same walling, and even just touching it let out a puff of dust. We danced till about 2 and when we woke up the next morning we were beyond dirty. Also, the temperature must have gone up 10 degrees because it was soooooooooo HOTTT. We took a cab back and I went into the lab for a few hours and then headed home...to find we have no water!! We usually boil our water the night before but since we were camping no one did that so we didn't even have much of a supply to fall back on. The pump was broken and the water was empty from the tank! ahhhh so I went to the store and bought some large bottles of water to use. On the way back luckily this guy from work picked me up and gave me a lift home, he said I looked like I was struggling haha. Laura went to work to take a bath, which I found extremely funny!
Sunday I woke up and went to the gym and showered there before church. There was this amazing sermon It was about parenting actually and in the beginning i was thinking, ummm i dunno about this, i wont be able to relate. But the topic of the sermon was "we live in a fatherless generation" meaning, many of the families here, the kids have never met their fathers, or their parents are dead, etc but also meaning people are not looking to the father, who is God. We all have a family, and if our biological family is not here for whatever reason, God provides people in your life to insert in that place for you, to show you, and to love you. The pastor was saying that when he was 8, his parents were divorced and he never met his dad, until he was in his late teens. he said he grew up with no father figure b/c his mother never had male friends and he only had sisters. there was this guy at church who didnt have a son and he started taking him to his house to watch sports each night after church. he never preached to him, but he was there for him. the pastor said at age 13, he was feeling love from someone, and he didnt understand what that was because he was not related to him. but he said this older guy who was married and had children, invested in him, invested in him. he said, when you think no one is there, there is. God has picked people out for you, and when you need that love it will come from a venue. I started thinking about some of my roomates and myself here in zambia, and how God uses people in different ways. My roomate laura has been so passionate about going to the orphanage every saturday morning, just so drawn to it. Erik, has reached out to the schools and has been teaching groups of kids there about HIV. and he does this every week. It's incredible because like our passions, God has created us differently, but He has made sure people cover others, there is someone for everyone. How bad would it be if we all wanted to help the school but there was no one for the orphanage,etc
Also, the sermon was about parenting and how your job as a parent is to believe in your kids not for the mistakes they make now, but for the people YOU believe they CAN become. At the end when the pastor asked if there was anyone who wanted to accept Jesus (I have found they do this every week in the pentacostal church) this boy, i think he looked about 16, he walks up, and hes just crying, and hes using his little handout for a towel to wipe his eyes. He walks up and he just buries his face in the pastor's robes and the pastor put his hand on him, and the boy just kept crying and you just knew, you just knew that he didnt have a father, the way he looked at the pastor.
Finally on tuesday the water was fixed!!! Laura, Nikki and I went to work trying to finialize plans for this trip to the lower zambezi to see some animals and go camping! We met with this guy twice to talk about details and he invited us to his house thursday night for dinner. Everything was going great, but he ended up saying something pretty inappropriate to me with his friends, which was completely uncalled for. The conversation we were having should not have in any way lead to that and I was so upset that I told him that what he said extremely offended me and that I have never heard that come out of someone's mouth before. he apologized profusely, but it still did not sit well with me, that this is the guy we are trusting to take us on this trip, and he can so easily have something like that fly out of his mouth. I lost my appetite completely and wanted to go home so badly but we had to wait for a cab for a really long time. The next day after talking to my mom, I still didn't feel right about how he acted and so as annoying as it was, I told my friends I would not be going on the trip with them. I was really upset about this because I knew they would have a great time, but I just did not want to be around this guy.
Everyone was very understanding about it and said they understood, and actually a little later in the day, the entire trip was cancelled, because two of my friends found out some other stuff about him, things that were inconsistent with what he originally told us. Now we are trying to get at least some of our money back, but he claims he already used it to buy food for the trip, so he can only give us some. I think it was a valuable lesson to learn and from now on, I will only be traveling with people who I personally know or who have been recommended by people I trust. I told Ngambo about this and as always I can count on her for a great statement: "kristen, you have seen these potentially dangerous blood samples we work with everyday. you must treat all men like these samples, you must treat all men as if they were infectious" haha well put.
Sooooo since we didn't have to wake up early for the trip, we had even more time to spend at our roomate's surprise birthday party!! It was so much fun, he always says "when in rome" from anchorman and so alanna and nikki thought up this theme to have a toga party! lots of fun, dancing till 3 and I just woke up today at 12 :D so finally catch up on emails and blogging.
thanks for reading :)
ps - other interesting names: fattress banda and my all-time favorite i think rubba banda! banda is a very common last name, from a tribe in eastern province.
samedi 13 octobre 2007
rest of september!
Hellooooo I haven't written in a long time - the days are very busy, it gets dark around 6pm! I'll try to give a brief summary of the past few weeks here!
Sept 15
I went on a "hippo cruise" with Laura, Nikki, and two other guys we know through CIDRZ: Kapata and Jim. The boatride was in Kafue, which is about 45 minutes from our house. On the ride we saw some interesting things such as a man on a bicycle with about 30 chickens strapped to the back, a lot of hand-made "animal crossing" signs, and a store called "Tiger Feed"(but did you know there aren't any tigers in zambia? or really in africa for that matter?). We passed many small villages as well with mud huts and homes made from only sticks. Once we got to our destination it was really nice to just sit back and enjoy the day! We went on a boatride at sunset and saw some hippos and interesting-looking birds. As we went down the Kafue river, we passed by dozen of those stick huts and families outside who were working on their land. It was a truely beautiful sight! The lab continues to be busy during the week and a student from University of Zambia has come to work with us and so I am now showing him how to run the dry blood spot tests.
Sept 22
This past weekend I helped out Aleen, a woman at my work, with her son's 3rd birthday party! It was a lot of fun and a good way to kind of get out of my element and relax with some cute kids! Barbara, from Alaska, has just started working in the lab as well and she came to help as well. All of my roomates are sick!! Some of them are dehydrated and they are having trouble keeping food in their stomachs. Actually three of the 4 ended up going to the hospital and needed an IV. They have been staying home from work and everything.
Sept 29
The sickness has spread to the other house, and everyone has decided I am probably the carrier because I haven't been struck yet.. no but in all seriousness, I'm pretty paranoid now!
I gave a talk at the weekly wednesday lab meeting today about PCR and contamination. I really enjoyed doing some research and learning more about the process and where along the process things can get contaminated. I know some of you readers are completely fluent in PCR and what it is, but I'll just give a short summary for those of you who may not know! Feel free to skip over it if you don't want to read - don't worry I won't be offended because I won't know :)
PCR, also known as the polymerase Chain reaction, is a method of amplifying, or making millions of copy of DNA. This is used in both tests i am running: the DNA HIV-1 Dry Blood Spot test and also the viral load test. The DNA dry blood spot test is a qualitative test, meaning it detects the presence of the RNA virus and the viral load test is quantitative, meaning it detects the amount of virus.
Before DNA is amplified, it must be present in solution. In order for this to be possible, we must extract the RNA virus and then transform it back into DNA. With the dry blood spot test, we start with 6 micrometers of blood, which comes from the heel of an infant. We wash these blood spots with a buffer solution to remove hemoglobin and impurities. Then an extraction solution is added in order to extract the RNA from the blood spot. In viral load testing, we start out with the blood plasma and extra the free RNA virus. This time the virus is extracted in a machine called the "Ampli-prep". The protein coating around the virus is lysed and suspended in a diluent solution. Magnetic beads attach to the RNA of the free virus and the rest of the plasma is washed away.
Although each test has a slightly different way to extract the RNA virus, once it is extracted, the "mastermix", which is a mixture of enzymes is added to each respective solution. One of the enzymes, taq polymerase is amazing in that it is able to perform reverse transcription to convert the RNA which was just extracted into DNA.
Now we are ready for PCR action! The samples, which now include the extracted RNA and mastermix solution, are taken to the thermocycler, which is a machine that varies the heat to specific temperatures in order to amplify the DNA. When the temperature heats up, double-stranded DNA is denatured, or unwound into single strands. The temperature then cools and primers (which are complimentary oligionucleotides also found in the mastermix) anneal to specific target areas on the DNA that correspond to the stretches associated with HIV. The temperature heats up and these new double stranded pieces are denatured. Primers again anneal to specific stretches forming double stranded DNA as the temperature cools. The pattern continues and as you can see, it is exponential! One cycle consists of heating and cooling, and there are about 30-some cycles in the hour and nine minutes that this machine goes for. In the end, over 10 million copies of DNA are produced and ready for detection.
In the old days before taq polymerase, there wasn't an enzyme that could survive at such high temperatures. This process was a lot more manual and involved a lot of extra additions of enzyme and closely monitoring the state of samples during PCR. People had to stay up over night because samples could simply not be left. So, as time consuming as the DNA-HIV run is (it takes about 9 hours from start to finish) we are really happy about enzymes such as taq!
Anyhow, in order to detect this HIV DNA, which is just so so small on its own, amplification is absolutely necessary! However, because millions upon millions of copies of DNA are made, if even a few foreign molecules are accidentally included in the sample, millions upon millions of copies are also made, thereby completely ruining results. When false positive results are given, a child is put on unecessary medication which leads to numerous negative side effects. When a false negative report is given to a child, the child is killed. Therefore, contamination - which can lead to false results- is a huge issue that needs to be dealt with head on. In my speech I described the effects of contamination in terms of spreading a rumor. If you tell your best friend a secret and an enemy(the "contaminator") overhears, after a few minutes, that person has told one other person. After a few more minutes, both of those people each tell someone. Then, each of those people tell someone, and 45 minutes later a couple million people know your secret.
So how do we avoid contamination? The preparation room and PCR room are separated by physical space and heavy double doors to the rooms in the lab. Also, aprons and gloves worn in each room must STAY in that respective room. Equipment such as pipettes and sample racks also stay in their respective rooms. We use "zero aerosol" pipette tips, which prevent aerosols, or airborne liquid molecules, from traveling and contaminating. We use powder-free gloves to avoid getting powder and skin cells in the samples. Pipette tips are also changed for each sample until after denaturation. (Denaturation occurs right after amplification and it is here that the amplifying comes to a complete halt)
I really enjoyed giving the speech and afterwards a few people came up to me and asked questions, which was great. Also, Ron has everyone come to the lab meeting, from the CIDRZ drivers, to the lab assistents, to the lab techs, to the cleaning crew.
Another thing about this week is, I realized I started feeling self concious about my appearance. Here in Zambia, everyone is pretty direct about things and being larger is seen as a very very good thing. Most of the women I encounter are extremely thin. Men comment on your appearance to your face and this happens on the streets, when you get into a bus, at the store, and also in the lab. It doesn't help that I am working with and constantly next to about 25 men in the lab everyday! I commented on cultural differences earlier and how Ngambo and I talked about what the definition of beauty is here and what it is in the states. She was so surprised when I told her that the people in the states all want to be tan and that they actually go to places to become darker. Also, being thin is very in style and celebrities go on these crazy diets to be a size 2. She tells me how people here actually put powder on their faces to look lighter and eat as many carbs as possible to be bigger! She says I should be happy with how I am. Then Sunday at church, there was a sermon about appearance! The topic was about outer appearance and how we are perceived by others. Pastor Walker described us as tents, and some tents are big and some are small, and some are sewn up from tearing, but the important thing is that the tent is a place for our spirit to live in. It was a much-needed and wonderful sermon that really helped me to focus on what is important, and realize again that I am adjusting to another culture. Also, I started thinking about what empty comments are. They are comments that are made that are casually thrown out perhaps by people who do not really know you for who you are, and they are usually comments that do not describe your inner self, but instead the outer self. Also, I am so lucky to be healthy! So in effect, I am trying to focus on the inner and realize there are changes you have to accept when going to a different culture. And I am choosing to let the wonderful parts of the zambian culture overwhelm me :)
This past friday we attempted to go to a place called "Le soleil", which was advertised to be this huge dance party and open bar night. However, after traveling along a dark and bumpy dirt road for a while, we became a little bit skeptical. Then we see there is a le soleil gas station, le soleil house, le soleil spiritual center, etc, and following the directions we ended up outside someone's house. The man walked out with two dogs and all I could think of was, ok this is when he pulls out an axe and kills us all. luckily he just asked what we were doing and our answer was "leaving" haha. So we go back to the spiritual center and call the woman in charge of the whole thing. The place is dead quiet and no one is in sight. She keeps telling us follow the music, there is music and we say this place is dead quiet. Then we are like where are you hearing the music? We are lost. Turns out she was at her home, in her bed about to go to sleep!! So we ended up all turning around and going back to Arcades, one of the main shopping centers to this bar called Times. It was really fun and I met and danced with these five zambian women until about 1:30 :) It was so fun and I didn't think about anything else except for feeling really happy, alive, and free. I also met a man named Pelvis, no joke.
So I woke up the next morning and something smelled really familiar and reminded me of college. I got up and walked around the house and then I saw it: Rain! Incredible. eventhough it gets so cloudy and overcast looking, the sky will be dark grey, it never rains here till rainy season, and once that starts - usually late october, it last till march! So Laura and I assumed it was rainy season and jumped into action! i got out my raincoat - you know, lightweight and breathable, fits into a tiny little convenient pouch, and my umbrella, and my water proof shoes! Laura opted for her sandals, raincoat and umbrella. We were so ready! We even took a picture. We get outside and, no one looked at all different than any other day. In fact, the rain stopped within a few minutes. It was rainy season at all, just a fluke. everyone knew this except us, pretty funny!
So by the time we got all ready for the rain, and talked about random stuff on the couch we left the house nearly 2 hours after we had planned. We went on the bus and sat in traffic for a while too, so we were pretty late. We had planned to meet up with Lisa, who is a housekeeper at CIDRZ. She was going to take us fabric shopping and then measure us because she makes african clothing! The fabric stores here are overwhelming, because there are just tons and tons of brightly colored cloth everywhere and people everywhere wanting to look at and touch everything! We got some fabric and I got some extra and some fluff to make rag dolls with! ( i have a plan to make them as christmas presents for the children of the people i work with at the lab) We got back to Lisa's house and she insisted that we stay for a traditional african meal of nshima (traditional staple starch, looks like mashed potatos), rape, and roasted chicken. She lives with her extended family in 3 small 2-bedroom homes, all contained in the same plot of land. Everyone was so incredibly friendly and warm and welcoming! I was taught how to cook nshima and they were saying its one of the foods you need to learn how to stir and cook properly before marriage.
We spent the whole day with Lisa and she took us into the market right by her house, which was amazing to see. She then took us to an outdoor sitting place where we could order drinks and one by one everyone in her entire extended family found us there and joined us! Lisa's brother has a car and so he said he could take us home, and everyone who could possible squish into the car went with us! We were jam-packed in there and the rest of the family who didn't come along was just giving us hugs and kisses all over the place and standing all around the car waving until we were out of sight. I remember looking out of the window, (well my entire body was was pressed against it so that wasn't difficult) and seeing all of these people who have less than what I have and seeing them all standing there so happy. Tons of kids were playing with this bag they stuffed for a soccer ball and others were running around chasing eachother. There was music in the background and I remember thinking how in the world am I going to leave this place??
sidenoooooooooote: My nightmares have stopped!
Sept 15
I went on a "hippo cruise" with Laura, Nikki, and two other guys we know through CIDRZ: Kapata and Jim. The boatride was in Kafue, which is about 45 minutes from our house. On the ride we saw some interesting things such as a man on a bicycle with about 30 chickens strapped to the back, a lot of hand-made "animal crossing" signs, and a store called "Tiger Feed"(but did you know there aren't any tigers in zambia? or really in africa for that matter?). We passed many small villages as well with mud huts and homes made from only sticks. Once we got to our destination it was really nice to just sit back and enjoy the day! We went on a boatride at sunset and saw some hippos and interesting-looking birds. As we went down the Kafue river, we passed by dozen of those stick huts and families outside who were working on their land. It was a truely beautiful sight! The lab continues to be busy during the week and a student from University of Zambia has come to work with us and so I am now showing him how to run the dry blood spot tests.
Sept 22
This past weekend I helped out Aleen, a woman at my work, with her son's 3rd birthday party! It was a lot of fun and a good way to kind of get out of my element and relax with some cute kids! Barbara, from Alaska, has just started working in the lab as well and she came to help as well. All of my roomates are sick!! Some of them are dehydrated and they are having trouble keeping food in their stomachs. Actually three of the 4 ended up going to the hospital and needed an IV. They have been staying home from work and everything.
Sept 29
The sickness has spread to the other house, and everyone has decided I am probably the carrier because I haven't been struck yet.. no but in all seriousness, I'm pretty paranoid now!
I gave a talk at the weekly wednesday lab meeting today about PCR and contamination. I really enjoyed doing some research and learning more about the process and where along the process things can get contaminated. I know some of you readers are completely fluent in PCR and what it is, but I'll just give a short summary for those of you who may not know! Feel free to skip over it if you don't want to read - don't worry I won't be offended because I won't know :)
PCR, also known as the polymerase Chain reaction, is a method of amplifying, or making millions of copy of DNA. This is used in both tests i am running: the DNA HIV-1 Dry Blood Spot test and also the viral load test. The DNA dry blood spot test is a qualitative test, meaning it detects the presence of the RNA virus and the viral load test is quantitative, meaning it detects the amount of virus.
Before DNA is amplified, it must be present in solution. In order for this to be possible, we must extract the RNA virus and then transform it back into DNA. With the dry blood spot test, we start with 6 micrometers of blood, which comes from the heel of an infant. We wash these blood spots with a buffer solution to remove hemoglobin and impurities. Then an extraction solution is added in order to extract the RNA from the blood spot. In viral load testing, we start out with the blood plasma and extra the free RNA virus. This time the virus is extracted in a machine called the "Ampli-prep". The protein coating around the virus is lysed and suspended in a diluent solution. Magnetic beads attach to the RNA of the free virus and the rest of the plasma is washed away.
Although each test has a slightly different way to extract the RNA virus, once it is extracted, the "mastermix", which is a mixture of enzymes is added to each respective solution. One of the enzymes, taq polymerase is amazing in that it is able to perform reverse transcription to convert the RNA which was just extracted into DNA.
Now we are ready for PCR action! The samples, which now include the extracted RNA and mastermix solution, are taken to the thermocycler, which is a machine that varies the heat to specific temperatures in order to amplify the DNA. When the temperature heats up, double-stranded DNA is denatured, or unwound into single strands. The temperature then cools and primers (which are complimentary oligionucleotides also found in the mastermix) anneal to specific target areas on the DNA that correspond to the stretches associated with HIV. The temperature heats up and these new double stranded pieces are denatured. Primers again anneal to specific stretches forming double stranded DNA as the temperature cools. The pattern continues and as you can see, it is exponential! One cycle consists of heating and cooling, and there are about 30-some cycles in the hour and nine minutes that this machine goes for. In the end, over 10 million copies of DNA are produced and ready for detection.
In the old days before taq polymerase, there wasn't an enzyme that could survive at such high temperatures. This process was a lot more manual and involved a lot of extra additions of enzyme and closely monitoring the state of samples during PCR. People had to stay up over night because samples could simply not be left. So, as time consuming as the DNA-HIV run is (it takes about 9 hours from start to finish) we are really happy about enzymes such as taq!
Anyhow, in order to detect this HIV DNA, which is just so so small on its own, amplification is absolutely necessary! However, because millions upon millions of copies of DNA are made, if even a few foreign molecules are accidentally included in the sample, millions upon millions of copies are also made, thereby completely ruining results. When false positive results are given, a child is put on unecessary medication which leads to numerous negative side effects. When a false negative report is given to a child, the child is killed. Therefore, contamination - which can lead to false results- is a huge issue that needs to be dealt with head on. In my speech I described the effects of contamination in terms of spreading a rumor. If you tell your best friend a secret and an enemy(the "contaminator") overhears, after a few minutes, that person has told one other person. After a few more minutes, both of those people each tell someone. Then, each of those people tell someone, and 45 minutes later a couple million people know your secret.
So how do we avoid contamination? The preparation room and PCR room are separated by physical space and heavy double doors to the rooms in the lab. Also, aprons and gloves worn in each room must STAY in that respective room. Equipment such as pipettes and sample racks also stay in their respective rooms. We use "zero aerosol" pipette tips, which prevent aerosols, or airborne liquid molecules, from traveling and contaminating. We use powder-free gloves to avoid getting powder and skin cells in the samples. Pipette tips are also changed for each sample until after denaturation. (Denaturation occurs right after amplification and it is here that the amplifying comes to a complete halt)
I really enjoyed giving the speech and afterwards a few people came up to me and asked questions, which was great. Also, Ron has everyone come to the lab meeting, from the CIDRZ drivers, to the lab assistents, to the lab techs, to the cleaning crew.
Another thing about this week is, I realized I started feeling self concious about my appearance. Here in Zambia, everyone is pretty direct about things and being larger is seen as a very very good thing. Most of the women I encounter are extremely thin. Men comment on your appearance to your face and this happens on the streets, when you get into a bus, at the store, and also in the lab. It doesn't help that I am working with and constantly next to about 25 men in the lab everyday! I commented on cultural differences earlier and how Ngambo and I talked about what the definition of beauty is here and what it is in the states. She was so surprised when I told her that the people in the states all want to be tan and that they actually go to places to become darker. Also, being thin is very in style and celebrities go on these crazy diets to be a size 2. She tells me how people here actually put powder on their faces to look lighter and eat as many carbs as possible to be bigger! She says I should be happy with how I am. Then Sunday at church, there was a sermon about appearance! The topic was about outer appearance and how we are perceived by others. Pastor Walker described us as tents, and some tents are big and some are small, and some are sewn up from tearing, but the important thing is that the tent is a place for our spirit to live in. It was a much-needed and wonderful sermon that really helped me to focus on what is important, and realize again that I am adjusting to another culture. Also, I started thinking about what empty comments are. They are comments that are made that are casually thrown out perhaps by people who do not really know you for who you are, and they are usually comments that do not describe your inner self, but instead the outer self. Also, I am so lucky to be healthy! So in effect, I am trying to focus on the inner and realize there are changes you have to accept when going to a different culture. And I am choosing to let the wonderful parts of the zambian culture overwhelm me :)
This past friday we attempted to go to a place called "Le soleil", which was advertised to be this huge dance party and open bar night. However, after traveling along a dark and bumpy dirt road for a while, we became a little bit skeptical. Then we see there is a le soleil gas station, le soleil house, le soleil spiritual center, etc, and following the directions we ended up outside someone's house. The man walked out with two dogs and all I could think of was, ok this is when he pulls out an axe and kills us all. luckily he just asked what we were doing and our answer was "leaving" haha. So we go back to the spiritual center and call the woman in charge of the whole thing. The place is dead quiet and no one is in sight. She keeps telling us follow the music, there is music and we say this place is dead quiet. Then we are like where are you hearing the music? We are lost. Turns out she was at her home, in her bed about to go to sleep!! So we ended up all turning around and going back to Arcades, one of the main shopping centers to this bar called Times. It was really fun and I met and danced with these five zambian women until about 1:30 :) It was so fun and I didn't think about anything else except for feeling really happy, alive, and free. I also met a man named Pelvis, no joke.
So I woke up the next morning and something smelled really familiar and reminded me of college. I got up and walked around the house and then I saw it: Rain! Incredible. eventhough it gets so cloudy and overcast looking, the sky will be dark grey, it never rains here till rainy season, and once that starts - usually late october, it last till march! So Laura and I assumed it was rainy season and jumped into action! i got out my raincoat - you know, lightweight and breathable, fits into a tiny little convenient pouch, and my umbrella, and my water proof shoes! Laura opted for her sandals, raincoat and umbrella. We were so ready! We even took a picture. We get outside and, no one looked at all different than any other day. In fact, the rain stopped within a few minutes. It was rainy season at all, just a fluke. everyone knew this except us, pretty funny!
So by the time we got all ready for the rain, and talked about random stuff on the couch we left the house nearly 2 hours after we had planned. We went on the bus and sat in traffic for a while too, so we were pretty late. We had planned to meet up with Lisa, who is a housekeeper at CIDRZ. She was going to take us fabric shopping and then measure us because she makes african clothing! The fabric stores here are overwhelming, because there are just tons and tons of brightly colored cloth everywhere and people everywhere wanting to look at and touch everything! We got some fabric and I got some extra and some fluff to make rag dolls with! ( i have a plan to make them as christmas presents for the children of the people i work with at the lab) We got back to Lisa's house and she insisted that we stay for a traditional african meal of nshima (traditional staple starch, looks like mashed potatos), rape, and roasted chicken. She lives with her extended family in 3 small 2-bedroom homes, all contained in the same plot of land. Everyone was so incredibly friendly and warm and welcoming! I was taught how to cook nshima and they were saying its one of the foods you need to learn how to stir and cook properly before marriage.
We spent the whole day with Lisa and she took us into the market right by her house, which was amazing to see. She then took us to an outdoor sitting place where we could order drinks and one by one everyone in her entire extended family found us there and joined us! Lisa's brother has a car and so he said he could take us home, and everyone who could possible squish into the car went with us! We were jam-packed in there and the rest of the family who didn't come along was just giving us hugs and kisses all over the place and standing all around the car waving until we were out of sight. I remember looking out of the window, (well my entire body was was pressed against it so that wasn't difficult) and seeing all of these people who have less than what I have and seeing them all standing there so happy. Tons of kids were playing with this bag they stuffed for a soccer ball and others were running around chasing eachother. There was music in the background and I remember thinking how in the world am I going to leave this place??
sidenoooooooooote: My nightmares have stopped!
dimanche 9 septembre 2007
pcr labs and kitchen parties and loving one another :)
A lot has been going on at the lab this past week...except the electricty - haha. The power has gone out numerous times, and when that happens, and generator is supposed to switch on. There was a problem with a switch earlier in the week, which went on for a few days. For this reason, the power goes out, and everyone starts running around trying to decide what to do about the tests that are running the machines. Monday, we had only enough power for one machine to be running at a time, and since viral loads were top priority, we had to be anticipating the amount of time each batch would run for in each machine so we could try to switch off the power to that machine in place of the next one, so we wouldn't lose the samples! Needless to say, I know a lot more about the timing for each step in the machines now, and how fast you really can trasport samples back and forth! It's really fun and challenging working in the lab because there are so many things you have to try to calculate and think about in your mind, that you don't have to consider when working in the states. The people in the lab are so resourceful though, and because everyone helps eachother out, things actually do work out in the end. Everyone in the lab continues to be very welcoming, and two of the lab techs, Jeffrey and Cornwell, call me Bupe (boo-pay), which is nyanga for "gift"! Eugene continues to call me mboya, which means cousin or grandmother, he chooses which one depending on the day, and says either way it means we are related, so in this culture he can make fun of me and laugh at me and I can't do anything about it! Then he tells me that the only reason he laughs so much is to extend his life. He has been reading up on things he says, and being happy and laughing helps you live longer. Everyone is just so nice; they also express their gratitude when I attempt to speak their language and they always ask me how I am doing, if I need anything, if I'm hungry, etc.
Despite some electricy issues, we've been running a great deal of viral load and HIV tests. Both tests have three steps - extracting the DNA, amplifying the DNA, and detecting the virus at the end. Ngambo and I have been starting earlier and running all the viral loads in parallel, meaning while one batch (23 samples) is in the extraction stage, another is in amplification stage. In the beginning it's simple to keep track of, but once the day gets going, it gets really busy and it also involves a lot of timing.
Something else exciting from the lab is that a woman from the bush (about 5 hours from here) came in to ask Ngambo and I questions about the PCR lab - about the equipment used, safety precautions, procedure of tests, amount of space needed, etc. She is starting up a PCR lab out there, and there has never been one there before! She asked my boss if we could both go out there for about a week to help set it up - which would be suuuuuch a cool experience - and he said he's completely behind it!
Also, Monday I was able to visit the Kalingalinga school. This school has grades 1-9, and sees over 30 classes each day. For the younger grades, school is only a few hours, so there are 3 shifts: morning, early afternoon, and late afternoon. There are 15 classrooms, and while the rooms are small, each class has over 60 students in it! I spoke with the headmaster to see if they had a place for a library, and she said there is no room for one. Indeed, the classrooms are all right next to one another, in the shape of a horseshoe, surrounding the ground that the children play on. The rooms all face this area. The roof on top of the rooms leaks when it rains, and of the few desks in the room (picnic table size) few of them are functional (not broken and splintered, having benches) There are no books. There are no bookshelves. Since there isn't a room free for a library, I was thinking of trying to raise money to put a bookshelf in each room, with a few books for kids of that grade level. The headmaster said they are severely lacking in books for the younger children, like ABCs and simple stuff. People build and sell furniture on the streets, so I could pay them to build some shelves and I already have looked into shipping prices of books, and children's books here. One of the guys at the lab is actually starting a foundation to raise money for food at the clinics, which he is still getting approved. He hopes to be able to provide lunch a few days a week. (many people come from so many miles away and wait all day to be seen. he is thinking of doing peanutbutter sandwiches because so many are malnourished, so it would be a good source of protein.) We are still looking into the prices and the creating of the website, but I know a lot of people have asked me how they can help out, so i was going to post information when the site is up and running for whoever is interested!
A strange thing is, while the school doesn't have books, there are places so closeby that are extremely modern and obviously have a lot of money put into them. One example is the movie theatre. When you go in, it's just like home, comfortable seats, good lighting, etc.
The days in the lab are really busy, but I look forward to going into work as much as I look forward to getting home and cooking and doing my own thing. I love the first few minutes when I'm off of work because we hop on this pick-up truck like vehicle that makes a few stops around town. I sit in the back with other lab techs and just let my hair blow in the wind and the only sound I can hear is the air whipping past. I watch the sun setting as the truck speeds through town and when my stop comes I jump off and then walk home :) The days are getting so busy and packed and it's really hard to get to the market for food and what not during the week, so all these errands get saved up for the weekends.
This past saturday, Laura and I went to an orphanage called Mother Teresa. We walked a few miles and then caught a bus the rest of the way there. The kids were so adorable and the babies just wanted to be held forever! We wrapped fabric chetenges around us so we were able to carry a baby on our back and then hold two in front. It was a lot of fun and it was so cute because they are trying to train some of the little kids to go to the bathroom on the toilet, and you walk into this room with these tiny kids all lined up on these tiny boxes, and they look so bored, and about 5 were actually asleep!
Later, we went to a kitchen party, which is what people call a bridal shower here. One woman my friend works is the cousin of the groom. As you have probably figured out, you don't have to know anyone there to be invited! Only women attend and there were well over 200 people there. I have never seen so many pots and plates in my entire life. Someone even gave her an oven and a table with chairs. The bride's family sits on one side of the room and the groom's family sits on the other. To ask for the woman's hand in marriage, the grooms uncle must go to the woman's family and ask and negotiate a price. The groom's family pays money, and throughout the entire ceremony that side of the family just keeps giving her money. Once they are married, the groom must pay again to be welcomed into the family.
In the beginning they had a lot of drumming and laura, alanna, and I held the babies for the women who were drumming. (this was my idea. the babies were completely fine on their clothe, but i was on a roll after the orphanage and they just looked so huggable!) Then everyone gets food and the bride's group of friends escort her in with singing. She is covered with fabric, and she walks slowly to the front. Everyone is singing and dancing around her and finally the groom's best man uncovers her. The bride must be completely silent and have no facial expression during the entire event as a sign of respect, even with people right in her face! (yea, i've already determined I would make a horrible zambian bride!) The groom then walks up and presents her with money. Then he sits down a little bit away from her and she gets up slowly with the other woman, kneeling and standing back up as she goes and presents him with flowers. Then they both kiss, and the hostess of the party separates them, and they are told to kiss again and the hostess again separates them. All the while, people are screaming and singing! Next comes the point when the hostess opens each present, one at a time, and the person that gave that present must come up and dance or sing about the gift, showing what the bride must do with it. For example, the woman who gave an iron, danced around with it and was moving the iron around her shirt as she did it. We gave a casserole dish but had to leave early (we stayed there already for over 3 hours and we had dinner plans) We tried to just walk out and they were like no no no you MUST dance, you must you must! so they pulled us on stage and we had to do a dance in front of all of these people. it was a little bit scary, but really really fun! we were trying to move our hips like they do, and i tried to simulate a caserole dish in my arms hahaha. people were screaming like crazy when the three of us americans were dancing, and afterwards everyone was hugging us and telling us they love us and saying how happy we made them. Lisa, the woman we went with, told us it didn't matter that we didn't know what to do, but that all of the women were so happy that we were embracing the culture.
Looking around and seeing all of these people who are so grateful for what they have is really so beautiful. I went to the same church today as last week and this one church member's story was told today. This woman and her family came from the Democratic Republic of Congo. They were refugees and her husband was killed on the way. She said that she and her son had basically no money and were starving when they got to Zambia. She attended a service last year but did not plan on going back or staying in contact with any of the people she met. But she said the women she met that day had something different in mind. They never stopped visiting her house and praying for her. She told us that they would not allow her family to fall. They said they would not let her family go. A few months ago she began coming to church again and actually a few days ago she got a job. She is very involved with the church now and her son actually is in the hip hop youth group that danced today, which was really really good.
I remember thinking, I don't even have to listen to the sermon today to feel the difference being in the room. Sitting with these people all around me, coming from these lives so so different than mine...hearing their voices sing and praise God, their voices are deep and rich....seeing them cheer eachother on - it's exactly what I think God calls us to do, to truely and deeply love and care for one another. We sang this song afterwards, all of the zambian people holding hands, and holding hands up in the air, eyes closed, happy and singing:
I stand in awe of you, Holy God to whom all praise is due.
Anyway, it was truely a beautiful day, and I look forward to the week! much love and God bless
Despite some electricy issues, we've been running a great deal of viral load and HIV tests. Both tests have three steps - extracting the DNA, amplifying the DNA, and detecting the virus at the end. Ngambo and I have been starting earlier and running all the viral loads in parallel, meaning while one batch (23 samples) is in the extraction stage, another is in amplification stage. In the beginning it's simple to keep track of, but once the day gets going, it gets really busy and it also involves a lot of timing.
Something else exciting from the lab is that a woman from the bush (about 5 hours from here) came in to ask Ngambo and I questions about the PCR lab - about the equipment used, safety precautions, procedure of tests, amount of space needed, etc. She is starting up a PCR lab out there, and there has never been one there before! She asked my boss if we could both go out there for about a week to help set it up - which would be suuuuuch a cool experience - and he said he's completely behind it!
Also, Monday I was able to visit the Kalingalinga school. This school has grades 1-9, and sees over 30 classes each day. For the younger grades, school is only a few hours, so there are 3 shifts: morning, early afternoon, and late afternoon. There are 15 classrooms, and while the rooms are small, each class has over 60 students in it! I spoke with the headmaster to see if they had a place for a library, and she said there is no room for one. Indeed, the classrooms are all right next to one another, in the shape of a horseshoe, surrounding the ground that the children play on. The rooms all face this area. The roof on top of the rooms leaks when it rains, and of the few desks in the room (picnic table size) few of them are functional (not broken and splintered, having benches) There are no books. There are no bookshelves. Since there isn't a room free for a library, I was thinking of trying to raise money to put a bookshelf in each room, with a few books for kids of that grade level. The headmaster said they are severely lacking in books for the younger children, like ABCs and simple stuff. People build and sell furniture on the streets, so I could pay them to build some shelves and I already have looked into shipping prices of books, and children's books here. One of the guys at the lab is actually starting a foundation to raise money for food at the clinics, which he is still getting approved. He hopes to be able to provide lunch a few days a week. (many people come from so many miles away and wait all day to be seen. he is thinking of doing peanutbutter sandwiches because so many are malnourished, so it would be a good source of protein.) We are still looking into the prices and the creating of the website, but I know a lot of people have asked me how they can help out, so i was going to post information when the site is up and running for whoever is interested!
A strange thing is, while the school doesn't have books, there are places so closeby that are extremely modern and obviously have a lot of money put into them. One example is the movie theatre. When you go in, it's just like home, comfortable seats, good lighting, etc.
The days in the lab are really busy, but I look forward to going into work as much as I look forward to getting home and cooking and doing my own thing. I love the first few minutes when I'm off of work because we hop on this pick-up truck like vehicle that makes a few stops around town. I sit in the back with other lab techs and just let my hair blow in the wind and the only sound I can hear is the air whipping past. I watch the sun setting as the truck speeds through town and when my stop comes I jump off and then walk home :) The days are getting so busy and packed and it's really hard to get to the market for food and what not during the week, so all these errands get saved up for the weekends.
This past saturday, Laura and I went to an orphanage called Mother Teresa. We walked a few miles and then caught a bus the rest of the way there. The kids were so adorable and the babies just wanted to be held forever! We wrapped fabric chetenges around us so we were able to carry a baby on our back and then hold two in front. It was a lot of fun and it was so cute because they are trying to train some of the little kids to go to the bathroom on the toilet, and you walk into this room with these tiny kids all lined up on these tiny boxes, and they look so bored, and about 5 were actually asleep!
Later, we went to a kitchen party, which is what people call a bridal shower here. One woman my friend works is the cousin of the groom. As you have probably figured out, you don't have to know anyone there to be invited! Only women attend and there were well over 200 people there. I have never seen so many pots and plates in my entire life. Someone even gave her an oven and a table with chairs. The bride's family sits on one side of the room and the groom's family sits on the other. To ask for the woman's hand in marriage, the grooms uncle must go to the woman's family and ask and negotiate a price. The groom's family pays money, and throughout the entire ceremony that side of the family just keeps giving her money. Once they are married, the groom must pay again to be welcomed into the family.
In the beginning they had a lot of drumming and laura, alanna, and I held the babies for the women who were drumming. (this was my idea. the babies were completely fine on their clothe, but i was on a roll after the orphanage and they just looked so huggable!) Then everyone gets food and the bride's group of friends escort her in with singing. She is covered with fabric, and she walks slowly to the front. Everyone is singing and dancing around her and finally the groom's best man uncovers her. The bride must be completely silent and have no facial expression during the entire event as a sign of respect, even with people right in her face! (yea, i've already determined I would make a horrible zambian bride!) The groom then walks up and presents her with money. Then he sits down a little bit away from her and she gets up slowly with the other woman, kneeling and standing back up as she goes and presents him with flowers. Then they both kiss, and the hostess of the party separates them, and they are told to kiss again and the hostess again separates them. All the while, people are screaming and singing! Next comes the point when the hostess opens each present, one at a time, and the person that gave that present must come up and dance or sing about the gift, showing what the bride must do with it. For example, the woman who gave an iron, danced around with it and was moving the iron around her shirt as she did it. We gave a casserole dish but had to leave early (we stayed there already for over 3 hours and we had dinner plans) We tried to just walk out and they were like no no no you MUST dance, you must you must! so they pulled us on stage and we had to do a dance in front of all of these people. it was a little bit scary, but really really fun! we were trying to move our hips like they do, and i tried to simulate a caserole dish in my arms hahaha. people were screaming like crazy when the three of us americans were dancing, and afterwards everyone was hugging us and telling us they love us and saying how happy we made them. Lisa, the woman we went with, told us it didn't matter that we didn't know what to do, but that all of the women were so happy that we were embracing the culture.
Looking around and seeing all of these people who are so grateful for what they have is really so beautiful. I went to the same church today as last week and this one church member's story was told today. This woman and her family came from the Democratic Republic of Congo. They were refugees and her husband was killed on the way. She said that she and her son had basically no money and were starving when they got to Zambia. She attended a service last year but did not plan on going back or staying in contact with any of the people she met. But she said the women she met that day had something different in mind. They never stopped visiting her house and praying for her. She told us that they would not allow her family to fall. They said they would not let her family go. A few months ago she began coming to church again and actually a few days ago she got a job. She is very involved with the church now and her son actually is in the hip hop youth group that danced today, which was really really good.
I remember thinking, I don't even have to listen to the sermon today to feel the difference being in the room. Sitting with these people all around me, coming from these lives so so different than mine...hearing their voices sing and praise God, their voices are deep and rich....seeing them cheer eachother on - it's exactly what I think God calls us to do, to truely and deeply love and care for one another. We sang this song afterwards, all of the zambian people holding hands, and holding hands up in the air, eyes closed, happy and singing:
I stand in awe of you, Holy God to whom all praise is due.
Anyway, it was truely a beautiful day, and I look forward to the week! much love and God bless
dimanche 2 septembre 2007
Kalingalinga Lab work, etc!
Hello everyone! it seems like so long time since I last posted; so much has happened since the roach and gecko fight...which..I wish I could tell you was an isolated incident, but unfortunately I don't have much say in the matter as there is a pretty nice size crack under our doors and these critters seem to know the place better than we do haha. I will tell you that I was chased out of my room by a jumping insect the other day...Erik claims it was just a cricket, but we all know crickets don't look or jump like that. Erik also saw this critter enter my room, but failed to notify me...hmm..call for revenge?...
Anyways! Working in the lab has been very very busy these past two weeks. It's been wonderful to be able to contribute my time and i have learned so much being there!
The first test I have been running is the HIV-DNA test, which tests for the presence of the actual HIV virus. For this we get simply a positive or negative result back (or "equivocal" if something goes wrong!) One of the main things we are working on in the lab is quality control regarding the dry blood spots that we receive. There are five blood spots on each patient's sample card, containing the patient's ID information, which we receive from the surrounding clinics. We use hole-punchers to punch exactly 6mm of this into each individual sample vial in order to run the tests. These small amounts of blood are ideal for testing infants so that they do not have to give up too much blood. It's important for the blood spots to be in the right amount (contained in the marked circles on the card) or the patient will have to have blood drawn again. Rejecting samples to be re-done should be avoided for a number of reasons. 1) this is a waste of time for the people in the lab and the nurses drawing the blood, but especially for the patient. Many people walk 10-20 miles to clinics that are far enough away from their homes so as to avoid being seen by others and the stigma that comes along with attending these clinics. 2) This shows the lab in a negative light. There are endless rumors and false speculations concerning the lab, and when others hear about people having to be bled numerous times, they are often less likely to want to have blood drawn themselves (more on this later!) So, in conclusion, it is very important to be able to keep track of the samples that come in and the clinics in which they comes from. I've had the opportunity to be helping in this in creating logs and recording percentages of samples rejected. This way we can track not only the number of samples being tested each day, but also if it seems a large number of rejected samples are coming from a certain clinic, we can notify and possibly further train the nurses at those clinics about taking correct blood samples. Keeping track of samples is important for another big reason: charting the number of samples coming in helps us to predict the increase in samples coming in for future months...and therefore can give insight in the ways the lab needs to continue to grow to accomodate! The clinics started giving out free ARV treatment in 2004, so the idea of getting tested at no cost of the patient is relatively new. While it has taken a little bit of time to spread the word and for people to feel comfortable trusting their information with the nurses (as this is true for anything new), now the number of samples being tested each month is growing significantly! As a matter of fact, in the next year, the number of samples will double. This will happen again the year after that. Ordering the correct amount of supplies to handle this growth, taking more people on to work, and starting night shifts are all important things to think about in the up and coming year.
The viral load test is designed to test for the quantity of the HIV virus in the patient's blood. All of the samples in this case come from HIV positive people, and for this reason, the result of this test is a number, and there are cut offs to determine what is ok and what is not. When the amount of the virus is too high, the patient may be progressing to a further stage of the sickness, may not be responding to the medication he is on (and therefore may need to change), or may not be taking the medications appropriately. This test utilizes two machines: the Ampli-prep(for extracting and preparing samples) and Amplicor(for amplifying samples and detecting the amount of RNA virus). Both of the machines require correct preparation and loading of reagents. In my next blog entry, my goal is to be able to describe what the machine is doing, and what the reagents are each for! Also, I am typing up a standard operating procedure for the DNA Dry Blood Spot test, so i will hopefully have more of a handle on that one as well!
Performing the two tests here is a very different experience than performing them at home. There are a lot of things to take into account! It makes me glad that I am being challenged and more informed of how things are. it also makes me homesick for the comforts of home!...for the people who know me well, and who I feel like I can talk to about anything! Last year, living with all of my friends at college park and my wonderful roomies ...I felt like I never had to really worry about things, everything was right there - classes, food, friends it was so comfortable - and after a long day, we'd come back and sit on eachother's beds, and talk for hours, or eat cookie dough and have a spur of the moment dance party! Here I have to think about things, determine the best thing for myself. Like drinking water- must be boiled first, bubbling for at least 3 minutes!- buying food- I walk to the nearest market and carry it home..going to work, I either have to time the transport, or I walk(which I enjoy, but it takes like 1.5 hours to get there)... walking in general, we're supposed to avoid it when it gets the least bit dark...showering - it happens when there is water and better when that water is hot (this one i like b/c there is little pressure to smell nice and some of you know I'm not the biggest fan of taking showers...haha)
Thinking about things you wouldn't normally have to is also true for the lab. As I said I have been helping to create logs and records for the number of samples that come in. Friday, in between running tests I was trying to determine the number of viral load test kits to order for the next two months. Because some of the records showed different numbers, and some of the records were actually non-existent, this definitely took longer than expected. Ordering the supplies as mentioned earlier involves charting the amount of samples received in the previous months and predicting the projected amounts of samples for the months to come. Also, an 8-10% of additonal supplies are purchased as a buffer for unforseen events (i.e. the machine breaks down in the middle of a run and samples need to be run again, but the reagents have already been used, or more samples are received than predicted.) One might think we should just order 100s of kits to be kept in the fridge just in case. But cost and expiration of supplies need to be taken into account! Test kits are very expensive - its roughly 800$ for each test kit. The DNA test kits run 86 samples (plus 10 controls) and the viral load test kits run 45 samples (+3 controls). This means that each DNA test costs roughly 8 dollars and each viral load test costs about 16$. These numbers do not even include all of the man-power and consumable lab materials such as pipette tips and gloves. For this reason, it is extremely important to make sure just enough supplies are kept on hand so that the test kits do not expire (800$ down the drain) because they could not be run due to lack of adequate lab materials.
Working in the lab has been wonderful for a number of reasons.
1) I am learning a lot about the science behind the lab procedures (which I find to be very ineteresting!)
2) I feel like I am able to work hard and contribute in different ways to the lab
3) I love talking to my fellow lab techs! It's a great way to find out more about them and the culture!
The two people training me and working along side of me are Eugene and Ngambo. They are both very nice and really efficient workers. They take a lot of pride in their work. Also, we have had some very fun and interesting conversations. One day Ngambo was telling me that she is trying to eat more so that she can get bigger. She puts her hands around her like in a big circle and she's like "I want to be BIGGG!", and as she says this, her eyes get wide! Ngambo is this beautiful woman who is naturally very thin and it's funny as she says this because I told her when I came in to start working, I felt a bit big next to her. She started laughing and she is like "You are crazy! I eat and eat to look like you, but nothing ever happens! I felt too skinny next to you!" And I was laughing because I was like do you understand that people in the states pay embarrassing amounts of money to look like you with all their dieting? I was telling her that she would fit right in with the celebrities in the U.S. and would be the definition of what men find attractive! Also, she was saying that people here bleach their skin and spend lots of money on creems to make their skin darker. Again, I told her that she would be perfect in the states because everyone else is getting skin cancer to have darker skin. Everything got funnier when Eugene told me later as I was pipetting some mastermix that his wife is FAT with a capital F. I gave him a look and I was like, "Eugene! she just had a baby!! give her some time!" and then he goes - "no i mean i love it!"
Everyone at the lab is just so nice and warm. I got homesick one day and Eugene kind of slapped me on the back and told me not to cry! erik said he WOULD give me a hug but he didn't want to contaminate me, how thoughtful, haha. Aleen, a woman who works with a lot of Quality control type-stuff is also very sweet. She is 36 and has these two little cute kids and lives with her husband just 5 minutes from the lab. She invited me, as well as the other interns, to her house for dinner last friday and took me to a book club a few nights ago. At her house, I ate buffallo tongue!! Also, Ron, someone who works for CIDRZ at a different location, had a party the weekend before and we all ate wharthog! I love dancing at these parties! The music is loud and I feel so free and wonderful.
I will share one more lab story (afterall this entry is entitled kalingalinga lab work!). Thurs of two weeks ago was amazing, by far one of my favorite days here! The lab is very number oriented; we deal with samples and results, and the community is all about these people, their faces, their families, their stories. It makes sense that people would wonder what goes on in the lab. ARV treatment, as I said before, is relatively new and when new things happen it is always common, and healthy, to question. However, false and negative ideas not only prevent people from being tested, but perpetuate further stories, that can get a little bit out of control and lead to unsafe situations. For example, the common question is, what does the lab do with the blood taken, and why do we have to take so much blood for the different tests. Rumors about satanistic activity have spread, like the people in the lab drinking all of the blood received. This lead to talk about people breaking into the lab to destroy the machines. In response to this, my boss invited over 100 religious leaders from around the community to come and see the lab firsthand. People got to come in and walk through and I got to be a part of it! They asked a lot of questions and wanted to see everything going on with the tests.
I admired the lab leaders so much that day. They did an incredible job of providing information and also emphasizing the point that this is not our lab to run our own experiments, but it is a lab for the people. They said the lab is always open to the people and that they should feel welcome anytime. My boss also said that he took a survey of what the community felt they needed the most, what was most urgent. He said they reported that they needed new bathrooms in the Kalingalinga school. During the rainy season, with the inadequate bathrooms they had, it was very easy for sickness to spread. My boss then announced that he heard what they had said, and that he has gotten permission and raised money from the states; there will be new high quality bathrooms installed before the rainy season comes this november. It was such an amazing thing to me, that he did not decide to do what he thought was best, but instead listened to what the community actually needed. By the end of the day, the community people and lab people were intermixed, talking, planning. It was so wonderful to see!
I think the connection to the people we serve is so important. It adds such a humanistic side to the work done in the lab, and helps me to further understand and see the importance of things like quality control...how these things directly affect the people. (like before when I was talking about trying to increase quality of samples to avoid having to make people come to get re-tested. At first it seems like a stat. But, what really makes that stat so important? I can think about how re-testing someone takes that extra time, may subject those people to stigma...those things i mentioned earlier...) Seeing people come together at the lab was truely meaningful and was something that gave me hope for the future!
All of the housemates are wonderful :) Everyone is just so sweet and it's fun to be sharing this new experience with them! The other night, Laura, Kim, Connor, Nikki and I went to this Indian place to eat and then got ice cream and yesterday I went into town with Laura to buy some fabrics to make a chetenge, the traditional skirt (you just wrap and tie fabric around your waist) We also went to this comedy show last night and it was soo funny because we understood the jokes at the beginning in English, but then when they were speaking in Nyange, the whole group of us were lost. Personally I kept laughing because everyone else was, and also because all of the interns had confused looks on their faces!
Today was soooo great! This past week I was getting a little bit homesick and missing my bible studies. Today I went to this Christian church here and just felt like I came home. It felt so great to be able to pray with all of these people, some who don't speak my language, but to know that we have these beliefs in common. I loved singing the songs, some in nyange and some in English. The homesick feeling kind of went away today, it felt like it was kind of filled up.
Hope you are doing well:) I think of everyone often! Also, I really realllllly love reading your comments on the blog although i don't know how to respond and I really really love getting emails! have a superb labor day and rest of the week!
Anyways! Working in the lab has been very very busy these past two weeks. It's been wonderful to be able to contribute my time and i have learned so much being there!
The first test I have been running is the HIV-DNA test, which tests for the presence of the actual HIV virus. For this we get simply a positive or negative result back (or "equivocal" if something goes wrong!) One of the main things we are working on in the lab is quality control regarding the dry blood spots that we receive. There are five blood spots on each patient's sample card, containing the patient's ID information, which we receive from the surrounding clinics. We use hole-punchers to punch exactly 6mm of this into each individual sample vial in order to run the tests. These small amounts of blood are ideal for testing infants so that they do not have to give up too much blood. It's important for the blood spots to be in the right amount (contained in the marked circles on the card) or the patient will have to have blood drawn again. Rejecting samples to be re-done should be avoided for a number of reasons. 1) this is a waste of time for the people in the lab and the nurses drawing the blood, but especially for the patient. Many people walk 10-20 miles to clinics that are far enough away from their homes so as to avoid being seen by others and the stigma that comes along with attending these clinics. 2) This shows the lab in a negative light. There are endless rumors and false speculations concerning the lab, and when others hear about people having to be bled numerous times, they are often less likely to want to have blood drawn themselves (more on this later!) So, in conclusion, it is very important to be able to keep track of the samples that come in and the clinics in which they comes from. I've had the opportunity to be helping in this in creating logs and recording percentages of samples rejected. This way we can track not only the number of samples being tested each day, but also if it seems a large number of rejected samples are coming from a certain clinic, we can notify and possibly further train the nurses at those clinics about taking correct blood samples. Keeping track of samples is important for another big reason: charting the number of samples coming in helps us to predict the increase in samples coming in for future months...and therefore can give insight in the ways the lab needs to continue to grow to accomodate! The clinics started giving out free ARV treatment in 2004, so the idea of getting tested at no cost of the patient is relatively new. While it has taken a little bit of time to spread the word and for people to feel comfortable trusting their information with the nurses (as this is true for anything new), now the number of samples being tested each month is growing significantly! As a matter of fact, in the next year, the number of samples will double. This will happen again the year after that. Ordering the correct amount of supplies to handle this growth, taking more people on to work, and starting night shifts are all important things to think about in the up and coming year.
The viral load test is designed to test for the quantity of the HIV virus in the patient's blood. All of the samples in this case come from HIV positive people, and for this reason, the result of this test is a number, and there are cut offs to determine what is ok and what is not. When the amount of the virus is too high, the patient may be progressing to a further stage of the sickness, may not be responding to the medication he is on (and therefore may need to change), or may not be taking the medications appropriately. This test utilizes two machines: the Ampli-prep(for extracting and preparing samples) and Amplicor(for amplifying samples and detecting the amount of RNA virus). Both of the machines require correct preparation and loading of reagents. In my next blog entry, my goal is to be able to describe what the machine is doing, and what the reagents are each for! Also, I am typing up a standard operating procedure for the DNA Dry Blood Spot test, so i will hopefully have more of a handle on that one as well!
Performing the two tests here is a very different experience than performing them at home. There are a lot of things to take into account! It makes me glad that I am being challenged and more informed of how things are. it also makes me homesick for the comforts of home!...for the people who know me well, and who I feel like I can talk to about anything! Last year, living with all of my friends at college park and my wonderful roomies ...I felt like I never had to really worry about things, everything was right there - classes, food, friends it was so comfortable - and after a long day, we'd come back and sit on eachother's beds, and talk for hours, or eat cookie dough and have a spur of the moment dance party! Here I have to think about things, determine the best thing for myself. Like drinking water- must be boiled first, bubbling for at least 3 minutes!- buying food- I walk to the nearest market and carry it home..going to work, I either have to time the transport, or I walk(which I enjoy, but it takes like 1.5 hours to get there)... walking in general, we're supposed to avoid it when it gets the least bit dark...showering - it happens when there is water and better when that water is hot (this one i like b/c there is little pressure to smell nice and some of you know I'm not the biggest fan of taking showers...haha)
Thinking about things you wouldn't normally have to is also true for the lab. As I said I have been helping to create logs and records for the number of samples that come in. Friday, in between running tests I was trying to determine the number of viral load test kits to order for the next two months. Because some of the records showed different numbers, and some of the records were actually non-existent, this definitely took longer than expected. Ordering the supplies as mentioned earlier involves charting the amount of samples received in the previous months and predicting the projected amounts of samples for the months to come. Also, an 8-10% of additonal supplies are purchased as a buffer for unforseen events (i.e. the machine breaks down in the middle of a run and samples need to be run again, but the reagents have already been used, or more samples are received than predicted.) One might think we should just order 100s of kits to be kept in the fridge just in case. But cost and expiration of supplies need to be taken into account! Test kits are very expensive - its roughly 800$ for each test kit. The DNA test kits run 86 samples (plus 10 controls) and the viral load test kits run 45 samples (+3 controls). This means that each DNA test costs roughly 8 dollars and each viral load test costs about 16$. These numbers do not even include all of the man-power and consumable lab materials such as pipette tips and gloves. For this reason, it is extremely important to make sure just enough supplies are kept on hand so that the test kits do not expire (800$ down the drain) because they could not be run due to lack of adequate lab materials.
Working in the lab has been wonderful for a number of reasons.
1) I am learning a lot about the science behind the lab procedures (which I find to be very ineteresting!)
2) I feel like I am able to work hard and contribute in different ways to the lab
3) I love talking to my fellow lab techs! It's a great way to find out more about them and the culture!
The two people training me and working along side of me are Eugene and Ngambo. They are both very nice and really efficient workers. They take a lot of pride in their work. Also, we have had some very fun and interesting conversations. One day Ngambo was telling me that she is trying to eat more so that she can get bigger. She puts her hands around her like in a big circle and she's like "I want to be BIGGG!", and as she says this, her eyes get wide! Ngambo is this beautiful woman who is naturally very thin and it's funny as she says this because I told her when I came in to start working, I felt a bit big next to her. She started laughing and she is like "You are crazy! I eat and eat to look like you, but nothing ever happens! I felt too skinny next to you!" And I was laughing because I was like do you understand that people in the states pay embarrassing amounts of money to look like you with all their dieting? I was telling her that she would fit right in with the celebrities in the U.S. and would be the definition of what men find attractive! Also, she was saying that people here bleach their skin and spend lots of money on creems to make their skin darker. Again, I told her that she would be perfect in the states because everyone else is getting skin cancer to have darker skin. Everything got funnier when Eugene told me later as I was pipetting some mastermix that his wife is FAT with a capital F. I gave him a look and I was like, "Eugene! she just had a baby!! give her some time!" and then he goes - "no i mean i love it!"
Everyone at the lab is just so nice and warm. I got homesick one day and Eugene kind of slapped me on the back and told me not to cry! erik said he WOULD give me a hug but he didn't want to contaminate me, how thoughtful, haha. Aleen, a woman who works with a lot of Quality control type-stuff is also very sweet. She is 36 and has these two little cute kids and lives with her husband just 5 minutes from the lab. She invited me, as well as the other interns, to her house for dinner last friday and took me to a book club a few nights ago. At her house, I ate buffallo tongue!! Also, Ron, someone who works for CIDRZ at a different location, had a party the weekend before and we all ate wharthog! I love dancing at these parties! The music is loud and I feel so free and wonderful.
I will share one more lab story (afterall this entry is entitled kalingalinga lab work!). Thurs of two weeks ago was amazing, by far one of my favorite days here! The lab is very number oriented; we deal with samples and results, and the community is all about these people, their faces, their families, their stories. It makes sense that people would wonder what goes on in the lab. ARV treatment, as I said before, is relatively new and when new things happen it is always common, and healthy, to question. However, false and negative ideas not only prevent people from being tested, but perpetuate further stories, that can get a little bit out of control and lead to unsafe situations. For example, the common question is, what does the lab do with the blood taken, and why do we have to take so much blood for the different tests. Rumors about satanistic activity have spread, like the people in the lab drinking all of the blood received. This lead to talk about people breaking into the lab to destroy the machines. In response to this, my boss invited over 100 religious leaders from around the community to come and see the lab firsthand. People got to come in and walk through and I got to be a part of it! They asked a lot of questions and wanted to see everything going on with the tests.
I admired the lab leaders so much that day. They did an incredible job of providing information and also emphasizing the point that this is not our lab to run our own experiments, but it is a lab for the people. They said the lab is always open to the people and that they should feel welcome anytime. My boss also said that he took a survey of what the community felt they needed the most, what was most urgent. He said they reported that they needed new bathrooms in the Kalingalinga school. During the rainy season, with the inadequate bathrooms they had, it was very easy for sickness to spread. My boss then announced that he heard what they had said, and that he has gotten permission and raised money from the states; there will be new high quality bathrooms installed before the rainy season comes this november. It was such an amazing thing to me, that he did not decide to do what he thought was best, but instead listened to what the community actually needed. By the end of the day, the community people and lab people were intermixed, talking, planning. It was so wonderful to see!
I think the connection to the people we serve is so important. It adds such a humanistic side to the work done in the lab, and helps me to further understand and see the importance of things like quality control...how these things directly affect the people. (like before when I was talking about trying to increase quality of samples to avoid having to make people come to get re-tested. At first it seems like a stat. But, what really makes that stat so important? I can think about how re-testing someone takes that extra time, may subject those people to stigma...those things i mentioned earlier...) Seeing people come together at the lab was truely meaningful and was something that gave me hope for the future!
All of the housemates are wonderful :) Everyone is just so sweet and it's fun to be sharing this new experience with them! The other night, Laura, Kim, Connor, Nikki and I went to this Indian place to eat and then got ice cream and yesterday I went into town with Laura to buy some fabrics to make a chetenge, the traditional skirt (you just wrap and tie fabric around your waist) We also went to this comedy show last night and it was soo funny because we understood the jokes at the beginning in English, but then when they were speaking in Nyange, the whole group of us were lost. Personally I kept laughing because everyone else was, and also because all of the interns had confused looks on their faces!
Today was soooo great! This past week I was getting a little bit homesick and missing my bible studies. Today I went to this Christian church here and just felt like I came home. It felt so great to be able to pray with all of these people, some who don't speak my language, but to know that we have these beliefs in common. I loved singing the songs, some in nyange and some in English. The homesick feeling kind of went away today, it felt like it was kind of filled up.
Hope you are doing well:) I think of everyone often! Also, I really realllllly love reading your comments on the blog although i don't know how to respond and I really really love getting emails! have a superb labor day and rest of the week!
mercredi 15 août 2007
man vs wild....or cockroach vs gecko
this is what happened to me last night. i had gone to bed around 1030 and woke up at 12 because my throat was burning and felt clogged...i later found out this was probably acid reflux or something, but of course being me and being paranoid about the doxy im taking for malaria, i thought the pill may have been lodged in my throat (with the doxy you arent supposed to lay down within 30 min of taking it, haha if anyone is reading this that was with me the first time i took it, you're probably really cracking up at me right now, as you should be)
anyways, thats the preface. so i go into the kitchen to eat some food and drink something, with the idea of getting the pill down my throat. i walk into the kitchen and there is this cockroach the size of a chipmunk speeding around on the floor!! i quickly went back into my room, only to find i had no food or water there. i knew i had to venture out again. i tiptoe in and make it to the fridge, quickly piling a few things on my arm and trying to slice a piece of bread balancing on my arm when out comes the cockroach again and then out of nowhere this gecko darts out from behind the fridge like 60 miles/hr and attacks the cockroach. at this point, i was just like beside myself and i was trying to get stuff back in the fridge but unfortunately i witnessed the whole attack, it was seriously like man vs wild, gecko won in the end, but they were like tumbling all over eachother, and the grossest part was how fast they were moving!! ewwwww i ran back in my room. i felt like i was in james and the giant peach or something grossssss
anyways, thats the preface. so i go into the kitchen to eat some food and drink something, with the idea of getting the pill down my throat. i walk into the kitchen and there is this cockroach the size of a chipmunk speeding around on the floor!! i quickly went back into my room, only to find i had no food or water there. i knew i had to venture out again. i tiptoe in and make it to the fridge, quickly piling a few things on my arm and trying to slice a piece of bread balancing on my arm when out comes the cockroach again and then out of nowhere this gecko darts out from behind the fridge like 60 miles/hr and attacks the cockroach. at this point, i was just like beside myself and i was trying to get stuff back in the fridge but unfortunately i witnessed the whole attack, it was seriously like man vs wild, gecko won in the end, but they were like tumbling all over eachother, and the grossest part was how fast they were moving!! ewwwww i ran back in my room. i felt like i was in james and the giant peach or something grossssss
dimanche 12 août 2007
Something about strength with God
This is about the power of faith. in the book of Job, a series of unfortunate events happen to Job. His servants were slain, his sheep were consumed, his house was destroyed.
"Then Job arose and rent his mantle, and shaved his head, and fell down upon the ground, and worshipped,
And said Naked came I, out of my mother's womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away; blessed be the name of the Lord."
Job 1: 20-21
I read this a few mornings ago and it reminded me of the great strength in faith I have witnessed amongst the people here. I can't tell you how many people have spoken to me about their own stories in living with HIV. And they are also the stories of the families and their friends.
People have come and gone in their lives. They have seen great desparation and have seen people they love disappear, and they thank God each day that they can praise Him. They have next to no possessions, and they thank God each day.
"Then Job arose and rent his mantle, and shaved his head, and fell down upon the ground, and worshipped,
And said Naked came I, out of my mother's womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away; blessed be the name of the Lord."
Job 1: 20-21
I read this a few mornings ago and it reminded me of the great strength in faith I have witnessed amongst the people here. I can't tell you how many people have spoken to me about their own stories in living with HIV. And they are also the stories of the families and their friends.
People have come and gone in their lives. They have seen great desparation and have seen people they love disappear, and they thank God each day that they can praise Him. They have next to no possessions, and they thank God each day.
thoughts about my visits to the clinics
The past two weeks have been filled with orientation, meaning we have been able to go around to various clinics in Lusaka and walk around the various parts of each, along with sitting in on doctor-patient visits. The first week I was here I remember all I wanted to do was to take pictures of everything. The streets are so natural looking and the people really are beautiful. The clinics inspired me because I was thinking it was such a wonderful thing that so many people were going and finding out their HIV status.
The past week and a half has been different for me. I go to the clinics everyday and everyday they are filled with people finding out their status, but also trying to hold onto their lives. I knew before that I was not just coming to see the different people in these clinics, but now, seeing these people all the time, and their families or lack there of, it's taxing and its heartbreaking. The people are not just sick and weak, they are dying from this horrific epidemic we call AIDS and they are fighting for life.
There are undoubtedly a number of obstacles in helping people in these clinics but the doctors have been amazing to see. They take these issues and just power through: they are kind to their patients, but also firm in getting things done. When I sit in on the visits, these issues go straight to my heart. Many people do not know their age, and the doctor will check multiple files and try to ask questions to the person to find out. For me, it's the reasoning behind the lack of information: many times the child grew up with different people than his parents and there were more important things to keep track of than age or the child never had anyone who looked after him. I think about how strange it must be to not know your age. .. and to not know your age because you did not know your parents. I take for granted that I know this information, that every year I have had people who have celebrated this knowledge with me, cards with the new number of years posted all over it. But right now in this clinic, this person is sitting right in front of me, and the many others just like this woman, they did not have this. There was no one for that child.
My days shadowing in pediatrics have shown me a lot about the stigma as well. This is what happens in the pediatric visits.
A twelve year old girl walks into the clinic with her caretaker (in this case her aunt) only she looks as if she is 6 because she is so small and thin. The doctor asks the girl how she is feeling and the girl will say her stomach is hurting from the pills she needs to take and her aunt will say she is having nightmares and she is not eating. The doctor then will ask the aunt how often she is taking her medication, and the aunt will smile sheepishly, a little bit embarrassed, because she is not sure. The doctor will ask who is at home with the child and the aunt says she is not at home with the child. Then the doctor will ask if the child knows why she is on the medication. And the aunt says no. The doctor then asks when the aunt is planning on telling the child and if she wants a counselor to be in the room to do it, and the aunt says she does not feel comfortable being there when it happens. And the doctor says, but the child will need you, and the aunt again has the smile, that she is embarrassed, she doesn't know what to do.
This whole time they are talking, the child is in the room. It's like this with all of the children, they sit right there as the doctor talks to their caretakers, and I notice that they all have the same eyes. Their eyes are wide open and they hang onto the doctor's every word; their eyes never leave the doctor's face. And when this happens, you want to be that person for the child, who will be home for the child, who will give the child the pills and who will talk to the child about anything the child wants to know. You want to just hug the child and you want to somehow implant the knowledge of the child's status so that it arrives gently and you want to be right there with the child so when his world is turned completely upside down, she will not be alone. You want to be that person for the child that keeps track of her age.
The doctor will turn to the child and ask if she understands what fighter cells are. The doctor says the more you have the better, because then they can fight off the bad things in the body. With this girl I remember the doctor asking if she wanted to have a little bit of good cells or not a lot of good cells. The girl nodded to "a lot of good cells". The doctor said, right now you have a little bit. The good cells are low, so that is why you need to take the medication. It kills me to hear the virus described in these terms, so simply and plainly. It kills me that this child does not fully understand why she feels the way she does.
I asked the doctor after the first time this happened, why they do not tell the children sooner. There are a lot of privacy policies and confidentiality surrounding the subject. It is forbidden for a doctor to tell the child any information unless having the caretaker's consent. Apparently it is very common for kids even 13 or 14 to not have been told their status. (some end up finding out themselves, but their parents don't know that they know) People are afriad at how they may react and they don't want to hurt the child. I think if I were 12 and no one told me that I have a life-threatening illness, I would feel not only horribly betrayed when I did find out, but also, feel empty like I did not know a big part of who I was. Also, I see this as prolonging the HIV stigma. I feel the child may grow up feeling he needs to hide this from others, since it was hidden from him this whole time.
More than ever now, I think it is so important to understand the individual and the culture in which the person lives. I see how the upbringing of a person can dramatically affect the chances of that person being HIV positive, affect when the person should or will find out his status, and how that person will take that new information. For example, talking to a child about HIV who is in an orphange and may not have solid parental units around is different than breaking the news with a family who can support the child. HIV stigma is a lot more powerful here than I could have imagined. I have seen how it prevents people from finding out their status and from seeking treatment- and how it is a double ended sword. We try to provide people with information about the virus, but at the same time we have all of these rules of confidentiality in telling people, especially children. We try to announce that there will be free HIV testing in the community, but in effort to make people comfortable and actually come to be tested, we have the line coming out the back of the building.
In protecting confidentiality, we prolong the stigma we are trying so desperately to mitigate. Prolonging the stigma prolongs the virus. Partners don't want to get tested or even be seen taking ARVs. It is common for men to have many sexual partners, but not be tied down to one of them. For this reason, it is easy for HIV to be spread, but less common to see men getting tested to know their status. A lot of women who are pregnant are found at the clinics because of the concern of the baby.
For this reason and others, a huge goal of HIV treatment is to spread public awareness about HIV and dispell rumors. Every day there are false ideas being spread, such as newspapers with articles about the "cure" for HIV. One day we walked past a stand that was selling these herbal remedies that supposedly not only cured TB and HIV, but also sexually transmitted diseases. It's also common for very religious people to refrain from accepting HIV treatment and information because they believe so strongly that God will save them and they do not have to practice safe ways of avoiding HIV transmission. Without taking into account religious, moral, family values of a person, I think it is impossible to reach that person and to connect to that person when counseling about HIV. I think apart from everything else, it is just so important to respect other people's beliefs.
The last story that I will share was about a woman at a support group who was praising her husband for helping her to find out her HIV status and for helping her to go to her support groups. Her husband was there and kept looking down and had a somewhat strange look on his face, especially because his wife was telling everyone how he had the "heart of a lion." Later, she stepped down and into the light and only then did we see one of her eyes was very very bruised. The community leader walked up to the woman's husband after the group meeting and told him he "also had the fist of a lion" and that if he hit her again, she was going to report him.
I see female empowerment, within the context of the culture, to be a crucial part of support and counseling for women. I say this because it is part of the culture for women to be submissive to men in certain ways, such as not being able to refrain from having sex with their partners if asked. If men are seeing other women on the side and not using protection(highly common), this is a prime way to spread HIV around. It was tempting to me at first to believe the answer to this is to empower women to be able to say "no" to their husbands, especially when they know they are sleeping around. However, in thinking about it, I can't see it going well if we think someone can go into a support group and tell women to withold from their husbands from sex or any other things for that matter. For many people, this goes against their cultural and religious beliefs, and I think it would do a lot more harm than good to try to get around this. I think talking to women about issues they are dealing with and thinking of alternatives to keep them safer is a much more logical idea. I think knowledge about safe sex and having groups where women can talk to eachother about things and/or report violence is empowering women and keeping them safer.
In the end, the goal is to help people to help themselves - it's to show people that they DO have a chance at living a positive sucessful life, even if they find they are HIV positive. People tell me that before anti-retroviral meds came along, people were just dying in the streets, and being carted away in wheel barrels. Now with the medicine and counseling, people are finding they can live again. There are always going to obstacles in finding people who need treatment, and then when they do find the people, in effectively treating them with the medication that will work best for their body, for their situation. But with those obstacles, it is so glaringly obvious how strong these people are. In church they praise God for thier lives and for their family's lives, those who are still with them. At work they pray to God for that day that they are living. In the clinics, they sing and they dance that they are alive.
As for me, I feel great. Some days are sad because it is hard seeing people go through what they must go through but every day is a new and incredible challenge in living in this new place. My great aunt passed away about a week ago, and it was definitely a different experience being far away from home and not being able to see my family during this time. She was a wonderful and strong Greek woman, who always had a smile on her face and had the most beautiful gardens in her back yard. I will always be grateful that I had the chance to know her and I will always remember eating eggs at her house each summer in traveling to East Hampton :) I got a chance to see how supportive my roomates were during this time and i did a lot of baking and running. Also, I had the wonderful opportunity to play the piano and I wrote a short song in the few words of Nyange that I know, about my great aunt.
Although I am getting more used to this new place, I am still getting very intense dreams each night. Also, another adjustment is walking everywhere! We walk hours out of each day and the days we go shopping we carry our gorceries miles home. I think it's really neat and I've started thinking about the places I will be walking when I get back home to md!
My housemates are really wonderful. I love that there is a great range of age (i'm the youngest) and range of fields people are interested in and places where they come from. We have started to cook lots of meals all together, which is so fun. Anddddd I made spanikopita last night! The two intern houses are about 3 miles away from eachother, so that means more walking! Here is an updated list of the housemates!
Katie - 26 - Public health major - she lives right next to me and is very sarcastic and funny. She has been such a good friend to me this whole time - she was the first person I met in coming on the trip!
Kim- 30 - She has been to sooo many different places and worked in the Peacecorps. She makes awesome food out of nothing and is very independent! She is applying to medical school right now.
Laura - also 30 - She has been in grad school and also has been to a lot of places, including living in a jungle for a few months to look at water conservation! She is such a sweet person and is always very calm, even in problematic circumstances.
Alanna - 23 - She is planning on going to medical school and has spent time in Lusaka previous to this trip. She was a diver in college and she is really small and cute! She is someone that is very relatable and good to talk to.
Steph - 28 - She has gotten two different master's degrees already and is from Australia. She is an amazing cook and is one of those people you can always count on to get good advice from. She is also really fun and up for adventure
Nicole - 26 - She just finished med school and is really cheery and a super fun person to talk and laugh with. She is a really warm person and wants to go into pediatrics.
Connor - 28 - He has finished his 3rd year in med school and is working in Obgyn. He's very nice, laid back, and from the south and likes to call people "gunners" when they overachieve. (for example, i said something in nyanga one day and he was like "ohh she's firing from both barrels" haha)
Nathan - 28 - He has worked in Peace Corps before and is planning on taking the mcats and going to med school. he is really really funny and enjoys quoting from movies like anchorman.
Eric - 32 - Really nice, finished med school and a masters in engineering. (yea, really smart) He will be working in the lab with me.
Gina - i think upper 20s - really sweet, she is working on a different project so I don't know her that well yet.
That's it for now! Hope everyone is doing well! I miss you all!
The past week and a half has been different for me. I go to the clinics everyday and everyday they are filled with people finding out their status, but also trying to hold onto their lives. I knew before that I was not just coming to see the different people in these clinics, but now, seeing these people all the time, and their families or lack there of, it's taxing and its heartbreaking. The people are not just sick and weak, they are dying from this horrific epidemic we call AIDS and they are fighting for life.
There are undoubtedly a number of obstacles in helping people in these clinics but the doctors have been amazing to see. They take these issues and just power through: they are kind to their patients, but also firm in getting things done. When I sit in on the visits, these issues go straight to my heart. Many people do not know their age, and the doctor will check multiple files and try to ask questions to the person to find out. For me, it's the reasoning behind the lack of information: many times the child grew up with different people than his parents and there were more important things to keep track of than age or the child never had anyone who looked after him. I think about how strange it must be to not know your age. .. and to not know your age because you did not know your parents. I take for granted that I know this information, that every year I have had people who have celebrated this knowledge with me, cards with the new number of years posted all over it. But right now in this clinic, this person is sitting right in front of me, and the many others just like this woman, they did not have this. There was no one for that child.
My days shadowing in pediatrics have shown me a lot about the stigma as well. This is what happens in the pediatric visits.
A twelve year old girl walks into the clinic with her caretaker (in this case her aunt) only she looks as if she is 6 because she is so small and thin. The doctor asks the girl how she is feeling and the girl will say her stomach is hurting from the pills she needs to take and her aunt will say she is having nightmares and she is not eating. The doctor then will ask the aunt how often she is taking her medication, and the aunt will smile sheepishly, a little bit embarrassed, because she is not sure. The doctor will ask who is at home with the child and the aunt says she is not at home with the child. Then the doctor will ask if the child knows why she is on the medication. And the aunt says no. The doctor then asks when the aunt is planning on telling the child and if she wants a counselor to be in the room to do it, and the aunt says she does not feel comfortable being there when it happens. And the doctor says, but the child will need you, and the aunt again has the smile, that she is embarrassed, she doesn't know what to do.
This whole time they are talking, the child is in the room. It's like this with all of the children, they sit right there as the doctor talks to their caretakers, and I notice that they all have the same eyes. Their eyes are wide open and they hang onto the doctor's every word; their eyes never leave the doctor's face. And when this happens, you want to be that person for the child, who will be home for the child, who will give the child the pills and who will talk to the child about anything the child wants to know. You want to just hug the child and you want to somehow implant the knowledge of the child's status so that it arrives gently and you want to be right there with the child so when his world is turned completely upside down, she will not be alone. You want to be that person for the child that keeps track of her age.
The doctor will turn to the child and ask if she understands what fighter cells are. The doctor says the more you have the better, because then they can fight off the bad things in the body. With this girl I remember the doctor asking if she wanted to have a little bit of good cells or not a lot of good cells. The girl nodded to "a lot of good cells". The doctor said, right now you have a little bit. The good cells are low, so that is why you need to take the medication. It kills me to hear the virus described in these terms, so simply and plainly. It kills me that this child does not fully understand why she feels the way she does.
I asked the doctor after the first time this happened, why they do not tell the children sooner. There are a lot of privacy policies and confidentiality surrounding the subject. It is forbidden for a doctor to tell the child any information unless having the caretaker's consent. Apparently it is very common for kids even 13 or 14 to not have been told their status. (some end up finding out themselves, but their parents don't know that they know) People are afriad at how they may react and they don't want to hurt the child. I think if I were 12 and no one told me that I have a life-threatening illness, I would feel not only horribly betrayed when I did find out, but also, feel empty like I did not know a big part of who I was. Also, I see this as prolonging the HIV stigma. I feel the child may grow up feeling he needs to hide this from others, since it was hidden from him this whole time.
More than ever now, I think it is so important to understand the individual and the culture in which the person lives. I see how the upbringing of a person can dramatically affect the chances of that person being HIV positive, affect when the person should or will find out his status, and how that person will take that new information. For example, talking to a child about HIV who is in an orphange and may not have solid parental units around is different than breaking the news with a family who can support the child. HIV stigma is a lot more powerful here than I could have imagined. I have seen how it prevents people from finding out their status and from seeking treatment- and how it is a double ended sword. We try to provide people with information about the virus, but at the same time we have all of these rules of confidentiality in telling people, especially children. We try to announce that there will be free HIV testing in the community, but in effort to make people comfortable and actually come to be tested, we have the line coming out the back of the building.
In protecting confidentiality, we prolong the stigma we are trying so desperately to mitigate. Prolonging the stigma prolongs the virus. Partners don't want to get tested or even be seen taking ARVs. It is common for men to have many sexual partners, but not be tied down to one of them. For this reason, it is easy for HIV to be spread, but less common to see men getting tested to know their status. A lot of women who are pregnant are found at the clinics because of the concern of the baby.
For this reason and others, a huge goal of HIV treatment is to spread public awareness about HIV and dispell rumors. Every day there are false ideas being spread, such as newspapers with articles about the "cure" for HIV. One day we walked past a stand that was selling these herbal remedies that supposedly not only cured TB and HIV, but also sexually transmitted diseases. It's also common for very religious people to refrain from accepting HIV treatment and information because they believe so strongly that God will save them and they do not have to practice safe ways of avoiding HIV transmission. Without taking into account religious, moral, family values of a person, I think it is impossible to reach that person and to connect to that person when counseling about HIV. I think apart from everything else, it is just so important to respect other people's beliefs.
The last story that I will share was about a woman at a support group who was praising her husband for helping her to find out her HIV status and for helping her to go to her support groups. Her husband was there and kept looking down and had a somewhat strange look on his face, especially because his wife was telling everyone how he had the "heart of a lion." Later, she stepped down and into the light and only then did we see one of her eyes was very very bruised. The community leader walked up to the woman's husband after the group meeting and told him he "also had the fist of a lion" and that if he hit her again, she was going to report him.
I see female empowerment, within the context of the culture, to be a crucial part of support and counseling for women. I say this because it is part of the culture for women to be submissive to men in certain ways, such as not being able to refrain from having sex with their partners if asked. If men are seeing other women on the side and not using protection(highly common), this is a prime way to spread HIV around. It was tempting to me at first to believe the answer to this is to empower women to be able to say "no" to their husbands, especially when they know they are sleeping around. However, in thinking about it, I can't see it going well if we think someone can go into a support group and tell women to withold from their husbands from sex or any other things for that matter. For many people, this goes against their cultural and religious beliefs, and I think it would do a lot more harm than good to try to get around this. I think talking to women about issues they are dealing with and thinking of alternatives to keep them safer is a much more logical idea. I think knowledge about safe sex and having groups where women can talk to eachother about things and/or report violence is empowering women and keeping them safer.
In the end, the goal is to help people to help themselves - it's to show people that they DO have a chance at living a positive sucessful life, even if they find they are HIV positive. People tell me that before anti-retroviral meds came along, people were just dying in the streets, and being carted away in wheel barrels. Now with the medicine and counseling, people are finding they can live again. There are always going to obstacles in finding people who need treatment, and then when they do find the people, in effectively treating them with the medication that will work best for their body, for their situation. But with those obstacles, it is so glaringly obvious how strong these people are. In church they praise God for thier lives and for their family's lives, those who are still with them. At work they pray to God for that day that they are living. In the clinics, they sing and they dance that they are alive.
As for me, I feel great. Some days are sad because it is hard seeing people go through what they must go through but every day is a new and incredible challenge in living in this new place. My great aunt passed away about a week ago, and it was definitely a different experience being far away from home and not being able to see my family during this time. She was a wonderful and strong Greek woman, who always had a smile on her face and had the most beautiful gardens in her back yard. I will always be grateful that I had the chance to know her and I will always remember eating eggs at her house each summer in traveling to East Hampton :) I got a chance to see how supportive my roomates were during this time and i did a lot of baking and running. Also, I had the wonderful opportunity to play the piano and I wrote a short song in the few words of Nyange that I know, about my great aunt.
Although I am getting more used to this new place, I am still getting very intense dreams each night. Also, another adjustment is walking everywhere! We walk hours out of each day and the days we go shopping we carry our gorceries miles home. I think it's really neat and I've started thinking about the places I will be walking when I get back home to md!
My housemates are really wonderful. I love that there is a great range of age (i'm the youngest) and range of fields people are interested in and places where they come from. We have started to cook lots of meals all together, which is so fun. Anddddd I made spanikopita last night! The two intern houses are about 3 miles away from eachother, so that means more walking! Here is an updated list of the housemates!
Katie - 26 - Public health major - she lives right next to me and is very sarcastic and funny. She has been such a good friend to me this whole time - she was the first person I met in coming on the trip!
Kim- 30 - She has been to sooo many different places and worked in the Peacecorps. She makes awesome food out of nothing and is very independent! She is applying to medical school right now.
Laura - also 30 - She has been in grad school and also has been to a lot of places, including living in a jungle for a few months to look at water conservation! She is such a sweet person and is always very calm, even in problematic circumstances.
Alanna - 23 - She is planning on going to medical school and has spent time in Lusaka previous to this trip. She was a diver in college and she is really small and cute! She is someone that is very relatable and good to talk to.
Steph - 28 - She has gotten two different master's degrees already and is from Australia. She is an amazing cook and is one of those people you can always count on to get good advice from. She is also really fun and up for adventure
Nicole - 26 - She just finished med school and is really cheery and a super fun person to talk and laugh with. She is a really warm person and wants to go into pediatrics.
Connor - 28 - He has finished his 3rd year in med school and is working in Obgyn. He's very nice, laid back, and from the south and likes to call people "gunners" when they overachieve. (for example, i said something in nyanga one day and he was like "ohh she's firing from both barrels" haha)
Nathan - 28 - He has worked in Peace Corps before and is planning on taking the mcats and going to med school. he is really really funny and enjoys quoting from movies like anchorman.
Eric - 32 - Really nice, finished med school and a masters in engineering. (yea, really smart) He will be working in the lab with me.
Gina - i think upper 20s - really sweet, she is working on a different project so I don't know her that well yet.
That's it for now! Hope everyone is doing well! I miss you all!
dimanche 29 juillet 2007
community and singing!
Wed
Today I woke up and went running with Kim, which helped me to really feel better. My stomach has been a little bit rumbly for the last 2 days and this kind of kicked it back into the norm again! Then I got a ride via a mailcar to kalingalinga (once again..the issue of timing!) I was trained at work today by a woman named Ngombe (in-gom-bay). I loved it, and I can't explaint he feeling of excitement I felt thinking about how I would be able to also run these tests for these people. Hundreds and hundreds of patient samples come in and the number of samples will be doubling within 12 months!! ... one of my projects here will be to decide how the lab will be able to handle the increase in samples (what new resources we will need, number of workers, set up etc) I got home and was locked out so I sat outside the house with the guard and heard african singing! It was so beautiful so decided to follow the voices and ended up at a church right up the street, which had a choir practicing for a festival that Saturday. I loved hearing the songs and talked to some of the people about coming to the festival. It was so beautiful and I sat there listening to them and watching them dance while the sun was setting :)
Thurs
We had orientation today and we had a chance to see all of the different CIDRZ locations (the organization I am working for, actually it's pronounced "ciders" if you want to sound cool!) Greeting people is huge in this culture and so all of us 9 interns (Steph, Nicole, and Nathan arrived the next night and are staying with Connor in the new house) went to meet everyone. This took a very long time as there are 4 locations, each with about 40 people! Then we had a traditional lunch with Kapenta (these small fish, I ate one eventhough chewing the eyes was a little weird at first), nshima, and other foods too! We got back late and went to the market to buy fruit/veggies. 10 sweet potatos are only 5,000 kwacha - like a little over a dollar, and 4 bananas for like equiv of 50cents total. I once again WISH i had my camera because the scene walking out of the other market overlooking all of the stands with the streets packed with crowds of people and food was beautiful...or course the sun was just setting, just adding to the frustration of not having a camera!! Today I made the mistake of taking doxycycline without eating first so i was nausiated all day - no fun! everything on the whole is wonderful though. At nights I am happy to be sleeping, but sometimes before I go to bed, I think, What the heck?? I am in Africa? or like Where am I?? just thinking how random it is to be here, or like a whole year?? like really? i stare at my white walls and the space around the room, which is really quite nice and uncluttered, and I wonder how it will be this next year.
fri
today we had our community orientation! we went to a clinic nearby and it was amazing!! It is definitely in the more rural and poor area of zambia, and they try to reach out to people to give them info about HIV and getting tested. When we drove in, there were lines and lines of people, mostly women with children, waiting outside of the clinic. They try to give info through a drama presentation. We got a quick tour of the administrative office (pretty small) and then watched the show. There was singing and dancing (yesss!!) and the people were dressed in fabric (the chetenge is the tradional skirt) that said "Positive for Life" and the skit started out as a man sitting far from his friends, but once he knew his HIv status he could sit with them, because the knowledge did not drive him away from the people, but instead brought them all closer. then they danced and one woman brought me out and it was so fun. its not like at home when you dance you try to make sure you don't look weird, everyone was very accepting and they were just happy i was dancing. a woman came and hugged me later because she said i was embracing her culture. i became emotional because everything was so beautiful and amazing, africa music which i have always loved was so real now, and you really feel the drum in your heart and you have to dance! also, the fact that they were dancing and trying to spread the message to help the people and bring the people in was amazing. then we got a tour of the clinic and they had all sorts of stations in this tiny tiny building. one for pregnant women, for counseling, for injections, etc etc. i felt like if i ever had the chance to work at a clinic like this, i would never be bored, and i would always want to go to work everyday. seeing all of the people and talking to them was such an incredible experience. driving back, we saw about 15 little kids pushing a van down the road - very impressive :)
sat
today was the choir festival! we crammed about 45 people on this tiny bus and traveled to Kafue, a very rural part of Zambia. On the way we passed by a lot of mountains and shacks and huts. The people ont he bus were singing and dancing the entire way there! i was smooshed against a window but did my best to shake it hahaha i went with my two roomates laura and ilana and we were the only non-zambian people there. We were supposed to leave around 730am from the church but ended up going at 930...we were supposed to get home at 2, but got back around 530! everyone was very gracious and friendly and where were about 20 different singing groups. i got the take care of one of the woman's babies while there - sooooo incredibly fat/cute - very healthy. a lot of the women have children and are in their late teens. the men there all asked if i had a boyfriend or was married. it can be pretty overwhelming i think because we were the only white women there. everytime you turn around, there is a pack of guys smiling at you and asking to be in a picture with you or asking you to tell them where you live so they can take you out. there were a few very persistent ones and so you have to just walk away. the singing and dancing was great and i was up in the front at one point kind of dancing a little and these 2 really large women came over and grabbed me and wrapped me in fabric and took my hands and pretty much dragged me closer to show me how to dance. they seemed pretty happy that i wanted to dance and they kept hugging me and kissing me and they brought me back to their families afterwards and everyone was hugging me and telling me how they are so happy i dance with them! i feel so lucky to always be able to be dancing here -i found out they really dont care how you dance, and lucky for me they take it as a compliment even if you have no clue what you're doing! During the trip, a guy named Paul was very helpful for the guys who kept asking for marriage. He pretty much stood next to me a lot and then other guys didn't approach me as much. Also he told me that while women are seen as submissive here, fortunately, stricter consequences are being put into effect for abuse. Another zambian - a girl named caroline- helped me when i wanted to go to the bathroom or get water. she pretty much lead me to where i should go and told me where I should not go. On the bus ride back, Paul saved me a seat next to him, but I ended up sitting a little farther back next to Caroline...the bus started moving and people changed spots i was squished next to a guy that was extremely persistent to be my boyfriend, which was kind of disturbing. if i wasnton a packed bus i would have moved, but unfortunately for 45 min i couldn't get away. i talked to a previous intern about this and she said that i should just get a cheap ring and tell them i am married. she said if this doesnt work that i should say very seriously that i am not interested and then ignore them. I think I was very caught up in the fun of the day and kind of let my guard down and then didn't know what to do. Allison, the former intern, told me that while I may meet some nice people, it's hard to know the intentions and that I must always take what they say in this way.
I'm learning a lot here and I feel just so so blessed to be able to have this experience!!! I'm so excited to keep learning and experiencing. I love and miss you all and keep everyone in my prayers.
Today I woke up and went running with Kim, which helped me to really feel better. My stomach has been a little bit rumbly for the last 2 days and this kind of kicked it back into the norm again! Then I got a ride via a mailcar to kalingalinga (once again..the issue of timing!) I was trained at work today by a woman named Ngombe (in-gom-bay). I loved it, and I can't explaint he feeling of excitement I felt thinking about how I would be able to also run these tests for these people. Hundreds and hundreds of patient samples come in and the number of samples will be doubling within 12 months!! ... one of my projects here will be to decide how the lab will be able to handle the increase in samples (what new resources we will need, number of workers, set up etc) I got home and was locked out so I sat outside the house with the guard and heard african singing! It was so beautiful so decided to follow the voices and ended up at a church right up the street, which had a choir practicing for a festival that Saturday. I loved hearing the songs and talked to some of the people about coming to the festival. It was so beautiful and I sat there listening to them and watching them dance while the sun was setting :)
Thurs
We had orientation today and we had a chance to see all of the different CIDRZ locations (the organization I am working for, actually it's pronounced "ciders" if you want to sound cool!) Greeting people is huge in this culture and so all of us 9 interns (Steph, Nicole, and Nathan arrived the next night and are staying with Connor in the new house) went to meet everyone. This took a very long time as there are 4 locations, each with about 40 people! Then we had a traditional lunch with Kapenta (these small fish, I ate one eventhough chewing the eyes was a little weird at first), nshima, and other foods too! We got back late and went to the market to buy fruit/veggies. 10 sweet potatos are only 5,000 kwacha - like a little over a dollar, and 4 bananas for like equiv of 50cents total. I once again WISH i had my camera because the scene walking out of the other market overlooking all of the stands with the streets packed with crowds of people and food was beautiful...or course the sun was just setting, just adding to the frustration of not having a camera!! Today I made the mistake of taking doxycycline without eating first so i was nausiated all day - no fun! everything on the whole is wonderful though. At nights I am happy to be sleeping, but sometimes before I go to bed, I think, What the heck?? I am in Africa? or like Where am I?? just thinking how random it is to be here, or like a whole year?? like really? i stare at my white walls and the space around the room, which is really quite nice and uncluttered, and I wonder how it will be this next year.
fri
today we had our community orientation! we went to a clinic nearby and it was amazing!! It is definitely in the more rural and poor area of zambia, and they try to reach out to people to give them info about HIV and getting tested. When we drove in, there were lines and lines of people, mostly women with children, waiting outside of the clinic. They try to give info through a drama presentation. We got a quick tour of the administrative office (pretty small) and then watched the show. There was singing and dancing (yesss!!) and the people were dressed in fabric (the chetenge is the tradional skirt) that said "Positive for Life" and the skit started out as a man sitting far from his friends, but once he knew his HIv status he could sit with them, because the knowledge did not drive him away from the people, but instead brought them all closer. then they danced and one woman brought me out and it was so fun. its not like at home when you dance you try to make sure you don't look weird, everyone was very accepting and they were just happy i was dancing. a woman came and hugged me later because she said i was embracing her culture. i became emotional because everything was so beautiful and amazing, africa music which i have always loved was so real now, and you really feel the drum in your heart and you have to dance! also, the fact that they were dancing and trying to spread the message to help the people and bring the people in was amazing. then we got a tour of the clinic and they had all sorts of stations in this tiny tiny building. one for pregnant women, for counseling, for injections, etc etc. i felt like if i ever had the chance to work at a clinic like this, i would never be bored, and i would always want to go to work everyday. seeing all of the people and talking to them was such an incredible experience. driving back, we saw about 15 little kids pushing a van down the road - very impressive :)
sat
today was the choir festival! we crammed about 45 people on this tiny bus and traveled to Kafue, a very rural part of Zambia. On the way we passed by a lot of mountains and shacks and huts. The people ont he bus were singing and dancing the entire way there! i was smooshed against a window but did my best to shake it hahaha i went with my two roomates laura and ilana and we were the only non-zambian people there. We were supposed to leave around 730am from the church but ended up going at 930...we were supposed to get home at 2, but got back around 530! everyone was very gracious and friendly and where were about 20 different singing groups. i got the take care of one of the woman's babies while there - sooooo incredibly fat/cute - very healthy. a lot of the women have children and are in their late teens. the men there all asked if i had a boyfriend or was married. it can be pretty overwhelming i think because we were the only white women there. everytime you turn around, there is a pack of guys smiling at you and asking to be in a picture with you or asking you to tell them where you live so they can take you out. there were a few very persistent ones and so you have to just walk away. the singing and dancing was great and i was up in the front at one point kind of dancing a little and these 2 really large women came over and grabbed me and wrapped me in fabric and took my hands and pretty much dragged me closer to show me how to dance. they seemed pretty happy that i wanted to dance and they kept hugging me and kissing me and they brought me back to their families afterwards and everyone was hugging me and telling me how they are so happy i dance with them! i feel so lucky to always be able to be dancing here -i found out they really dont care how you dance, and lucky for me they take it as a compliment even if you have no clue what you're doing! During the trip, a guy named Paul was very helpful for the guys who kept asking for marriage. He pretty much stood next to me a lot and then other guys didn't approach me as much. Also he told me that while women are seen as submissive here, fortunately, stricter consequences are being put into effect for abuse. Another zambian - a girl named caroline- helped me when i wanted to go to the bathroom or get water. she pretty much lead me to where i should go and told me where I should not go. On the bus ride back, Paul saved me a seat next to him, but I ended up sitting a little farther back next to Caroline...the bus started moving and people changed spots i was squished next to a guy that was extremely persistent to be my boyfriend, which was kind of disturbing. if i wasnton a packed bus i would have moved, but unfortunately for 45 min i couldn't get away. i talked to a previous intern about this and she said that i should just get a cheap ring and tell them i am married. she said if this doesnt work that i should say very seriously that i am not interested and then ignore them. I think I was very caught up in the fun of the day and kind of let my guard down and then didn't know what to do. Allison, the former intern, told me that while I may meet some nice people, it's hard to know the intentions and that I must always take what they say in this way.
I'm learning a lot here and I feel just so so blessed to be able to have this experience!!! I'm so excited to keep learning and experiencing. I love and miss you all and keep everyone in my prayers.
Zambia Arrival!
Hello Everyone!
I'm in Zambia! I can't believe I'm finally here. It's so weird because I have been anticipating it for so long, but with no idea what to expect. Everything is just so beautiful, the people, the land, the trees, it's so natural and it feels so great to be able to be walking these streets! This e-mail may be a little bit long - probably longer than the next just because these are my first impressions in this new place! feel free to read whatever you would like!
The plane ride went pretty well over - I only felt sick for a few hours- which I am very grateful for (because of how easily I get motion sickness usually!) I went with Katie - 26 - finished Public Health and Connor - 29- in his 3rd year in med school. There were 2 kind of unsettling things that happened on the way over - there was a boy that was semi-out-of-control on the plane - he was fighting with his brothers, they were probably about 10years old, 15 years old, and 20 years old. They kept fighting with eachother and the flight attendents were having trouble calming them down - the boy kept spitting and cursing at his brothers, then they were throwing juice at eachother, finally ending with a full out fist fight....not very fun when you are 2 million feet up in the air (I know the physics but I still kind of think planes work by magic...I don't fully "get"/believe how they can stay up there with all weight, so at this point I was surprised the whole thing wasn't just tipping over because of all the commotion. Then we got into the next plane and this guy was trying to fight the security guards to get on and they wouldn't let him on... if I wasn't so exhausted I probably would have been more concerned...but we got to our place finally!! Our driver was very nice who picked us up from the airport and the first major change...they drive on the left!...actually I should say they are supposed to drive on the left, From what I have seen Zambian drivers pretty much use any part of the street - if it's open, it's fair game haha. Also, all of the homes have fences and guards.
The first night I got here I couldn't sleep too much so I was starting to read Harry Potter. I had been a little bit worried that I wouldn't bond with my roomates, them being a little bit older and more experienced with travel - but about an hour later Katie knocked on my door and we ended up talking/laughing until about 4am. I was very relieved to hear she also felt a little uncomfortable with the silence in the house and the guards/bars on the windows/padlocks everywhere!
tues july 24
The next morning when I woke up I looked out my barred window and the first thing I saw was the guard, standing like 5 ft away ...yea little unsettling... It's going to take some getting used to! We have a maid, who is very nice, and the house is just lovely. The kitchen and living room are pretty well furnished and we have a tv! I've seen a ton of bugs since I've been here, which never fails to scare me everytime - the roaches are enormous and I've been shoving my pillow case under the crack of the door...which to me is far more useful as a bug block! My room is pretty bare, aside from the toiletries and clothes, there is not much else. I miss the comforts of home and things in my room, but I really have everything I need! We got picked up and I went to the lab where I will be working. On the way we stopped for about 40 minutes so someone in our car could drop something off. (My driver said it's common in Zambia to just do soemthing without worrying about the time) I really enjoyed not being on a schedule and WISH I had my camera with me. I loved seeing people of all different ages in all different types of dress walking the streets, all going their separate ways. Some dressed in school uniforms and some in traditional dress, some carrying baskets on their heads with bright fabrics wrapped around their waists. The people here just have such a natural way about them, and the kids are adorable! Also, on the radio there was this speaker who spoke about the importance of thinking of God, not based on how we feel at the moment (if we feel good, God is good, but if we feel upset, we think where is God?) but based on all of the amazing things He has created, and how is always working in our lives. I thought this was so appropriate as I was looking at the streets in front of me. It was really a sight to be seen and one that was more than I could have imagined. It was very "everyday" here, but it's that, which makes it incomparable to anything else.
We left and then got to the lab...it's in a place called Kalingalinga a few miles away from my house. The semi-paved roads quickly changed to dirt roads with fruit and veggie stands on either side. There were lots of stands, such as a single haircutter booth, many handmade signs for things, and tons of people on the roads. I met the people I will be working with and also my bosses. They are about 80% male and I'm having a little bit of trouble remembering names! Barry, one of the men I am working for was super nice and really took me under his wing, showing me eating places and making sure I had everything I needed, which was just so kind of him. They serve lunch there everyday, and for 70,000 kwachas (1USD = 4,000 kwacha) you can get lunch for a month!! The food they eat a lot here is called nshima, which is a plain mix of cornmeal and water...consistency of mashed potatos...pretty much my dream come true - I seriously can't get enough of it. I eat it with everything, even jelly mmmm! I am thrilled to be working in the lab, but I would also like to get out in the community on weekends and volunteer if possible. I told Barry of my inetrest in helping out in a school, possibly at a library, even just to help get things organized or help with whatever was needed. Barry told me of a foundation he has started - The Kalingalinga Foundation. He is having shirts made with hand-painted Kalingalinga pictures on it and is going to sell them for like 40 dollars to raise money for the school! He said I may be able to help set up a library at the school, which they do not already have (mom, i know you must be so happy right about now haha) Talking to him about what his goals are was extremely inspiring! I will be running DNA-HIV tests and viral loads in the lab. It's so exciting to be able to run a test that can give the patient's HIV status. The viral load test can be used to see if medication is working. Doctors look at the count, and if it's over 400, it usually means the patient is not responsive to the medication. I'm so so excited to be able to run tests that give the patient the HIV status, but I am also nervous in that I just hope to be as successful as possible and I hope I can contribute to the lab as much as possible.
My three other roomates arrived today! - ilana (23, graduated from McAllister and is an expert diver who has traveled to Lusaka quite a few times before) Laura (30, has an amazingly calm voice and has done all sorts of work in the peace corps) and Kim (also 30, done work in Peace Corps and is now applying to med school)
I'm in Zambia! I can't believe I'm finally here. It's so weird because I have been anticipating it for so long, but with no idea what to expect. Everything is just so beautiful, the people, the land, the trees, it's so natural and it feels so great to be able to be walking these streets! This e-mail may be a little bit long - probably longer than the next just because these are my first impressions in this new place! feel free to read whatever you would like!
The plane ride went pretty well over - I only felt sick for a few hours- which I am very grateful for (because of how easily I get motion sickness usually!) I went with Katie - 26 - finished Public Health and Connor - 29- in his 3rd year in med school. There were 2 kind of unsettling things that happened on the way over - there was a boy that was semi-out-of-control on the plane - he was fighting with his brothers, they were probably about 10years old, 15 years old, and 20 years old. They kept fighting with eachother and the flight attendents were having trouble calming them down - the boy kept spitting and cursing at his brothers, then they were throwing juice at eachother, finally ending with a full out fist fight....not very fun when you are 2 million feet up in the air (I know the physics but I still kind of think planes work by magic...I don't fully "get"/believe how they can stay up there with all weight, so at this point I was surprised the whole thing wasn't just tipping over because of all the commotion. Then we got into the next plane and this guy was trying to fight the security guards to get on and they wouldn't let him on... if I wasn't so exhausted I probably would have been more concerned...but we got to our place finally!! Our driver was very nice who picked us up from the airport and the first major change...they drive on the left!...actually I should say they are supposed to drive on the left, From what I have seen Zambian drivers pretty much use any part of the street - if it's open, it's fair game haha. Also, all of the homes have fences and guards.
The first night I got here I couldn't sleep too much so I was starting to read Harry Potter. I had been a little bit worried that I wouldn't bond with my roomates, them being a little bit older and more experienced with travel - but about an hour later Katie knocked on my door and we ended up talking/laughing until about 4am. I was very relieved to hear she also felt a little uncomfortable with the silence in the house and the guards/bars on the windows/padlocks everywhere!
tues july 24
The next morning when I woke up I looked out my barred window and the first thing I saw was the guard, standing like 5 ft away ...yea little unsettling... It's going to take some getting used to! We have a maid, who is very nice, and the house is just lovely. The kitchen and living room are pretty well furnished and we have a tv! I've seen a ton of bugs since I've been here, which never fails to scare me everytime - the roaches are enormous and I've been shoving my pillow case under the crack of the door...which to me is far more useful as a bug block! My room is pretty bare, aside from the toiletries and clothes, there is not much else. I miss the comforts of home and things in my room, but I really have everything I need! We got picked up and I went to the lab where I will be working. On the way we stopped for about 40 minutes so someone in our car could drop something off. (My driver said it's common in Zambia to just do soemthing without worrying about the time) I really enjoyed not being on a schedule and WISH I had my camera with me. I loved seeing people of all different ages in all different types of dress walking the streets, all going their separate ways. Some dressed in school uniforms and some in traditional dress, some carrying baskets on their heads with bright fabrics wrapped around their waists. The people here just have such a natural way about them, and the kids are adorable! Also, on the radio there was this speaker who spoke about the importance of thinking of God, not based on how we feel at the moment (if we feel good, God is good, but if we feel upset, we think where is God?) but based on all of the amazing things He has created, and how is always working in our lives. I thought this was so appropriate as I was looking at the streets in front of me. It was really a sight to be seen and one that was more than I could have imagined. It was very "everyday" here, but it's that, which makes it incomparable to anything else.
We left and then got to the lab...it's in a place called Kalingalinga a few miles away from my house. The semi-paved roads quickly changed to dirt roads with fruit and veggie stands on either side. There were lots of stands, such as a single haircutter booth, many handmade signs for things, and tons of people on the roads. I met the people I will be working with and also my bosses. They are about 80% male and I'm having a little bit of trouble remembering names! Barry, one of the men I am working for was super nice and really took me under his wing, showing me eating places and making sure I had everything I needed, which was just so kind of him. They serve lunch there everyday, and for 70,000 kwachas (1USD = 4,000 kwacha) you can get lunch for a month!! The food they eat a lot here is called nshima, which is a plain mix of cornmeal and water...consistency of mashed potatos...pretty much my dream come true - I seriously can't get enough of it. I eat it with everything, even jelly mmmm! I am thrilled to be working in the lab, but I would also like to get out in the community on weekends and volunteer if possible. I told Barry of my inetrest in helping out in a school, possibly at a library, even just to help get things organized or help with whatever was needed. Barry told me of a foundation he has started - The Kalingalinga Foundation. He is having shirts made with hand-painted Kalingalinga pictures on it and is going to sell them for like 40 dollars to raise money for the school! He said I may be able to help set up a library at the school, which they do not already have (mom, i know you must be so happy right about now haha) Talking to him about what his goals are was extremely inspiring! I will be running DNA-HIV tests and viral loads in the lab. It's so exciting to be able to run a test that can give the patient's HIV status. The viral load test can be used to see if medication is working. Doctors look at the count, and if it's over 400, it usually means the patient is not responsive to the medication. I'm so so excited to be able to run tests that give the patient the HIV status, but I am also nervous in that I just hope to be as successful as possible and I hope I can contribute to the lab as much as possible.
My three other roomates arrived today! - ilana (23, graduated from McAllister and is an expert diver who has traveled to Lusaka quite a few times before) Laura (30, has an amazingly calm voice and has done all sorts of work in the peace corps) and Kim (also 30, done work in Peace Corps and is now applying to med school)
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