Wednesday, 07/02/14, 9:07 p.m.
Well, it happened. People here in Ifakara have finally caught on, which means I better pack up my bags and bow out.
A man passing me on a bicycle during my run yesterday called me chizi--crazy.
This, of course, does not faze me, as my friend Gus has been calling me chizi kama ndizi (crazy like a banana) since freshman year. The rest of you have been calling me crazy since antediluvian times. But it means that I have now been here long enough for the locals to get to know the real me, which, in my opinion, is the real crazy thing. I suppose tomorrow does mark the beginning of my fourth week here, which means that pretty soon I’ll be halfway through these two months in Tanzania.
To be sure, I actually had never met that man before, and he probably only called me that because I was being so quintessentially mzungu by exercising for fun (still keeping it up, every weekday morning at 6:30 a.m.!). In fact, while the word mzungu refers to “white” or “European,” it technically comes from the word for being dizzy. The first nutjobs showed up and no one knew exactly why they acted so funny. Heck, the other mzungus here don’t even run. However, Diana, who is a young Tanzanian woman studying to become a doctor at the training center on the IHI compound, just told me today at the Ultimate Frisbee game that she wants to start running and will join me tomorrow! Not only will I enjoy her company because I admire her for her sweet nature and impeccable dressing (even during exercise), it will be interesting to see if anyone calls out to us. Mzun-wait, what?
Let’s see, more updates. I finally have a stove! After I told the building manager (or whatever you call him when you’re not at Harvard) last week about the pitiful effort of my previous one, an electrician came and said it was a problem with the electrical system. They yanked the whole darn thing out and replaced it with a gas stove, but, lo and behold, I was told there was a gas shortage in Ifakara. Of course there was. I got free meals in the guest house restaurant for a whole week while waiting for gas to arrive. Not such a bad thing, considering how minimal my cooking skills are, but I worried about all that produce I bought and the things I schlepped from Dar going to waste. Monday evening, they finally hooked up the gas, and it all worked great! Although it is embarrassing to admit, Geofrey had to come and give a lesson entitled How to Light a Gas Stove with a Match So That--Oh God Taylor Don’t Do That You’ll Burn Your Eyebrows Off. Bear Grylls disapproves of everything that I am. I’ve now made sautéed vegetables and canned beans, and good old spaghetti--my friends’ blogs describing the food they’re eating in Europe puts my summer cuisine to shame. But it was a much-appreciated belated birthday present from IHI!
Speaking of my 21st birthday, I had a great time! In an ironic twist of fate, I had absolutely no alcohol on Sunday, and was asleep by 10 p.m. I’m planning on spending my 81st birthday in a similar fashion. (But not my 91st. If I make it that long I’m throwing a freakin’ rager and doing body shots off my more supple septuagenarian friends. I know your 21st birthday is a big milestone, but think about it--which is more worthy of celebration?) I spent the morning reading by the pool and swimming, there was impromptu Frisbee-ing in the afternoon, and as I walked through Lisa’s door for Argentine tango that evening, I was surprised by music, a “Happy 21st Birthday!” banner, a bottle of sparkling grape juice, and a packaged heart-shaped pound cake from the SimbaOil gas station (the only baked good in town). As I blew out the single hefty candle forcefully inserted into the heart, I thought about how grateful I was to be welcomed so warmly here.
The joint birthday party the night before for two expats who work for a water sanitation company in town did not end up making any mention of me, but I really didn’t care at all because everyone I knew was there and having a good time. In a backyard, people danced to the thumping Tanzanian hip-hop music, a genre known as Bongo Flava for Dar es Salaam’s nickname “Bongo,” or brain. (They say you have to use your brain to get by in Dar.) I told a woman there in Swahili that I couldn’t dance because I don’t have a butt, and she might have gotten a hernia from laughing as if it were the funniest thing she’d ever heard. Well, I try. There was roasted goat, a common spiced rice dish called pilau, local Tanzanian beers like Kilimanjaro and Serengeti, and mouth-watering maandazi, which I would say are like doughnuts but are probably more phylogenetically similar to crack. Candles stuck in the necks of liquor bottles flickered and winked as laughter wafted out over the fence into the cool night air. All in all, birthday celebrations this weekend were a success. The next morning, thinking I was being nice, I brought the extra cake to the office and first offered some to my coworker, Khamis. He then politely declined and said he was fasting for Ramadan. You jerk, you even knew it was Ramadan! Didn’t you learn anything while fasting in Mombasa last summer? Waving cake of all things at somebody in the middle of the day is about the worst thing you can do. Later in the day, though, he shyly asked me if he could bring the rest home to his family for after they broke fast. Of course, the answer was a resounding YES, so I’m happy to report that Allah and I are on good terms again.
On the work side of things, I’ve been following supervisors out on home visits this week both so that I am familiar with the study’s field work and so I am prepared for my upcoming interviews with the supervisors about the “Saving Brains” questions themselves. It’s been really fascinating to go out into the surrounding villages to do this; this week has made the neighborhood around IHI feel like a bustling metropolis. A supervisor, who has researched the location of each house and has drawn up a map to get there since house numbers aren’t a thing, leads on his pikipiki (motorbike) as the study driver, Bangaseka, Geofrey, and I follow in the ubiquitous blue pickup. Along the way, we often stop to ask people where to go next, and sometimes someone even joins me in the backseat of the pickup to give directions. The truck, by sheer force of will alone, somehow makes it through small, bumpy footpaths between the banana trees. We eventually pull up to small houses made of bricks cemented together with mud and roofed by thatched palm fronds to find out whether we can conduct the interview. More often than not, the mother has either permanently moved away since her information was collected for the original Vitamin A study a couple years ago, or she is out in the shamba (farmland) because it is harvest season now.
When we do get lucky, the mama invites us to sit on stools outside under a shady tree (people rarely go inside during the day) while hordes of curious children and neighbors scrutinize us from farther away. Often chickens will peck around us, or a mangy dog will doze nearby, its ears lazily flicking flies away. The supervisor introduces us and explains why we have come, reading through the entire lengthy, but thorough, consent form, since some of the mamas cannot read. At least for all the interviews at which I’ve been, the mamas have always consented to have information about their child go towards improving understanding of early development and interventions that may be beneficial--the goals of Saving Brains. The supervisor then takes out their tablet (provided by the study to save loads of paper) and goes through a battery of 70 questions related to cognitive, motor, and socioemotional skills with the mama while Geofrey and I look on to note hesitations or any other signs of confusion or lying. In theory, there should be no right or wrong answers to these questions, but some of them are certainly very loaded, such as “Does your child hit, bite, or kick other children or adults?” Who wants to readily admit that? However, the supervisor is prompted to stress that children have different personalities and develop at different rates, and that that’s completely alright.
Sometimes the toddler, whose ears must burn quite a bit, pays us no heed and plays nearby with a piece of trash, and at other times they can’t get enough mama-cuddling. I’m always reminded of college guys whenever I’m around these toddlers--for a long time, you aren’t quite sure whether they like you or not, then they have a lot of feelings about everything all of a sudden, and then, without warning, pass out. I’ve also had to get used to casual breastfeeding during the interview. It’s natural, it’s nothing I haven’t seen before, and it’s an integral part of raising a baby! My male coworkers hardly bat an eye. Why, as an American of pretty WASP-y upbringing, do I try so hard to look anywhere else? What’s wrong with me? I think this is a question much of America is still trying to figure out. At the end of the interview, the supervisor brings out a portable scale and instrument for measuring height, and takes measurements of both mama and baby. The child then gets their head circumference measured, and they’re usually writhing so hard in protest it looks like some sort of rodeo stunt. The mama is invited to the clinic for an appointment the next week in which a nurse will do the Saving Brains-modified Bayley Scales with the child, and she is given money for transportation there. We pack up, say many thank you’s and good-bye’s, and set off for the next house in a cloud of dust.
Dr. Masanja, a bespectacled older man who is the P.I. for the study from IHI (with Dr. Fawzi as the P.I. from Harvard), is usually located at the Dar office, but is visiting Ifakara this week. He is also using the data pool from the original Vitamin A study for a maternal mortality study for the WHO. Apparently, data about pregnancy outcomes from these mothers are missing, even though in many cases it’s clear what the outcome was because, duh, the mother and child are now involved in Saving Brains so they must be alive. Unless I completely misinterpreted this study and we’re helping zombies by saving braaaaaains. I actually got to help Dr. Masanja by creating questionnaire forms in Swahili (!) so that they can go back and find the missing outcomes for 3,000 mothers. Geofrey is not optimistic about this, which I understand after seeing how hard it’s been for us to locate them, but apparently Dr. Masanja will have some issues with the WHO if he doesn’t produce results. I’m hoping Saving Brains, which also has been presented to the WHO, will have some important findings!
Other office duties have included sorting and stamping forms, a la that grouchy secretary monster from Monster’s, Inc., and coding the data from the translations I’ve made. Not the fancy computer-programming kind, but just turning qualitative data into something quantitative so that it can be analyzed by Dana, Dr. Fawzi, and others. I feel like I’m getting a really good view of what research in the field of public health is like, which is exactly what I wanted from this internship. I’m also hanging out with some pretty cool people, especially those under the age of 3. On the flipside, I’m also getting some time alone to be self-sufficient and just relax, which is very welcome after a bit of a roller-coaster spring semester. I highly recommend rural Tanzania for anyone who desperately needs time to just sit and stare for awhile.
Oh, speaking of those who are good at sitting and staring, the frog in my shower drain? Yeah, he’s totally a regular now. Strange choice of real estate, but hey, who am I to judge?
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