back in the USA

made it back, safe and sound, after a pretty brutal set of flights and layovers. glad to be home, glad to be reunited with my jeans! and eric too, of course. :)

last day in mozambique

things are closing out really nicely. or, as nicely as they can be. i have everything i need, i think, and all seems fairly tidy. the sad news is that professor v's daughter died while i was in catandica. she was 42 and professor was understandably distraught. i was so sad for him. despite this, he still met with me, managed to make a few truly nice remarks about fernando torres' goal for liverpool on tuesday (he saw my picture of torres on my computer's wallpaper which launched us into a 2 day discussion of football when we were in chokwe!) and some other niceties. he's a really sweet man, and he was truly a pleasure to work with.

it's amazing: he's must be in his late 70s, he used to be vice-minister and minister of health in mozambique (he had some amazing stories of the 80s and early 90s when there was a terrible civil war here), yet he's still working hard to equip mozambique's countryside by training cohorts of tecnicos of surgery. i'm really glad i had a chance to make it all the way out here and meet some truly good people.

everything is packed and i'm ready to head back home tomorrow! here is my lunch today for you foodies: it's a spicy seafood soup and something i had for lunch a lot all over mozambique, though gussied up because this is the big city, it's called prego.

thanks for all your comments and keeping tabs with me here. the interweb is a great, great thing.

lengthy car rides

i forgot to mention the ride to catandica was almost 6 hours! there were 11 of us, crammed like sardines in an ambulance from beira to chimoio (where we made a brief pit-stop) and chimoio to catandica. it was suprisingly fun! 8 of the 11 were patients who'd had VVF (fistulas) repairs in beira that were too complicated for the rural hospitals. mostly we were chatting and they were all pointing things out to me in the countryside. hooray for no motion sickness (i cheated, i took the dramamine)!

the ride back to chimoio from catandica yesterday was great! it was just the driver, tecnica and i (she just wanted to make sure i made it to the airport in chimoio safely), and i got to see the whole agricultural area (sugar cane, tobacco, maize) and mountain range. it was gorgeous. i was really glad to have seen it during the day time; i didn't get to see it on the way to catandica, because by the time we got to that part of the trip, it was already pitch-black and i didn't see anything. beyond that mountain range is zimbabwe!

birthday hernia

no, i didn't have a hernia (though i easily could have with what my documents-stuffed bag weighs now), but now i know what one looks like! what started out as an expectedly busy day collecting information from the hospital ended with tecnica inviting me to her house for a little surprise birthday celebration. she'd made some cookies and had some cherry cordial and soda laid out for me. her son sang me happy birthday in protuguese and then....she received an emergency call from the hospital! a patient with a hernia was vomiting and the suspicion was that his hernia had become incarcerated (pinched) and needed to be operated immediately. she asked me if i wanted to tag along, and i thought, "what the hell! i can do this!"

she lent me some scrubs, i helped her scrub up (i just poured water while she did the whole handwashing routine) and calmly observed from a corner in the operating room. ok, so i'm lying. i wasn't calm at all. even though the operating room was very nicely air conditioned and cool, i had a cold sweat sitting on my brow for the entire procedure. the first bit was tough for me to watch, but after a while it was so interesting to see it all! she did a great job of explaining it all to me (not easy to do with a mask over your mouth and speaking a language that i really need to concentrate to understand) and pointed out things of interest. i won't gross those of you out there with a weak stomach (like mine), but it was one of the neatest things i have seen. any surgery is probably interesting to everyone at some base level, but to see someone who is very poor, in a lot of pain (i was with her when she did the initial assessment at the ward), out and open on the operating table, and then recovered the next day, walking around, animated and eating, is truly amazing. in these remote places, people like the tecnica are very literally life-savers. that was cool to see.

i also got to watch her do a skin graft of a 17 year-old patient with piomiositis (a disease of the developing world where there is a severe infection of a large group of muscles) and that was equally amazing, for the same reasons. i never thought i'd find the actual witnessing of the operations so interesting (i like cold hard numbers on the computer screen!), but i did. definitely a birthday i'll remember!

the photos are the view of the hospital through her vegetable patch in her backyard.

catandica

catandica was the place where i was both, the most amazed and comfortable and the most skittish! it was a fantastic place to end my data collection experience. i became good friends with the tecnica of surgery there and her 8-year old son (who calls me tia ana--so cute!), but the remote location in the mountains and gorgeous environment makes it the perfect place for absolutely ginormous insects and arachnids to flourish. i spent my last night there terrified that a spider the size of my palm (ok, half the size of my palm, but that's still really big!) would jump onto my face during the night. i was right to worry! the morning i left, i opened my eyes to see one of the scary, hairy and striped fellows crawling directly above my head on the ceiling. i shot out of bed, got ready in record time, and scooted out the door. i'm just not good with creepy crawlies that are as big as rodents.

but, that aside, catandica was simply awesome. it's a sleepy little town in the mountains with no bakery (my tecnica friend has to buy bread in bulk from chimoio, some 2 hours away by car), one restaurant, one gas station and a huge street market with vendors selling all kinds of goods in little stalls. it's incredible. the hospital was wonderful. the tecnica runs it with ruthless efficiency (she's a very caring clinician, obsessively making the rounds through all the wards) and doesn't take any crap from any of the nurses, clinical assistants, administrative people and aides she has to manage. i was amazed by how much responsibility she has. she's the only clinician trained to perform surgical procedures in the entire northern half of the province of manica (usually these hospitals serve a district but she serves 4 districts: a huge, remote area), and all emergency cases in the area get brought down by ambulance for her to treat. she also has to maintain all the hospital records, data, and deal with human resource management issues. makes my head spin.

so i'm very motivated to doing a good job documenting the rural hospital's surgical caseload and costs so we can get our reports and papers out and distributed to the health ministries of the countries we're studying! the idea is that the personnel at these hospitals are overworked and underfunded yet have good outcomes for their patients. that's certainly true in catandica.

beira

it's raining like crazy, and i'm waiting for my ride to start the 5 hour trek to cantandica. ug, if i thought i hated long car rides at home (road trips are the stinks!) i really don't enjoy car rides over here. i get too car sick. thank god anna gave me a good supply of dramamine.

i keep expecting my good luck with internet connectedness to run out. i thought for sure i wouldn't have any in this sleepy beach town, but here i am, blogging away. i am *for certain* not to have any in catandica though. everyone keeps correcting me when i ask about the town, saying "no, no, it's not a town, it's a village." so there you have it.

i'll be back in maputo on wednesday, and counting down the days until i get home! although it's been an amazing month, i'm sick of the turtle, 'house-on-my-back' life. i think i will put the 4-5 outfits i brought with me on a year-long hiatus from wardrobe rotation. if i don't see or wear another pair of linen pants in my life.....sigh. is it weird that i really, really miss wearing my jeans?

maputo nightlife

last night lene (norwegian lost baggage buddy) and i went out to costa do sol (a popular seaside seafood place) for dinner and out to listen to some live music and dancing at a place called the africa bar. the food was great, and the music and dancing even better! although, the caipirinhas at costa do sol are a bit too strong...i had a hard time getting up early this morning to meet with professor v. and finish up our remaining chokwe data issues.

lene is a great going-out partner, so in hindsight, i'm glad our luggage was lost and we had a chance to bond. the funny thing is that she works on health sector projects for NORAD, so we're professional colleagues here too. we chatted a lot about the work i'm doing here and we shared some information that we each found useful (she coming from the top-down, me working from the bottom-up so we could cross-reference our facts).

i fly to beira tomorrow morning and then head by ground transport to cantandica on sunday. apparently cantandica is in the mountains so i'm hoping for some really pretty views. it's also very close to the border with zimbabwe. i'll see if i can post anything from there, though i doubt i'll have access (i've been pleasantly surprised about my access before though!). i'll be back at the hotel in maputo next wednesday, so i'll definitely update by then.

time to pack!

photo albums

i hope you can all view my facebook photos page, because i put up some photo albums of my favorite snaps so far.

chokwe

that's one more hospital done, and one left to do! we managed to gather most/all of what we needed to in a day and a half. it was so fast! the hospital itself was fantastically organized and really on top of everything. all the people i worked with there were also extremely professional and super helpful. by far my best experience here.

i didn't manage to take many pictures while i was there, but here is one of the limpopo valley that we had to drive through to get to the hospitals we visited. it's really pretty in the area; flat vast prairie lands dedicated mostly to sugar cane and cereal production (rice is mainly what i saw) as well as cattle ranching. during the wet season the whole valley floods, but it looked pretty parched now during the drier times. i really wanted to get a picture of the huge anthills i saw on the sides of the road. most of them were taller than me. but, we were in a hurry and speedy ant hill pictures don't look too good.

the hotel i had to stay in when we were in chokwe qualifies me as a bona fide "roughing it" girl. i've earned my stripes. if the management there actually maintained the rooms, it might have been decent, but they clearly have let the place go. i guess i can't complain for $16 a night, but the hospital workers were all horrified by my mosquito welts the following day. i must have had to assure everyone at least 50 times that yes, i did remember to take my anti-malarial drugs, and no thank you, benadryl makes me want to take a long nap.

off to dinner!

food, glorious food!

maputo has wonderful seafood dishes. here is a photo of my dinner tonight right before i annihilated every scrap (i was hungry!). as you can see, the photo of my chocolate mousse dessert is not intact....i just couldn't wait. dinner was delicous!

bags in tow

i got my luggage this morning! and the best part is that everything was there (despite worries that my packing of electronics cables in the checked baggage was a big fat no-no). next time i'll think twice about what i can't live without for one night.

i have work to catch up on, but so far maputo is beautiful! i'm very close to the bay and the houses here are old (colonial) style and gorgeous. more later....

i ran the jo'burg airport marathon

of course this had to happen to me. i get to johannesburg airport, thinking that one hour is penty of time for a plane change. apparently it's quite tight. i was calmly strolling through the passport check only to have the border agent tell me (incorrectly) that i had to quickly collect my luggage (that was supposed to be checked through), re-check it, run upstairs to get a new boarding pass, and quickly head to my next gate. hmmmmm. i waited for my luggage to come, but it never did. so i asked at the luggage claim and was told that my bad had been checked through and to HIGH TAIL it to the gate. i thought that was weird since i still had 45 mintues or so until my flight was supposed to leave, but i picked up the pace.

here's what everyone was warning me about: the jo'burg airport, though thoroughly beautiful, and a shopper's paradise, is insanely peppered with checkpoints, stops, immigration posts and other heinous hindrances to getting to your destination in a timely manner. i was literally running through the airport, clutching my carry-on bag and pushing all sorts of people out of the way. i must have looked like a madwoman. after reaching my wit's end at the 2nd or 3rd passport check (i lose track) and feeling sick at the sight of a line wrapped around 3 of those barricade mazes, i quickly did this "do -you -mind- if- i- skip- ahead-my-flight- leaves- in- 20- minutes" kind of slurred push inquiry, not bothering to notice whether or not the person understood or even registered what i was saying. after that, more running. i got to my gate all out of breath and sweaty (and they had given my seat away), but i got on the flight!

...too bad my luggage did not! poor professor v. was waiting for me with a sign and was all crestfallen when i told him i had to go through the process of filing a claim for my bag and putting myself on a call list for when the sucker does roll into maputo. sad (and scary?) part is that some 10 other passengers didn't get their bags either, including a really nice norwegian girl who works for NORAD (norwegian USAID). we pal'ed up immediately and it turns out we're staying in the same hotel! we've pledged to go nighclubbing in our grubby flight clothes tomorrow night if our suitcases don't come. hooray for improvising!

bye bye to my sad swahili

so, i tried my hardest to speak as much swahili as i could muster (and lonely planet phrasebook could provide) but it was, on the whole, very inadequate. there's something very frustrating about managing sad little pitiful "sorrys" and "pleases" and "thank you very muches" for two weeks straight. when i return to tanzania (i've already decided i have to) i have resolved to do the following:

1. speak in complete sentences (even if those sentences could have been constructed by a 3 year-old).

2. visit zanzibar, kilimanjaro in the *daylight* and any one of the big game parks. it's kind of unforgivable that i didn't manage even one of these...

3. stay in one place for more than 3 days!

i have to say that my last few days in tanzania were the definite highlights. hanging out with anna and molly was fantastic, mostly because anna, with her savvy swahili, gave me a great whirlwind tour of kigoma city's markets (you thought your local flea market was crazy) and helped me slog through they muddy streets after we finished up data collection at the hospital (thanks anna, i could not have done it without you!). lake tangayika is GORGEOUS. more beautiful than i ever imagined. and, given that the day was exceptionally clear, we could see the mountaintops of the congo across the water. dreamy. yes, i definitely need to go back with more time on the agenda.

close, but no gombe

i am so close to gombe national park!!! it drives me crazy that i'm only in the region of kigoma for 3 days only, 1 whole day of which is devoted to the 4 hour drive from kigoma city to kasulu (where the hospital is). people keep telling me how amazing gombe is (jane goodall's chimpanzee research mecca) and how easy and great it would be for me to visit if i only had an extra day or two. i guess that means it's just a great reason for me to come back and stay a little longer next time.

i was able to meet up with two other grad student researchers here. molly is with me at UM (the redhead in the picture) and anna (so much confusion in explaining the two an(n)a's to people) is from BU. i get to speak english at my normal speed, AND anna is quite fluent in swahili. jackpot!


kigoma region is gorgeous. lush green foliage, deep red soil, mountains....it's breathtaking, and my photos don't do the area justice. there are a couple of refugee camps nearby because of the turmoil in burundi (which is very close to where i am right now) and UNHCR has a strong presence here. my brother keeps fretting about it (don't worry!). it actually feels quite peaceful here, and the officials at the hospital told me the rebels have been inactive for some time now, and some of the refugees are starting to go back. let's hope they are able to return to their lands peacefully.

i won't have internet access for the next two to three days. i head to mozambique on saturday, so hopefully i will update then. thanks for all the wonderful comments and positive feedback, all, i'll keep the posts coming!

PS--sarah and kyle (and all you other foodies), i am working on my techniques for snapping 007 photos of my food plates, or at the very least, of markets and food vendor stalls. i got yelled at once already for the camera so i am trying to be careful, but rest assured, i'm taking mental notes!

"wild" life

here are the crocs, the birds, and a poor little fish stuck in low tide (i would have moved him but the bright orange color and spikes on his body were warning enough!).

ruins

these are the kaole ruins, and the surrounding gorgeousness.

sunburned

at the risk of receiving hate mail (or hate comments) i have to complain a bit about my sunburn. i was only away from the shade of trees for a little while! this equitorial sun is brutal, i can't even remember how long it's been since i've gotten toasty red. so tomorrow i will slather on the sunblock.

today was wonderful. we finished up rather early with all of our number crunching. luckily we were able to do the data entry at the hotel outdoor dining area right by the seashore. much better setting than the hospital. we then headed up to the kaole ruins, where archeology students from the capital are doing an excavation of a 16th century (i think?) old arabic settlement. it was neat; there were the remains of a mosque, the well where men drew water to wash their feet before entering, and a mausoleum in the adjacent plot.

after touring the ruins, we passed by a crocodile farm. they keep them in separate pools according to their age and raise them for meat and skin. not quite the big game reserve experience, but it was really interesting to see how that particular farm used their land area for croc raising, vegetable farming and fruit orchards as well. i'll post pictures of a guava tree they had that was also colonized by a host of yellow birds for all of you wildlife enthusiasts, as well as some of the crocs and the ruins in the following post.

enjoy!

one down

and three more to go. done with the first hospital, and i'm breathing a huge sigh of relief. today i get to relax a bit and see more of bagamoyo! it's a very coastal fishing town, away from the big game reserves, so for those of you clamoring for wildlife photos, i'm afraid all i can muster is some pics of some very non-wild animal life. :) you'll have to settle for some interesting pics of a farm i visited by just strolling around. the cows seemed really puzzled about what i was doing.

as for the food pics, i'd love to but i'm too embarassed! the surgeon i'm working with explained to me that tanzanians are very particular and sensitive to photo-taking so i've been very careful about what i snap. i try for mostly landscape, but if there are people in the shot (or animals belonging to someone nearby, or buildings belonging to someone nearby...you get the idea), then it is expected that you ask permission first and offer a small compensation for the inconvenience. it kind of puts a damper on the whole photojournalist gig.

i'm posting a pic of a very well preserved traditional zanzibari door from a house here in town. the man in the photo is the chief surgeon at the hospital here (the residents were more than happy to have their doctor take a photo by their door). i also posted a pic of my cow friends.

today i am visiting the ruins of a 16 century arabic town here. more later!

bagamoyo

i'm in bagamoyo now for a few more days. it's so relaxing here! it's a good thing, too, because the data collection is h-e-c-t-i-c. the hospital itself is amazing; people really are doing a great job with few resources and the patients seem very well cared for and content with their care (my swahili is not good at all--lonely planet might be good for catch phrases but not for conversation!). it's really heartening to see. the flip side, of course, is that the medical staff are not such great record keepers, which is where the hectic part comes into play. the surgeon i traveled here with and i have been swamped trying to make heads or tails of it all. we're trying hard to document all we can and get us the information we need to do our research, but it certainly is not easy.

the great news is that my internet connection here is amazing! i feel kind of like a cop-out because i'm staying in a very resorty place (my colleague called it posh, which i found really cute--when he said it i had images of a skinny mrs beckham running through the lobby). i have a tv in my room that broadcasts...drum roll please.....the UEFA champion's league soccer tournament! i about fell out of my chair when i turned the tube on and saw arsenal playing against inter milan.

i've also had a chance to do more traditional things outside of the resort. we visited the historical museum that documents the slave trade route through the sea port here in bagamoyo. this was an old german colonial town before WWI, and a british one after WWI, so it has some interesting cultural sites. and of course, because it is still an important sea port i'm completely in love with the food here. so good!

back to data cleaning! miss you all!

arrived!

i got in safely and soundly last night at a ripe old 11pm, local time. there is nothing more frustrating than sitting by an airplane window with a stop in kilimanjaro in the pitch black darkness. the mountain was out there, but my very un-catlike eyes can't see a thing. the flight itself was fairly uneventful except for this pair of really annoying spaniards (i know!!!) on my last leg. they sat next to me and i didn't say a word to them the whole flight, which was some feat. mostly they were just being jerky and rude to the flight attendants. i was embarassed for my kind and tried to be overly polite to compensate. the other highlight of the flight (or low-light) was the crappy soup whose lid read, i kid you not, "soup has been in the diet of humans since 6000 BC. early ingredients consisted mainly of hippopotamus." no wonder hippos don't like humans so much.

dar es salaam is nothing like i expected. granted, i haven't seen too much of the city yet (late night careening through the streets in the cab doesn't really count), but i wasn't expecting to see a home depot and a mercedes benz plant right out of the airport. welcome to globalization.

i'm glad i'm a florida girl, because it is hot and humid like nobody's business. my hair is still struggling to dry after my shower 10 hours ago. now i remember why i moved up north so many years ago: sticky weather and ana don't mix all that well. i'll have to figure out some strategies on keeping myself cool that don't expose too much for the mosquitos to munch on (they've already found the one swath on my feet that my mary jane slip-ons don't cover). that might be tricky.

my hotel is cute! i kind of have to beat down some very tropical foliage to get to my door, but it kind of reminds me of my parent's back yard. except, instead of squirrels running around outside my window, there are these mongoose-type creatures that keep chasing each other into the ground cover. if they weren't so speedy, i'd try to snap their picture.

i have a meeting at muhimbili university in 1 hour, so i'd best prepare for it. hugs to all!

slight changes

so i haven't even left yet, and my schedule is still getting tweaked. i'll be visiting one additional hospital in mozambique....so far. i have a feeling this is going to be one of those data trips where things are only semi-structured. i'm cool with that though; i think this will be a great experience for me to learn to take things as them come and do some creative problem-solving. from what i've been told, there will be problem-solving to be had!

i'll try to keep you guys updated as much as i can. i expect to have internet connection in dar and maputo, but otherwise....i'll enjoy that unplugged from the world feeling.

more soon!

pre-trip training

i've gotten so many request to keep everyone updated, that i'll just try a central location of events for all to access. we'll see how this works out...i'm not sure what my connectivity will be like in some of the locations.

here's the timeline of where i'll be, and when, with changes as they come!

Tanzania Leg
17 Feb: Fly to Dar es Salaam
20 Feb - 24 Feb: Travel to Bagamoyo
24 Feb: Return to Dar es Salaam
25 Feb: Fly to Kigoma
28 Feb: Return to Dar es Salaam

Mozambique Leg
1 Mar: Fly to Maputo
3 Mar: Travel to Chokwe
5 Mar: Travel to Majacaze
8 Mar: Fly to Beira
9 Mar: Drive to Catandica
10 Mar: Birthday data collection day!
12 Mar: Return to Maputo
14 Mar: Fly back home
15 Mar: Arrive in Detroit