Tuesday, July 30, 2013

The Field

We woke up early and met with a member of the ministry of health before riding into the field to see our clinics.  We will be implementing in 10 clinics.  These clinics are primarily womens clinics which treat HIV.  We will be helping to reduce the mother to child transmission of HIV by introducing mobile phones.

At the clinics, women sat in circles, waiting for hours to be seen by a nurse.  Our interviewer was a genius with them.  He made them laugh and teased them.  It was the most relaxed and successful focus group discussion I have ever seen.  The mothers were very young.  Most in their teens with a few in their early twenties.  Their babies fed openly or crawled on the dirt floor.  They were colorful.

When I get older and have a baby, I want to swaddle it so hard that you only see it’s face and then I want to tie it on my back like a little baby hunchback.

There was one clinic that really clung.  We made friends with a baby girl who is HIV positive.  She was liberal with her love and plopped on any and everyone’s lap.  She took a sledgehammer to my heart.  The clinic was run by the fiercest nurse.  No games, she started to yell at us as soon as we came explaining that she did not have enough medicine to distribute.  When we explained that we were not doctors (Oi ma, I know, I know), she stopped yelling.  She told us that she didn’t want to tell mothers they were HIV positive if she didn’t have the medicine to treat them.

She didn’t want to tell mothers they were HIV positive if she didn’t have the medicine to treat them. 

The rest of the trip went by, but those words I brought back with me and hung up in my mind next to my concept notes and grant agreements.



Wednesday, July 24, 2013


We woke up disgustingly early and packed our bodies into a cramped little airport.  I started to have a panic attack, drank Sprite out of a satisfying glass bottle, watched The Sopranos on my laptop, and all was well.
We boarded this stupid small propeller plane and flew for two hours to Mwanza.  Mwanza, also known as “Rock City,” has jutting inselbergs that balance like Stonehenge.   It’s a view worth smushing your nose against the airplane glass for.

We land, and five of us press ourselves into a car for the 3 hour drive deep into rural Tanzania.  A red cloud dust picks up behind us.   I can’t see anything out of the back window.  Swahili loops around the car and I look out the window.

Our hotel is down a long dusty path.   The red dirt is cleansed by shocks of red and purple flowers.  Our rooms were bright.  A bed, a mosquito net, a desk and a toilet.  Sparse enough for me to lay under the floating net and pretend I was in Africa. Birds flew into my window with a bang.  They were stupid birds. 
I prepped for my day by writing up a few checklists and an interview guide for our trip to the clinics.  The hotel owner brought my fresh papaya juice she had squeezed.  We had to ask for dinner 2 hours in advance because she first had to catch the chicken and pluck it before she could begin cooking dinner over an open fire.

Gabriel, Peter and I went for a walk into the village and skirted around the edge of a town hall meeting.  The pastor rang a loud bell and all the families came to sit under the tree to listen.  A few children chased us down the street.

We went back to the hotel and sat waiting for our dinner, listening to African pop, feeding our skin to the mosquitos, and talking about philosophy and politics.  The “P” topics are always the most satisfying when sitting outside at night.  Dinner was Ugali (maize and water mixed into a dense ball) beef in a red tomato stew, white sweet potatoes and green with onions.  You use the ugali to leverage the soppy stew into your mouth.  It’s amazing.

I slept heartily.


Thursday, June 27, 2013

It's an Escape

I've been  busy.  These past few months since I've moved to DC my life has been frenetic.  I'm putting my back into my job which is a whirlwind of acronyms and email protocol to remember.  Trying to met new people in my city.  Putting myself in awkward situations to see if I can meet that kindred friend I know is out there.  I've gone on many dates.  I've had a boyfriend, then didn't, then did, then didn't again.  Testing the limits of what it means to be in my 20s.  Trying to quiet my inner narrative about what it means to be a woman and if I'm living up to that.

But when I'm traveling, it all disappears.  The toys, boys, and noise take a backseat to adventure.  Being in a new place makes me giddy and wriggly and at peace.  I have, for two weeks, escaped.

I made time between meetings to walk in the neighborhood around the hotel.  Women carry comically large burdens on their heads.  Their hips sway as they walk down the street as if they're dancing.  I've got to learn how to do that.  I walked into the market and breathed deep the stink of it all.  When you're traveling, dirt and danger seems quaint and character building.  Chickens gawked at me and so did the vendors.  As I went deeper, the market closed in and the eyes got bigger and my followers pressed in tighter.  I thought it was best not to linger.

For dinner, Peter and I ate at a streetside BBQ.  The chicken was roasted over a large pit and the smoke was a thick fog around us that clung to my hair even after I showered.

Tomorrow we will travel to Tabora to visit our field sites.


Friday, June 21, 2013

Intro to mHealth

‘One of the greatest things about being in a foreign place is it seems to mock my incessant inner dialogue. 
“Am I doing a good job at work?” 
“Shut up, you’re in Africa.”
“Why won’t he message me back?”
“Shut up there is a woman  in front of you carrying 3x her weight on her head.”

The past few days have been hard work.  I’ve been in and out of conference rooms.  Had meetings at the Ministry of Health.  Waking up early and staying up late for US time zone conference calls.  Because this is not so sexy compared to the rest of my blog, let take this opportunity to tell you about my field of mHealth.

Once upon a time a bunch of scientists were frustrated that basic health necessities were not reaching those in need.  Were frustrated that there is 1 physician for every thousand people in many lower and middle income countries.  And yet, despite not having essential vaccines, Coca-Cola and Samsung made their way to the most rural parts of the world. I saw this in Bangladesh.  Men without limbs scooting around drinking a Coke.  Women with starving children, talking on cell phones.

These smart scientists got together and decided to use this corporate phenomenon to improve access to improved health care.  Check out this site if you would like more information: healthunbound.org

Which brings me to my work here in Tanzania.  I’m working to help facilities prevention mother to child transmission of HIV by using mobile phones to consolidate all patient information onto one database, help remind mothers to take their ART and to come into visits, and to make sure infant HIV status gets to the mothers quickly so the infant can get treatment as soon as possible.

We’re implementing a trial with 10 health care facilities in rural Tanzania for 6 months.  I’m here now to get all the partners together, draw up contracts, and to get the project off the ground.

I’m like a sexier, corporate, Indiana Jones.  With cell phones as my lasso and contract agreements as my safari hat.

Tuesday, June 18, 2013

First time in Africa

It has been a year and three months since I left Bangladesh.  I’m now living in DC working for the United Nations Foundation.  It’s satisfying work and I’m learning an enormous amount but its office work and sometimes I want to trade in my desk for my motorcycle and go back to the fields.  When my boss told me on Thursday I would be leaving for Tanzania on Monday, I audibly squealed.  This is my first big girl working trip.  I am going to Tanzania, Dar es Salaam, for 11 days.

Flying into Dubai is flying over a never ending desert, interspersed every so mile with a white house.  And then the city rises up like a sci fi novel.  The steel buildings reflect the gold sand and sun making them shine like Olympus.

The airport is hedonistically glorious.  The best perfume, clothing, accessories, and then there are women in Burkas looking at me from behind their veils, making me feel guilty for feeling guilty for feeling guilty.

I arrived at the Dar gate.  Although nothing could be as overwhelming as being 19, alone, in the Kolkata airport during the H1N1 scare, this was pretty close.  But I’m like the visa mafia and know how to work a passport like nobody’s business.

Rule 1: Never wait in a line if you’re not explicitly sure what it’s for and if it’s necessary.
Rule 2: Make friends with an official by using the few words you know in his language liberally.
Rule 3: Stick to your passport like it’s your lifeline.  Follow it with your eyes.  Follow it with your soul.

In no time, I got the visa, and was hired by a cab (how it always feels) and rode to the hotel.  When you’re a little girl, and you were playing pretend NGO worker, dressing up in your tevas and perfecting the sloppy expat bun, you dreamed of Africa.  Since then, you learned that there are many other countries in other continents that desperately need help.  But Africa was like your white wedding fantasy.

And I’m finally here.