Tales from the Snail Trail

Once upon a time, in a province ten hours north of the mighty Manila, lived many hardworking Filipinos. This sprawling land, filled with rice terraces and cornfields, just off the Pacific Ocean, had recently fallen victim to the dreaded snail. This black snail, no larger than a grain of rice, was host to the a parasite. Dangerous to humans, the parasite seeps into the skin and causes schistosomiasis – a debilitating disease of the GI tract. In hopes for a master plan to halt the nasty buggers, our team of eight (including 4 Japanese, the oldest of which may or may not be Mr. Miyagi) trekked to Cagayan. We forged our way through the fields and down the valley to seven sites near villages where schisto is endemic. From there we spent hours scrutinizing the tall grass and marshland for these sneaky villans. Collecting over 700 snails from these sites, we hitched up our wagon, headed back to the great school of UPM and analyzed our data, developing program interventions as we went. And the people of Cagayan lived happily ever after…

Well, not entirely true. But it was a very successful trip! And the weather was on our side (I can only imagine doing the backbreaking work we did in the pouring rain). Not to be cocky, but I must say I have become quite the snail detector (my aching body will attest to this). After collecting all our samples, Dr. Leonardo presented our initial findings to the regional, provincial, and municipal health officers and provided suggestions to help prevent human contact with the snails. We spent all of today crushing snails to inspect how many were infected. The sad news was that far more were than we had hoped, including a site that had not been previously. I’m excited though to see how our research will develop into action!

This segment of the journey is completed, but tomorrow begins anew. I fly out to Bohol to meet the Canadian boys – for real this time – and enjoy a few days exploring breathtaking beaches, seeing Tarsiers and of course visiting the Chocolate Hills. So until next time…to infinity and BEYOND!

Lindsay? Like Lindsay Lohan?

It's been 12 days in the Philippines and I can say it has yet to be boring. Picking up from where I left off, last weekend combined foreign friends and local culture in an obscure blend that you only ever experience traveling. I met so many interesting people at the guesthouse I was staying at - Brits, Australians, Canadians and even a few Spanish ladies. Hands down the best part of traveling aside from the incredible sights is the thought-provoking conversation you have with fellow globe trotters. And when you put a group of 20-somethings (who've already enjoyed the free rum from the hostel) into the pumping scene that Malate nightlife offers, you know it can only end one way - noteworthy. From meetings the ever-present prostitutes and lady-boys to the late-night karaoke, I think it's safe to say we did Manila right.

Two of these friends, the Canadian boys Allan and Andrew, are traveling the Philippines for a month. We all decided to head down to Palawan together, though since I had a meeting Tuesday the plan was for them to head south Monday evening and I would meet them in Puerto Princesa Tuesday night. Which sounds like a great idea, except that they don't have a phone (seriously, I have no idea how people functioned prior to 2000). I arrived in Puerto Tuesday evening around 9PM and asked the tricycle driver (think of a motorcycle with a sidecar - Wallace and Gromit style) to take me to the internet cafe. But ah-ha silly me, it's too late. There are none open. Finally finding a nice woman to let me use her internet, I get a message from Allan that they never even made it off Luzon. Shit. I end up spending an exuberant amount on a hotel (1200 pesos...or just shy of 30 whole dollars) and the following morning make my way on a bus to Sabang. And what is in Sabang you might ask? Well nothing more than one of the New 7 Natural Wonders of the World (no but really).

The underground river in Sabang is a 8.2 km river within a cave. The most incredible part is The Cathedral, a huge opening with rock formations that disturbingly look like the 3 wise men, Jesus, the Last Supper, etc.  One of the girls joked she almost had a religious awakening. Spending a few days on the beach, meeting more travelers from all over and playing in the water - all and all not a bad week. But I was pretty happy to get back to Manila and my apartment (where I've discovered INTERNET). And back to my favorite Filipinos. Because it wouldn't be a normal day in Manila if a taxi driver or security guard weren't asking me in all seriousness if my parents named me after the great singer, Lindsay Lohan. But such comforts of home must be short-lived as Monday I leave for a 5 day trip to northern Luzon to study snails and schistosomiasis...!

Welcomed by a flood of kindness

Here we go again...another adventure! For those of you who haven't heard, I moved to Manila earlier this week for 5 months. I'm studying at the University of the Philippines, Manila (UPM) to finish my Masters in Public Health (MPH). I'll do a quarter of school, a 10-day tour of health finance in Northern Luzon and a 6-week internship (hopefully at the WHO). 

When I landed in Manila Tuesday night, I didn't realize quite how dire the situation was. It had rained for 10 days straight, at one point not stopping for 18 consecutive hours. After 20-some hours of travel and a stopover in Tokyo I finally made it to the Philippines, only to have a hell of a time finding my ride (no thanks to you, Verizon). Once we connected, the drive from the airport to my hostel was filled with flooded roads, some entirely impassable. The school had suspended classes and offices indefinitely. Where I am the flooding is gone, though other parts of the city are still covered in water. As I write, the rain is coming down hard again. Relief efforts are still going on several days later for those displaced. Everyone joked that I was getting a true Filipino experience (not so much the flooding, but the general chaos and issues of the third world, which they speak frankly about with a smile).

On Thursday the rain subsided and my advisor Dr. Leonardo sent her son, Alvin, to help me look at a potential apartment in a nearby highrise. After a quick inspection, I decided the tiny place, which has enough room for a fold-out couch/bed, kitchen, bathroom and small balcony (19th floor) was worth the $333/month I'd be paying. I only found out today that that price also includes access to the gym! Only issue is that there is no closet or drawers, meaning I'll be living out of my suitcase (and wishing I had brought less clothes). The rest of the day we spent walking around the city, trying local foods and of course enjoying some local beer, San Miguel. The nightlife is just as hectic as the daytime. 

Today started early - being accepted into the school (phew), signing up for classes, trying to get my student permit (and being turned away), taking out 5 months worth of rent in cash (eeeek!), checking out the place again, getting a background check and certificate, walking around the old Spanish town within the city, Intramuros. Poor Dr. Leonardo's assistant, Dharyl, escorted me through the entire 8 hour process...!

If there is anything I have learned so far, it is that Filipinos are extremely willing to help, going above and beyond anything I could have expected. Dr. Leonardo, Alvin, Dharyl, the hostel guys who keep giving me a place to stay since my apartment isn't ready yet, even my realtor Hector have all done everything in their power to get me settled. It is more than I could ever ask and they don't think twice. 

I have to be at school on Monday to get my permit and ID but then I don't have class until Saturday (I'm taking two classes, one of which is a field project so I only have one real class a week). Meaning I'm looking to do some great traveling this week! Thoughts on the underground river in Palawan? Or maybe visit the Chocolate Hills? And of course explore Manila further - full description to come.

It's the final countdown

This past week has been busy as I realized that my time in Ghana is coming to a close. Thursday I had to say goodbye to the Swedish volunteer I worked with and ate a Ghanaian meal while dreaming of turkey and pumpkin pie (I haven't had dessert in 2 months!). Friday an acquaintance from UCSD, Joeva, came to visit me in Ho from Cape Coast where she works. That night the remaining 6 of us - 2 Americans, 2 Australians and 2 Irishmen - made a "Thanksgiving dinner" of sausage, mashed yam, plantain chips and guacamole. It was so nice (though admittedly rather strange) seeing a familiar face in Ghana and sharing Thanksgiving with a fellow American. I took Joeva around town and showed her the lush surroundings of Ho. We sat at a hotel for hours discussing Ghana, life after college, doing "good" in the world, and the neverending itch to travel. Sunday was my final day at the orphanage. I am going to miss those kids and their energy and excitement for life! I have never felt so attached to children in my life. They are so sweet and loving and playful, it broke my heart to walk away from the 35 of them knowing I may not see them ever again.
So it has come down to the final 36 hours in Ghana. And much like in Florence and at Dartmouth I am not ready to leave the life I have started here, the incredible people I've met and the family that has so kindly welcomed me into their home. I can't say exactly what I expected from this experience but I do know it was beyond anything I could have ever imagined or hoped for.  I will miss my host family (and Bea's awesome cooking), the diabetes nurses, the VAF volunteers, my Ghanaian friends, the orphans, the lepers, my town and the slow-paced yet deceiving chaotic life here. I've found that living in a 3rd world country does not equate to living below the poverty line; that aesthetics are not everything and there's no reason to get rid of something before it's broken; that you can live without running water, electricity, internet, TV, a car, a steady income and still be completely happy. I have realized just how lucky I am to come from a place where education, healthcare and a basic amenities are expected, not a privilege. Ghana is only a 53-year-old country and has come much farther than most African countries but it still has a long way to go. I may not have been able to give back as much as I took away from this experience but it is with all my heart I hope I am able to go to grad school and get a job which gives me the resources to help many more people around the world in need of healthcare. I will miss Ghana but I am excited to come home and start working towards a job with greater opportunities.

Take care and see you on the other side

World Diabetes Day

This past Sunday the 14th was World Diabetes Day. But because Ghana is a religious country, everything closes down on Sundays (as I sit here the internet cafe is literally the only business open and the man at the front desk asked me why I hadn't gone to church). So a celebration on a Sunday would not be very well attended. I don't know why no one thought to do it on Monday but regardless the national celebration was set for Tuesday in Ho. The diabetes ward was informed a week ahead of time that we needed to help staff the event and that our head nurse Florence would be speaking. However on Monday I saw a TV special on World Diabetes Day and said that the event would be on Thursday, as Tuesday the 16th was a Muslim holiday. Ghana recognizes both Islam and Christianity and the country essentially closes down for both religions' holidays (which is means you get double the days off!) I had to laugh at the fact the no one in Ho or Accra had thought about this conflict until a few days before the event was scheduled. Finally on Thursday we headed over to one of the biggest churches in town which was acting as our venue for the day. Because the whole day had been so poorly planned at the last minute we were not given any supplies. The head nurse brought some of her own test strips so that we could test people's blood glucose levels for free as well as measure their blood pressure, weight, height etc. No one from the capital had thought (or taken the time) to make handouts so we used the ones I had made to give to all the attendees. The program was quite unlike anything you'd see at home. Everyone sat in the church and before beginning they said an opening prayer. There were a number of speakers which were fairly informative, though I have a hard time understanding Ghanaian English sometimes. I had to laugh at the end when they provided everyone with biscuits (kind of like a dry cookie) and soda. What a healthy snack for a whole bunch of diabetics! All in all it was a pretty good day but it definitely stood as a example of the lack of infrastructure, communication and functioning bureaucracy I had already witnessed in the country.
I head home in just 9 days, which is unbelievable. There is much left I feel like I could do if I had more time but I can only hope that I will return in the near future. Hope everyone has a happy, family-filled Thanksgiving! I know I will be missing the turkey and gravy but we are going to make our own hodge podge Thanksgiving dinner with chicken and whatever else we can find at the market. Love!

What a week!

It's been a crazy week! Monday started out fairly normal working at the diabetes clinic during the day and heading up to the market for market day (which is absolutely insane but worth seeing all the vendors shouting and trying to convince you to buy their vegetables or dried fish or fabrics). Tuesday we went to village nearby to do another child welfare clinic. I've getting more comfortable with the language so I'm able to talk to more of the people we treat which makes the whole experience more rewarding and they get more from me I'm sure. I even gave some babies the typhoid vaccine. Wednesday another volunteer and I went to a nearby clinic on the outskirts of Ho to shadow a nurse there. She was probably the most progressive woman I've met since I've been and Ghana and I spent several hours with her discussing the major issues facing Ghana's healthcare system - mostly the fact that it lacks any sort of real infrastructure. Thursday is surgery day at the hospital so after working in the diabetes ward in the morning I went to the theatre where I watched the surgeon perform another mastectomy and a C-section. I've never seen a live birth and it was absolutely incredible (and very speedy!) The baby had stopped growing because the mother was pre-eclampsia and so the doctor was forced to do a C-section at 34 weeks. The baby was so tiny but screamed it's little head off, which we were all thankful for. Friday I returned yet again to the leprosy village which is becoming my favorite outreach. I've gotten to know some of the lepers and they have such a happy demeanor regardless of their unfortunate situation. All I can do is tend to their wounds and given them pain medication but I think they appreciate having visitors and a break from the monotony of their lives.
Friday night we also had a little party to savor the life in Ghana and each other's company before we all begin to go on our separate ways. Anna, the Swede, leaves next Thursday and then I follow suit the following Tuesday. I can not believe that I am down to almost 2 weeks left! It feels as though the past month has just flown by now that I have settle down into a life here. Had I planned to be here for longer there are quite a few projects I would like to get started on, the main one being creating a system for the hospital in which clinics in the nearby villages check up on patients and do followup appointments. However with only 2 weeks left I will try to accomplish as much as I can. I still would like to observe some traditional medicine as it is estimated that 80% of people in Ghana receive some kind of traditional medicine and some refuse Western treatment. I am trying to take in as much as I can before I have to leave and return to my normal life back in the States.

Life on the equator

I don't think I've yet to talk much about the weather or food here so this post will be dedicated to the two things which my life pretty much revolves around here.
Weather: I woke up this morning around 4:30 am and I was sweating. I can't imagine growing up in a place where the coldest temperature you've ever felt in your life is 65 degrees but that's literally the life here. My host brother refuses to go to the internet cafe because he thinks the AC is too cold. The days are usually between 80 and 90 degrees and it's incredibly humid this time of year since it's the rainy season. Which means you basically never stop sweating. At night it might get to be 70 degrees. Maybe. In the afternoons in October until December or January it will just absolutely downpour. Sometimes it lasts until the following morning but it will never rain past about 8 am. And then it's hot all over again. I hear dry season is rough because everything is so dusty and your skin gets cracked so I've been told I'm very lucky to be here this time of year. Which I believe until I'm caught under an overhang waiting out the rain which can last for hours at a time without ceasing and the roads begin to flood.
Food: As I've mentioned before Ghanaian food is primarily carbohydrate-based. But it's not quite like the carbs we know and love at home. The three main dishes you have to try when arriving in Ghana are fufu, banku, and kenkey. Fufu is made from maize and is ground up and made into a sticky dough which is put into a nut or palm oil soup. My first day in Ho, my program head Ash got me to eat fufu but apparently I was eating it wrong and I got scolded by a man (you are supposed to cut the dough, dip it into the soup and eat it. I had skipped the dipping step...). They even tried to give me a soup to eat it with (the majority of dishes are eaten with you right hand).
Banku (aka akple) is similar being fermented corn and cassava cooked in hot water to make a paste and is eaten with a stew or sauce. And then there's kenkey which I actually haven't tried yet but it's essentially banku that's been wrapped in cornhusk and it doesn't taste quite as good.
They love their plantains here, which are like very large bananas. You can either pick them raw and fry them to make plantain chips or you pick them ripe and cook them in oil to have fried plantains. Red red is a bean dish served with fired ripe plantains with the typical red sauce that they put on everything here (it's spicy and kind of salty and you get it with pretty much everything).
The Irish volunteers say they feel at home here because of the amount of potatoes you have with your meals. One lunch option my host mother makes for us several times a week is sweet potatoes, yams, cassava (likes a huge potato originally from South America but grows rampant here) and fried plantains with some stewed vegetables. I have yet to understand the need for 3 different types of potatoes in one meal...
You often find women selling bread on the street - you can get plain bread, tea bread or sugar bread. Since our trip to Cape Coast I've become newly addicted to sugar bread, especially when they sell it fresh from the oven.
Finally you have your  rice and pasta. Which, much to the dismay of the Asians and Italians I'm sure, they often serve together in one dish mixed together with the red sauce. You can also get Jollof which is rice cooked in a meat stew. You see chop bars all over town which means meat and fish are served there  however meat is fairly expensive here as are vegetables. They have carrots, tomatoes, peppers, cucumbers, lettuce and onions but salad is not a part of the traditional dishes and vegetables usually aren't prepared with meals (something I've been having to deal with in the diabetes center).
I have this pineapple lady (she's a diabetic) who chops up whole pineapple with a machete and sells it fresh for a cedi (roughly 70 cents!) It's also the best pineapple I've tasted in my life. My host family continues to give me coconuts from their yard, oranges and of course bananas which are half the size of bananas at home.
You can find pretty much the same variety of 20some snacks all over town. I've recently become addicted to milk sticks which are bread sticks made with coconut milk. I'm not sure if I've mentioned how much they LOVE Obama over here and at the market in town (the kind with stalls where the venders sell fresh foods and fabrics etc) they sell Obama crackers with his face alllll over the package! There is one supermarket in town  that has a few more Western goods but it's all rather expensive so I'm just sticking to Ghanaian foods for the time being.