Tuesday, September 28, 2004

Welcome to the Jungle

Hello from sunny Tanzania, where even if the jet lag
lets you sleep until daybreak, the chickens won't.

I've been here for five days now, which leaves about 9
and 3/4 months to go. To those surprised by this fact,
a brief update: I’ve opted to take a year out between
my 3rd and 4th years of med school to do clinical
research in adult and pediatric HIV infection in
Moshi, Tanzania. Until sometime in July of next year,
I’ll be working here with a great group comprised of
folks from Duke University and from our host hospital
(Kilimanjaro Christian Medical Center, or KCMC). The
long-term goals: personal and professional growth,
productive work, some sense of where I fit into the
research/practice schema, and an idea of whether life
in the developing world is really for me.

The short-term goals are a bit different, naturally.
Right now, managing my hair tops the list. (Just
kidding.) I'm still not completely adjusted to the
idea that I effectively live here now, but I suppose
that fact (and the accompanying panic) will set in

Or maybe not: Since I'm living among Westerners in a
rather nice house in a mostly expat neighborhood,
there's almost none of the culture shock that often
accompanies this sort of travel. I do appreciate the
amenities I've got, but I also sort of long for the
challenge that true developing-world living presents.
So although I might look happy in pictures I send, I'm
really crying inside over my in-house internet
connection, my daily maid, and my nearby swimming
pool. How ever will I survive?

The greatest cultural adjustment for me has actually
been to the expat types around me. Boy, are they ever
wacky. In fact, they say and do stranger things than
the Tanzanians do. The wackiest thing a Tanzanian has
yet said to me is, "You look like a Jew." (Which
really isn't all that wacky. I mean, I *do* look like
a Jew.) But the expats are always making up new words,
offering up new variations on the "socks with sandals"
theme, and wackiest of all, "hashing." This is
completely not what you think. Rather, it's an outdoor
activity where a designated person leaves a trail of
cryptic signs in white flour along an obnoxiously hard
route of his or her choice, and the poor slobs who get
convinced to participate have to hunt down (and
thereby run) the trail. Afterward, everyone drinks
enormous quantities of beer, which I suppose is to
make it less likely that the guy who planned the thing
gets a sound beating. I went on my first of these
yesterday, and it was rough--lots of river crossings
and rock scrambling. But the scenery was downright
breathtaking, and the fellowship was great. The next
one's in two weeks. Consider me a poor slob.

Workwise, my research is just getting off the ground
and up onto the starting blocks. My world will be one
of red tape for the next few weeks. During this time,
I'll be preparing submissions for ethics review boards
of various institutions so we can all be assured that
I'm in no way taking advantage of the vulnerable
population I'll be studying (kids with HIV). It could
take months to get approval for my study, so
meanwhile, I'll be doing a lot of work on the adult
study that parallels my own. I'll also be helping out
in one of the study clinics for adult patients with
HIV, and will be rounding in the hospital several
times a week. I suppose I'll stay busy.

We'll see what kind of adventures life here brings.
Hopefully, I'll be able to get away from my
spoiled-rotten life now and then. When things get
interesting, I'll let you know.

Meanwhile, please to enjoy these pictures of our house
and of the little bastards that wake me up every day.

Vaya con dios (I still don't know how to say "Goodbye"
in Swahili),


Program note 1: If you'd rather not get these emails
from me, let me know and I'll take you off the list. I
won't be offended, I promise--I know how the clutter
battle can be. See below for other viewing options, or
just stay in touch as you see fit.

Program note 2: I'm considering doing these updates in
a weblog format rather than a group email format to
avoid cluttering mailboxes and to allow me less guilt
about including pictures. There would probably be a
feature that would have an email sent to you (if you
so chose) every time I posted something new to the
blog site. If you care (or if you don't know what a
blog is), have a look at the temporary setup I've got
at www.sparkpod.com/Keren. If you have a strong
visceral reaction, let me know whether it's good or
bad. (If you're indifferent, you are invited to
passively refrain from comment.)

Program note 3: I now have a cellphone, which means
you can call me. Dialing from the U.S., it's
011.255.0748.373.089. From anywhere else, replace the
011 with your country's international calling code.
Just check your local calling fees before picking up
the phone, or you could end up selling your family
into slavery.

Little house on the savannah

Our backyard

Early morning offenders