Friday, January 16, 2009

London calling!

So these last posts were written a while ago, but we lost all internet for our last week in Mbarara. Ah well, life in Uganda...

We did a whirl-wind tour of London, although it did not start out auspiciously...we were tired and hungry from our long flight from Entebbe, checked into our hotel near the airport, then hopped a bus and the tube to Picadilly Circus...hmmm, trying to find dinner in Soho and the Theater District on a Friday night...not bright...

But we finally found food, then did the crazy walking tour - Trafalgar Square, Big Ben, Westminster Abbey, Downing Street, Buckingham Palace...We just arrived back a few minutes ago...and it is time for bed. All of us are looking forward to being back tomorrow...only 12 hours on a plane and 3 in a van to go!

I am afraid to check my email...gulp...

Penultimate thoughts…

We are in the lab cleaning up from our stay here in Mbarara. We spent an hour last night going around the table talking about our trip and our experiences. To put a point on it, the hospital will not open until April or May. For whatever reason, the administration is not hired, the engineer has made his own design decisions about the building that are counter to what the nursing consultants had recommended. Anita told me that if she had known how little progress had been made since October, she would have cancelled this trip.

I guess I spent last year in a haze. So much was new and different that I only saw the trees, not the forest. I am seeing the forest better this year. They don’t need me here. They need a microbiologist. The issues with the Rwizi River are all bacterial. All of the fecal counts, once again, are double what would close a beach in the US for contact exposure. People drink this water! On our first sampling day, a man near our furthest down stream sampling site took a handful of water and drank it straight when I told him he should boil his water. He said his blood was stronger than ours…I am not sure any blood is strong enough to consume water that contains over 1000 fecal coliform bacteria per 100 mLs, as well as about the same number of other bacteria! We did not see him at our site on our second sampling day.

Knowing this, I guess the hospital could dump hundreds of gallons of waste a day and it probably would not make the river any worse than it is now. I can train one of the nurses to do the important measurements that they need. They just need to be cognizant of sterile technique. The chemical waste issues are tertiary to biological and societal issues. Will I come again if invited? YES. Am I the right person? Expertise-wise, no. The same is true about any future project in Bwindi. I wish I could find the right person to step and do this. It is such an opportunity. I will continue to offer it to my students as long as I see them gaining an amazing life experience as well as the application of science to environmental and health issues. However, I am unsure if this will ever amount to a scientific publication.

I may write more tomorrow. Ashley, Denise, Erica, and Joel did great jobs, but that was not a surprise to me. Time for us to pack up and get home. I am curious to hear about their responses to our arrival back in the States. I know what mine was last year, and I do not want to implant thoughts in their heads. Stay tuned, there will be more to come.

Amazing Mweya and our Second Sampling Day

We woke up early on Saturday morning to get on our bus to travel to Mushange and pick up the Nursing half of our team. They had been there for a week training local nurses on pediatric care. We arrived there before 8 am, gathered them all up, and headed for Mweya – Queen Elizabeth National Park. Amazingly, we were able to cover the distance in less than 2.5 hours!

Our hotel – Mweya Safari Lodge – is deep inside the park on the channel that connects Lake Edward and Lake George. To get there, we have to travel through much of the park. As we were driving there, our bus driver – Bosco – stopped and picked up a bunch of bananas. He had brought his daughter along, and I thought that these were for them to eat in their hotel room. I was wrong. About 15 minutes into the park, there was a troop of baboons running along the road. We stopped and took pictures. Bosco reached over and tossed a banana to a big male baboon! This went on for about 5 minutes, and Matt got a really great picture of an airborne banana and a baboon reaching for it. We started to leave, but along came another baboon, and Erica opened her window to throw it a banana. The next 20 seconds or so were quite exciting! The baboon saw the banana, jumped up and grabbed the frame around the window, and it was sitting half in, half out of the bus! Erica jumped into the next seat on to Laurel’s (our psych nurse) lap, clutching the one thing the baboon wanted most close to her chest! Laurel on the other hand reacted to become an even bigger baboon than the one on the window! She was hooting and hollering, and waving at the baboon! Bosco, sitting two feet away was laughing uncontrollably. After what seemed minutes, but was really only about 5 to 10 seconds, Erica realized, get rid of the banana, get rid of the baboon! The banana went out the window and the baboon followed! We are so lucky the baboon did not see the giant bunch of bananas directly in front of Bosco! If it had come completely into the bus, it would have really been crazy!

We arrived at the hotel about 11 am, and lunch was not until 1 pm. A couple of folks explored the health club and discovered one hour long massages were 30,000 Ugandan Shillings. That totals about $15!!!! The masseuse was busy for the next day! Fortunately or unfortunately, the bar was also open. We figured it was happy hour somewhere, and had some pre-lunch libations. A double Wild Turkey (101 proof) and Coke cost me $4.50! Lunch was delicious and off we went on our water-borne safari! Last year we had a great time, but we saw mostly hippos and cape buffalo. This time, we saw 5 or 6 different male elephants, and much more wild life along the shores. One of the elephants decided he did not like us looking at him so he charged the boat, even though we were 20 to 30 yards off shore! Lots of noise, but all show…We also say a croc that was at least 2+ meters long. We also saw a group of 3 male elephants feeding together. One decided it wanted the tree its “buddy” was feeding on, so he charged him! Nailed him right behind the head with a good solid head-butt that we could hear! Sounded like a good football collision! The elephant under attack ran hastily away, with lots of trumpeting.

We returned to showers, massages, and happy hour while watching the sunset over Congo. A bon fire was started and we were treated to a troop of Ugandan drummers and dancers! As many of you know this group quite well, it was not long before it was a mixed group of Ugandans and Mzungu! Anita even pulled me out! They seemed to have a great time with us and I know we did with them.

Our next morning was an early start for a 6:30 am jeep safari. We saw some hippos moving from the brush where they grazed at night to the lakes, but we did not see much else. It is much warmer and dryer than last year, and most of the animals seemed to be near the shoreline of the lake. We did see the occasional elephant, kob, and waterbuck. Finally, we got word – LION! We found our other jeep, and they had spotted a lioness up in a tree! We could not see it from the road, but we were able to drive up to the tree, one jeep at a time. She was gorgeous, and had obviously just finished a big meal! Seeing a cat that big in a tree was amazing.

We began our return trip to the hotel for final showers, breakfast, and departure. Along the way, we spotted another male elephant. This one was obviously cranky, trumpeting, and making his ears really wide. Then, he charged the other van. I have video, and Kyrra, one of the docs on the other jeep has up close video! It was amazing and scary at the same time.

Our trip to Mbarara was uneventful, and upon our arrival, we unpacked and got into a game of yard golf while the health care professionals began their preparation for today’s seminars. We did our second sampling this morning with the whole team. It was a good walk! Along the way, we ran into an old friend! Issac! Ashley - The Original’s boyfriend from last year! He was all smiles when he recognized me, but he did look disappointed when I told him Ashley and Raffie had not made the trip. I have a picture with him, that I promised I would send it to Ash and Raf. So now we are into our last sets of analyses. A day and a half more work, then clean up…it is amazing how this flew.

I am going to try to get everyone else to contribute their thoughts here. Stay tuned!

Friday, January 9, 2009

Internet Issues

Sorry for the delay in getting these out, but we have had a 20 hour power outage and internet issues. Hope all is well. Our love to all...

Mbarara Sampling, the Olympics, and the Ugandan Masters

Since we did not spend as much time in Bwindi as we originally anticipated, we decided to do our first Mbarara sampling on Thursday the 8th. We got the lab set up after we returned from Bwindi. Got up on the 8th, got breakfast and got ready to go. Well, all was not kosher. It was pretty obvious that the continual on the go was taking its toll. Ashley did not feel well at all and could not keep food down, Erica felt better than Ashley but was not 100%, and Denise looked very tired. So, I gave the girls the day off. That meant that Matt, Joel, and I went out to do our sampling. Let me tell you, without the GPS, we would have gotten “lost.” So much has changed since last year. New houses, new vegetation, new crops in fields. We “picked up” a guide along the way, Gilbert. We had a great time playing the kids along the way. Just like last year, we gathered a crowd; and just like last year, everyone was very supportive.

Sampling and analysis was uneventful, and was going incredibly quickly. Bringing 3 vac pumps and two filter rigs definitely sped up the process. Just watching everything yesterday, I was in awe that Raffie, Ashley, and I were able to do everything with just three people last year. We were so lucky that none of us got sick and we had few equipment failures. We have already destroyed the two hand pumps and one of the vac pumps has a screw loose! As I said, analysis went very well until the power went out. With no hand pumps we pretty much “had” to take the remainder of the afternoon off.

The girls went and took showers and naps…the guys, well, let’s just say the testosterone started to flow. First off was the Ugandan Olympics. Three events – the Cylinders (attempt to put the cap of a 15 mL centrifuge tube into bottles of various sizes, each worth various point totals from a distance of about 5 feet. Believe me it is more difficult than it sounds!), Chalkboard Bullseye (propel the bottle cap of a beer bottle by snapping it off your fingers at a target on the chalkboard), and Long Distance Hoops (throwing a “ball” made of labmat and tape into a box from a distance of 40 feet). The standings at the end of the day had Matt in First Place, trailed by Jim, with Joel bringing up the rear. Since none of us like to be board, we then expanded on Joel’s game and played the equivalent of Frisbee golf around the grounds of Montfort with a box and the “labmat and tape balls” we made. After nine holes, Matt stands at -2, Joel at -1, and Jim at +5. The plan is to play 27 holes today to finish the tournament!

It was nice to have a relatively stress-free day. Hopefully we will finish the analysis today and be able to chill out again for a while. Hope all is well at home!

Bwindi

Well, as I begin writing this we are stranded on the road 20 km outside of Mbarara with our car broken down. Issac has just left to find us a ride back to Mbarara and we are just kinda chillin’…Life is an adventure!

So where to begin? Our drive to Bwindi was probably the most beautiful drive any of us have ever taken. Green, lush, incredible mountains and valleys. Luckily for us, Issac was a skilled driver and our “free African massage” was not that bad. We hit a few bumps along the way but nothing like that bus were on the previous day. Along the way, we stopped and gassed up at a local station and Erica, Ashley, and Denise discovered a way to deal with the squat holes that serve as toilets. Since this is a family audience, I can’t repeat Ashley’s exact quote, but let’s just say it went something like “when it gets difficult (replace this word for the exact quote), get naked!” That is what they did…off came the pants and it made using those facilities much easier!

We arrived at the Conservation Through Public Health headquarters in Buhomo only to be told that they had moved their headquarters up near Mweya, the site of the Queen Elizabeth Safari Park! What we did not know what that they gorilla conservation clinic was 20 meters up the road along with the Silverback Mountain Resort, where we spent the last three nights! We were greeted by Joseph and Ibrahim and shown to our tents. Talk about a jungle hide-a-way. We could see the mountains of the park, Congo and Rwanda all from our location. Absolutely beautiful. We settled down for dinner, and I had a brief meeting with Steven, one of the veterinary technicians for CTPH to plan our day on Monday. Otherwise, it was an uneventful evening with some cards and an early bedtime.

- Crazy, idiotic out of shape mzungu
We began our next morning to a wake up call from Joseph, which consisted of him standing outside your tent saying “Hello, good morning.” We had our breakfast and went to see the lab. It is a small one room cottage, but is well set up with a -20 freezer and a 5C fridge. The crew, of which we have a new member – Matt Simone – set up the lab and got ready for an afternoon of sampling around the community. Me, well, I jumped on the back of a motor cycle with Steven to go to the Bwindi Impenetrable Forest Park offices to meet with the administrators for our access to the park on the next day. Again, as with all my meetings in Uganda, it was pleasant and they were very happy to work with us…so we were set to have our sampling in the mountain gorilla park on Tuesday!

So, we get back to the lab and Steven is ready to take us for sampling around the community, just 200 meters down the road. We figured it would be a short, half hour trek so we were completely unprepared for what came next…an hour steep up hill hike, in 90 degree heat with minimal water or snacks of any sort. As much as I hate to admit it, the heat, altitude (1500 meters or about 4700 ft), and my lack of getting water over the past few traveling days hit me like a brick. We got to the spring at near the top of this “hill” that was the main water source for the village, and I nearly passed out…(200 meters from the border with Congo – DON’T WORRY MOM, all is well, otherwise I would not be typing this!) Luckily, Ashley had half a bottle of water with us, which Matt – our newly bestowed chemist and resident nurse practicioner – made me drink. I felt better afterward, but extremely embarrassed. I knew the rigors of this trip were coming, and I had always prided myself on being the first one up, the last one to bed, and willing to do the toughest jobs on any of our trips…I feel like I failed…It won’t happen again.

- What is it about Ashley’s?
We collected our water, got some lunch and packed up to head out PREPARED this time for our other sampling around the community. We sampled from some tap water and from various streams around the communities surrounding the park. We met many different people. Alex, one of the techs for CTPH, came with us. Like Ashley Parks last year – with her Ugandan boyfriend Issac – Ashley now has her own Ugandan boyfriend (ignoring the fact he is married and has two kids!). Alex was obviously smitten with her!

Along the way, Denise was able to take a video that we will post when we get a chance. A VERY drunk elderly woman joined us and began teaching the girls a Ugandan tribal dance! It must be seen to be believed!

We collected our samples and then headed back to the lab where everything went to hell…It seemed like we were all doing this stuff for the first time (can you say jetlag and exhaustion?). We finally got our acts together and crunched through most of our analyses, and finally headed to bed about 11 pm.

- The Gorilla Park
We got up for breakfast at 7:30 so we could be out by 8:30 on Tuesday. None of us slept well. Denise, because she took a malerone (our antimalarial) at 9 pm…as I can attest, one of the side effects is insomnia. OK OK, I know most of you are going, how can you know the malerone caused it…trust me, my insomnia was worse last year when we came back. Denise did not remember taking her malerone earlier in the day, and so even though her count on the number of pills she had left matched everyone else’s, she took another one.

We arrived at the park at about 9 am, got a guide and off we went. We hiked up a steep slope to our first sampling site, a spring that supplies the villages below with water. It is also the center of one of the gorilla troops home ranges. I must admit, the thought of having a hike like that all day made all of us concerned…

So we went off and sampled a few other sites. We trudged down to a beautiful river, took our samples and headed back to the main trail. As we got to the main trail the guide stopped us and said, we have to stop, gorillas are crossing the trail! There they were, about 100 meters away. I saw two females, potentially with babies. As Joel put it, our experience was kinda like going to a strip club, all tease. We were not allowed to get closer as we did not have the $500 per person permit, nor were we allowed to take pictures. We did not argue, especially when about 12 Ugandan Wildlife Authority soldiers came out of the woods behind us from their nightly patrol to keep the Congolese rebels out of the park. Hard to argue with a guy when he has muscle armed to the teeth to back him up…


We finished our sampling and most of us helped support the local economy by buying stuff just outside of the park. Off to the lab and analysis! Danny, if you are reading this, we have already burned out a pump…luckily we brought three this year! Our analysis went well and was much more efficient than the previous day. We went back to the Center/resort and took a break for some cards and a beverage or two. While we were there a bus load of Italian tourists showed up. Four people stormed off the bus and demanded to see the accommodations. Joel and I looked at each other and thought oh crap, we do not want them staying here. Luckily for us, the accommodations were not luxurious enough for them. It would have been a long night as they were loud and demanding!


As we were walking back from the lab that night, we looked up to see the mountain top above the park in flames! My first thoughts were “Oh f---“ Having made two successful evacuations from Poway, I wondered what it would be like to evacuate from one of the most remote regions of Uganda! None of the people walking the trail were concerned. We asked what the fire was about, and they said it was people clearing land for their animals. That makes it even harder to believe that I slept straight for 7 hours last night…I guess I was a bit tired!

So we finished up our analysis on Wednesday morning, wrapped up with Steven and headed for “home” (aka Mbarara). Along the way, we ran into a wonderful African thunderstorm. Issac had been quiet as he had suffered a malaria attack on Sunday night and was still recovering. He was quiet until he looked back and saw Joel riding along with his head stuck out the window fully enjoying the rain! The rest of the ride was good and fast, and along the way Denise earned a new nickhame that will undoubtedly stick for the remainder of her natural life. Matt was asking Joel about Raffie. As Joel was describing her, Matt asked if she looked Asian or Italian. Joel responded mostly Asian. Matt then asked what does that make Denise then? Is she a Super-Asian? And given the fact that Denise has fallen in love with the Ugandan cookies named Marie’s (yes, they are the Ugandan version of Maria’s!). So, Denise became SAM, for Super-Asian Maries. We have decided that Matt is Sam2, Super Alaskan Matt….

So the trip progressed until Issac looked down and saw the temperature gauge rising. And that is where I started this. We blew a water line. The car was not going anywhere else. We finally got a hold of Father B, and he sent Bosco (the Archbishop’s driver) to pick us up in a Range Rover. We finally got home about 7 pm, in time for dinner and getting the lab set up for sampling on the 8th!

Amazing amazing time….

Saturday, January 3, 2009

The Flight, The Arrival, The Stress…

Believe it or not everything went according to plan(!!!), to London that is. We departed USD at about 2:15 pm and headed to LAX. We were off. There was absolutely NO ONE(!!!) in the International Terminal. We checked in put our bags through security, and then we had three hours to kill. We went and got dinner, hung out for a bit and got to know the folks from Loma Linda. It was the most relaxed I have ever been on a trip. Get this…I slept completely through the night the night before we left, and was not at all stressy!

We took off a bit late for London, but no big deal – we had a 6 hour layover. Movies (I watched the latest Mummy movie) and then I crashed. I did something else I never do…I slept for 4 straight hours on the plane! Joel and I had one of the few open seats between us…but the leg room sucked…ah well, we were in London!

We went through security, and I had a major faux pas….I forgot to pull the poker chips out of my bag. On an Xray machine they look like metal, and a bag of randomly arranged chips is not something that an Xray tech can identify! My big yellow bag gets stopped and the tech is looking at it…moving it back and forth…then very politely (with a British accent obviously) says “Excuse me, but who’s bag is this?” I answered him, and he asked what I had in the bag. I said poker chips…I know, I should have taken them out. Well, yes, he says, they do look like metal on the screen. But that is a fabulous idea traveling with your own poker set!

Se we chill in Heathrow for a while. I get a hot chocolate that was about 2,45 pounds…probably the most expensive hot chocolate I have ever had…off to the gate and we are on our way!

The flight was uneventful. Joel asked to switch with me so he could have the window seat. Again, meals, sleep, reading, etc. As the sun is rising, Joel is staring out the window…all of a sudden there is a firm clap on my shoulder. Joel is all wide eyed! We are in Africa! “I finally believe this is actually happening!” He never thought he would get to this continent…he has pretty much had the biggest smile on his face that I have ever seen since that time!

We are approaching our arrival time, the captain comes on the intercom…”there is fog over Entebbe Airport. This is quite unusual for this time of year. We will continue our approach and see if it burns off.” Nope, so we circle a bit. Captain again…”we are going to attempt our approach, but we may have to turn off if we do not feel it is safe.” Down we go…looks good, no fog…further down..still no fog, we can see the landscape all around. We get down to about 500 feet, all of a sudden, fog everywhere! Engines back to full thrust, and up we go! Time to go to Nairobi for more fuel! So, I can now honestly say I have been to Kenya! We spent about two hours there, hanging out and getting antsy…we take off again and finally get to Entebbe.

We collect our bags and head out through customs. Well, of course they flag down Joel to Xray our bags, and he has the cart with all our gear. The supervisor “randomly” picked him! So we are stacking our stuff back on the cart after the Xray, and the customs agent asks Joel, do you have any electronics…Joel – yes…agent…no you don’t have a nice day. LOL he didn’t want to inspect our bags!!!

Lunch, dinner, and arrangements for our trip to Bwindi. Everyone was exhausted, so it was an early night, but most of us were wide awake by 4 am…I set the record…I was up and ready to go at 2 am (3 pm CA time!). To make a long story short, we were on the bus for almost 11 hours today…and Ashley’s comment is wrong…our butts are not sore…my kidneys ache and I have shrunk to 5’4”…that is how bad the roads were. If you ever want to have some one find religion, have them ride shotgun on a bus in Uganda. I swear I put a hole in the floor trying to slam the brake. I saw us miss bicyclists by inches. I saw us about to fall into a pot hole so deep, I saw molten lava in the bottom. I saw us play chicken with cars, cows, trucks, and buses. But, Tanasi did not play chicken with the petrol truck…small miracles…

There were some good moments to the day. I have most of my shopping done already! We went to the zebra park at Mboro National Park. We saw zebra, eagles, gazelles, kob, waterbuck, hippos and monkeys. Erica saw her favorite animal of all time, a meercat. But the highlight was the warthog who ate lunch with us. He was BF warthog. (BF = Big Freakin’) His tusks were at least 8 inches long. He was munching away. We have some amazing pics, but missed the opportunity of a life time to video it when it took a short charge at one of the docs from Loma Linda who got too close! No blood no foul, but definitely more care the next time.

So now for the stress…our trip to Bwindi was within a hair of being cancelled! They came back with a cost of two people per tent of $120 per night when we had budgeted $75 for a double tent. Things got pretty hairy to say the least! They finally relented back to their initially agreed upon amount, but only if we did it as a bed a breakfast…so, we figure we will just buy dinner there and hope everything works out. But let’s just say my blood pressure rose a bit. Throw on top of that, we had to unload, unpack, and repack all of our personal and laboratory gear, and let’s just say I am done! I am NOT looking forward to another 6 hours in car tomorrow…

Hope life is good. Go CHARGERS! I will have the others write some for the next post. Let’s just say watching their faces as they discover Africa has been amazing. We probably won’t be back for 3 or 4 days, as we are unsure if Bwindi has internet access for us. Until then…