Sunday, April 18, 2010

End of March-Mid April

First to get some lab updates out of the way...
In order to test the “contamination” in the yoghurt that showed up on some gram stains in the lab, we made blood agar plates which can be used to grow E. coli. We used human blood from a local hospital’s blood bank!!! To ensure the gram stain worked as it should, I plated a Gram negative species (E. coli) and a Gram positive species (Staphylococcus aureus). I Traveled to Bugando Hospital Microbiology Lab (Bugando University College of Health Sciences) and plated E. coli, Streptococcus, and Staphylococcus on Fusidic Acid and Blood Agar plates (6 plates in total) and transported them back to NIMR to be incubated. It turns out that there was no proof of contamination in the probiotic yoghurt, but perhaps some in the non-probiotic yoghurt from using the MARA milk, so we purchased a better-quality yoghurt from U-turn to inoculate the remaining quantities of non-probiotic yoghurt needed for Joke’s trial. Problem solved and the trial continues.

I finally got the chance to go visit the children at Forever Angel’s Orphanage. I’ve been reading Amy’s Blog for quite some time now, since around the time I discovered the Western Heads East program. Amy and Ben, a couple from the UK, have set up a very unique and extraordinary Baby Home here in Mwanza, Tanzania. They have taken in young children who have been abandoned, abused, or lost their parents for AIDS-related illnesses. Many of the children have had very rough family histories and they have in some cases been very severely abused, malnourished, and/or are very ill. Some need hospital attention upon entrance to the Orphanage!

The unique aspect of Forever Angels is that it is a baby home and they are constantly having new children coming and going. The Orphanage tries to find homes for the children, whether it be with a more responsible family member or adoptee parents. In some cases, the parent finds a job and can again support their child with food and shelter. Of course, the children are monitored and checked up on when they leave the orphanage!

I visited with Corinna (who had volunteered for the past three months there, but now works at Tunza) and Nadja (who was also there for the first time) to spend an afternoon with the kids. When we first arrived, we went to a room with toddlers playing with blocks, next to a room with many cribs/mosquito net coverings. The first baby I got attached to was named Angel and she would grasp onto my clothes so I wouldn’t let her go!! Then, I got a chance to spend time with the “tiny babies”, cradeling them and holding them and tickling them J. Sooo cute! Then I went back to see the “big babies” (toddler age) and played blocks again with Angel! Then, lastly we went to see some of the older children when the toddlers were taken inside for snack time! The older kids were speaking in English and Swahili and the girls were playing with my hair, while the little boys were asking me to lift them up and spin them around again and AGAIN, to the point where I was getting dizzy!

I also had the opportunity to visit Salome and the children she works with at Starehe Children’s Home! I took the daladala and was dropped off right at the gates of the Orphanage. The director, or Salome’s boss, offered to show my around the property and explain how things operate on a day-to-day basis there. There are approximately 125 children, ranging from new-born age up to 18 or 19. Many of the children are school-aged, while others attend the nursery on sire. The plot of land the orphanage is situated on was much larger than I had imagined, with multiple residences for the children, based on sex and age.
I stayed after the tour to play with the kids and help out with feeding, bathing, dressing them, and putting them to sleep. After a messy dinner of rice and beans, the kids were playing on the jungle gym play set. The kids were getting put to sleep around 6:30 pm, but they were all really rambunctious and wanting to take pictures with my camera. It was so hard to leave them, but I know they need their rest! I went down to the basketball courts to play some games with the older boys until Salome’s shift was over at 7 pm!

For the Easter long weekend (Friday until Sunday), I got the chance to go to Rubondo Island, my first trip to one of Tanzania’s National Parks. From what I had heard, there was going to be some great wildlife, including crocodiles, hippopotamus, elephants, and sitatungas (type of antelope).

On Friday morning, there was a little confusion regarding where I was to meet the group leaving Mwanza and a little disappointment with the drizzly weather, BUT I caught the ferry just in time. Luckily, I hopped on just as it was about to leave the port!!! I met Khaled, Major, Henku, Jaques and Corinna! Major’s car was on-board with a speed-boat on a trailer, and Khaled’s car was packed with camping supplies, like sleeping-bags, tents and food and drinks. We had to wait over in the ferry terminal at the other side for a while because Jan (Henku’s dad), Jan’s broher (all South African) and two Spanish men who work at Major and Khaled’s shipyard were coming on the next ferry to meet us. We had chips mayai and mishkaki! After that stop-over, we were on our way to drive through the country-side. Major’s trailer was coming undone from the trailer, so they stopped early and drove the boat all the way to Rubondo. We drove further, speeding down dirt-roads and beeping all the while to keep people on bikes out of harm’s way. We passed through a few villages, and when we stopped briefly for food, it seemed as though the whole village came out to watch us! When we got to the boat, there were engine problems and the engine was moving us very slowly and continually stalling. There was a beautiful sunset over Lake Victoria and then the stars started twinkling, but overall it was an extended journey. When we arrived at the campsite and had unpacked our things into the “banda” and the shared kitchen, we sat by the bonfire and grilled some goat meat for dinner!

On Saturday, I rose early to catch the sunrise and join in on the fishing trip! We managed to catch a couple really big ones! Unfortunately, the fish weren’t biting as much as they used to because of some illegal fishing in the area!!! The area of the lake is supposed to be a conservation area, and it usually costs money to get a permit to fish. We discovered a floating water-bottle that when we lifted it up revealed a never-ending line of hooks with tiny fish attached for bait. There were only a few catches, so it must have been placed there the night before, and we cut these off. We did manage to see some other wildlife, like crocodiles sticking their heads out of the water, some hippos near-by shore, and birds like Fish Eagles and White Eagris! After fishing, I went on a tour with Corinna, Henku, and an Austrian couple living in Mwanza. I had bare-feet because I literally came right off the fishing-boat and hopped onto the 4WD headed on the tour. As it turned out, the journey by car was short and we walked through a couple of trails leading to look-out points. Besides a couple problems with thorns and ant-highways, I got away without any harm done to my feet because the ground in the forest carpet was damp and muddy from recent rainfall. I got to see crocodiles through binoculars, confirming they weren’t rocks! When we finished the guided tour, we went exploring on our own to the “landing strip” and the “airport lounge” where small planes can enter the island. When we returned back to camp, we grabbed some late lunch and waited for the fish for dinner to come from the second fishing outing of the day! When the guys returned, they revealed a bundle of fishing nets!! We removed the fish caught up in them and set fire to them. After grilling more fish than we could ever possibly eat, we sat around the fire as the sun went down.

On Sunday, we went for another tour with the Austrian couple. We drove quite a distance around the Island to the Northern area and saw a few Bushbucks (small antelopes) along the way. We also stopped a number of times to let groups of butterflies huddled on the road to flutter away!! We were literally bush-whacked by palms and vines overhanging onto the dirt paths we were driving on, and had to continually keep our guard up and duck down!!We saw monkeys in the trees and some crossing the road, including Vervet monkeys, recognizable because of their blue scrotum haha…When we retuned from the tour, we were packing up and already getting ready to take the boat back to Mwanza! After a MUCH quicker boat ride back than the previous one on Friday night, we drove through the beautiful (this time sunny!!) country-side. Once we got to the ferry it was clear that it wasn’t up and running because of the Easter holiday…there were no cars or trucks waiting at the terminal!!! Luckily it was easy enough to organize a smaller boat to take us back to Mwanza! Everyone headed to Tunza Lodge and I got to indulge in my FIRST hot shower since arriving in Mwanza!!!!

Arja and Yolanda, the two Medical students from Rotterdam, in the Netherlands, arrived to Mwanza at the end of March and are now living with us in our apartment. We are collaborating our efforts for the “Moringa Project” where we will be mixing Moringa plant powder with the probiotic yoghurt produced by the Mamas, and also with a “probiotic porridge” made from fermented grains.

Steph and I picked them up from the Mwanza Airport on March 31st and (after filling out some paper work because their luggage was left behind in Nairobi :S) we showed them around a bit of Mwanza. We met Joke and some of our other girlfriends at Talapia for dinner to familiarize everybody! I think they’re at a great advantage (and grateful for it) that Steph and I have been here for a few months and can show them the ropes and workings of Mwanza.

Joke is now back in the Netherlands until mid-May doing a course required for her Medical School at Rotterdam. She took the blood cards and the vaginal swabs from the initial tests with her to be analyzed in the lab. The collection from the final tests are being stored in our apartment at present and will be sent to the lab later.

On Tuesday April 6th, we went to the hospital to carry on with Joke’s trial (the final stretch, as the patients will all finish on Saturday April 10th). We rose early so we could be at the hospital for 8 am. We filled in the forms when the patients came to collect yoghurt for the day of and for Wednesday (another national holiday!!). We marked down patients needing to come back to the hospital on Saturday for their Dry Blood Spot tests (we ran out of papers), and also CD4 tests for those who haven’t had one recently, within the last two months (the lab was unavailable).

On Saturday April 10th, we all went into Sekou-Toure and the final blood tests and vaginal examinations were completed. I filled in forms and checked that patients had updated their CD4 counts within the last two months.

The trial closed officially on April 14th with just a few more dry blood cards to be collected in bags and the fridge to be returned to NIMR on April 19th. I have just finished typing up a summary of the lab work from the trial.

Second-hand Clothing Market
The market across the street from our apartment is filled with clothes, shoes, backpacks, purses, etc. Truck loads of bushels of clothing/shoes come into town everyday!

Some local people in our neighborhood have invited us into their homes to talk, to meet their families, to offer us food etc. I feel safe in the area we live in. Some people we have meet will come visit us at our house now too.
Joseph is a 19 year old in Form 5 and wants to eventually be trained as a doctor and move to Europe or North America! Him and his younger brother Davies (10 years old) live around the corner from our apartment and are always asking us to come to their home to greet their family. Joseph even asked us to help him with some biology questions, which at first we thought were from his own curiosity, but turned out to be from his homework haha.

The Chemichemi group works under Kivulini Women’s Rights Organization in Mwanza and aims at working with individuals, community groups, companies and governmental organizations in encouraging the use of traditional plants, like Moringa. The leaves of moringa are harvested and dried, and when ingested it is proven to enhance the immune system (white blood cell counts) and it is used as an anti-malarial drug (traditional medicine).

Yolanda, Arja, and I traveled to Buswelu to visit the Community Health Centre where they produce a porridge using a mixture of millet, rice, peanut, maize, and soy flours. After boiling and cooling the porridge, 1 tsp of Moringa powder is added to each cup. There are demonstrations for the community at the Health Centre each week on how to cook the porridge, and then weekly supplies of flour are allotted to each family so they are able to make the porridge for their children at home. The project specifically targets children who are malnourished (they track the childrens’ growth and weight on charts). This method of feeding malnourished children with a balanced diet is a great initiative and many people travel 5 to 10 km just to pick up the flour each week. The government supplements the costs for these families, so there is no fee!

The Chemchemi company is very informative for local women, advising them as to their rights, and educating pregnant women on maintaining diets for a healthy pregnancy. We got to oversee a nurse giving a pregnant woman a check-up. She was 24 years old and it was already her fourth pregnancy. The health worker couldn’t find the heart beat of the fetus with the fetalscope, so she was referenced to Seckou-Toure hospital for tests! Her baby’s head had already aligned into the pelvic region, so she is expecting very soon!!


Steph, Esther, and I met with the Headmaster, teachers, and students at the Primary School (Form 1-7) in Buswelu. There are 1, 450 students enrolled currently and only twelve classrooms! The classrooms were very overcrowded with around 100 students inside and many of the children sitting on the dirt floor at the front of the chalkboard instead of sitting at desks.

Tecumseh Elementary School in London, Ontario works on a school twinning project with Buswelu Primary School, and they have raised around 2, 000 dollars of support!! Currently, we feel the best way to spend this money would be on new desks for the children (each costing around 50 dollars each). Other immediate needs include the restoration of the water pipeline that provides the students with fresh water. The teachers also mentioned that there is always a need for new textbooks and notebooks, but that they have been wanting to purchase a computer for the staff room. This is an investment we’re looking into, but it would involve tighter security and extensive training in computer literacy.

We are having the children produce some artwork/drawings of their homes, family, and hobbies (life in Tanzania) to take back to the school in Canada. The children at Tecumseh are also drawing pictures to send to the children in Buswelu to educate them about life in Canada. We’re returning this upcoming week to take in colored pencils, paper, and other supplies for the kids to use!

Overall we were very impressed with the school and the children were all very friendly and welcoming! All the kids were very polite and even rose and called out “Good Morning Madam!” in unison when we entered the classroom, and after we greeted them, in return they exclaimed, “Thank you Madam!” haha

Yolanda, Arja, and I have been working at NIMR and experimenting with mixing different quantities of the moringa powder with the yoghurt. We need to be sure that the moringa does not affect the probiotics and render them ineffective. Once we have finished the work with counting colonies that grow in the probiotic yoghurt with moringa versus the probiotic yoghurt without moringa, then we can let the yoghurt sit with the moringa in it for about a week and test again.

We have also purchased a container of the porridge flour used by the Chemchemi company so that we can prepare it ourselves and try to add the probiotic strain to it. In the upcoming week, we will be making broth cultures with the different probiotic strains that I brought from the Lawson Research Institute Lab in London to see which one survives in the porridge.

We’ve been cooking a lot more Tanzanian-style dishes at home these days! Lots of Ugali, sauce with okra, tomato, and onion, fried/baked Talapia fish (fresh from the local market), and spinach with peanut sauce!

We’ve also been invited over to several peoples’ homes for lunch or dinner, and eaten rice and beans, or ugali and sauce, and always accompanied by a soda haha

We’ve been writing down all the recipes, so expect some African dinners in Canada! Margaret and Esther have even been asking for us for some “Canadian dish” recipes, like our banana muffins and pasta sauce. They find it interesting that we infuse our food with so many spices because they’re used to only using salt…and lots of it!!

For the past few weeks (since before Easter weekend), I’ve been feeling a little ill, but I doubted malaria because I have been careful to take my malarone each day! On April 12th I felt head-achey and feverish so, to be safe, I got tested at the Hindu Hosptial for malaria. The lab results of my finger-prick blood test indicated positive for three-ring malaria! I purchased the prescribed medication at the local Global Pharmacy and had to take pills for three days, but my flu-like symptoms like coughing and runny nose haven’t gone away. There’s not really any way to know whether the lab results are accurate here or not, and it often takes a few tests to be absolutely sure of one’s malaria status. I’m feeling fine at the moment, so hopefully my sickness doesn’t return and I remain in good health for the remainder of the trip!

We have been to Salome's Church a few times, and we've gotten used to the elaborate presentations of gospel music and dancing and adapted to the Swahili-spoken sermons. However, the last time that we visited, in the middle of the service, we watched as Salome went to help a girl who was seizing on the ground off the side of the room. We heard muffled cries and noticed that she was being pinned to the ground by several people, and Steph, Arja, Yolanda and I were shocked that no medical attention was being called upon! Eventually the girl was able to stand off and was escorted out of the room. At the end of the service, we inquired about how she was doing, and it was explained that the girl had "evil spirits" placed inside of her by a local witch doctor. Apparently there are some so-called "evil" witch doctors who prescribe traditional medicines (traditional healers). It's strange to me that these superstitions in traditional herbal medication are still being used all over Africa, and are often more "reliable" (ie. accessible) than doctors in the hospitals.

Wednesday, March 24, 2010

Playing catch-up (The past three weeks have flown by)

Summary of the past few weeks/happenings in Mwanza up to and including March 21st...:
-Joke’s trial is up and running, with all 153 patients!
-We've been responsible to deliver the yoghurt to the hospital and making sure the Mamas know how much of the probiotic and non-probiotic yoghurt they are to be making!
-Steph has sometimes been at Sekou-Toure Hospital helping with the yogurt packaging and distributing it to the women.
-I have been doing quality control at NIMR. There have been multiple frustrating days, where things just don’t go my way: the fusidic acid plates not working, unexpected contamination like yeast and potentially E. coli. Lots of waiting around. These are precarious times, when we don’t know if the yoghurt quality is up to snuff for the trial (ie. meeting the standards we have set in order to yield adequate differentiation in the results).
- We are still trying to organize the finalization of packaging/labeling for the yoghurt for the Mamas. We will be traveling to Nairobi, Kenya next week to pick up the packaging ("juice-box" or "milk-carton" style), and then we can start mass-distribution of the yogurt to local restaurants, markets, shops, orphanages etc.
-TWG received their grant from this years’ Mwanza Charity Ball 2009!! Yay. There are many good ways for money they received to be spent! We have 1, 987, 450 Tsh (almost 2, 000 dollars!). This money can be used to support the 125 people living with HIV/AIDS in the community who were being subsidized for their yoghurt. Many have not been receiving it for over a month now because there was no funding to support them!!!!
-We’re in the process of applying to the SCF grant (for small and medium enterprises within Tanzania’s food industry) and the Global Fund for Women (American organization that supports projects run by women internationally).

Recap of my birthday week :)!
On Monday, Steph was feeling ill and stayed in all day. I did a much-needed grocery shopping trip to Lavena supermarket and somehow ended up spending about 60 dollars on groceries (all imported foods are super expensive here, in contrast to the market where fruits and veggies are a steal).

On Tuesday, we worked at the apartment with Esther, on editing documents and proposals for grants. I did some reading (I’ve been reading a lot for pleasure here, and it feels so good to have the freedom to). Later in the evening, we were invited to Joke’s place for home-made pizza! Really yummy, one with pineapple pieces and another with grilled eggplant! Then, we stayed late to watch a movie. Joke and Major had a few travel guides on Tanzania and Zanzibar, so I was eagerly digging into them, looking into a Safari at Serengeti National Park and a trip to Stone Town in Zanzibar.

On Wednesday, I went into NIMR and check on some plates. It wasn’t a very eventful day. I can sum it up with some gram-stain tests and microscope work, really.

On Thursday, Steph, Esther, and I took a taxi to St. Augustine’s University. We met with the Vice Chancellor (who had been out of office). We reiterated our ideas for student interns from Canada to be “matched” with students from equivalent programs at SAUT (social sciences, business) or Bugando (health sciences).

On Friday, Steph and I baked a chocolate cake for my birthday! We even made chocolate icing (lots of Blue Bandi margarine…) and even found rose-shaped decorations at Lavena market! Later that night, we went to Villa Park for early birthday celebrations!

On Saturday (finally my birthday!), we went to the local market in the morning to purchase the food to cook our big, buffet-style dinner. We had the mamas’ help with making rice, pasta, deep-fried potato and green bananas, chapatti, green beans, and cabbage with carrots and peppers. We cooked literally ALL day long. We had our home-made cake and fruit kabobs with pineapple and grapes for dessert. After some champagne toasts, and speech from Esther, Joke drove us to Tunza for the beach party they were hosting, complete with a DJ right on the beach. We ended up having a late night at Villa Park, which was rockin’ til’ the sun came up. Africans sure can shake it. Even the young girls were far better dancers than us white girls will ever be haha.

On Sunday, I did some reading and finished up one of the books I was working on reading, called Zanzibar :). It’s great to have the rooftop of our apartment building to have some privacy away from onlookers from the street. There’s also a great view of sunrises and sunsets from the roof. I always find myself feeling guilty when I look around and see the mud huts and tin-roofed buildings all crammed together in the hills. Thinking of where people so near-by don’t have access to electricity and clean water like we do, I feel guilty living in this paradox. They don’t have a stove; they use charcoal burners and brass pots. They don’t have beds or couches with cushions to sleep on; they sleep on straw mats on the hard ground.

On Monday, Esther dropped by the apartment and we were informed that Hassan’s baby nephew had passed away that morning!!!! Puice stopped by the apartment after the funeral. Steph and I were asking how the baby died (he was less than two years old), but noone could give us a definite answer. Esther said it might have been malaria “or something”, as if the whole ordeal was quite common and nothing out of the ordinary. I was shocked and wanted to know exactly what had happened and why his condition could not be cured. This little baby had been running around our house the previous week and smiling, playing, and eating with us. We were told he was in Sekou-Toure Hospital and then Bugando Hospital. The family is Muslim, so the boy was buried the same day, but Esther says that the mortuary at Bugando is always overflowing with bodies that there's no room in the "fridge" for them. I said I wanted to visit and she said "yes, it's possible, but you might get nightmares"...We carried on business as per usual on Monday, but I was feeling a little stirred up by the whole ordeal. I went to NIMR and Sekou-Toure to help out Joke, while Esther and Steph went with Esther to the packaging company. Joke and I went for lunch at Kulianas. Later, we skipped out on yoga at Tunza and decided to bake! We had some rotting bananas that Esther was convincing us to throw away, but we decided to use them up by baking banana muffins!

On Tuesday, we visited Hassan’s house (also Pendo and Margaret) and were introduced to the rest of his family. We gave our sincerest apologies (Pole sana sana!!!) and we were offered to sit down (Karibu kiti!!) and stay a while. We were given kitanges to cover ourselves with (tradition for mourning). We stayed and chatted, took some photos, and ate some fresh pineapple! We walked from there directly to NIMR for quality control and found some unexpected contaminants, such as yeast and potentially E. coli, which was a little scary. Joke is worried about using the contaminated yoghurt, (even though the lab tech was not 100% sure it was E. coli) so she told the nurses that they may have to throw it out. The nurses said that if they throw it out, “God will punish them” and that they should distribute it throughout the hospital to people who have shown interest in it, but could not be included in the study. I think she kind of missed the point that the yogurt could make people sick!!!

On Wednesday, we went back to NIMR to check on the quality control. On my walk home, I purchased another Kanga and some henna dye. We went to the packaging/labeling company again to inquire about maybe traveling to Nairobi, Kenya. Because it was St. Patrick’s Day, we went to the Yacht Club (near Talapia) which is operated by an Irish man. We ate dinner and a couple drinks to celebrate, but nothing too crazy. Not many people celebrate the holiday here, but there were two birthdays that evening too, so lots of food and cake to go around!

On Thursday, we had Mama Joyce and Esther prepare a speech and we filmed a video for the upcoming event in Canada called “In the Market for Western Heads East”. We're in the process of uploading it to youtube now. I finished editing the SCF grant for Esther and we added the budget proposed for the packaging/labeling from Nairobi.

On Friday, Steph was already up when I woke up and she explained that she had been sick all night and wasn’t sure if it was from something she ate, or malaria again. She couldn’t eat or drink anything without throwing up, so it was obvious she needed to spend the day in bed. We cancelled our plans of going to Nyomongholo to check up on the cows (heard they are not being fed and watered enough) and Mtoni Secondary School. I collected yogurt from the kitchen and went to Sekou-Toure to meet Joke. We went to NIMR and we plated three different types of MARA milk to see if an E. coli contaminant was coming from one pack or if a whole batch may have been contaminated. We won’t be able to check the results until Monday, so it’s a bit of a precarious situation. We went for lunch at Kuiliana’s for pizza. The place was chock-full of other mzungus who I hadn’t seen before. After going back home to check on Steph, we decided to take her to the hospital for a blood test. The results indicated that she did indeed have malaria- this time three ring. Very sick! So, we went home to spend the night in. We received an email from Canada stating that we have to get the quality control of the yoghurt up to required standards, or they will not be paying for the yoghurt and the trial will have to end. Seriously, despite consequences to the mamas, the women enrolled in the study, the students involved etc. the trial could just end!!! We’re carrying on and working harder than ever to keep this study going!!!

On Saturday, Steph was feeling a lot better. Also, the sun has been shining all week. AMAZING, amidst the supposed rainy season!! Steph’s relaxing inside today because she’s feeling dizzy and weak still, so I’m going to work on some proposal editing, write some emails, get some fruit at the market, and do some photo-blogging :) Some days you just gotta take ‘er easy, or you’ll get worn-out and drained during the week. Hassan and I went to the big market and it was really bustling. On the way we saw goats running around the streets blocking cars from passing haha. There were some surprising sights at the market, like rows of suitcases on the ground, knives lying on tarps for sale (just out there in the open were anyone could grab them!!).

On Sunday, we were trying to go to Forever Angel’s Orphanage, but the contact number for Amy (owner/founder from the UK), and until we got in touch with the organization, we decided to postpone our visit to Tuesday. I can’t wait to see the kids! Amy and Ben have a really amazing organization set up where they take in orphaned and abandoned children, or children whose families are unable to support them. Many of the children have been dropped off at the gates of the orphanage and left there! Some children come in really bad shape, malnourished and diseased, literally on the verge of death. The orphanage accepts lots of volunteers and hires employees experienced in education, child development etc. They operate programs for feeding, schooling, arts/crafts etc. for all the children and I’m hoping to get the chance to help out for the next few months! Mama Asha’s daughter and son ended up coming by our apartment and we found some treasures in the dresser drawer labeled “stuff for children” haha (skipping-rope, coloring books, stickers, noise makers, and a puzzle etc.). Later, Salome also popped in for a bit. Then, Aisak, Mohammed, their friend who didn’t speak any English, and Puice came and we had some fun with silly photo-taking, dancing and music, fashion shows with our kangas, and eye-brow plucking because the boys were curious as to what tweezers were (we may have also done some makeovers with mascara and lip gloss…hahah). We have a busy week coming up so Kwa Heri!!! Usiku Mwema!!

-I started running in town this week every morning, trying to establish some routine. I find myself dodging people, bikes, cars, dala-dalas, and pike-pikes!!! It’s also difficult with my ipod in because I know lots of people are probably saying Mambo! When I run by, but I can’t hear them, so I hope they don’t think I’m being rude!! It’s also extremely hot here, even early in the morning.
-“Street children” are always coming up to our car when we are in the city center. They congregate where tourists come, near hotels and markets. It’s a major issue in most African capitals, towns, and urban centers. I’ve had several encounters while stopped at traffic lights or in a traffic jam where they try to wash the windshield of our car with a dirty rag and swarm the windows. They hold their hand to their mouths and moan how hungry they are. It’s sad to see them in their dusty, ragged clothing, sucking on little plastic bags full of ice water. I know they’re hungry-evidently suffering from malnutrition and ill-health. One of the boys even had a huge, jagged scar on his forehead, shoddily stitched together; Joke says he was hit by a car while trying to beg for money :S
-We’ve been warned about the dangerous, precarious nature of pike-pikes (motor-bikes) and dala-dalas (van buses), but we’ve bee taking our chances and using them because they’re so much cheaper than taxis.
-Mama Joyce called me “Mama Giraffe” this week hahah…She says it’s because I’m so much taller than her daughter who is about18 years old too. Stunted growth is really common here because malnourishment is wide-spread. Our friend Hassan is also19 (a few months older than me), and I was so skeptical that he was lying at first, to the point where he brought his birth certificate to prove that he was born in 1990 haha.
-Joke informed us that a thief who tried stealing from the local shop near her house was caught and burned to death!!! Just burned, right there, in the open, in front of a mass crowd of people. I’m not sure what he stole, wether it was as little as a piece of food or as much as thousands of Tsh. Either way, public forms of punishment here shock me to no end.
-They BURN garbage here. And they also burn bags and bags full of leaves and grass to make lumps of coal for fuel.
-When driving home from SAUT, Esther pointed out the place where dead bodies are burned into ashes. She asked us whether our families at home buried the dead or burnt them.
-I can’t stop thinking about Hassan’s little baby nephew who passed away this week. It just makes me feel ill. I get this pit in my stomach, this empty feeling in my chest. I wonder how many poor children die due to poor medical systems in the developing world. I wonder how many people suffer just so we in our rich countries can live the lifestyle we so wish.
-Seeing children taking care of children (seven year olds carrying one year olds) is another mind-boggling thing to me. Children here are going to school, cooking, cleaning, AND taking care of their younger siblings!! It’s as though they have the same responsibilities as “adults” at home do. It’s inspiring that they can do all these chores, yet still be cheerful, playful children!
-Sometimes I get the feeling that I’m intruding on other peoples’ lives here. I want to take as many photos as possible of all the sites here in Mwanza because they are so foreign to me. But then I think, this is just every-day life for these people. I don’t think I’d want pictures taken of me either. A couple people have taken pictures of me with their cell-phones, so at least you take a few, you give some back??

Wednesday, March 3, 2010

WEEK 5 IN MWANZA (The Medical Research Begins!)

A SUMMARY OF WEEK 5 HIGHLIGHTS (if you're too lazy to read the whole post):
-We have packaging and label design for it. Now, we have found a company to print the label onto the packages!!! Once that’s all done we can expand our selling market!
-Joke’s clinical trial has begun!! 150 HIV+ women, half taking probiotic yoghurt, half taking non-probiotic yoghurt, for 30 days, everyday, 125 mL servings. On the first and last day a simple blood test with a finger prick (to calculate viral load) and then vaginal samples with a pipette (to test for Bacterial Vaginosis, condition which makes women more susceptible to STIs, and the transmission of HIV from mother to child). We advertised by putting up posters and distributing pamphlets around Mabatini and at Sekou-Toure hospital. (Seeking women >18, HIV+, taking ARVs, no allergies to milk etc.)

On Monday we went to NIMR (National Institute of Medical Research, Mwanza) to get our lab space arranged for Joke’s trial which was set to start on Saturday. We finally got the chance to speak with Dr. Changalucha (Senior Scientist in NIMR). I stopped in the hall to look at the research posters, many of them describing works in rural areas of Tanzania, studies dealing with access to antiretroviral treatment. Most of them were carried out by the London School of Hygiene and Tropical Medicine (Jamie, a past intern, is actually doing her Masters there, and working as a nutritionist in Malawi at the moment).
Later that afternoon, we went to various stationary and printing companies in town (there are SO many little hole-in-the-wall shops that do printing and photocopying. We looked at a couple shops that carried sticker-type labels on sheets that we could stick into a printer and imprint the Fiti-brand label. We have the final label designed on the computer and put on USB, or “flash” as they call it here.

On Tuesday morning we returned to NIMR to talk with George, the lab-tech, after receiving the heads up from Dr. Changalucha to go ahead with the work we requested space for. We were shown some of the lab equipment and I felt as though we had gone back in time, the lab was not heavily equipped with supplies like in Canada. The autocalve machine (for sterilizing, through application of high heat and pressure) was ANCIENT (It looked to be from pre-historic times compared to the one I had used at Lawson Research Centre back in London). They had a fridge and two incubators (kept at 37°C) that we have access to use for storage of yoghurt samples and agar plates. Later that afternoon, the final company we tried turned out to give us the best deal as long as we printed in mass amounts! This company was originally going to print us water-proof labels (much better than the paper ones we were looking into), but then once we described the packaging, they informed us we could print the label directly on the plastic surface of the bags! Packaging has been a huge hurdle the mamas needed to overcome, so we were very pleased with the results of the day!! Joke dropped off the posters and pamphlets she had printed outlining her trial and we told her we would put them up in the yoghurt kitchen the next day to advertise for patients.

On Wednesday morning we walked to the kitchen to count the number of packages we had. The labeling company told us we could get a much cheaper price if we printed out 5,000 bags, for example. Turns out we have over 10,000 bags! Of course, when I went to pull the box out from under a pile of old file folders and papers, a couple mice scurried away (terrified me!!) and when we opened up the box it was infested by ants and what looked like cockroach (hey, I didn’t look to closely at it!). There were probably about 1,000 bags that were ruined, shredded and chewed through by mice (they’ve been sitting in an open box in a neglected corner of the kitchen for some time now, when they thought the sealer was broken…) We dumped the contents of the bag outside, and luckily there was a large lag, completely sealed that had untouched packs of plastic bags, each containing 100 packages, so it made it easy to count. Now we know we can get a cheap deal for the labeling, so we’re ecstatic!
Later that afternoon we went to the local market to re-stock on fruits and vegetables. One vendor we were purchasing cucumbers from proposed to me haha, and although I rejected his offer, he gave me an extra cucumber and a green pepper free of charge (only to be eaten by me, I was informed by Esther haha). Then, Joke picked us up to go try out an aerobics class at Family Fitness. It turned out to be a small, mirrored room, humid with the stench of sweat. We paid for a step class, which I am terrible at because it’s all about coordination and following the pattern of motions of the instructor, but he was going soo quickly and I always found myself unsynchronized with everyone else! Once we got home we bought “chips” (like an omelet with fried potatoes in it) from the street vendor.

On Thursday we stopped by the kitchen to collect samples of “probiotic” and “nonprobiotic” yoghurt to be tested. We arrived at NIMR with a big suitcase full of lab materials, including an endless supply of plates, a micropipette, agar and MRS broth powder, an anaerobic chamber and anaerobic packets that release carbon dioxide etc. Lots of nerdy things, really…It turned out to be a long day at the lab, as we had to make a large number of agar plates to last the entire length of the trial (For quality control three times a week). We ran into a few problems, like the weigh scale not working, but we worked around it by walking over to another part of the lab to do our measurements. After mixing the agar solution according to the recipe, we needed to keep it in the autoclave machine, and then cool it. The actual process of diluting the yoghurt samples and plating was really quick and then they were placed in an incubator in an anaerobic chamber.

On Friday, when I returned to NIMR to check on the plates, there was bacterial growth on both plates! Yikes! This isn’t what was supposed to happen. The non-probiotic sample should not have indicated any presence of GR-1, if it was in fact probiotic. We decided that there was evidently a slip-up in the procedure, so we decided that on Saturday the women would have their tests, but not be given yoghurt, until a new batch was made that would could test just to be sure to not have faulty data. We will have to delay and start distribution on Tuesday now, just to be safe!

On Saturday we went to Sekou-Toure Hospital early in the morning to help out Joke. We had cake and sodas for the patients enduring the long waits, because there was only one nurse and one doctor to perform the tests. There was also another woman who was helping the women fill in applications and sign consent forms. The patients received 3000 Tsh for that day (the tests are a little invasive, so we figured they need some incentive to come in), and they will generally receive 2000 Tsh for each time they come to pick up yoghurt, to cover traveling costs. In the end, there were 35 women who showed up for the initial tests. A few men also showed up, even though it clearly specified “women” on the posters, and unfortunately they had to be turned away. They all brought little cards with their medical histories, and I noticed they also displayed CD4 counts. More women are set to come on Monday for more tests, and some women who had initially signed up did not show up today so hopefully they will come in on Monday. The study is called a “30-day trial”, but it is expected to last a few months because not all patients start consuming yoghurt at the scheduled start date, and there will be more and more women joining in the future.

On Sunday we headed to the kitchen to oversee the entire process of making yoghurt and ensuring that the “non-probiotic” yoghurt truly is non-probiotic this time. We think that last time it was contaminated wither by using the same spoon to stir both containers, or by inoculating the new milk with a spoonful of probiotic yoghurt as a “starter culture”. After boiling the milk and stirring constantly, it was separated into to separate containers and placed in a cold-water bath. After cooling, the probiotic milk was added to one container, and Mara Milk (local yoghurt that we purchased at the convenience store) was added and then it was sealed and placed in a warm water bath to be incubated.
After this was finished at midday, we went home and headed straight to Talapia for Major’s (Joke’s boyfriend’s) birthday celebrations on the boat! For lunch, there was a whole goat roasting on a spit over hot coals, potato salad and a salad with a tomato and red onion base, EVERYTHING eaten with our hands. Joke also made some amazing breads in her bread-maker and banana muffins! Some of the guys had a couple fishing rods out, trying to catch some fish, but the attempts were unsuccessful haha. We ended up getting stuck in the eye of a storm, and the waves started getting choppier and the rain poured down in sheets, while we tried covering up with a gigantic orange tarp. Just as we started rolling back the tarp, thinking the rains had stopped, a new bout of showers would fall from the sky haha. It was a really fun outting, even if we were freezing, our lips were purpled and teeth chattering, in our clothes soggy and sticking to our skins.

-I had to buy some shampoo/conditioner, and I noticed some at Zagaluu, the convenience store across the street from us. The packaging looked to be Dove, but once you looked closer at the translations it says things like “for sexy, slippery hair need lots of drinking water”…"For god filled hair colr"..."water water is smooth smooth, soft and soft, and bright bright". Interesting translation hahah.
-We noticed a man at NIMR and also man in Mlango Moja (the area we live in) walking on his hands (with flip flops on) and dragging his feet; it looked like a strenuous effort to lug his crippled body down the street, and I thought in Canada this man would without a doubt be in a wheel-chair.
-We’ve started cooking our own ugali (using maize and cassava flour), a staple in Tanzanian meals. It’s rolled up into a ball with the hands and dipped into a sauce with okra, tomato, and onions. It’s delicious!!
-Whenever we wear our African-print Kangas, everyone compliments us “ume pendeza!!”…and they say we look like “African women” haha. Esther never wears Kangas and wears more modern, city clothes. She says that only “Mamas” wear the Kangas and Kitanges (similar to sarongs).

Sunday, February 21, 2010

Highlights of Weeks 3 and 4 in Mwanza (A month has passed, like no time at all)

On Monday, we had our weekly meeting with the mamas at 4 PM, so we went to the kitchen in the late morning. On our way, we found buns and once we got to the kitchen we ate some left over chapati that the mamas had made. Too much deep-fried food available in Mwanza! (The concept of gaining weight in Africa...) At the meeting, we discussed the packaging from BestPack Ltd. After reviewing the samples and the prices, we decided that it was too expensive and would force the mamas to increase the price of the yoghurt by at least 25%. The meeting ran late, so we didn’t have time to make it to Yoga, but we bought some mangoes and bananas and walked home instead. Hassain came over for his nightly routine of exchanging English lessons for Swahili lessons.

On Tuesday, we made an effort to rise early so we could catch the mamas making chapattis and mandazi (buns) at the kitchen at Mtoni Secondary School. The kids all swarmed us when we got near the kitchen with our cameras and everyone kept reaching for my camera and asking me to take pictures of them with me. When we had finally woven through the masses and got inside the kitchen, kids would curiously peek through the windows at us. Steph and I noted there were two different uniform colour schemes (burgundy and beige, and turquoise and white), and as it turns out Mabatini Primary School is directly beside Mtoni Secondary School and they share the grounds for sports etc. We had our first Swahili language lessons with Gaudence at 1 til 3 PM. Gaudence is a professor from the International School, helping us learn Swahili (we’re going to be having lessons about two or three times a week from here on out). It’s helpful because although we’re learning a lot from Esther and other people who speak English, Gaudence is good at explaining the grammar and sentence structure and answering our questions of “BUT WHY?” (because Swahili is entirely different from English in every way possible, unlike say French or Spanish). He's really experienced and has done a lot of translating for missionary groups and priests.

On Wednesday, we went to NIMR (National Institute of Medical Research) with Esther and Mama Joyce. Mama Joyce was collecting the probiotic culture, which she does weekly. The probiotics are cultured at NIMR and mixed into milk and transported back to the kitchen to be mixed into a greater quantity of milk (Some incubation time Et Voila, Yoghurt!). We met with some of the lab staff, but unfortunately the director, Dr. Changalucha, has been out of the office sick for a while. So, we’re still looking into contacting him to secure a lab space for our research.

On Thursday, we visited the site at Nyamhongolo, where the mamas are keeping their cows! There was a large, fenced-in plot of land, with some rice growing in one corner, the shed for storing cows in the other (four cows and two calves). The man in charge of feeding the cows has a tiny living quarters at the site, as well. We found out that the mamas used to have 5 cows, but one sadly was put down last month (however they did get to sell the meat for 200, 000 Tsh, which is beneficial). The two calves were so cute and tiny and we got close enough to pet them! We rode the dala-dala (a van converted into a bus) there and back, and we were crammed into it, not even sitting in seats, but either sitting on the floor or standing up. We found out that Joke got the last signature she needed to receive official ethics approval for her clinical trial (Congratulations to Joke, as she’s been waiting patiently a long time for this!) She came by the apartment to discuss the details of the lab work, and then we drove to Tunza for Yoga. We were the only three people there, and it was so peaceful and relaxing to unwind some of the week’s stresses. We got some amazing views of the sun setting over the lake, and saw some kids bathing and swimming, and it was so tempting to go in for a swim (but it’s polluted with raw sewage…and apparently you can get worms infections if you go in...)!

On Friday, we visited Mtoni Secondary School to meet with the teachers and students. We had arranged a meeting with Albert, the assistant head master (the head master is presently busy invigilating exams). He informed us that there are only 20 teachers for about 900 to 1000 students. Often up to 300 students are absent on any given day, as attendance is not regulated as it is in Canada (it's hard when kids are out sick more, and girls often have to stay home when on their periods etc.). Mtoni was set up as a governmental school in 2007, so it is still a very new community school. We presented Mtoni with the funds raised by Clarke Road Secondary School in London, Ontario (sister schools, with students writing emails/letters as pen pals throughout the year) and we are waiting to hear back about what the money will be spent on (hopefully something to benefit the entire school community). Albert told us that there are eight periods in a day, 45 minutes each, and there are sports teams for football (soccer) and netball. He was very interested in comparisons we were making between Canadian schools and what we had seen at Mtoni. The school was definitely lacking in space for expansion, books and stationary supplies, and teaching staff. We were introduced to all the students, and we spoke about where were coming from and what we were doing during our time in Mwanza. It was nice to be introduced to everyone, and we felt really honored to be able to make a speech. We also got the chance to meet with the staff and personally introduce ourselves. After this, we were shown around the grounds. That afternoon, we went to meet with Maimuna at Kivulini Women’s Rights Organization. We got to travel on pike-pikes (motorcycles)! This ended up being super fun, but I was nervous because it’s extremely dangerous on the roads and drivers are not exactly cautious here. Also we had no helmets! (the driver took off his helmid midway there…maybe it was too hot…). Kivulini is just into Isamilo, so it wasn’t a long ride, and once there we spoke to Maimuna about having the mamas train other women’s groups in the area. She informed us of four that she knows of in the rural areas surrounding Mwanza.

On Saturday, we had planned a Valentine’s Day Party and invited lots of the friends we had made since our arrival in Mwanza. We went to the market early in the morning to pick up all the food for the mamas to cook dinner with. After that, we went to town to pick up the heart-shaped cake we’d been eyeing for the past week, and to buy some wine and sodas. We spent the whole day preparing, cleaning, and decorating. We also had a home-made chocolate cake! Our house was full of people helping out with the cooking, and everyone seemed to really appreciate the food. It turned out really well, despite a little power-outage that we solved by lighting candles stuck in empty wine bottles (TIA).

On Sunday, we were woken up at 8 am by Salome who had come to take us to her church service! We walked for about an hour in the beating hot morning sun, and arrived on time for the 9 am service. The church didn’t exactly look like a church as you might imagine it, from the outside nor the inside. When we walked in, there was a woman singing into a microphone, beside large loud speakers at the front. We filed through the rows of chairs set up, and sat down the front row. Yes, front and centre, not drawing any attention to ourselves…Steph and I each got our own translators to sit beside us and they would whisper in our ear after every sentence spoken in the sermon. It was a little hard to hear because of the booming loud speakers, but the woman was very good at speaking English and I was appreciative that she was there. There was a lot of soulful gospel music being sung, and plenty of dancing too! Near the end of the service, the pastor called us up to be greeted and to introduce ourselves to the people in attendance. After the service, Salome kindly invited us to her home for lunch. Salome exclaimed "they all loved you!" haha. It was a far trek up the rocky hill that she lives upon, and when we finally got to her house I was shocked to see how tiny it was. It literally consisted for three rooms: a bedroom with a mattress on the floor and piles of papers, pictures, and some clothing in the corner, a kitchen area with a coal burner for cooking and some dishes and piles of food like veggies and eggs, and a living room with two wooden couch frames, with no cushions! She cooked us some ugali (common, staple food here made from maize, not very flavorful, an alternative to rice), which we then balled up in our hands and dipped into a tomato sauce with vegetables. When we finally walked home, I was feeling a little sick, and I started getting paranoid that my flu-like symptoms might mean I had malaria (But, luckily a couple days later I feel back to normal, so I think I was just a little run-down). We went to Talapia later that night to do some work, but we were dragged to the casino at New Mwanza Hotel (probably the smallest casino ever haha).and we were convinced to play some Roulette…”Come on, it’s Valentine’s day, you don’t need to sleep!” haha. I think we won twice, thankfully it’s just a game of chance, not strategy because we honestly had no idea how to play!

That next Monday we rose early to arrive at the kitchen at Mtoni secondary school by 8 am. We basically helped with kneading dough, rolling chapatti and then frying them. We went back home for our Swahili lesson, and then to Jiko la Jamie yoghurt kitchen for our weekly Monday meeting. However, we were informed that the mamas were attending a funeral that afternoon, so the meeting was postponed. We ended up sticking around the kitchen and playing with the local schoolchildren and street-kids (probably my favorite part of my days).

On Tuesday we went to the kitchen and found packages that had been sent from the project in Oyugis, Kenya. The mamas have packaging AND the sealing machine to go along with it. So, we tested a few packs, and as it turns out, 250 ml fits perfectly into the bag, with enough space left to seal it closed. We started designing a label on the computer, with the FITI brand, and a design of a cow, as well as the nutritional information. We found a few sheets of large sticker-style labels in the filing cabinet at home, and worked with the information from these. Now we just have to look into the pricing of getting the labels printed, to make sure the plastic bag packaging is still cost-effective once the labels com e into the equation. We also researched into other packagers in the area, in Arusha, Mwanza and Nairobi.

On Wednesday evening we were doing some work at Talapia on the internet, and decided to take some time off later in the night and ate at the Japanese Restaurant with Tim (British mate). We also met some other Mwanza folk, including some women employed as teachers here, not teaching English as we originally assumed, but teaching math and sciences. It was really cool with the grill right in front of us and lots of fresh seafood. On Thursday evening we were invited to go on Joke and Major’s boat on a ride from Talapia to Tunza (there was a bonfire beach party planned for Tunza). We got to watch the most amazing sun-set over the calm, calm waters of Lake Victoria. The views were amazing!

On Friday, we went to Mwanza City Council to speak with the representative for TASAF (Tanzanian Social Action Fund) and also the representative for HIV/AIDS counseling on council. We are inquiring about funding needed for the project to continue to support the 125 PLWAs (People living with HIV/AIDS) with yoghurt daily. The funding has ended as of January of this year. The visit to TASAF was promising and he gave us a very encouraging response. However, when meeting with the HIV/AIDS coordinator, I was a little discouraged because he seemed a little critical of our packaging advancements, by saying that the bags we were looking into may not be good enough quality to receive health safety standards approval (ie. He wondered about contamination during the packaging process, which we hadn’t really thought much about).

On Saturday, we attended the wedding service of Mama Joyce’s daughter. Unfortunately it was a rainy day, but Joke, Esther, Stephanie, and I were invited into their home in Mabatini. We were offered some amazing food, rice, potatoes, beans, a mix of cassava leaves and ground peanuts, and soup that the mamas had cooked up! Mama Joyce introduced us to some of her other children and relatives and we had some fun fooling around with the camera for a while. Her daughter was marrying a Muslim man, and although she is Christian, she is now officially Muslim by law. Apparently her friends and family had deterred her from this, but she persisted. The bride looked very beautiful in her dress and had henna painted all down her arms and hands. After seeing the couple off in a car, we watched a group of “street-kids” breaking it down on the “dancefloor” surrounding the dj’s blaring sound-system. Saturday night was our last night with some friends we had made from Zurich (they were now finished their volunteering and were heading on a Safari and then to Zanzibar for a week)! It was sad to see them go, but we had a great last night at Tunza, with a little trip out on Joke and Major's boat again. It was so cool to be on the pitch-black water with nothing but the tiny lights from the fishing boats to light up the skies.

On Sunday, we had been invited to our friend Lillian’s house for lunch. Lillian works at the Kivulini dress and souvenir shop below our apartment. She’s twenty-one years old, is well educated and works as a seamstress. She has a two-year-old son. Lillian is so sweet and always has a smile on her face. She came by dala-dala to pick us up, then showed us how the dala-dala system worked, and brought us home! She made an amazing meal and was so welcoming. Her home was drastically different from Salome’s home last Sunday, as she had lots of furniture, a fan, a television etc. Her house was also in a nice area, in the country-side, a nice contrast from the loud, dirty city. It was so peaceful there, with a beautiful, lush landscape. She was very generous and gave us some eggs, fresh from the chickens in her yard, and also some of the large, green bananas that are used in savory dishes here! The TV programming that was on while we ate was a hilariously cheesy Asian soap opera.

Just some general points that don’t really fit anywhere particular:
-So, it’s come to my attention that I failed to note that our bathroom consists of a “squat” toilet and requires a bucket of water to be flushed and the shower is presently cold water. That’s pretty much the extent of “roughin’ it” in our apartment. (Our water heater broke and we are far too lazy and broke to go out and get a new one.)
-On one of our trips to Tunza, we saw a funeral party marching across the street as we were stuck in a traffic jam. Apparently it’s Muslim tradition to be buried immediately, the same day of death, and it’s mandatory that the whole village must attend the burial. Well, all men that is, but women are not permitted at the service.
-Many men from the Masaai tribe run Tunza and Steph is always scared when we walk by them because they look so intimidating haha
-I’m not sure which visit to Mtoni this occurred at, but we witnessed a teacher “punishing” a group of boys by making them do planks and then he started whipping them with a wooden stick. A little ruthless to be “spanked”. I mean I’m sure it happens in some people’s households in Canada, but it’s looked down upon, whereas here it happens in public.
-We’ve been trying to wake up earlier to go to Mtoni to help the mamas with making chapattis and buns in the mornings. They are there every day (shifts here and at the yoghurt kitchen) from about 8 am until 12 pm and it’s tiring work!
-There are basically no garbage cans…there’s garbage “piles” on sidewalks and street-sides, but most people will litter the streets with trash. Also, I was wondering where all the excess produce from the markets goes, when we walked by a huge mount of rotting bananas (fermenting bananas don’t smell so sweet…). And that leads me to recycling- well the glass bottles from sodas are all recycled and reused. Big trucks collect crates of empty bottles from the shops, so when you’re done drinking a soda, you have to return it, or else they’ll keep pestering you about when you’re bringing it back.
-The majority of local shops around our house are either convenience/general stores, or shoe stores. Oddly enough, there are tones and tones of used shoes piled up in little “hole in the wall” shops along our street. Bags of used shoes arrive from Europe and Canada and the US and come here to be “revamped” (a little washing, super-gluing beat-up soles, and shining leather goes a long way) and then resold. What I’m wondering is if these are shoes that people are sending for “charity” to help children in Africa with no shoes? The reason I ask is because in some used clothing stores here, I’ve noticed some ValuVillage tags, which struck me as odd.
-We saw an albino man at the dala-dala station. At first I thought he was a white man, but I later realized he had a pigment disorder, and his hair was very white and his eyes very light blue. It's strange because earlier in the trip, a child ran from us screaming that we were albino, and another child told him no, no just Mzungus, so I think people are really terrified of albinos here.

Wednesday, February 17, 2010


Moringa project
• Visited Adilisha (company that grows and produces moringa products outside Mwanza)
• Purchased moringa powder and seeds
• Obtained suggested dosage information and health claims from the company; currently seeking
literature and other nutrient information from the company
• Researched nutrient content of Moringa oleifera
• Found fresh moringa grown in Mabatini, harvested some, dried it and ground it
• Combined different amounts of our homemade moringa powder with Fiti yoghurt
• Planning with the Mamas to plant moringa at the Nyamhongolo site
• Completing ethics approval form to send to UWO to cover the whole project
• Arranged a meeting with Dr. Changalucha (NIMR) for this Friday to discuss lab space for testing
viability of GR-1/quality control, etc
• Next steps: mix fresh moringa with the yoghurt, test viability of the GR-1 strain in the fortified
yoghurt with different amounts of moringa added, perform sensory evaluations

Porridge project
• Goal: develop a porridge by fermenting millet, cassava flour, maize
• Located and purchased maize/corn flour, millet, sorghum, and cassava
• Discussed with various locals their methods of making porridge and ugali using different grains
• Next steps: try different fermenting methods, try drying methods for cassava

Joke’s clinical trial

• Having regular meetings with Joke to discuss logistics
• Reviewed task list and roles with Joke
• Olivia’s role: quality control of the supplemented and non- supplemented yoghurt three times per
week throughout the trial
• Steph’s role: assisting with distribution of the yoghurt, follow-up if patients do not show up for
yoghurt intake, checking that all patients receive yoghurt collecting samples and supplies if
• Beginning recruitment on Feb. 23rd (ie flyers and posters around Mabatini and Mlango Moja areas,

Sensory testing of yoghurt with thickening agents

• purchased gelatin, tapioca flour, potato flour, white rice flour, soy flour, and potato starch in
Canada, and Sensory Testing Methods by Edgar et al
• working on producing homemade sweet potato flour/obtaining information from Roy
• discussed with Ellena her plans for testing with sweet potato flour- she has not begun and may not
be able to
• reviewed Ashley Motrans documents from the sensory testing done with gelatin and MSNF in summer

Tukwamuane Women's Group

• Meetings every Monday with interns, Mamas and Esther
• New leadership positions were filled by election at the first meeting. Mama Joyce is the new
Chairperson, etc. The position of Discipline Chairperson has been introduced
• Visited the Nyamhongolo site, discussed expansion plans, etc
• Noted a need for quality control of the yoghurt. It is consistently lumpy. Community members have
vocalized that they prefer it this way, and we have even heard people ask specifically for lumpy
yoghurt. We think a sensory evaluation could be useful to test the acceptability and preferences
of different consistencies
• Developed tracking sheets for Mamas salaries and hired help salaries, milk collection, sales, etc
as well as a task completion list for each week for the Mamas
• Looked into purchasing an umbrella, table and chairs for yoghurt sales outside the kitchen like
other vendors in town. Received a reduced price offer of 24, 000 Tsh for an umbrella and 9, 000
Tsh per chair. Mamas like this idea.
• Need to hire 3 more Mamas

Yoghurt Packaging

• Investigated Best Pack Ltd thoroughly. They seemed to be an excellent option as the transportation
of the packaging to the kitchen from Arusha would be very inexpensive. The Mamas have decided
however that the packages are too expensive.
• Currently investigating Tetra Pak (Nairobi), Bright Oyat Manufacturer (Mwanza), Dennis Shio
Packaging (Arusha), and Event Solutions (Nairobi)
• Spoke with Roy about the bags and straws used in Oyugis. He is looking into transport options to
Mwanza from Nairobi (where they are manufactured)
• Discovered a huge box of the Oyugis bags at the yoghurt kitchen, as well as a sealer. This was a
shock; no one seemed to know about this
• The sealer works, and the bags hold exactly 250 ml of liquid with enough room to seal properly
• We hope to use this as a temporary option for selling yoghurt in the market until we can either
find a different option or begin ordering more bags from Kenya.

Yoghurt Selling ideas
• Discussed with the Mamas the idea of “junior mamas” and allowing students, volunteers and/or
children of the Mamas to take yoghurt to sell in the market
• Working to develop more ideas to increase sales. There is already a long list of possibilities,
for example the manager at Tunza is interested in having it on their menu. These will all be more
feasible once packaging is established.

Funding $

• Working on the SCF grant that will be submitted ASAP. A budget and expansion plan needs to be
• Mwanza City Council- planning a meeting with Mukama

NIMR (National Institute of Medical Research)

• Spoke with lab staff to arrange lab space to do quality control of yoghurt
• Waiting to meet with Dr. Changalucha to run this by him

SAUT (St. Augustine University)
meeting with Mary Mushi
• Discussed integrating health benefits into course credit for a science or social science course.
Mary agreed to contact the Vice Chancellor to see if there has been any progress with this
• Vice Chancellor needs to be contacted for main campus (social science)- he is out of office
presently. Professor Mongolie is our contact for Bugando campus (medical sciences).
• Discussed interns from SAUT to be matched up with us
• This will have to wait until after exams
• Discussed the WHE account. Account is dormant, accountant is on study leave. A new account may
need to be opened for Esther, pending confirmation
• Discussed having SAUT students help to teach English and Computer skills at Buswelu primary and
Mtoni high school.

Mtoni Secondary School

• Discussed options for the funds from Clark Road, waiting for a decision from the faculty.
• Met with the assistant headmaster, toured the school, compared Mtoni education systems to systems
used in Canada (ie truancy, student government, etc) greeted the student body, discussed making
videos to bring back to Clark Road, etc

Other women’s groups to produce yoghurt

• Discussed possibilities with Maimuna. She mentioned 4 groups that she knows of in rural areas.
• A women’s group called Shedefa is interested in being trained by the TWG Mamas. They are all HIV
positive, they have their own cows and milk supply, a house and resources for cooling, etc.
• Providing assistance to TWG to prepare a budget and/or list of items that Shedefa will need for
• Two TWG Mamas will train Shedefa


• Shot a video of Mama Paskwalina discussing the benefits of the project in the community, with
Esther translating.
• Star TV looked for the clips from the November steering committee meeting but didn’t find them.
• Identified a need for awareness within the Mwanza community about the benefits of
probiotics/spread of HIV/use of the yoghurt for the general population/importance of ARVs despite
benefits of probiotics, etc


• Looked into internet options for the intern apartment
• Tilapia is far and costs 2, 000 Tsh per hour plus transport there (usually 2, 000 Tsh)
• Internet cafĂ© near apartment closes sporadically for days at a time, and otherwise closes at 7 PM
(end of our work day)
• We are taking Kiswahili lessons from Gaudance for an hour three times per week

Tuesday, February 9, 2010

"It's The African Way" (What more can I say?)

It’s been a little over a week since my last blog post, so I know this is a little overdue (I wrote this on Sunday, but the internet was being wonky). The time has passed me by so quickly; it’s unbelievable that it’s been two weeks already since I began globe-trotting!

Last Sunday (and again today), we experienced the “Sunday Market” scene. It was absolutely packed to the gills with vendors selling fresh produce! The first time we were lucky to have Pendo (our house-keeper) with us to negotiate pricing and show us not to make hasty purchases the first time you see the fruit/veggie you want. There’s multiple multiples of the same stalls all over, but some bear nicer looking products than others, or at cheaper prices that you can bargain down. Everyone wants you to buy their product, and some will go to great lengths to persuade you to buy from them (i.e. chasing us around with cauliflower, which we are not interested in buying, and following and pestering us, peeling away the leaves from the flowerhead, trying to make it look more enticing…). There’s little boys carrying mass collections of plastic bags (so environmentally unfriendly, I know…), and they will follow you around trying to get you to buy one to put your purchases into. An Indian woman happened to wander by when they were harassing Steph and I and warned us to “be careful around those boys” (I guess there’s lots of attempts to snatch your bag or purse, but I don’t think these little boys mean any harm). Luckily, we’ve built up our own little collection of bags and baskets that we continue to reuse. There are also coops of live chickens for sale! Talk about fresh meat…The man took a couple out and was waving them around by their talons for us while we snapped a few pictures. We picked up carrots, peppers, cucumber, tomatoes, potato, bananas, mangos, passionfruit, pineapple, onions, garlic, rice, and beans, all for under 15 bucks… so much cheaper than the grocery stores here!

On Monday, we were scheduled to meet with the Yogurt Mamas! When we walked over to the kitchen in Mabatini, only a few mamas were there and we were informed that the others were at Mtoni Secondary School (just up the road) serving tea, chapati, and buns. On our walk up to the school, all the kids swarmed us and we definitely sparked some curiosity. Next week we’re going to go back and watch the mamas prepare and dole out the chapattis (fried in unreal amounts of oil) with gallons of tea (super sweetened)! We walked back to the kitchen and had our “formal” weekly meeting with the mamas, sitting on the floor in a circle… like I said, formal. Sometimes Esther and the mamas would rattle on in Swahili for what seemingly forever, but Esther was great at translating at several intervals inbetween for Steph and I. Mama Joyce let us know where we could purchase the Moringa (at Adalisha, a medicine packager) for our lab testing, which was great progress on the research front of our project. Later that evening we went to Tunza with Joke and did yoga on the beach-front there. It was the perfect setting, with the sun sinking lower and lower in the sky, the rolling waves, and the soft music in the background. Yoga is every Monday and Thursday, so we’re going to try go out once a week! Later that night, Pendo’s son, Hassan, and Melissa’s friend, Mohammed, both dropped by and we did some Swahili lessons. We’re learning polepole! (slowly!!). We ended up talking out on the porch with Pius and Ben for a while, and by the time my head hit the pillow, I was more than ready to hit the dream highway and get some shut-eye.

On Tuesday morning, I awoke to knocking on our front door. “Mr. Tito” dropped by and displayed his batiks, cards, bookmarks, key-chains, and jewelry all over our living room floor. We chose some souvenirs and gifts to take home (a little soon to be thinking about that, I realize). Later that morning, Mama Joyce arrived with Moringa leaves and we left them to dry on our counter-top; in a few days we can grind them into a powder with our blender. We took a trip to Adalisha with Esther and Mama Joyce to see their pre-packaged Moringa products and also to get the contact information for their packager. We took down the packaging information, so that we can look into using it for the yogurt. If we get a good, cheap, sustainable source of packaging and labeling, the yogurt can be sold to grocery stores (and overcome a big obstacle in the expansion of distribution).

On Wednesday, we took a trip to SAUT (St. Augustine University). Esther pronounces it Sauti, because all nouns in Kiswahili end in vowel sounds haha. The drive there was extended by Pius’ so-called “short cut”, which ended up taking us through seemingly the middle of nowhere, down lots of winding dirt roads. We got some nice views of the country-side though- a nice change from the city scene. At one point, we were stopped at a local “prison” area, while Puice asked for directions. We realized that everyone we had passed by on the way who were working in the fields were prisoners! They seemed to have a lot of freedom, so Steph and I wondered why they didn’t just run away and Esther said they’re watched over by guards as they work. We got to SAUT and the first thing we see: MONKEYS!! There were a bunch lounging on the rocks! We met with Mary Mushi and reiterated some of the things Bob (our project director) and her had discussed during his visit back in November, about matching WHE interns with SAUT students in their relating programs.

On Thursday, we went to the kitchen for a bit to meet with the Mamas. Steph went to the hairdresser near by and got rows of braids put in her hair (only costs a dollar here!). While we were sitting inside, all the kids started flocking over and swarming the door. The lady who owned the shop would try to shoo them away, so I moved outside to play with the gang of almost forty children that had evolved! We made a jump-rope out of string and the kids all seemed pretty impressed with my skipping abilities haha. We all ended up counting in English and Swahili. The kids got really into it and were dancing and shouting out the numbers haha. One game that later got underway seemed similar to “duck, duck, goose”, and we all sat in a circle and held hands, while one person wandered around the outside. Esther told us after that the song they sang while playing it essentially translates to “searching for a wife”, and they try to “find her” by cutting the clasp of two people holding hands. Esther also said some kids were complaining because they always seemed to favor Steph or I haha. After a while, the kids seemed to adopt some sort of “mob mentality”, and they would get angry at one another and start bopping eachother on the heads. Sometimes a woman would come over and break the squabbles up, waving her arms and threatening to slap them with a shoe or sandal she had picked up. We also comforted a girl named Rose who some boys seemed to be teasing. When she was sitting on my lap, Esther explained that Rose has no home and lives on the streets and the boys tease her that her mother is a prostitute. We bought her a couple of buns to eat, but I still felt guilty leaving her alone when we went home, even though I know she is apparently being sponsored.

On Friday, we were invited to Joke’s 27th birthday celebrations in the evening! We met at Joke and Major’s place and were introduced to some folk from Mwanza. We ate home-made chocolate cake and some goodies Joke had brought back from Dar (you would rarely come across cake in Mwanza, so we all gorged ourselves)! Then, in reverse, we ate dinner after dessert, and were stuffed silly with amazing Indian cuisine… grilled Talapia, cinnamon-spiced rice, coleslaw, and brown bread with goat’s cheese.
On Saturday, we were invited to Tunza Lodge for “Ladies Night” that evening. We had met Nadia (social events coordinator at Tunza, originally from Denmark) the night before. Girls got in free, but of course we ended up paying for Puice and Hassain…Anyways, it was a fun night and we recognized a lot of the people there from Friday night and also some friends of past interns. Mwanza is so small that everyone is friends here and basically everyone finds themselves out at the same places…

On Sunday, we had a sunny day, finally, after those couple cooler, rainy, dare I say miserable ones... Steph and I ventured out to the Sunday Market, as we’d been without fruit for a couple days. We restocked on most of the things we had purchased the previous Sunday. Then we spend the rest of the day lounging at Talapia on the internet to catch up on emails. Of course what started out a beautiful sunny day ended in pouring rain and thunder/lightning!

This is Africa (TIA): Just a few random observations to add that I forgot to mention
-On our way to the market, a young guy was calling me and motioning me over to talk, but we were on a mission so I kept walking. Then, he ran over to me and declared, “I miss you, I love you”. Then he proceeded to grab my hand and motioned to his cheek, “Touch me”. I kissed my palm and touched his cheek and he was beaming. A big group of guys near by were cheering him on haha.
-“Exotic fruits” that would be terribly expensive at home are super duper cheap here (like passionfruit and mango and avocado), but things that would be commonplace in grocery stores back home are harder to find here or else much more expensive!
-Bugs keep managing to crawl into our bread, so we’ve been storing it in the fridge. And ants have now invaded our sugar container!!!
-Nouns in Kiswahili always end in vowel sounds, so they add “eee” sound onto the end of names ending in consonants. We've started calling our taxi driver Puiceeeee! haha
-The “rainy season” is upon us now! But that in no way translates into “raining all the time”. Some days we will wake up to pouring rain, and by the afternoon, the sun is out and shining. Other days, it’s just cloudy and cool all day. Other days, it’s hot and sunny. It’s unpredictable, really.
-The market scene carries on late into the night. The vendors don’t just “pack it in” for the night when the sun goes down. Instead, they light oil lamps sell fruits and veggies by candle-light. It’s a little harder that way to tell the condition of the fruit, so Esther uses her cell-phone light to make sure the mangoes aren’t bruised haha
-The chapati and buns are basically deep fried dough (flour, water, sugar) and we've been eating heaps of them because they're the equivalent of 10 cents each. The whole irony of doing nutritional aid for malnourished people, yet we are eating foods that have zero nutrients...
-Printing pages from a computer is a big ordeal, and we have to go to a local print/photocopying shop and pay to get it done.
-There are "soda machines" (fridges full of coca cola products) in literally every store, whether it be clothing, stationary, etc.
-There's huge sea birds (really ugly, scruffy looking things) that swarm fish and piles of rubbish. From far away they look like beautiful great blue herons, but don't be fooled...

Saturday, January 30, 2010

WEEK 1 (January 24th-January 30th)

(Hi! How are things?)

This is the first time I've accessed internet since last Sunday! (I must have set some new personal record...) So, it was an extraordinarily long, tiresome journey, extended by countless hours resting in airport lounges after long, sleepless nights in the sky. To put things into perspective, we departed Sunday night and arrived Tuesday morning! After traveling on three flights, from Toronto to London; London to Dar-es-Salaam; and Dar to Mwanza, I can FINALLY exclaim, "we are here"!

We arrived at the Mwanza airport Tuesday morning and were warmly greeted by Mama Joyce and Esther in their Western T-shirts and signs proclaiming "OLIVIA and STEPHANIE" (we were worried we wouldn't be able to find them in the hustle and bustle of the airport, but they were unmistakable!). It's been a few days now and we've gotten settled into the apartment and spent a lot of time resting in attempt to adjust to the new time-zone. I think it's going to take me a while longer to recover from my jet-lag; I've found myself falling asleep at 6:30 pm and waking up at 5:30 am the first couple nights! But, I'm not complaining because I've gotten to see the breath-taking sun-rises above the rooftops just outside my window! (and ohh the most radiant, flushed of skylines…)

For the first couple of days we were taking taxis everywhere, with our trusty driver Puis, who works for Kivulini. He's been a great help for us to get around and about in our new, unfamiliar surroundings. But, today and yesterday we have mainly been walking, and I'm starting to get a feel for the whereabouts of places around Mwanza (It may be the second largest city in Tanzania, but it seems pretty small by my standards. I like to think by the end of the month I’ll have a pretty strong sense of the city and its faces). I've noticed that the city truely never sleeps and the streets are always brimming with people. Steph and I were sitting on our balcony doing some reading this morning, while secretly I was just people-watcing. (Oh the crazy things on the streets that are so ordinary here, but so unusual to me! A truck with a big set of booming speakers and a DJ drove by at 10 am; Women carrying everything and anything on-top of their heads; Children running off to class for the day in big bunches, all dressed up in the same uniforms…)

-We visited the yogurt kitchen in Mabatini for the first time yesterday and were introduced to the yogurt mamas (or at least 9 of 10 of them, because one is sick right now and out of the kitchen)! They seemed receptive and enthused about our research plans to work with Moringa. They know it is being used now to help the immune systems of people with HIV/AIDS (they call it a “medicine” here). We got to taste the yogurt the mamas had produced: It was a little sour and a little lumpy in texture, but cold and delicious on a hot day.
-A vote was held and new positions were assigned!
-Plans were discussed to increase distribution by selling at the local market

-We also had the opportunity to buy some fresh produce at the daily market! Esther let us in on the bartering-ways of the markers and we set off to pick up loads of fruits and veggies (Amazing fresh pineapple and mango, dripping with sweet juices…drooling just thinking about it!) We also got the chance to go grocery shopping, but will likely be avoiding these places in the future, as “Americanized” foods are far more expensive here than at home! (I paid about 9 bucks just for cereal!)
-Yesterday we had an amazing woman from Kivulini cook us a Tanzanian-style meal of rice and talapia fish fried up, served with a tomato and vegetable sauce!
-I’ve noticed a big Indian influence on cuisine here. There’s lots of Indian food offered at Talapia.
-We’ve been boiling all of our water from the tap, then using purification drops, and THEN running it through a filter! So, it should be good enough to drink now!
-There’s an unreal amount of soda! And an overwhelming number of Coca-cola, Sprite, Fanta advertisements everywhere (entire sides of buildings painted with the COKE sign for example)! Also- there’s pineapple and passion-fruit Fanta here- sooo tasty!!

-Knowing your greetings in Swahili goes a long way! "Mambo! Habari!" (Hi! How are you!), Then you can say "Nzuri!" (Good!) as a response to pretty much anything, if you don't understand. When greeting elders, like the mamas, we say "Shikamoo!" to be respectful and then they reply "Marahaba!"
-I’m making an effort to smile at every stranger who meets me eye and I’m saying Mambo! Habari! (Hi! How are you!) to everyone I see on the streets!
-Some people point and wave and shout out, “Mazungo! Mazungo!” To me this essentially means, “Hey look there’s a funny looking white person!” I’m often not sure if they’re laughing at us or if they’re just curious about us because they don’t see as many tourists in the area.

-There are women and men carrying things on their heads everywhere! I know it’s stereotypical, but I can't get enough pictures; their balancing-act is amazing! Baskets full of fruits like bananas, or baskets full of peanuts are pretty typical. But we even witnessed a man carrying a tall stack of mattresses!!

-The children here are so adorable and lovable and I just want to cuddle them all. Lots of them are a little shy, but if you shoot them a smile, they will smile back at you and greet you, but they don't like to be photographed. Others are more outgoing and approachable and ask if they can be photographed (I am more than happy to!).
-I’ve seen children as young as five carrying babies on their backs!

-We've seen a few Mosques around town due to a large proportion of the population being Muslim (Islam is more prevalent in Tanzania than in surrounding countries in East Africa).

-There are an overwhelming number of vendors on the streets: offering shoes, clothing, electronics, tools etc. (often all crammed into a little closet-sized space). You name it, and there will be multiple shops on a single street that can service your needs! (often several carrying exactly the same things!) There seems to be an overwhelming amount of shoes for sale, and I notice people scrubbing sneakers and shining black dress-shoes to get them ready for sale. There are also plenty of people sifting through large piles of clothing to be put up for sale.

-The women all wear brilliantly colored kangas (basically long pieces of fabric wrapped around themselves) or long skirts and dresses of many different patterns. I’ve been trying to fit in by wearing skirts/dresses instead of pants. I picked out some fabric from a store in town and I’m getting a dress and bag sewn at the tailor downstairs from our apartment!
-We see children commuting to and from classes in their school uniforms, and they look so sharp! The boys in khaki pants or shorts and white shirts, while the girls sport white blouses and long turquoise skirts and knee-high socks.

-The taxis are indistinguishable from regular cars. I’ve noted a common white-color scheme, but there’s no signs! We’re lucky to have Puis to drive us because often taxi drivers will rip off unsuspecting Westerners. Their mind-set: “Ohhh they have lots of money, so we can charge them double!” Also, at nighttime, it’s nice to be sure you have a reliable driver to get you home safely.
-There are lots of Dala-dalas (kind of like a large van-cab, that transports people like a bus to various locations). They only cost 250 Tsh (the equivalent to 25 cents), so they're much cheaper than taking a taxi. They’re always packed and stuffy- and sweatiness comes along with that, naturally!

-There are lots of tribes in East Africa, including the Maasai (who live in Northern Tanzania and Kenya). I’ve been able to spot a few in Mwanza because their look is very different from the typical Tanzanian. They dress in long, colorful sheets (often striped in deep blue and burgundy hues) wrapped around their bodies, they have pierced ears and often stretched earlobes, and they wear lots of beaded, hand-woven jewelry. And for some reason, to me, they always look much taller and lankier than most, and often carry wooden walking sticks.

-There are a lot of animals scattered around- like a goat in the street this morning, and roosters crowing at all hours of the day(not saving it for the break of dawn…), or little ducklings floating down the nearby stream…
-There are also some really nice tropical flowered trees, and lots of palm trees of course!
-Nothing too exotic yet, but there’ll be plenty of time for spotting “The Big Five” on a weekend Safari…

-First-off, it's sunny and hot here everyday. We were told we are entering the rainy season, but that the skies usually only open up in the evening for a short period of time.
-Mwanza is called the City of Rocks for a reason! The naturally occurring rock structures here are astonishing!
-Lake Victoria (The biggest fresh-water source in all of Africa) is magnificent. Sitting at Talapia Hotel and overlooking the sun setting over the lake is awe-inspiring.

-At hotels like Talapia, lots of Westerners assemble here for drinks and chats. Lots of people are here for developmental and volunteering reasons, working at orphanages or hospitals, but some are just here passing through while traveling. I met a guy from France today (his name escapes me now) who has spent the past couple months traveling through Congo, Rwanda, and Uganda. He was looking for a couple of “whities” (as he called Westerners) to join him and his friend on a camping/Safari trip to Serengeti National Park (to split the costs of the car/campsite). Unfortunately, they want to leave in a few days and Steph and I can’t join in…but it’s definitely on my list of places to go and things to do! Interesting guy for sure though, he says he teaches scuba diving lessons for a living…another thing on my list is scuba diving or snorkeling off of the coast of Zanzibar!


Right now, I’m sitting at a table, lake-side at the Talapia Hotel (it’s right on Lake Victoria). Lots of Westerners lounging around here, which is something I haven’t seen for a while! We have access to free wireless internet here and some great food, so it’s going to be THE place to come write up my blog posts!

We’ve met up with Joke here and gotten the chance to introduce ourselves to her and some of her Tanzanian friends! (Joke is the Dutch doctor whom we will be helping out with clinical trials!)

Sunday, January 17, 2010

Importance of HIV/AIDS Awareness

“Stigma and discrimination associated with AIDS delays treatment and care for HIV-positive people, and prevents people coming forward for testing."

"Realization of Human Rights and fundamental freedoms for all is essential to reduce vulnerability to HIV/AIDS. Respect for the rights of people living with HIV/AIDS drives an effective response."
-Declaration of Commitment adopted at the United Nations General Assembly Special Session on HIV/AIDS, June 2001

Stigma related to HIV/AIDS has unfortunately become a great barrier to HIV treatment and prevention in the developing world. The stigma surrounding HIV makes people much more skeptical to reveal their status, and it also makes it difficult to manage the spread of the pandemic. People can be so afraid of being stigmatized that they are unwilling to admit they have the disease; therefore, they cannot take the steps necessary to overcome it. People often refuse to be tested so they do not have to reveal their status to anyone. Some might try to hide the fact that they are receiving treatment, or inconsistently consume medication, or just refuse treatment entirely. Many HIV + people refuse to use preventative methods that avoid further infections, such as using condoms, in fear that partners/others will assume they have the disease.

Stigma can lead to many challenges in developing countries. People who are discriminated against because of HIV/AIDS are often shunned from their communities. They can lose their jobs, be kicked out of school, and/or be abandoned by their partners and their families. HIV/AIDS is often negatively associated with prostitution, drug-use, and promiscuity, so societies may look at the disease as punishment for these sorts of behavior.

Without ever-increasing public awareness about how HIV is transmitted and how it can be managed, the epidemic will continue to spiral out of control. When the facts of HIV/AIDS are openly discussed within groups of people in communities, cities, nations,and on a global scale, all people can understand the facts and this can dramatically reduce its stigma.

Friday, January 15, 2010

Outline of Major Research Endeavors

Part of my internship includes doing some scientific research at NIMRI, the National Institute of Medical Research in Mwanza, Tanzania. I am being overseen by my academic supervisor, Dr. Gregor Reid, who specializes in research on probiotics and is a professor of Microbiology and Immunology. I have been meeting at Lawson Research Institute over the past couple of weeks working in the lab and learning about making media, growing bacteria on selective plates, performing quadrant streaking, and doing dilution series to plate a small quantity of the bacteria so colonies can be counted easily (basically all this work to assess the number of bacteria in a sample)!

Dr. Joke's Clinical Trial:
I will have the opportunity to help out with a 30-day trial with 150 HIV+ women. Of these, 75 will be receiving probiotic yogurt and the other 75 receiving unsupplemented yogurt. The trial is being led/overseen by Dr. Joke, a Dutch Doctor presently working in Tanzania. She is hoping to take blood-spots and vaginal samples at day 0 and day 30, as well as filling in questionnaires on the demographics and health history etc. of the women. The blood-spots will be analyzed for viral load and the vaginal samples will be analyzed for Nugent scoring (a Gram strain scoring to test for bacterial vaginosis) and using a microarray and tested for STIs. Some of the analyzing of samples will be done in the Netherlands, but some will be done locally at NIMRI in Mwanza. A Tanzanian doctor and a Nurse in Sekou-Toure will be responsible for acquiring the patients for the study, and a nurse in the hospital will be helping with the vaginal samples and questionnaires. It sounds like an amazing opportunity to observe the positive health benefits that the probiotics confer to patients!

The "Moringa Project":
1. This lab research will explore the potential of adding a micronutrient source to further enhance the yogurt. We will be looking into the use of adding Moringa, an exceptionally nutritional vegetable that grows locally. We want to discover whether the Moringa will affect the viability of the probiotic strains and also how it effects the sensory qualities of the yogurt (ie. taste, texture, appearance).

2. In addition, we're looking into ways to carry probiotic strains in other fermented foods, such as a fermented porridge! This might be easier and cheaper source of probiotics and micronutrient because it would not require cows and refrigeration for the milk.

(The Moringa may be able to be used in the yogurt and the porridge to enhance nutritional value if the research indicates positive results!)

P.S. There will be two Dutch medical students joining us in Mwanza in March or April to work on the same project. I'm thrilled to have the chance to work alongside some really knowledgeable people and to have the potential to publish a scientific article. It's always amazing when things I'm learning at school can really be put to use in "the real world".