Today is my last full day here in Moshi and it's bittersweet. I am certainly looking forward to the modern conveniences of house - namely hot showers without a hand-held nozzle, clothes that actually get clean when you wash them, high-speed internet, and friends! I will also miss many things about Moshi, and about my time here, but after being away from home for a month, I am ready to return.
Today will be full of wrapping up all the loose ends with work. The final version of my survey has been translated into Swahili, and then back into English. Today I am working with Berny to make sure that the translation is good enough, and to make any last-minute changes. Then, it's just a matter of logistics and paper-pushing when I get home to get the questions incorporated into the final survey in November.
While Berny and the other people in the office were working on the translations, yesterday, I went on a short 1-day safari in Arusha National Park. It was much different than the safari I did last time I was in Tanzania, 6 years ago. Up here, there is much more forested area, and therefore, no lions :-( You can imagine my disappointment since they're my favorite animal. While this is a bad thing for me, it's a very good thing for the rest of the animals in the park. For instance, giraffes in the Serengeti must sleep standing up because of the constant fear of predators, but here in Arusha, they sleep laying down. I even caught a few pictures of a sitting, resting, giraffe. I had the opportunity to add on a 2 hour walking safari, which was the best part of the day. I was accompanied by a park ranger, who carried a gun just in case any of the animals decided to charge us! The ranger was also one of three women rangers in the entire park of about 40. She spoke very good English, and it was really fun to talk with her for the few hours we had together. I think the sweetest, and saddest animal story was of the dik-diks. They are small antelopes that are monogamous. They choose a mate early in life and stay with them until they die. When one of the pair dies, it is common for the remaining dik-dik to either eat a plant they know is poisonous, or to stop eating until they also die. I told the ranger that it reminded me of Romeo and Juliet, but I think the analogy was lost on her.
Anyway, I will be sure to post pictures and videos when I return (I get back to Durham on Sunday, so check back sometime after that). Keep checking back - I've got a months worth of visual stories to tell...
And for now, I am getting ready to say goodbye to Moshi. As I said before, it's bittersweet, although it's looking more and more likely that I'll be returning in November, so maybe it's just goodbye for now.
Thursday, August 12, 2010
Friday, August 6, 2010
running...finally
I went for a run this afternoon for the first time in Africa, and it wasn't nearly as bad as I thought it would be. There were definitely some challenges, but overall, it was really nice. The biggest drawback is breathing the dust from the dirt roads, the smoke from burning stoves, and exhaust from the old, unmaintained cars. The roads are bumpy with many rocks, and therefore, it's impossible to "zone out" - you have to constantly be watching your footing. It was nice not having to stop for stop signs or stop lights, and it was also nice getting to interact with many of the locals. Almost everyone I passed said hi to me (in Swahili of course) and I was able to respond with the little Swahili I've picked up so far. The most common greeting I got was "pole" (pronounced pole-ay) which literally translates to "sorry". I had to read up on this after I got back because I was really confused why people were apologizing to me as I was running by. Apparently, it's customary to say "pole" when you are sorry, but also to express sympathy if someone is having a difficult time or (as in my case) working hard. It is also used when someone is doing something as simple as walking across a room to get something. In any case, I received a warm reception, and lots of staring, but overall, nothing to discourage me from doing it again (aside from the fact that the power went out when I got back, so I had to take a cold shower in the dark - ha). I just might be able to squeeze in a long run before I leave next week.
Thursday, August 5, 2010
free day in moshi
Today was my first free day in Moshi and I think I made the most of it. The lodge where I'm staying is quite a bit outside of town, but I decided to walk instead of call a car. It took me about 45 minutes and it took a bit of coordination to not get hit by cars and motorbikes that were driving and turning from the left lane of traffic! It is also very very dusty here. It doesn't rain much and the roads are primarily dirt, which means lots of dust in the air. I don't see many people walking around breaking into handkerchiefs like I remember from India - I wonder why not. Anyway, I made it into town and went to a coffee shop that I heard had wireless internet (so far I've been accessing the internet through a data card which gets a maximum download speed of 40mb/sec - in case you're wondering it takes about 60 seconds to load a webpage and about 5 minutes to upload each of these blog posts...oh, how I miss highspeed).
Well, the internet wasn't working, but the coffee was really good. I was talking with the project manager, Berny, who told me that even though Tanzania grows some of the best coffee in the world, Tanzanians don't like the taste of it. So, most businesses only buy the cheap, instant coffee because it's not worth it to them to spend the money on the good stuff that grows next door that people won't buy. It's pretty crazy. But the coffee place I found caters to the tourists, and had the good stuff (expensive too at about $1.50 for a latte). I stayed there and did a little work on my computer using my data card and then went for lunch at a place recommended in the guide book. It was obvious that they get most of their business from tourists using Lonely Planet because the place was packed with white people - it was nuts! They offered as a side dish either rice, chips (french fries), or ugali. Ugali is the local staple and I hadn't tried it yet. It's made from corn flour and water and cooked until it's like dough consistency. I asked for it, and the waiter said "no, no, you want chips" and I said "no, I really want to try to ugali." Finally, he agreed. I wouldn't say that I either liked or disliked it. I would describe it as grits with the consistency of a stiff polenta. It tasted like grits too. I suppose that's not surprising since grits are made from hominy which is a lot like corn (or maybe it is corn, I don't know).
On my way out of town I stopped at the "hot bread shop" which is basically a bakery. I had been craving something other than chicken, which is all that my hotel restaurant can seem to cook. I'm not ashamed to admit that I ate donuts and pastries for dinner and that they were delicious!
I thought I had the route back to the hotel memorized when I left town, but apparently I had gotten a few turns wrong. I found myself wandering, rather aimlessly, along unmarked dirt roads in the general direction that I thought the hotel was. A boy came up across the road and we started talking as we were walking and we had quite a nice conversation. He was a calculator salesman who was making sales calls to the tourist hotels. He was very nice, but seemed genuinely concerned that I was almost 27 years old and was not married. I really think he felt bad for me. I tried to tell him that things are a little different in the U.S. but that didn't seem to alleviate his worry for me - ha.
He was very nice and even helped ask some people walking by if they knew of the road that my hotel was on. It turns out that I was right all along and just turned one street too early. Not too bad. It was nice to have a 15 minute conversation with him though.
Back at the hotel I ran into the girl who is usually working in the restaurant and since it seems that I'm the only one staying at the hotel we talk almost every day. She commented on how much she loved my shoes (reef flip flops with silver piping). I told her that I would give them to her on the day that I left if she wanted and I swear I've never seen anyone's face light up the way hers did. It was a good day, but I'm beat. So much walking and dust, an oxygen mask sounds pretty awesome right now - ha.
Well, the internet wasn't working, but the coffee was really good. I was talking with the project manager, Berny, who told me that even though Tanzania grows some of the best coffee in the world, Tanzanians don't like the taste of it. So, most businesses only buy the cheap, instant coffee because it's not worth it to them to spend the money on the good stuff that grows next door that people won't buy. It's pretty crazy. But the coffee place I found caters to the tourists, and had the good stuff (expensive too at about $1.50 for a latte). I stayed there and did a little work on my computer using my data card and then went for lunch at a place recommended in the guide book. It was obvious that they get most of their business from tourists using Lonely Planet because the place was packed with white people - it was nuts! They offered as a side dish either rice, chips (french fries), or ugali. Ugali is the local staple and I hadn't tried it yet. It's made from corn flour and water and cooked until it's like dough consistency. I asked for it, and the waiter said "no, no, you want chips" and I said "no, I really want to try to ugali." Finally, he agreed. I wouldn't say that I either liked or disliked it. I would describe it as grits with the consistency of a stiff polenta. It tasted like grits too. I suppose that's not surprising since grits are made from hominy which is a lot like corn (or maybe it is corn, I don't know).
On my way out of town I stopped at the "hot bread shop" which is basically a bakery. I had been craving something other than chicken, which is all that my hotel restaurant can seem to cook. I'm not ashamed to admit that I ate donuts and pastries for dinner and that they were delicious!
I thought I had the route back to the hotel memorized when I left town, but apparently I had gotten a few turns wrong. I found myself wandering, rather aimlessly, along unmarked dirt roads in the general direction that I thought the hotel was. A boy came up across the road and we started talking as we were walking and we had quite a nice conversation. He was a calculator salesman who was making sales calls to the tourist hotels. He was very nice, but seemed genuinely concerned that I was almost 27 years old and was not married. I really think he felt bad for me. I tried to tell him that things are a little different in the U.S. but that didn't seem to alleviate his worry for me - ha.
He was very nice and even helped ask some people walking by if they knew of the road that my hotel was on. It turns out that I was right all along and just turned one street too early. Not too bad. It was nice to have a 15 minute conversation with him though.
Back at the hotel I ran into the girl who is usually working in the restaurant and since it seems that I'm the only one staying at the hotel we talk almost every day. She commented on how much she loved my shoes (reef flip flops with silver piping). I told her that I would give them to her on the day that I left if she wanted and I swear I've never seen anyone's face light up the way hers did. It was a good day, but I'm beat. So much walking and dust, an oxygen mask sounds pretty awesome right now - ha.
Wednesday, August 4, 2010
back to work
I've been here in Moshi for 5 days and I finally feel settled enough to sit and write a little something about the work I'm doing here.
As you probably already know I've been intersted in the AIDS epidemic in Africa for quite a long time. It was the subject of my honors thesis in college, and it was my main motivation for going back to grad school. Last winter I met the director of the Duke Center for Health Policy, and she invited me to work with her on a project here in Moshi. The project is called CHAT (Coping with HIV/AIDS in Tanzania) - catchy huh? It started in 2008 when they began interviewing a mix of HIV positive and negative people in the Moshi area. The study asks them many questions about their families, jobs, attitudes, opinions, health history, trauma history, medication history, and (most important for me) medication adherence. While AIDS is certainly a huge problem in sub-Saharan Africa, many countries have taken huge steps in combatting the epidemic. Tanzania, in particular, offers every citizen free anti-retro-viral drugs through the public health system. We have found, through the first few rounds of data, that many HIV positive people who are on anti-retroviral drugs, do not fully adhere to their recommended treatment regimen, making the drugs far less effective, and in most cases, completely ineffective.
In a nutshell, my research is studying why, if they have access to free drugs, they do not fully adhere. The subject is common in sociology, psychology, and public health, but not in economics. I suppose it seems like a weak link to what most people think is economics, but having just finished teaching Economic Principles, I am even more convinced that my work has a place in the field. After all, economics is the study of how individuals, businesses, and governments make decisions when resources are scarce. It seems more relevant with this definition in mind.
Ok, I'm getting way off track...Basically, I'm writing a new section of the CHAT survey to be included in the next 2 rounds (November and April) of data collection. In order to make sure I have good, culturally relevant, and useful questions I came to Moshi to talk with people who are similar to the people in the CHAT survey. This way I can get a preview of how my questions will be interpreted, what people don't understand, and first-hand information about how people think about the problems that I have written so much about.
On Monday I met with all of the 18 people that will be participating in my focus groups throughout the next week to make sure that they all knew which day they were supposed to come and what time we were starting, etc. It was really an amazing experience to be in a room full of HIV positive patients who had all come into the office because of my project. It was really the first time that I felt that I was in control of some aspect of my research and that it would go in the direction that I decided, it's really empowering. I am obviously very thankful to all of them for agreeing to spend a day talking about HIV and helping me understand how they think about their situation and their future. What I wasn't expecting at all was how enthusiastic they were about participating and how grateful they were to me for being interested. Each and every one of them came up to me after the meeting wanting to shake my hand and thank me profusely.
Yesterday, Tuesday, was our first full day focus group. While I'm still inexperienced, I can now say I have some experience running a focus group. It was really kind of fun. The project coordinator here, Berny, was translating from English to Swahili and back again. He really was doing most of the work. But it was so great to hear their answers to questions, think to myself, "why on earth would someone choose to loose $10 tomorrow instead of $5 today?" and be able to ask them myself and get an answer. The most common answer to that question was that you need money today, and you have to deal with tomorrow when it comes. It's pretty sad if you think about it. In fact, there were many aspects about the day that were heartbreaking. The people who came were all HIV positive and all had very depressing stories. Most of them were widowed, and had overcome tremendous obstacles in their lives. When asked if she would rather have 10 extra healthy days this year or 100 extra healthy days next year, a common response was that they would rather have the 10 days this year because they don't know if they will be alive to collect the healthy days next year.
I don't know if I'm getting any closer to answering my research question, but I am learning much more about the problem. I suppose that has to be the first step.
As you probably already know I've been intersted in the AIDS epidemic in Africa for quite a long time. It was the subject of my honors thesis in college, and it was my main motivation for going back to grad school. Last winter I met the director of the Duke Center for Health Policy, and she invited me to work with her on a project here in Moshi. The project is called CHAT (Coping with HIV/AIDS in Tanzania) - catchy huh? It started in 2008 when they began interviewing a mix of HIV positive and negative people in the Moshi area. The study asks them many questions about their families, jobs, attitudes, opinions, health history, trauma history, medication history, and (most important for me) medication adherence. While AIDS is certainly a huge problem in sub-Saharan Africa, many countries have taken huge steps in combatting the epidemic. Tanzania, in particular, offers every citizen free anti-retro-viral drugs through the public health system. We have found, through the first few rounds of data, that many HIV positive people who are on anti-retroviral drugs, do not fully adhere to their recommended treatment regimen, making the drugs far less effective, and in most cases, completely ineffective.
In a nutshell, my research is studying why, if they have access to free drugs, they do not fully adhere. The subject is common in sociology, psychology, and public health, but not in economics. I suppose it seems like a weak link to what most people think is economics, but having just finished teaching Economic Principles, I am even more convinced that my work has a place in the field. After all, economics is the study of how individuals, businesses, and governments make decisions when resources are scarce. It seems more relevant with this definition in mind.
Ok, I'm getting way off track...Basically, I'm writing a new section of the CHAT survey to be included in the next 2 rounds (November and April) of data collection. In order to make sure I have good, culturally relevant, and useful questions I came to Moshi to talk with people who are similar to the people in the CHAT survey. This way I can get a preview of how my questions will be interpreted, what people don't understand, and first-hand information about how people think about the problems that I have written so much about.
On Monday I met with all of the 18 people that will be participating in my focus groups throughout the next week to make sure that they all knew which day they were supposed to come and what time we were starting, etc. It was really an amazing experience to be in a room full of HIV positive patients who had all come into the office because of my project. It was really the first time that I felt that I was in control of some aspect of my research and that it would go in the direction that I decided, it's really empowering. I am obviously very thankful to all of them for agreeing to spend a day talking about HIV and helping me understand how they think about their situation and their future. What I wasn't expecting at all was how enthusiastic they were about participating and how grateful they were to me for being interested. Each and every one of them came up to me after the meeting wanting to shake my hand and thank me profusely.
Yesterday, Tuesday, was our first full day focus group. While I'm still inexperienced, I can now say I have some experience running a focus group. It was really kind of fun. The project coordinator here, Berny, was translating from English to Swahili and back again. He really was doing most of the work. But it was so great to hear their answers to questions, think to myself, "why on earth would someone choose to loose $10 tomorrow instead of $5 today?" and be able to ask them myself and get an answer. The most common answer to that question was that you need money today, and you have to deal with tomorrow when it comes. It's pretty sad if you think about it. In fact, there were many aspects about the day that were heartbreaking. The people who came were all HIV positive and all had very depressing stories. Most of them were widowed, and had overcome tremendous obstacles in their lives. When asked if she would rather have 10 extra healthy days this year or 100 extra healthy days next year, a common response was that they would rather have the 10 days this year because they don't know if they will be alive to collect the healthy days next year.
I don't know if I'm getting any closer to answering my research question, but I am learning much more about the problem. I suppose that has to be the first step.
Monday, August 2, 2010
internet.in.tanzania.is.very...slow
Boy, do I have some stories to tell.
Let me see where this story begins...last I wrote Matt and I had just arrived in London. That really seems like it was a year ago now. We got up on our only full day there, went out to breakfast and took the tube to Buckingham Palace. We arrived as the changing of the guards had already started but we pushed through the crowds and got a pretty good place to stand and watch as the parade passed on the way out. From there we spent the afternoon on a double-decker tourist bus, which was a lot more fun than I think it should have been. With all the sightseeing and me being sick, we both really appreciated seeing the sights without tiring ourselves out from walking. We got off the bus at the Tower of London and took our book's tour around the compound. I'm not sure what I was expecting, but there was something about it that fell short for me. Maybe I had just unrealistic expectations.
We had a low key night and spent the next morning packing and planning. Matt's flight left in the afternoon to DC and my 20 hour trip to Tanzania didn't start until even later in the evening. After passing off all the formal clothes I had brought for the wedding plus a few other things for Matt to take back, we set out for our last meal together.
In retrospect, we both ended up paying for all the good luck we had up until this point. Matt ended up missing his connection in Washington DC, which was the last flight to Durham of the night, and decided to rent a car and drive the 5 hours back to Durham instead of wait overnight in DC. But he made it home, only to find my car had been broken into while we were gone - I blame our housesitters - just kidding, we totally owe you guys! I had fairly smooth travel, although I had to unexpectedly check one of my bags, buy an expensive replacement UK battery charger for my computer which for some reason got fried in the outlet in our hotel, and then when I arrived in Kilimanjaro, my ride forgot to pick me up. I was left at the airport, not knowing Swahili, and not having a phone to call the guy anyway. Ah, international travel, how I missed you all year...
Thankfully, the people here are the nicest of any I've ever met. A taxi driver let me use his cell phone so I could call my ride. He had mistakenly written down my flight arriving at night instead of in the afternoon, a simple mistake. I ended up paying about double than I would have otherwise to take a taxi the 40 km from the airport into town. But I arrived, met Berny, the project coordinator, and got checked in to the hotel. While it's not very nice by our standards, it has the essentials for proper lodging in Moshi: electricity, hot water for 2 hours a day, a bed-net to protect from mosquitoes, and that's about it. It's not the cleanest, but the owner "Mama-Moshi" is very nice and speaks English, and she let me borrow her cell phone so I have a way of connecting with Berny and the other people in the office.
My first impressions of Moshi are very positive. It seems to have many characteristics of India, but with a much different feel to it. I am overwhelmed with how nice and welcoming everyone is that I meet. Welcome in Swahili is "Karibu" and I've never heard one word spoken so many times. When Berny introduces me people get this huge smile on their face and thank me for coming to their city and their country. The level of development is very similar to India, but people have a much different attitude. In addition to there being much fewer people all together, everyone is very respectful and considerate (except when driving! - I've seen a taxi driver nearly run over a couple of school children who he thought were waiting too far into the street). The streets are dirty, but not because people litter particularly much or pee in the streets, but more just because the roads are dirt, and there's dirt everywhere. There are paved roads, but not many, and the ones that are often don't have sidewalks.
Don't get me wrong, I loved parts of India, but Moshi is much easier to love. This morning I met with some of the participants that will take part in my focus groups this week and I have much more to say about them which I will dedicate an entire post to after we meet tomorrow. It will be a good one, so keep checking. I'm sorry there are still no pictures, I was never able to find a camera cord in Paris or London, and now it would be a futile search. I will provide a summary of photos and descriptions after I return.
Let me see where this story begins...last I wrote Matt and I had just arrived in London. That really seems like it was a year ago now. We got up on our only full day there, went out to breakfast and took the tube to Buckingham Palace. We arrived as the changing of the guards had already started but we pushed through the crowds and got a pretty good place to stand and watch as the parade passed on the way out. From there we spent the afternoon on a double-decker tourist bus, which was a lot more fun than I think it should have been. With all the sightseeing and me being sick, we both really appreciated seeing the sights without tiring ourselves out from walking. We got off the bus at the Tower of London and took our book's tour around the compound. I'm not sure what I was expecting, but there was something about it that fell short for me. Maybe I had just unrealistic expectations.
We had a low key night and spent the next morning packing and planning. Matt's flight left in the afternoon to DC and my 20 hour trip to Tanzania didn't start until even later in the evening. After passing off all the formal clothes I had brought for the wedding plus a few other things for Matt to take back, we set out for our last meal together.
In retrospect, we both ended up paying for all the good luck we had up until this point. Matt ended up missing his connection in Washington DC, which was the last flight to Durham of the night, and decided to rent a car and drive the 5 hours back to Durham instead of wait overnight in DC. But he made it home, only to find my car had been broken into while we were gone - I blame our housesitters - just kidding, we totally owe you guys! I had fairly smooth travel, although I had to unexpectedly check one of my bags, buy an expensive replacement UK battery charger for my computer which for some reason got fried in the outlet in our hotel, and then when I arrived in Kilimanjaro, my ride forgot to pick me up. I was left at the airport, not knowing Swahili, and not having a phone to call the guy anyway. Ah, international travel, how I missed you all year...
Thankfully, the people here are the nicest of any I've ever met. A taxi driver let me use his cell phone so I could call my ride. He had mistakenly written down my flight arriving at night instead of in the afternoon, a simple mistake. I ended up paying about double than I would have otherwise to take a taxi the 40 km from the airport into town. But I arrived, met Berny, the project coordinator, and got checked in to the hotel. While it's not very nice by our standards, it has the essentials for proper lodging in Moshi: electricity, hot water for 2 hours a day, a bed-net to protect from mosquitoes, and that's about it. It's not the cleanest, but the owner "Mama-Moshi" is very nice and speaks English, and she let me borrow her cell phone so I have a way of connecting with Berny and the other people in the office.
My first impressions of Moshi are very positive. It seems to have many characteristics of India, but with a much different feel to it. I am overwhelmed with how nice and welcoming everyone is that I meet. Welcome in Swahili is "Karibu" and I've never heard one word spoken so many times. When Berny introduces me people get this huge smile on their face and thank me for coming to their city and their country. The level of development is very similar to India, but people have a much different attitude. In addition to there being much fewer people all together, everyone is very respectful and considerate (except when driving! - I've seen a taxi driver nearly run over a couple of school children who he thought were waiting too far into the street). The streets are dirty, but not because people litter particularly much or pee in the streets, but more just because the roads are dirt, and there's dirt everywhere. There are paved roads, but not many, and the ones that are often don't have sidewalks.
Don't get me wrong, I loved parts of India, but Moshi is much easier to love. This morning I met with some of the participants that will take part in my focus groups this week and I have much more to say about them which I will dedicate an entire post to after we meet tomorrow. It will be a good one, so keep checking. I'm sorry there are still no pictures, I was never able to find a camera cord in Paris or London, and now it would be a futile search. I will provide a summary of photos and descriptions after I return.
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