Friday, July 31, 2009


The power is unreliable here. Many days we come home at 5 or 6pm to no power, and it's hard to know when it will come back on. It's fine until 7 when the sun sets, and then you are left wandering around in the dark, totally bored.

Last night the power was out for a very long time, until around 9pm.
We all ate dinner by candlelight, and then played rounds of Bananagrams, which is insanely fun. It's like scrabble, but without all the boring waiting-for-other-people-to-take-their-turn.
Victor, one of the doctors here, is ridiculously good at it. He forms his words quickly, then gets bored waiting for us. No one even comes close to beating him. It's especially impressive given that English is his second language.

Having no power is much more fun with lots of people around. Also, it's not as catastrophic here.
I was in medical school during the blackouts in New York in 2003. It was like the apocalype - all stoplights off, intersections confusing and frightening, traffic backed up for hours over the bridges, no subways, long lines at the gas stations, total chaos. In my mind, it was like the London of Children of Men, but with block parties.

After the power came on, we turned on the TV and watched a National Geographic program on the Beeb called Dolphin Army. There were dolphins, squids, birds, sardines and sharks. Disappointingly, there were no adorable dolphin uniforms (I was hoping for something Sgt. Pepper-esque), but still it was pretty fascinating.

Will the Real iPhone Please Stand Up?

James, one of the doctors here, has a fake iPhone, and it's a pretty good fake, especially from the front. We compared ours side by side.

The benefit that the fake one has is that it can take 2 SIM cards at a time, so he can use two different networks and take advantage of the freebies in both (free calls at different hours, etc.).

Thursday, July 30, 2009


Tamara and I found a cute little library near the clinic the other day.
It had a large area with tables and benches that were filled with uniformed students quietly working. It also had a good-size shelf filled with novels. Most of them I had never heard of, but there were 3 by Nabokov (Ada, Short Stories and Lolita), 1 by Phillip Roth, some Harry Potter, and some others that looked good.
A one-year membership costs 3000 shillings ($1.50).

Wednesday, July 29, 2009

Ugandan Burrito

Dr. Mugyenyi from Mbarara taught me to eat what he called a Ugandan Burrito.
It's a samosa wrapped in a chapati. I had it for lunch yesterday.

The chapati gave me heartburn but it was worth it.

Monday, July 27, 2009

Preventing Malaria through Tennis

Tamara found a tennis-racket-bug-zapper today being sold in town.
It's rechargeable (it plugs directly into the wall), and looks like a tennis racket.
When you turn it on and hold down the button, you can swat the mosquitos around you and ZAP! - mosquito dead.
Julia and I demonstrate the use of the instrument:

Julia got about 7 of them tonight in clinic. Only 750 billion to go.

Sick Kids

The kids here seem so active. I remember the kids in Mbarara being so sedate. They didn't make noise, run around or cry much. I thought maybe they were just disciplined in public.

Here the tiny tots in the clinic are always running back and forth, crying, screaming, babbling. The clinic is cacophonous in the morning. It's really different. I mentioned it to Julia, and she said that probably all the children I saw in Mbarara were ill. These are healthy - they can come for problems or just for routine check-ups, so often they are fine.

One little girl with a very cute smile is especially playful. She started approaching me closer and closer every time, then screeching and running back to her mother's lap to laugh. Finally she was brave enough to tag my leg and run away, howling with laughter. She has been here 3 days in a row (they have to come every day if they get malaria), and now she is my BFF. She marches in and out of my workspace, grinning and singing, occasionally tagging me.

This other little girl had an IV in her hand, and so apparently is being treated. She must be on the mend, because she was not shy at all, and hovered near Tamara, shaking her hand.

The child in the background is getting blood testing. The mother holds the baby in her lap, and the lab technician holds the childs hand for a finger prick. The children usually screech and twist for a minute, but they calm down quickly (especially when they glimpse a fascinating mzungu).

Saturday, July 25, 2009


1. So what exactly are you doing?

Setting up a research study to see if certain HIV medications prevent malaria better than others.

2. What do you do on a day-to-day basis?

At the moment, run around trying to find an adequate electrical outlet and adapter for my laptop. Once I find that, I sit and create documents that are only referred to in acronyms: CRFs, SOPs, IRBs, INDs. Then we have meetings in which we talk mainly in acronyms.

3. How do the documents tie into the larger purpose?

We are at the initiation stages of the study, so we are basically deciding and documenting how every little detail of the study is going to run. This is like that science "experiment" they make you do in elementary school, where they tell you to write down how to make a peanut butter and jelly sandwich. So you thing "Wow, easy homework!" and you write down "Take 2 pieces of bread, put peanut butter and jelly on them, and put them together." and then you go off to watch G.I. Joe. The next day, you get to science class to find that you have the crappiest answer, and the annoying know-it-all has written "Take a knife out of the drawer. Unscrew the peanut butter cap. Take a scoop of peanut butter with the knife, and spread it on the bread..." and so on, and you feel like an idiot.
Well, it turns out that the experiment has value (beyond that of learning to accept your own mediocrity). The scientific process requires a ridiculous level of detail.
Luckily, I am no longer that seething little kid in the back of the class, terrified that I will be called on to read my crappy common-sense peanut-butter-and-jelly instructions. I am embracing the process.

4. What is the hospital like?

It's similar to other hospitals in this region, with freestanding one-story well-ventilated (ie. windows) cement buildings (wards) connected by covered walkways. Tororo District Hospital looks quite nice compared with most, because of the money for renovations provided by the CDC and the Japanese government. The labor ward was quite nice, with clean new delivery beds, whitewashed walls and a preeclampsia management protocol posted on the wall. The nurses I met were all extremely friendly and welcoming. The other wards weren't quite as nice-looking as L&D, but I did notice that each patient had a bednet, and none were on the floor (patients, that is).

5. What is the town like?
It's small, although bigger than I had thought. There are 2 parallel streets that make for good shopping, and one traffic circle that has several banks, including Stanbic and Barclay's. The shops are haphazard, all selling small amounts of things, and no single store's stock is comprehensive (ie. the stationary store may or may not have pens or paper). There are many stores selling the same type of thing, and in order to find something specific, you really have to hunt it town in each corner of the town. There are multiple stores known as "grocery stores" or "super markets" but neither name is accurate, since they don't really sell groceries, and they are far from super.
There is a marketplace, which is a large number of adjacent wooden shacks. There is a vegetable section, a "stuff" section (where all things are plastic and cheap), a hardware section (locks, tools), a rubber section (where they sell flip-flops made out of old tires, which they make right there in the shop), and a section that sells some sort of powdery substance that might be flour.

6. Is it hot?
Not as much as I expected. During the day it gets up to a peak of probably 85, maybe it hit 90 a couple of times, but at night it goes down to 70 or cooler. I often need a light sweater at night. It is humid, but no more so than New York in the summer. Which is pretty humid, I guess.
Supposedly it will get hotter than this, though.

Placenta Cream

I don't want to know.


There are lots of adorable kids running around the clinic. Many of them are smaller than an American 1-year-old, but walk with the skill and balance of at least a 2 or 3-year-old, and as it turns out, they are.

We use the offices as workspace, and often patients are sitting on benches waiting while we furiously type away. It makes for a lot of sheepish smiling back and forth. The people here don't seem to be as wary of cameras as they were in Kenya, perhaps because they know and trust the clinic doctors.
This mom was very smiley, and tried to get her daughter to come and greet me. The daughter was having none of it, and nearly had a meltdown when the mother tried to drag her over.

This little guy was rolling around during his mom's visit, and eventually wandered off out the clinic door. His twin brother came to get him, and seemed to be admonishing the first one to come back inside, swatting him with the toy he was holding. They looked about the size of a 9-month-old, but they were actually 2 years old.

These 2 girls were sitting on the bench across from where I was working for a long time. The older one was very curious about me, and watched me everywhere I went. When I gave her attention, she broke into a broad grin, but I couldn't get her to repeat it for the camera. She did like seeing herself in the digital picture, though.

Friday, July 24, 2009

The House

Pictures of our house in Tororo.

Technically, it's a 6-bedroom house, but it has extra nooks and crannies that can fit more people if needed. I have lost count of how many are staying there right now.
It has a large kitchen (in which the shelves need some finishing), and a large living room with a haphazard collection of furniture. We have a TV with satellite cable, although I haven't used it much yet because I keep falling asleep by 9pm.
The bathrooms are strangely distributed, with 2 of them in individual rooms, and only 1 off the hallway, which means that 4 women (right now) are sharing 1 bathroom. So far, there have been no scuffles, but we'll see how long that lasts. Eventually, there will be 5 of us with 1 bathroom.
It was a rather spartan bathroom, too, but Beth and I bought some decorations in town. We found a blue shower curtain, blue plastic shelves and a blue wastebasket, and now it looks much prettier.

Note the front yard, excellent for gardening, and the hammock-worthy trees.
The night guard has already started a garden in which he grows corn.
The porch makes for nice afternoon lounging, and we're planning to start playing frisbee in the front yard.

Wednesday, July 22, 2009

Tororo, Uganda

I am in Tororo, Uganda.
I moved here for the year to do my UCSF RID fellowship research on Malaria and HIV in pregnancy.
On my way to Tororo, I went from San Francisco to Amsterdam to Kampala and finally to Tororo. I left on Saturday and arrived on Tuesday night.
Amsterdam was pretty. I'd go back.
In Kampala, I was surprised to find all kinds of shopping, including raspberries, camping gear, inflatable mattresses, South African wine, and all kinds of things I didn't expect.

I was also surprised that I was easily able to set up my iPhone for use here thought Uganda Telecom, and even using the internet on it isn't too expensive (it's all prepaid).
Kampala was very trafficky, and leaving in the car was slow going. We hit another traffic jam near Jinja, trying to cross a bridge over the mouth of the Nile.

Our house here is really beautiful, with a large porch, a yard with big trees (good for hammock placement) and plenty of space for gardening. The only thing it needs is more bathrooms.
We walked to the hospital today to get the lay of the land, and found that it was about 40 minutes down a fairly sleepy but very pretty road. We saw mostly bicycles, a few motos, and very few cars. I'm looking forward to buying a bicycle.

I've noticed that although we get a lot of stares here, we don't get a lot of people shouting "Mzungu!" When we stepped into the clinic, some of the mothers with crying toddlers did try to quiet them by pointing at as and whispering "Mzungu!" (it worked, except for one).
We toured the hospital grounds, and I was surprised to discover how nice it was, especially the labor ward. Much bigger and less crowded than in Mbarara, although apparently very few doctors here. The CDC and the Japanese government have donated a lot toward renovations, and did a very nice job. (Pictures to come).
We need to buy some things for the house, so Beth and I are headed to town this afternoon for shopping and exploring.