Pictures...for real!

For some reason the internet is working MUUUUCH faster tonight...uploading pictures is on!!

It's lions and zebras and floating in the Dead Sea!

Jordan

It's my first trip to the Middle East, and although it will be brief and contained to a lovely sea-side resort (though I'm not complaining about that), the incredible mystique of this place is inescapable.  I'm here to attend a working session of regional disease surveillance networks that are working together as a community of practice to improve international infectious disease surveillance efforts.

Yesterday I hopped two planes and a continent and found myself sitting in the back of a taxi rolling through the hills of Amman, descending to the lowest place on earth.  Even in the dark it seemed beautiful; the tiny lights twinkling out from the city, the dry, pale, sand-swept looking vegetation breezing past me, the winding, steep hillsides.

After 18 hours of traveling, I arrived at the Kempinski Dead Sea Hotel, someone handed me some complimentary apple juice and I went outside to the patio to smell the sea.  Wandering down to literally the bottom of the face of the earth, even in the inky blackness it was breathtaking to behold.  The moon was out, but clouds partially obscured the light. So not being able to see much I just listened for a minute to the water lapping up on the beach.  Just be standing next to it, this strange and historic body of water seemed to impress upon me just how ancient it was.  I felt really small; really temporary next to it.

Despite my exceptionally luxurious digs, I've mostly been couped up in a small, windowless room with padded blue walls (not kidding).  But come 7am tomorrow morning...it's time for a float.

(actual picture of the Dead Sea I got to upload!!)

Pictures!

For the last several weeks I've been wanting to put up pictures of my recent trip to Mikumi National Park (where I saw lions, zebras, elephants and giraffes!) and recent hike in the Ulurguru mountains.  Uploading pictures to the blog can be difficult on my internet connection in the TZ, so I've been holding out for my little jaunt up to the Middle East (more on that later) where they have many wonders - like the Dead Sea and Petra and wifi.

However, despite the wifi, the working meeting I'm at has turned out to be some long days of, well, working and so I haven't had much time.  I started uploading some pictures, left for dinner, thought they'd be done when I got back, but...turns out this is the only one that took.

So, here is a picture of my feed post-hike in the Ulrugur's.  That's dirt, not a tan.  It really was a beautiful hike...I swear.

I get by with a little help from my friends

After two crazy weeks, I feel like I am finally climbing out from under a rock.

The insanity was set off by the realization that I really DID need to retake the GRE and the ensuing full-force math review that needed to happen.  Then I heard I was going to the field to help with data collection for November.  ALL of November.  And applications are due for some schools at the beginning of December.  Then the internet on my modem went out.  Then the power started routinely going out.  Then......you get the idea.

Trying to get all this done, needless to say, was kind of stressing me out and bringing out someone I like to refer to as "Intense Angie".  She's not really dangerous; I just wouldn't get in her way.  Ten hour days on an mind-numbingly slow internet connection was making even Intense Angie a little more grouchy than normal.

I could not have gotten through the last few weeks without some serious help, support and encouragement from my friends and family and I want to give them a special shout-out:  to my Mom for sifting through boxes and files to find transcripts and student loan info; to my brother who is entering all of my previous coursework for me into applications because it would literally take me two days here; to Ameet who tutored me in math over gchat; to my sister, who is 29 weeks pregnant and doing her residency, but told me she'd help out any way she could; to Andrew who thought he had malaria, but told me not to worry about it and just focus on getting ready for my test (thankfully, no malaria).

And to all the other friends who have sent packages and emails and talked over Skype and basically just been extremely awesome.

I think sometimes in the US we like to think that it is possible to only rely on ourselves to get things done; to make it through.  Tanzanians suffer no such delusions.  Here, life is often difficult enough that it is understood that it requires help from other people.  And you can accomplish relatively little entirely on your own.  While the resources found in the West do often make it feasible to accomplish more individually, complete self-reliance is obviously an illusion - yet one we Americans are strangely and ardently attached to.

For my part, I think the Beatles had it right.  I could not have gotten through the last two weeks & I definitely would not make it through this year without my friends and family.  Thanks everybody.

Sunrise

I woke up at 5am this morning.

Technically I think that is actually before sunrise.

My mind was racing about applications and research ideas and math reviews.

You see, about a week and a half ago I made a decision: I am going to apply for PhD programs for next year.

To many that is far from a surprise.  Getting my PhD is something I’ve been thinking about for a long time, years in fact.  But it’s taken me until now to officially commit to the application process (which very sadly means a trip to Dar to re-take the GRE).  

What finally made me decide to do it?  I think deep down in my heart I’ve known that this is something I’ve wanted to do and would eventually do, for a long time.  But sometimes I like to play this game with myself, where I allow my head to mull over something for awhile before it is ready to accept what my heart knew all along.  Basically, I’m a stew-er, and I had to let this percolate in my brain for a bit before I was ready to fully and with a 100% commitment go for it.  I just can’t seem to do things half way.

And so, at 5am I woke up with a revolving list of programs and schools running through my mind and a nagging fear that perhaps I really wasn’t smart enough for this after all.  Did I really have innovative research ideas?  Did I really have research ideas at all?  Would I be able to make a contribution to the topics I’m most passionate about?  Was this all just one crazy idea?   

I think part of what I’m struggling with is the courage to believe in myself that I can do this.  Because I do have ideas, lots of ideas, and things I’m interested in, and anybody whose talked to me in the last few years knows I’m an absolute research geek about global health and maternal health issues…I love this stuff.  I actually like statistics; that’s how big a dork I am.  But I think my stumbling block right now is being brave enough to commit those ideas to paper, to put myself and my skills and ideas out there for the review committees to see and say: ‘Here I am!  Evaluate me!  Tell me if you think I’m good enough for this or not.’     

Obviously it’s a scary thing to be evaluated by anyone in any situation in life.  But what makes me so hesitant to articulate my interests and ideas? 

I am terrified I’ll make a mistake.

As a lifelong perfectionist, mistakes are not something I do well.  It’s probably visibly painful (for myself and any bystander) to see me struggle with something I don’t feel competent at.  I squirm and writhe and basically do whatever I can to ever avoid ever being in that situation.  Well, at least that’s what I’d like to do. 

However, in the last few years I have thought a lot about the notion of perfection; all that it ntails and all that it requires (remember: stew-er).  And while that’s a personal journey best saved for another time, I’ve concluded two things:

1. Perfection is an illusion, and a dangerous one at that
2. Mistakes make life infinitely more messy, but also more funny

I think what it really comes down to is that the world does not expect perfection of me; I expect perfection of me.  And so I have to decide if I can make peace with myself, to accept my own limitations and flaws, but also strengths and gifts, for what they are and go out into the big, beautiful world to actually live in it, or if I will continue to hold myself to some unattainable standard and live instead for the chance to berate myself whenever I fall short of that standard. 

It’s probably something I’ll struggle with the rest of my life, but at least for this morning I'd like to choose option 1. 

I think I can do this.  I think I should at least try.  I think I need some coffee.  

Is this what going crazy feels like?

I think it's probably fairly routine for all of us, from time to time, consider the current state of our own sanity.  Or maybe that's just me...  But regardless, the weekends in Mogo are shaping up to be a real test to my mental tenacity.  The deal is there just are not that many people around or things going on during the weekends and it's starting to make me go a little crazy.

Wait, revision: there are almost NO people around on the weekends and there are ZERO things going on.

You know how they say that babies will die if no one touches them, because they need the human interaction.  Yea, that's kind of how I feel right now.  Not just that I don't have "things" I could be doing (I've got plenty of both mundane and relatively fun activities I could occupy myself with); it's that I am starved for human contact.  I could go on a long walk somewhere or tooling around town, but I simply cannot bear the thought of one more afternoon spent alone amidst people that so clearly feel at home here right now.

If you're starting to be concerned for my mental wellbeing, rest assured you're hearing the most extreme, but also honest, version of how I feel.  I do have a couple of co-workers I occasionally go out for a beer with and my neighbors are wonderful and I do spend time with them.  But overall it's just nowhere near enough to sustain the level of human interaction I apparently need.

I'm not averse to time by myself; some of that I like, some of that I need.  But my introverted tendencies have long since been satisfied and now the extrovert in me is kicking and screaming to get let out.  I could delineate all the reasons why it's so hard to meet people here (I live far from town, work in a very small office that doesn't interact with any other departments at the university, people go to Dar for the weekend, etc. etc.) but the point is this situation cannot keep up this way.  I can't mentally handle it.  It makes me feel crabby and lonely and isolated - and I can't go through feeling this way every single weekend I'm here.

I guess the best thing I can think to do right now is a dual-strategy: 1) make every effort I can to find some people to hang out with.  This can be hard for me, because my introverted side comes out when I'm in new situations and I can be a little reserved.  Time to get over that.  2) try to recalibrate my social needs a little more. What I mean is that in a normal life in the US you have friends you see on a daily basis, here friendships or special outings or events might be more spread out, but they also tend to be bigger (i.e. going to Zanzibar for the weekend, not just out to dinner).  This isn't the best strategy, but trying to get myself to adjust to lonelier times in Mogo, in exchange for more exciting times of travel and adventure with friends might help.

To any friends who have lived outside the US, any advice on how to deal with the loneliness factor or make friends?

But what are you "doing" over there?

I've realized that most of my blog posts have been more about some of the social and personal aspects of my life in Tanzania, rather than the professional ones.  In case you are interested in what SACIDS, the organization I work at, is all about, I am going to shamelessly re-post a blog entry I wrote for the Global Health Corps Fellows Blog. 

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One Health: Sounds good...what does it mean?

When I first arrived at SACIDS somewhere along the line of new information, concepts and acronyms I was introduce to the idea that SACIDS was a “One Health” organization.  Like a good and studious fellow when this was told to me I nodded and smiled; “One Health” sounded catchy, it sounded progressive, it sounded positive; I had no idea what it actually meant.    

Luckily, in the past few months I have become much more acquainted with not only the work of SACIDS, but how the overarching framework of “One Health” fits into that.  Simply stated, the concept of “One Health” means adopting an integrated approach between the human, animal and plant health sectors to addressing infectious disease threats. 

You can read much more about the official definition and how it was developed here, but in terms of SACIDS’ work, the concept of “One Health” often means trying to increase collaboration between the animal and human health sectors. 

In the United States, we may not think about animal health as having a large impact on human health, but in rural (or not so-rural) Tanzania, animals and humans intermingle on a daily basis.  This routine contact between animals and humans can create a big problem when animals develop diseases that then transfer to humans, or what are called zoonoses.  According to the Foresight Study, 70 to 80% of new/emerging infectious diseases of humans had originated from animals. Diseases such as avian influenza, swine flu or Rift Valley Fever are all diseases that have started in animals and transferred to humans. 

Yet, Tanzania, like most countries, has no official system for coordinating disease preparedness, surveillance or outbreak response across animal and health sectors.  Often when coordination does happen it is on an ad hoc basis, based largely on whether the person in the ministry of health happens to know their counterpart in the ministry of livestock (or vice versa). 

Adopting a “One Health” framework means not only looking at how infectious diseases develop, spread and could potentially be stopped in one sector, but rather taking a comprehensive approach to how a disease is likely to be transmitted and who or what is likely to be effected overall.  Improving coordination in preparedness planning, data exchange and outbreak response between the human and animal health sectors could potentially dramatically reduce the severity of an outbreak and save both human and animal lives.  

The concept of “One Health” is gaining traction, and just this past week the a new One Health Commission was announced in the US to increase coordination between the animal, human and environmental health sectors in addressing infectious diseases.   As scientists, veterinarians, epidemiologists and public health experts continue to work on mitigating the impact of infectious diseases in places all over the world, it’s exciting to be apart of an organization taking an innovative approach to enhancing those efforts here in southern Africa.