First Day at Work
I woke up, remembering a small bit of a dream from last night. Apparently someone spilled spaghetti sauce all over my camera, and the case that covers it. Then they put the camera case in the refrigerator, and left the camera on a table... In my dream I then started brushing off the dried spaghetti sauce off of my camera case. The end. Not very vivid... I'm kinda thinking that mefloquine doesn't really have a big impact on me.
I actually woke up at 5 am at first (I went to sleep at 10 pm the night before, because our electricity is on the fritz. Our house, and apparently much of Kampala, is on a rotating 24 hours of power from the grid, 24 hours of no power at all. We have a battery in the house that charges on the "power-on" day, but keeps us from doing a lot of computer related stuff/electricity intensive stuff on the off days). I kinda tossed and turned, listening to the roosters crowing back and forth, then dozed off till I woke up at 8 am. I got dressed, packed my stuff, and Nuhu showed up to take me to work at the hospital. I brought with me one of the heavy suitcases I packed (filled with filter paper for collecting blood samples on), my backpack, and a laptop bag filled with epi books for a newly-developing medical library, and a new laptop for Hasifa, the person who I'm working with/for. First we drove to the laboratories on the hospital grounds, where I met Sam, the lab director. I gave him the filter papers, and when he heard that I was going to be helping with the surveillance in Apac (a central region in Uganda- Kampala, where I'm at, is about 5-6 hours south of it), he laughed and said that he had never been there himself! Wow, in just a week, I'll have traveled more of Uganda than some natives have ever seen!
After meeting Sam, we drove down the street a bit to the Anatomy building, where I met Catherine (who runs the house that I'm staying at and does other work, of which I'm not completely sure of) and Hasifa (who I'm working with). Ugandans here are very different than the african-americans that I see in the States. The most striking thing is that many of them have skin that is a much richer, dark chocolate color, compared to African-americans in the States (who seem almost pale by comparison). Derek also mentioned something interesting as well- apparently the skin of many of the Ugandans he stitches is extremely tough, compared to US citizens. At first he thought that his needles were dull, but apparently all the medical students who come from the States to work here have noticed it too... just two interesting observations, which are most definitely not true for all Ugandans- just a few.
Another interesting thing about Ugandans is that most of them are not immediately friendly- pretty much without exception, they stare (or at least give a long look) to most foreigners, and maybe without intending to, they have a suspicious look on their faces. It isn't until you wave at them or smile or both that they seem to open up and be friendly back. Most of them are friendly and will respond to your waves and smiles with greetings and smiles too, but a few of them just continue to stare at you suspiciously. It can be a bit intimidating, when I walk down a street, or into a ward, or around the hospital, and 10-20 people are looking at me, and Ican't wave and smile at all of them (since they're all surrounding me, and I also would feel kind of foolish spinning around and waving). I imagine that I'll get used to it after a while- it's pretty natural to be curious and look at people who are dressed and look very different from the norm.
All the people who I have to work with are friendly, which is a good thing. They seemed a bit unsure as to what type of person I would be (overseer-type, or secret spy, or normal student- even I was kind of unsure what exactly I should be doing) but they all seemed to warm up to me when they realized that I wasn't there with a secret agenda, and was just there to help out. For the rest of the day, I worked with Alan, the woman (I thought Alan was a guy's name, but maybe it's spelled differently) who does the majority of the data entry for the surveillance project. She's a nice lady, kind of quiet and shy around new people (like me), and has a ton of data to process, and understandably, has more to do than she can do alone. Of course, this kinda meant that I was sucked in to doing data entry, and will probably be doing data entry for a few days. I'm hoping that I won't have to do this for long- I did a ton of data entry when I was back in my undergraduate years, for the Stanford Hospital, and doing it here in Uganda took me back to the old days, where data entry was kind of boring, or at least, not the most stimulating of mental pursuits to be doing. It is a necessity for epi, since in order to look at any big trends/population level effects, you need a lot of data to analyze (and hence the tons of data to be entered), but since I entered PhD training, I was hoping that I was past the menial labor and into the realm of answering deeper questions and tacking bigger problems.
Not that the data entry doesn't have a lot of problems to be tackled. There's always issues with what you can do to minimize the amount of error in your data, and there seems to be a lot of missing data. Most of the problem seems to be lying with the clerks who record the data firsthand at the clinic in Apac. Apparently this surveillance project has created a lot of extra work for them, and they feel that they should be paid more for it. But the flip side of the arguement is that their job description has changed, and to earn their salary, they should be doing their job, even if it's harder than it was before. The bottom line ends up being that the clerks are unmotivated to do the extra work, and so the surveillance data tends to be messy and a bit sloppy, especially as the day goes on. Apparently it's common knowledge that a good bit of work gets done in the morning in Uganda, but after lunch, productivity almost comes to a standstill. At rural clinics, apparently, it's not unheard of for clerics to just leave their posts after mid-day, or the sole laboratory technician to just leave early to get her manicure- which leaves a lot of half collected data, and missing lab results for a lot of people. This is just a sample of the problems that have to be dealt with... how? I don't know yet. I'll be heading out to Apac sometime in the next week, so I'll hopefully be able to update with new thoughts later.
I went out to lunch at a fancy restaurant where native Ugandan food is the focus. It pretty much consists of a starch base, with some sort of sauce that goes on top. The starch base can be steamed bananas a la plantain style, potatoes, rice, sweet potatoes, or anything really. The sauces range from meat sauces to spicy sauces to ground nut sauces. The starches tend to be rather dry and kind of hard to eat without the sauces, and apparently one common staple is the plantains with ground nut sauce. I went with Heidi (an assistant professor who runs a rapid diagnostic malaria test study, a mosquito capture project, and a few other interesting projects) and her friend Susan who came from UCSF to visit her. After lunch (which was really filling- I now have resolved to survive off one meal a day and store food like a bear does, as long as they keep serving me buffet style) (oh and the passion fruit juice is really good here) we went to a building next door filled with art. It was rather nice actually- there were pictures made out of wood chips melded together, large sculptures of wood and metal fused together, and textured paintings where layers of paint had been cut away and pushed around to make a 3D surface.
Actually, I almost forgot to mention the roadblocks that we encountered on our way to lunch. Apparently, the place we went to eat at is right in the vicinity of the Ugandan President's house. The President just amended the constitution to allow himself a third term in office, and apparently he's not the most popular of people with people outside of the southern part of Uganda. He's been accused of using force and throwing around money to get people to vote for him, and this unpopularity apparently led to the deployment of roadblocks with armed guards around his house. It's a bit disturbing going from Cali where guns are only really seen on TV and in movies to Uganda, where troops carrying big rifles and AK-47's are walking around on the normal streets. Our driver apparently got harrassed by the guards (Heidi translated "Who are you? Where do you live? Do you even live in Kampala?") who finally told our driver how to get around the roadblocks to the restaurant we were trying to find... crazy eh?
After lunch and the art, I took my first boda-boda ride back to the Hospital. Boda-boda's are essentially moped-motorcycles that taxi 1-2 people around Kampala, for a price around 2k USH for a chinese guy like me and more like 1-1.5k for people like Heidi, who can speak the local language. They're fast, and daring, on a different level than the taxi drivers. Taxi drivers drive fast and daring, but boda-boda drivers take fast and daring, and mix it with no armored protection and more weaving between large vehicles with the potential to crush bodas with no problem. It's kinda nerve-wracking at first, but the breeze is nice, and it's much faster than cars and taxis when the traffic sucks.
After getting back to the hospital, I entered a bit more data, and finally got Skype to work, and talked with Paula for a bit. However, it was getting late (6 pm) and I had been warned to not be out alone in Kampala after dusk. Uganda's supposed to be safe, as long as you don't do the 2 following things- be alone after dark, or be in the northern regions of Uganda where the Lord's Resistance Army is. I packed up, and went outside, and a boda offered to take me where I wanted to go. I told him the "blue mango" (which is right across the street from where I'm staying) and he promptly started driving in the opposite direction. Fortunately, Derek and I had walked all around on Sunday, or I probably wouldn't have caught it... I kept asking him if he knew where he was going, and he kept saying yes, the "mango." After about 1 minute of going farther and farther in the wrong direction, I just stopped him, and told him to go back, and he acquiesed and just drove where I told him to go. Fortunately, I was able to remember the way back... man, the day I have to give directions to a ugandan is a scary day indeed. I don't know where I would have ended up if I just let him go to his version of the mango...
More to follow later.
I actually woke up at 5 am at first (I went to sleep at 10 pm the night before, because our electricity is on the fritz. Our house, and apparently much of Kampala, is on a rotating 24 hours of power from the grid, 24 hours of no power at all. We have a battery in the house that charges on the "power-on" day, but keeps us from doing a lot of computer related stuff/electricity intensive stuff on the off days). I kinda tossed and turned, listening to the roosters crowing back and forth, then dozed off till I woke up at 8 am. I got dressed, packed my stuff, and Nuhu showed up to take me to work at the hospital. I brought with me one of the heavy suitcases I packed (filled with filter paper for collecting blood samples on), my backpack, and a laptop bag filled with epi books for a newly-developing medical library, and a new laptop for Hasifa, the person who I'm working with/for. First we drove to the laboratories on the hospital grounds, where I met Sam, the lab director. I gave him the filter papers, and when he heard that I was going to be helping with the surveillance in Apac (a central region in Uganda- Kampala, where I'm at, is about 5-6 hours south of it), he laughed and said that he had never been there himself! Wow, in just a week, I'll have traveled more of Uganda than some natives have ever seen!
After meeting Sam, we drove down the street a bit to the Anatomy building, where I met Catherine (who runs the house that I'm staying at and does other work, of which I'm not completely sure of) and Hasifa (who I'm working with). Ugandans here are very different than the african-americans that I see in the States. The most striking thing is that many of them have skin that is a much richer, dark chocolate color, compared to African-americans in the States (who seem almost pale by comparison). Derek also mentioned something interesting as well- apparently the skin of many of the Ugandans he stitches is extremely tough, compared to US citizens. At first he thought that his needles were dull, but apparently all the medical students who come from the States to work here have noticed it too... just two interesting observations, which are most definitely not true for all Ugandans- just a few.
Another interesting thing about Ugandans is that most of them are not immediately friendly- pretty much without exception, they stare (or at least give a long look) to most foreigners, and maybe without intending to, they have a suspicious look on their faces. It isn't until you wave at them or smile or both that they seem to open up and be friendly back. Most of them are friendly and will respond to your waves and smiles with greetings and smiles too, but a few of them just continue to stare at you suspiciously. It can be a bit intimidating, when I walk down a street, or into a ward, or around the hospital, and 10-20 people are looking at me, and Ican't wave and smile at all of them (since they're all surrounding me, and I also would feel kind of foolish spinning around and waving). I imagine that I'll get used to it after a while- it's pretty natural to be curious and look at people who are dressed and look very different from the norm.
All the people who I have to work with are friendly, which is a good thing. They seemed a bit unsure as to what type of person I would be (overseer-type, or secret spy, or normal student- even I was kind of unsure what exactly I should be doing) but they all seemed to warm up to me when they realized that I wasn't there with a secret agenda, and was just there to help out. For the rest of the day, I worked with Alan, the woman (I thought Alan was a guy's name, but maybe it's spelled differently) who does the majority of the data entry for the surveillance project. She's a nice lady, kind of quiet and shy around new people (like me), and has a ton of data to process, and understandably, has more to do than she can do alone. Of course, this kinda meant that I was sucked in to doing data entry, and will probably be doing data entry for a few days. I'm hoping that I won't have to do this for long- I did a ton of data entry when I was back in my undergraduate years, for the Stanford Hospital, and doing it here in Uganda took me back to the old days, where data entry was kind of boring, or at least, not the most stimulating of mental pursuits to be doing. It is a necessity for epi, since in order to look at any big trends/population level effects, you need a lot of data to analyze (and hence the tons of data to be entered), but since I entered PhD training, I was hoping that I was past the menial labor and into the realm of answering deeper questions and tacking bigger problems.
Not that the data entry doesn't have a lot of problems to be tackled. There's always issues with what you can do to minimize the amount of error in your data, and there seems to be a lot of missing data. Most of the problem seems to be lying with the clerks who record the data firsthand at the clinic in Apac. Apparently this surveillance project has created a lot of extra work for them, and they feel that they should be paid more for it. But the flip side of the arguement is that their job description has changed, and to earn their salary, they should be doing their job, even if it's harder than it was before. The bottom line ends up being that the clerks are unmotivated to do the extra work, and so the surveillance data tends to be messy and a bit sloppy, especially as the day goes on. Apparently it's common knowledge that a good bit of work gets done in the morning in Uganda, but after lunch, productivity almost comes to a standstill. At rural clinics, apparently, it's not unheard of for clerics to just leave their posts after mid-day, or the sole laboratory technician to just leave early to get her manicure- which leaves a lot of half collected data, and missing lab results for a lot of people. This is just a sample of the problems that have to be dealt with... how? I don't know yet. I'll be heading out to Apac sometime in the next week, so I'll hopefully be able to update with new thoughts later.
I went out to lunch at a fancy restaurant where native Ugandan food is the focus. It pretty much consists of a starch base, with some sort of sauce that goes on top. The starch base can be steamed bananas a la plantain style, potatoes, rice, sweet potatoes, or anything really. The sauces range from meat sauces to spicy sauces to ground nut sauces. The starches tend to be rather dry and kind of hard to eat without the sauces, and apparently one common staple is the plantains with ground nut sauce. I went with Heidi (an assistant professor who runs a rapid diagnostic malaria test study, a mosquito capture project, and a few other interesting projects) and her friend Susan who came from UCSF to visit her. After lunch (which was really filling- I now have resolved to survive off one meal a day and store food like a bear does, as long as they keep serving me buffet style) (oh and the passion fruit juice is really good here) we went to a building next door filled with art. It was rather nice actually- there were pictures made out of wood chips melded together, large sculptures of wood and metal fused together, and textured paintings where layers of paint had been cut away and pushed around to make a 3D surface.
Actually, I almost forgot to mention the roadblocks that we encountered on our way to lunch. Apparently, the place we went to eat at is right in the vicinity of the Ugandan President's house. The President just amended the constitution to allow himself a third term in office, and apparently he's not the most popular of people with people outside of the southern part of Uganda. He's been accused of using force and throwing around money to get people to vote for him, and this unpopularity apparently led to the deployment of roadblocks with armed guards around his house. It's a bit disturbing going from Cali where guns are only really seen on TV and in movies to Uganda, where troops carrying big rifles and AK-47's are walking around on the normal streets. Our driver apparently got harrassed by the guards (Heidi translated "Who are you? Where do you live? Do you even live in Kampala?") who finally told our driver how to get around the roadblocks to the restaurant we were trying to find... crazy eh?
After lunch and the art, I took my first boda-boda ride back to the Hospital. Boda-boda's are essentially moped-motorcycles that taxi 1-2 people around Kampala, for a price around 2k USH for a chinese guy like me and more like 1-1.5k for people like Heidi, who can speak the local language. They're fast, and daring, on a different level than the taxi drivers. Taxi drivers drive fast and daring, but boda-boda drivers take fast and daring, and mix it with no armored protection and more weaving between large vehicles with the potential to crush bodas with no problem. It's kinda nerve-wracking at first, but the breeze is nice, and it's much faster than cars and taxis when the traffic sucks.
After getting back to the hospital, I entered a bit more data, and finally got Skype to work, and talked with Paula for a bit. However, it was getting late (6 pm) and I had been warned to not be out alone in Kampala after dusk. Uganda's supposed to be safe, as long as you don't do the 2 following things- be alone after dark, or be in the northern regions of Uganda where the Lord's Resistance Army is. I packed up, and went outside, and a boda offered to take me where I wanted to go. I told him the "blue mango" (which is right across the street from where I'm staying) and he promptly started driving in the opposite direction. Fortunately, Derek and I had walked all around on Sunday, or I probably wouldn't have caught it... I kept asking him if he knew where he was going, and he kept saying yes, the "mango." After about 1 minute of going farther and farther in the wrong direction, I just stopped him, and told him to go back, and he acquiesed and just drove where I told him to go. Fortunately, I was able to remember the way back... man, the day I have to give directions to a ugandan is a scary day indeed. I don't know where I would have ended up if I just let him go to his version of the mango...
More to follow later.
posted by Vince at 8:51 AM
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What a great site, how do you build such a cool site, its excellent.
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