Thursday, March 29, 2012

the trip that wasn't meant to be

So, we had this awesome plan to go to the Nyriagongo volcano in the DRC and see real live lava. UNFORTUNATELY, some bad things happened. 

"To Fallen Soldiers"
Some of my readers who know me well may recall that one time, almost exactly a year ago, when I jumped - just jumped - during a dodgeball game and came down and broke the 5th metatarsal on my R foot. Well. Just wait.

First, Katie was too sick to even travel to Kampala with us on Friday. Sooooo that was super sucky. Rwandair said they would refund her ticket, but they are not very good at doing what they say, as we shall find out.

Then, Jess and I go the Posta bus station (..the post office). Oh wait, the bus "had a problem." It's not coming today - the posta guy suggests going to Kla tomorrow. Well, that's not an option. So we start walking to the taxi park to find a matatu.

Cue me EATING IT right off a curb. I stepped off with my right foot, my sandal was not on tightly, and I came down with all my weight on the R side of my foot. Just like exactly a year ago. As soon as it happened I knew I most likely would not get to climb that volcano. "ARGHHHHH" was probably in my thought bubble.

So I was like, well I have to go to Kampala anyway to get a good xray, and I already have a ticket to Rwanda, so I might as well just complete this obviously doomed journey. So I get in a matatu, Jess makes an emergency run back to the lab to grab an ice pack, and we were off.

We eventually get to Kla and I don't have any new breaks, which is good. Gonna get a f/u tomorrow just to make sure, but hopefully this healing process will be much quicker than last time.

The next morning we head to the airport after eating leftover Chinese for breakfast, and Rwandair doesn't have a record of my or Jess' ticket. Maybe two Jessicas is one too many to ticket? Anyway, Rwandair now owes me 276$ because we had to pay for another ticket in cash, in the airport. SO MANY FAILS. Agnes' comment on our travails was that God did not want us to go on this trip. She was probably right.

I did get to ride in a wheelchair in the airport, which made Jeff's day. Forgot to take pictures, though.

When we get to Kigali after a plane ride that took a shorter amount of time than the arguing that we did to actually get ON the plane, we got some food. And it was delicious. Frogs' legs in garlic and butter? Are you serious? It was amazing. I didn't eat my soup because I didn't like it and they took it back and gave me a free dessert. I nearly fell out of my chair. Rwanda turns out to have pretty amazing customer service, not counting its airline.

Then we went to the genocide memorial (even though originally we were gonna go on our last day) because Jeff had been to Kigali 3 times and never been. I think what's so extremely disturbing about the Rwandan Genocide is how it was just so....personal. Yes, the govt played a huge role, but so many of the stories in the museum were about neighbors killing neighbors, friends killing friends, and even family killing family. It was just so horrifying. You can't say "oh, nobody knew what was going on, it was this remote thing where people were being shipped off and killed." It was mass murder in streets, in churches. Just horrible. The two quotes I remember are a woman saying "Not everyone was evil. I would say 5% were good, 5% were neutral, and the remaining 90% were evil." And an 11 year old girl "They killed all of my family, but they survived. I will never see my family again, but I will have to see the people who killed my family every day for the rest of my life."

I am not sure how you are supposed to deal with something like that. With believing that 90% of people are bad, or with living in a society full of people who previously tried to murder you and your family. Or with seeing babies and children murdered. These are horrors absolutely beyond my imagining.

Then we went to Gisenyi.

That big building on the left is where we stayed. Right on the beach of Lake Kivu.

I really thought I might be able to struggle up the volcano (against medical advice, but FOR awesomeness). But then Innocent, our tour guide, took one look at me and started shaking his head no. And Devan got that look on your face when you're about to tell a patient really bad news. So I excused myself and pouted on the beach all day while they climbed a volcano. =(


wah wah

More crazy customer service: when it started raining and got a little chilly they heated up hot coals for your feet. Seriously. And not just for me because I was the sad pathetic loner but for everyone!

Took a boat ride to a tiny island!

Wah wah. Again.
What my friends were seeing:

Sigh. Photo credits to Devan.

So the next morning Innocent picked me up and we crossed the border into the DRC so at least my visa didn't go to waste! 

Some background: Rwanda, post-genocide, is really an aberration in terms of East Africa. It's clean (plastic bags are actually outlawed, and will be removed from your person), boda drivers wear helmets and carry an extra one for the passenge, the roads are amazing, and it's generally more developed than its neighbors. If you talk to people in Uganda, they insist that the people of Rwanda are suffering because the economy is so restricted (so many rules - can't have kiosks, etc) and they may be right. On the surface, though, it's like a glossy coffee table book. Very pretty to look at.

The Congo is not like that at all. Crossing the border was dramatic: from hills to flat plains full of lava rubble, from kids in school to kids not in school, from perfect public transportation and roads to pickup trucks and crazy potholes. Night and day. 

Lava fields. Nyiragongo erupted in 2002 and killed over 100 people in Goma,
and left huge fields of lava rock behind.
Smoky smoky Nyiragongo
So I was there to see my friends emerge victorious from the volcano:


Not sure what's with all the bullet holes
Check out my sweet polio crutch
That night we had more delicious dins, were rebuffed from trivia night by the way-too-hardcore Rwandan expats, and I lost the sole of my left hiking shoe while walking so I left it in the garden of the restaurant. I hope it grows shoes that are not-so useless. What if that had happened while I was on the mountain??

The next day we pretty much relaxed in Kigali and ate MORE delicious foods. Then we went home to Uganda, where we made sure to buy cheese and lettuce at 1:30am because groceries are priority #1 if you live in Tororo.

Kigali st: GORILLA in the middle, boda passing by.
Now I am home with the babies getting as much work done as possible before Amanda and Dad get here. Only 7 kids left to do my assay on, then I'm coming home!

Yes, Hope's finger is in my eye.
How am I going to live without Hope and Feen back in the US??

Monday, March 5, 2012

if (when) we flip

This weekend my friends and I did grade 5 rafting on the Nile. 8 boats, 45 people. Not all of those people were my friends, but it was a big group. Omgggg it was crazytimes. It was also super fun. And it was great to see everyone! We had Fogarty & Doris Duke people come from all over East Africa so that we could get thrown into the water together over and over again. Definitely a bonding experience!

BEFORE: Introducing "Team Dangerous," consisting of Mara, Devan, Alex, Franzie, Mike, Leila, and I. Smiling because "look we can paddle forward no problem!":

That's me in the green shirt and black shorts w/white stripes. Hard to tell without glasses!

Eating it.
Over and over.
And over.
Things I learned this weekend:
1) I'm willing to paddle into waves over and over again, knowing that I will soon be thrashing around underwater and being fallen on by my raftmates. And somehow it's still fun
2) I don't understand water. It's complicated.
3) I follow directions to the letter when I'm terrified.
4) My contacts are amazing and never fell out, despite being pushed up my eyelids numerous times

Our guide Alex is yelling commands to us in the following photos:
GET DOWN!! (or, prepare for flipping)
FORWARD! HARDER! I'm pretty sure we didn't flip on this rapid but then we were paddling really hard to get back into it. And we did flip on the 2nd try.

The worst rapid is probably the one they call the "Bad Place." You actually have to get out of the raft and walk around a grade 6 rapid to get to the grade 5. And then there's a grade 3 after the grade 5 called "the Other Place," which is a very Ugandan name. Anyway you never make it to the other place because you eat it hard in the Bad Place. This was definitely my hardest fall.

Oh noooooooooooooo.

Definitely my most hilarious shot (yes, those are my legs). Devan's trying really hard to hold on. I am a lost cause. 

Anyway, quite the experience. I highly recommend it. I better, since I'm doing it again in one month with Dad and Amanda! Dun dun dunnnn. Enjoy these pics, guys! I can't wait to see ours! Hehe...

Anyway, for now it's back to the grind. More updates later!!

Saturday, February 25, 2012

there's a bathroom on the right

If you can sing the title of the blog post out loud and automatically know which song lyric Katie's brother rewrote, you win!! I don't know what you'll win. I'll be impressed?

It was a weird past week in the house because I was alone for most of it. I decided since nobody was around that it would be a good time to get Ellie spayed.

Poor Ellie! On the "operating table"
 I called a vet that Beth knew and who had previously neutered her cats and done a good job....the Tororo vet has this odd way of showing up out of nowhere in a pickup truck, running in and doing whatever you want him to do, and running out. I didn't really want this to be a rush job so I called Bernard instead.

He was still 2 hours late, but when he finally came he did a good job. Agnes and I both helped assist. After watching this surgery I'm pretty sure I could have done it myself - if I could have found the ovaries. That was the hardest part for Bernard too. But seriously, after doing the pig lab during my surgery rotation at Hopkins, I think I have enough skills to successfully spay a small dog. Take that as you will.

Don't worry. It's a pig, not a human.

Pig lab was really the only part of my surgery rotation I enjoyed (that's only a slight exaggeration). But it was the only time when you got to make decisions and actually do some of the things surgeons do, and because of that it was the only time surgery was even mildly appealing to me. It's a pretty awesome much better than just standing around and retracting during a 7 hour pancreatic surgery.

Anyway, Ellie had a rough couple of reminded me of when she was a small small puppy and I had to baby her all of the time. Poor Ellie! But then she totally recovered like a boss. She never even vomited after the anesthesia and generally was totally better by Tuesday, when Katie's family came. It was amazing.

Most interesting comments by Bernard the vet:
"You could never operate like this on a human. They'd get sick immediately. Dogs are tough." - on operating outside in the backyard, as aseptically as we could make it

"Um, well once a dog pulled the stitches out in the night and all of her intestines came out and she died. But that was only once." - after I asked what to do if Ellie messed with the surgery site. I was like REALLY?? Thanks for that anecdote. Thank God that didn't happen.

Anyway then Katie's family arrived on Tuesday! (After a very long, very arduous journey from the Masai Mara.) They decided to hang out in Tororo an extra day instead of heading to Sipi because of said arduous journey. That means we finally got to meet for more than 5 minutes! It was fun to meet everyone and hear about their trip experiences. It made me really excited for Dad and Amanda to come! Get ready to have adventures!!

We ended their last night in town by googling some guitar tabs and lyrics so Katie's dad could play the guitar while we all sang. It was like a Briggs get together but without the Return to Pooh Corner song...which both of Katie's parents knew but none of the kids did. Haha!

I'm heading to Jinja next weekend to raft the Nile! I'm sure I'll get some pictures of that magic.

But for now, pictures of the two hammiest hams I know. They do love them some Christmas hats. 

Thursday, February 16, 2012

on transforming a work-related crisis into funtimes and increased productivity!

Most of my readers probably don’t know this (because I didn’t write about it) but my lab project changed oooh, about a month ago. I just wrote a couple of sentences to explain why and then I deleted them. So if you want deets about why my cultured Elispots weren’t working, leave me a comment? Lolz

But anyway my new project involves intracellular cytokine staining so that I can check and see if any of these kiddos have T cells that secrete cytokines (specifically IFNy and IL-10) specifically in response to being stimulated in vitro with malaria peptides. Sound fun? It totes is. It’s also objectively more work (the assay takes much longer, and I have to chase down specific samples) so these past couple of weeks have been, as we would say in this household, “cray cray.”

I’m trying to capture  samples from 20 HIV-exposed kids who were on Bactrim until 4 years of age and 20 who were on it through breastfeeding (standard of care) to try to see if there are any differences in their responses to these malaria antigens. I’m also freezing down parallel tubes of these samples so I can do more complicated flow cytometry assays back in SF to look at more/different cell markers and cytokines. Once again, if you want more info, leave a comment! (bet you $5 I get negative comments. Is that possible?)

And I’m also trying to capture samples from 10 HIV-unexposed kids who fall in the lowest quartile of malaria incidence and 10 who fall in the highest, to see what their responses are like (hopefully they’re different) without the confusing context of chemoprevention.

So I flagged all these charts, and made all these lists, and got everyone in the “okay, we’re doing this, we can draw TCC PBMCs in green top tubes,” etc, and then I ran out of one of my reagents! FAIL

So Ann (our immunology coordinator) and I pulled off some sort of massively heroic (in my opinion) switcheroo and moved all of that week’s appointments to the next week (this week). And it worked (that’s the really amazing part). But for it to be worth it, I had to get my hands on some costimulatory molecules.

Cue a trip to Kampala! What a great excuse to do a little R&R (except we didn’t rest…at all). We stayed with Mara and did all sorts of awesome things, including but not limited to: Korean bibambap & karaoke bday party, Congolese clubbing, made tasty meals, went salsa dancing, shopped, and went boxing. 
Devan "proves" he can subtly wink. Haha.
Nothing brings a bunch of people our age together like "mmmbop." Apparently.

Shoot, I forgot about the goth/valentine’s day party. That too. 
So goth.
And then Sunday night I went down to Entebbe with Katie so she could meet up with her family and I could get my hands on my precious reagents! Yes, we resorted to using Katie’s parents as lab supply mules. Yes, we are verrrry thankful (thanks so much!!). 

Buuuuut the weekend wasn't over. I got back into Kampala at about 1am and Mara's like "omg we have to go watch the end of the Africa Cup!" It was a shootout and it was awesome. 

That awful moment where Arul thought Zambia had lost.
But Cote D'Ivore missed too! Then a few shots later ZAMBIA wins! Total craziness.
After a 5:30am mad dash back to Tororo....I am back in business and I have been slammed this week because it’s basically 2 weeks worth of kids in one. But no complaining – it’s awesome to be working again! And I got my first response EVAR and I was so proud it was like I had birthed a baby. Except not really but you know what I mean.

Anyway, JBloome is in Turkey now and I’m all alone in the house until Tuesday when Katie does a drive-by with her fams. It’ll be fun to meet them for more than 5 minutes finally!

Things I have done since being alone (and I feel super productive having done these things):
1)   Made a ridiculously tasty egg sandwich
2)   Discovered I can’t hack into Katie’s computer (weh), so I can’t use the projector
3)   Made coffee ice cubes
4)   Put a bottle of wine in the fridge
5)   Made a mental note to eat those mangos/make smoothie
6)   Discovered more gluten-free baked good recipes I’m gonna make
7)   Failed to watch any of the movies I was planning to watch.  But I will work on that this weekend! 

Also, say a little prayer for Ellie, as she is going to get neutered on Sunday. As Agnes says, “Ellie needs family planning.” Don’t we all.

Sunday, February 5, 2012

Tororo rock & Sipi Falls

Sooo I've been here for 4+ months and I had not climbed the rock until last week. Since there's literally nothing else to do in Tororo - the rock is the only attraction, and the natural wonder after which every single thing in town is named (Rock Classic Hotel, Rock View High School, etc etc..) - it's strange that I made it this long without climbing it. 

(Let's not mention the time Jess Bloome and I tried to go and couldn't find the trail. Let's just not talk about it).

We went bright and early.
 Mara and Devan had come on Friday to visit us (hooray!) and we ambitiously decided to wake up on Saturday and "do this thing." And we did it. I think we got up the rock in about 30 minutes, only stopping to take photos!
Sunrise from the middle of the rock!
Katie and Mara
 Pras brought with him a new point and shoot camera I had ordered after having my old one stolen in Zanzibar, so I got to play around with all of its creative functions when we reached the top.

I like this watercolor feel.
 We reached the top! Hooray!! But the hiking was not going to stop there.


This is what the rock looks like from the bottom! And we climbed all the way to the top. It does require the use of some ladders. And good shoes.

So then we managed to shower/eat breakfast in time to make the study transport to Mbale, where we (Mara/Devan/Katie/Pras/me) picked up Radha who came by bus from Kampala. Then we took a private hire to Sipi Falls! At first I was a little disappointed because in my memory (and, looking back on fb, in my pictures) Sipi was so much greener. But then I figured out that that's because it's dry season now, and it's been super dry. So... just not as green as it will be in a few months!

Gazing out over the valley
 It's hard to see, but in the picture below there is a rainbow at the bottom of the waterfall (!!) and a person dangling from a rope on the left side of the waterfall (!!!!!!). No, parents, I did not rappel off a cliff next to a waterfall. I'm probs too chicken to do it anyway (see: my bungie jumping non-history.)

I discovered that the "vivid colors" function makes it look like it does in my memory/rainy season!
Middle waterfall!
The crew gets soaked. That's the waterfall, not rain.

Beautiful! From a cave underneath the waterfall.
Apparently tasty berries which I did not try.
So many rainbows!! Does it count as a double rainbow if they're in separate places?? Probably not =(.

Everyone all together! At the bottom of the top waterfall.
Top of the top waterfall!
4 hours later...
 So we ended up doing a LOT of hiking on Saturday. Like a ton! 4 hours in Sipi....we were ready for food & drinks by the end of our adventures. Except we could barely make it up the incline from our rooms to the restaurant....haha.

It was super fun to see Mara, Devan and Radha! And I think we set a record for "quickest trip," which is hard to do in this country! On Sunday Katie, Pras and I chilled at the Mount Elgon Hotel in Mbale and had some tasty curry while we waited for study transport back to Tororo. A super busy/fun weekend in a super busy/fun week!