A couple days at the ICDDR,B

Our third day in Dhaka is wrapping up. It’s been a great trip so far, and it has been pretty productive as far as our project goes. The ICDDR,B is the research institution where Maia has been working for the past couple years, and where the three of us have been working for the past couple days, and where we will probably work for much of the trip. They run several hospitals across the country but their primary work takes place here in Dhaka where they treat diarrheal disease. They were the organization that actually pioneered oral rehydration solution (ORS) which is still today one of the major treatments for diarrheal disease.

Their campus is housed at a location called the institute for public health which also houses a number of other hospitals and research groups. It is in a different part of the city from where we are staying. While it is not too far away as the crow flies (I’ve always wanted to use that saying!) it can take 45 to 90 minutes to get there due to the traffic. Today was not as bad as yesterday, but there were moments when we were stuck in standstill traffic for quite some time. One of the many complications of commuting in a megacity.

The campus of the ICDDR,B has several different buildings, with the largest being about 5-6 stories tall where most of the labs and offices are. The institute provides clinical services, and also has many labs that work on different microbiological studies. One of the buildings has the library where we have been going when not meeting with people. It is a nice space that is air-conditioned with very fast internet, though there is a filter that prevents you from going to facebook on the network, or doing anything not so work related. The library is also filled with tons of print medical journals from mainstream ones such as the New England Journal of Medicine and the Lancet, to more obscure journals such as the Iranian Medical Journal ofInfectious Disease.

Yesterday we met with Dr. Pitroni who is the institute’s medical director. He directed us to a number of different people we can talk to to help us with our project. He has helped advise Maia some over the past couple years, and he was eager to support us by giving us advice on our project. One thing he warned us of however was that as with many universities and research institutions, we need to work our way through a lot of hierarchy and politics in order to get things done, but I think we are up to the task.

Today we met with a man whom Dr. Pitroni had recommended we speak to. His name is Dr. Siraj Islam, and he has been working with cholera for over 30 years. I felt bad because he wa ssick and planning on taking the day off, but decided to come in just so he could meet with us. He has done a lot of work linking the spread of cholera in Bangladesh to blue-green algae blooms in the Bay of Bengal, which is now one of the most important concepts in current cholera tracking in the country. He has also developed a compound that can be used to eliminate cholera from water that is safe to consume. The compound is undergoing more extensive trials now, but seems to have a lot of potential for cholera prevention. After explaining our project, Dr. Siraj became interested in the idea of tracking the spread on a larger scale which has not really been done before. He offered up his expertise on the environmental factors that help cholera transmission and has offered to give us access to the dozens of journal articles that he has written. He also boasted (a well deserved boast) of the over 32 million dollars he has raised over the years in grant writing that he may be able to offer his wisdom on. He even offered to come with us to Matlab (a region a few hours away from Dhaka that we are going to for a couple days) next week to show us first hand some of the work that is going on there.

The past two days have been productive, and this productivity will hopefully continue. Tomorrow we have a meeting at the Dutch Embassy with their head of development in Bangladesh that Kate’s father was able to put us in touch with. It should be a neat experience.

Also, people have been asking for pictures. /Well, I don't really have any, except for this one that was a struggle to take today. It was quite sunny out and we could not stop ourselves from squinting. It looks a bit darker because we had to change the colors around to make it look better.

First Day in Dhaka

I’ve arrived safely in Dhaka and the first day has already passed. The flight in was pretty uneventful. I flew Etihad which is the national airline of the United Arab Emirates (UAE). I had never really heard of them before booking the tickets so I did not know what to expect, but they are actually considered one of the nicest airlines in the world. The first flight was roughly 13 hours from JFK to Abu Dhabi. I was stuck in a middle seat, but fortunately I had courteous neighbors who did not infringe on my space at all. I slept for a bit and watched a couple movies (Chronicle and Sherlock Holmes 2). There was a brief one hour layover in Abu Dhabi before another 5 hour flight to Bangladesh. The airport at Abu Dhabi was beautiful. It might have been one of the nicest airports I have ever passed through. The second flight went by quickly. I finished a book and took a brief nap and before I knew it, the plane was decending over Dhaka. One thing that I noticed that was different about this second flight was that I was one of maybe 6 people of Western decent on the entire flight. While this is to be expected to some degree, it was very different from my trips to Kenya and Uganda, where on each almost half of the flight were westerners. While there are many expats in Bangladesh doing humanitarian work, it is not on the same scale as in the African countries I have traveled to. It seems to me that quite a bit of the humanitarian industry is driven by Bangladeshi’s themselves, if the Grameen Bank is any example of that.

The flight arrived in Dhaka around 4am. I was able to pick up a visa without any difficulty, though the process was a bit confusing. I first had to go to a bank to pay for it. The teller was asleep when I arrived so I had to wake him up. I then needed to go to a visa desk to pick up the actual visa, before proceeding to immigrations for them to stamp my passport. As I bought my visa on arrival, I had to go to a desk that also served the flight crews. There were supposed to be two people working there, but there was only one, so when the flight crew arrived from the plane I had just departed, they were allowed to cut me in line. While I was waiting, one of the flight crew came over to say hello to me, and two other Americans who were standing behind me. I think he felt bad that we had to wait on their account. He asked us each how long we were staying in Bangladesh. I told him two weeks. One of the other guys behind me though frowned and said “too long”. That really struck a chord with me. I know that he was probably joking to some extent, but he obviously had negative feelings towards the country as he said it with a frown on his face. I wanted to call him out on this, but I could think of nothing to say in response that would be appropriate. I imagine saying something like "Wow, way to devalue an entire country and its people" might not be the most productive thing to say on a visa line at the airport.

After passing through immigration, I waited at the baggage claim for Maia and Kate to arrive. They flew on a different flight that got in about an hour later than mine. After meeting up we exited the airport and met up with two of Maia’s uncles. They took our stuff and drove us to one of their homes where we remained for most of the day. Driving through Dhaka was very reminiscent to driving through Nairobi last year. There are certainly some differences. Bangladesh has quite a few rickshaws and does not have as many motor bikes or matatus, however the type of congestion, the way the roads and advertisements looked, and the types of stores were very similar, though everything was in Bengali rather than Swahili.

At Maia’s uncle’s house we ate a nice breakfast of bread, eggs, potatoes, and mango juice before hanging out and talking for a while. Exhausted from jetlag, we then each went to read our books or to take naps for most of the rest of the day. It is very hot here. Today was a milder day, though it had to be around 80-90 degrees with at least 90% humidity. It is going to be a warm stay, and we will have to drink prodigious amounts of water to stay hydrated. After eating a dinner of rice, chicken, lentils, and some other vegetables, we left the uncle’s house to come to Maia’s grandmother’s house where another aunt, uncle, and cousins live. The bedrooms here are air conditioned which will be nice. Maia and Kate are in a room together, while I’m staying in a room with one of Maia’s cousins. I feel bad that I’m infringing on his space like this, but there are two beds, and I think he speaks English pretty well so I think we will get along fine.

Tomorrow we will begin our work with our first meeting at the ICDDRB. It is exciting to finally get to work on something that we have been planning all year. That meeting should lay the groundwork for some of the rest of the trip. We are also starting to make plans to take a look at the types of phones that are available, as well as what organizations have community health workers we can work with. One of Maia’s uncles might even hook us up with a TV interview sometime during our stay which should be interesting, though incredibly helpful in raising awareness.

This is the beginning of what will be a long trip, though one that will hopefully be full of excitement and success.

Summer 2012: Cellphones in Southeast Asia

Once again this summer I am planning on making use of this travel blog. I have another couple countries on my itinerary for the next couple months, and I am looking forward to both trips.

I am leaving for Bangladesh this Saturday, the 26th, and will be there for two weeks. Then on June 12th, I'm flying directly to Nepal where I will be until August 5th.

The first leg of my summer will take place in Bangladesh. If you are reading this, you have probably already heard of the Village Zero Project. Two other Tufts Students (now alum!) and myself are working to track the spread of cholera in Bangladesh using cellphones. It is theorized that cholera spreads geographically starting in the coastal regions before moving their way inwards. Our eventual goal is to have community health workers use cellphones to track this propagation so that we can create a map of key intervention points. This summer, we are going to be laying the groundwork for the project. We are going to meet with key partners as well as use already collected data to create a preliminary map.

Following Bangladesh, I am flying straight to Nepal. In Nepal, I am going to be interning with Nyaya Health as a part of a partnership with the Tufts Chapter of Globemed. Nyaya Health operates a hospital and community health worker program in the remote Achham district of far-western Nepal. With Nyaya, I will be an intern in their research and data department. Primarily I will be working on implementing a new cell phone system that will allow for community health workers in remote areas, to use cellphones to aggregate the data they collect about the population of the district.

All in all, this summer will be filled with Mobile Health, or mHealth which is a growing field that uses new technology to impact global public health. I will try to post with some regularity. Please also follow the Village Zero Project and the Tufts Globemed blogs which have links to the right. I will also work on updating the two of those internet permitted.

Summer 2012, here we go!