'For a few weeks after we arrived (in America) I kept rubbing my eyes, thinking I was losing my sight or maybe my hearing. But it was the sense of smell that was gone. Even in the grocery store, surrounded in one aisle by more kinds of food than will ever be known in a Congolese lifetime, there was nothing on the air but a vague, disinfected emptiness. I mentioned this to Anatole, who'd long since taken note of it, of course. "The air is just blank in America, "I said. "You can't even smell what's around you, unless you stick your nose right down into something." ' -The Poisonwood Bible by Kingsolver
I’m almost done with this book, one I desired to finish before I left, and have appreciated it more and more the longer I am in Africa. Africa is a place of smells, which seep in through every place and part of your daily life. It is amazing and sometimes horrifying what there is to smell here, but it at least makes you aware of its absence in America; something I’m not sure I’m looking forward to when returning to America.
We were a bit nervous about trying to find a church here in Kisumu. Churches could not be found on the internet and had to wait to look until we were here. Once here we had a few church names through denominations we thought resided in Kisumu, but no boda boda (our present transportation) knew where to find them. A lady I work with at the CDC invited me to her church, Life Community Church. Somewhat reluctantly (because we didn't know much about their standards of beliefs), but also excitedly (fore it was A Church and we knew someone there), we went to it this Sunday. Pentecostal in denomination it was fairly similar to most like denominations in the US. However, and thankfully, the sermon was very encouraging and scriptural, we were very impressed. We were also invited to the home of a woman we sat next to during service. She translated most of the songs for us. The sermon was in English. We went back with her two children to a part of the city called NaLenda, partly slum area, where we ate a very large meal and enjoyed one another’s company. We spent the whole day with her and her children and are planning on having them to our house for lunch next Saturday. It turned out to be a very restful Sabbath. Praise God!
hello everyone,
I am presently at work today, my first day here at the CDC. Tim is supposed to find an internet cafe and say hello, but I will write too b/c 1) the first day is always a bit slower than others and 2) Africa is always a bit slower than everyone else.
so, now for updates. please keep sending the e-mails; it is nice to know what is going on in America.
so, we touched down in Entebbe last wed morning and spent the day in Kampala with Al (the new Karamojong pastor). it was a nice day full of new experiences of Africa driving, which is horrible, even by the new missionary. They think in cms not in inches. Everything (bikes, people, motorcycles, cars) can drive at 30km and come within cms to something else. you usually sit with your mouth and eyes opened wide fearing they will hit someone (in Africa, to be afraid or scared is said, ''to be fearing''). We picked up a girl Hayden from the airport that night and drove up to Karamoja the next day. Jim, David (Jim’s friend), tim and I ate dinner at a restaurant in Kampala (khana khazana....the best Indian I have ever had).
The road to karamoja is beautiful. (we passed the Nile on the way. also mom, if you are trying to track our journey....karamoja will not be on the map, but if you follow the Ugandan eastern boarder north there will be a game reserve on the left and a district called k...piripiri, I forget what comes after the k), it is maybe about 100 miles north of Mbale. there was such a change going from the big city Kampala to the little town of karamoja. The karamojong are these beautiful, yet sickly looking people. In contrast to the rest of the country they dress in bright beautiful colors with these colorful pleated skirts for women and bright beads on men, women, and children. The babies are rapped on the backs of the women with multiple layers of shawls, they look like they will suffocate from the heat, but this is considered their winter here. because they usually are poor and starving the shade and rain seems to keep them very cold. you should have seen. worship was beautiful there on Sunday. it was a new experience worshipping with a translator, dogs running around under foot, and people coming and going (karamojong are often late). A karamojong nurse sat next to me and tim and lead the singing....that was amazing.
we tried writing from karamoja but it seemed difficult to have the radio e-mail working, too much trouble. Hopefully we will be able to write more now that we are in Kisumu Kenya.
We then headed to Mbale to stay a night with the Proctors (another missionary teacher in Uganda) before using a Matatu (the common people's taxi) to get from Mbale to Kisumu. The Proctors were very hospitable and helped us in many ways (including letting us borrow a cell phone). Yesterday on the Matatu we passed the Equator and saw Lake Victoria. After arriving in Kisumu we were very very tired. White people are Mazungu. This word becomes your name which is yelled at you continuously. we have gotten used to that, but are a little thrown off by being bombarded by people wanting to carry your luggage or take you in a taxi to your hotel. it is as if all they see is money with the Mazungu. we took a Boda Boda, a bike which carries the passengers on the back...men forward and women sitting properly to the side (I’m not so good at balancing). It was fun, but these boys work very hard for their 10cents they are getting. I think the excitement of traveling and trying to keep our wits about us for the entire day wore us out. we slept for a very long time yesterday (from 7pm-10am); I wanted to start the day off right at the CDC I guess.
no one has gotten sick (yet). sorry Megan and Andy for making your stories a little less interesting, no defecating in the bushes. Malaria is prevalent but we have not gotten it yet. ALL of the missionary kids had it when we were up there. it's like a minor flu or the common cold here. but we continue to take our antimalaria prophalysis, vitamin B complex, and garlic pills. tim is being very very good about taking all the vitamins I have us taking 3x a day.
Today is my first day in the office. tim is doing something, getting water groceries, we'll see. Andy, to inform you of what I am doing with the CDC.... with a translator we will be interviewing 30 women who are either pregnant of just delivered a baby. These women are HIV+ and use a MEMS cap (Medication Events Monitoring System) which records the date and time the vial is opened by the women. The MEMS cap then gives a % adherence, which is compared against their viral loads (the gold standard in measuring adherence...if they take their drugs, their VL will go down) and their self reports (which sometimes might over report b/c they want to please the interviewer....making their adherence look a little better than it really is). These MEMS-cap-using women, however, have some potential barriers in using it and might have some benefits to its use. this is what I am trying to find out. barriers might include that the vial is large and every time they are to take their medication they are to open the vial. however, sometimes husbands do not know they are HIV+ or that they are in the study. in this case women might open the vial once in the morning, take out three drugs for the day, and take them on time. however, the MEMS bottle will only say they are 33% adherent. this is a problem of using MEMS. The good part about MEMS is that at each visit the mother's MEMS adherence graphs are charted and they talk with the pharmacist about why the medication was not taken at certain times. These women know that someone is checking their adherence (a non-blinded study) they may adhere more b/c they know someone is checking on them. my part of the study is to do an interview of women in order to ascertain what barriers the women find in using the MEMS caps and if they find it embarrassing or helpful to talk with the pharmacist. Then I will use the VLs, self reports, MEMS adherence levels, etc to see if there is any difference b/t those who use MEMS and those who do not.
The study has not yet been approved by the CDC in the US. Yes, this means that right now I cannot start my study until they are given approval. isn't it wonderful to be here in Kenya and not be able to start the study :). oh well, that's Africa. my translators are Anne and Lillian (these are their baptismal names, no one gives Mazungus their African names b/c we can't remember them). they are getting a kick out of the fact that I want to also know their African names. They have translated the interview and consent form into Duluo and next we'll do Kiswahili. they will also need to be back translated into English to see if they are correct translations and then piloted on a few women. that's what is happening here.
ok, so this is very long. I feel like if I have the opportunity to write I should write a lot, b/c it seemed like before it was difficult to get to an internet.
sorry if this message has many spelling errors and sounds rough. I have noticed that we talk more like African English here than I can help (forgetting the 'is, a, the', etc).
love you all,
ari (and tim)
Well, this is it, in about 5 hrs we'll be on a plane to Uganda with a stop in London. We are both anxious and nervous to go.
we'll keep up via e-mail, drop andy, www.loapher.com/blog, a line if you're not getting updates from mass e-mails.
we'll try and post pictures as we go. love you and see you soon.