New Reading Material

Hey there, friends, just wanted to let you know that the Washington Post, Newsweek & Slate Magazine have started a new online magazine that looks pretty interesting (it launched this week).

http://www.theroot.com/

It's like Tell Me More does Slate Magazine...pretty interesting so far, so I'm keeping my eye on it for now...

Notes from Africa (Tanzania January 24, 2008)

View from the Muhumbili University of Health Allied Sciences/Dar es Saalam City Council/Harvard University (MDH) partnership rooftop.

Satellite dish on the roof of the MDH partnership site.

The Harvard delegation visiting Muhumbili University laboratories.
Muhumbili University building.

January 24, 2008
I was hoping I'd semi-starve to jump start weight loss. No such luck! Even in resource poor Uganda the eating was good for the fat Americans. One night in Uganda I ordered a whole Tilapia -- it reminded of Power Friday night (Friday night dinners at my grandfather's house). The head was on, the skin was rubbed with peppery spices, the eyes were milky white and there were so many bones I had to roll up my sleeves. By the end only a sucked dry carcass remained on my plate. I wasn't playing! There's lots of Mediterraen food choices (hummus, baga ganoush, falafel, grilled lamb/chicken, feta etc.). Today, for the first time, I forced myself to moderate my eating and exercise (did my Forrest yoga tape since there's a DVD player in my room and I went for a swim on the rooftop pool:-/

Dar es Salaam, Tanzania is full of contradictions. When we arrived I was reminded of New Orleans. It's bordered by the Indian Ocean -- and very hot (102 yesterday!). The air smells like water (it's very developed. There are no burning smells though I see did people burning cook fires on the beach). The streets are wide and traffic-filled. The city is old with lots of wrought iron facades and balconies. There are mid-day traffic jams that easily rival any US metropolis.

We visited a premiere clinic yesterday funded by our tax dollars, literally (and our President's promises: PEPFAR). It was absolutely incredible -- better than any clinic I've seen anywhere (Bellevue can learn a thing or two). In the center of the building there was an open-air garden surrounded by wait room seating canopied by an overhanging roof (so that clients don't have to get wet when there's a spontaneous rain shower). The treatment, counseling, reception, data entry etc rooms are on the perimeter - all air conditioned (highly inefficient one of the workers commented to me during lunch). The rooms are walled with frosted glass so there's a lot of light everywhere. The only sadness are the faces of the clients who are managing their illness. But here's the contradiction: only HIV/AIDS diagnoses get these resources.

If should find yourself with cancer (or any other chronic disease) -- kiss your ass goodbye. Seriously, find a gun and end it. There's one radiotherapy machine per 2,000,000 people (compared with one per 150,000 people in the US). Cancer care in Tanzania is palliative -- and this descriptor is generous. Opiates are banned in Tanzania (as in most of Africa) for complicated reasons. Families not resourceful enough to smuggle morphine in must settle for two Tylenols when their loved are writhing in pain as their bodies rot from the inside out (which we witnessed when we toured the Oceanside Cancer Institute today - THE premiere cancer treatment center).

30% of their cases are women with cervical cancer who present (that is, come to the hospital) at the point of no return. To give you an idea of what this means: NO ONE in the Western world dies of cervical cancer! We get annual pap smears to detect changes. Our daughters get HPV vaccinations before they bloom (the human pappiloma virus which is sexually transmitted is the number one cause of cervical cancer).

I refused to go into the men's ward during our tour today because I could see from beyond the glass doors that there were men lying on pads on the floor in immense pain in an overcrowded un-air conditioned, unlighted room with their loved ones sleeping beside them (or tending their needs). There were no nurses. I was sort of rope a doped into entering the children's ward. I cried. Deformed children with massive tumors growing on the sides of their heads, eyes missing, bandages in unlikely places, again tired mother's lying beside them. No nurses. No painkillers. No cure. The director of the Center said they must ration care. 50% of the people get nothing other than Tylenol to treat their cancer.

None of the great HIV/AIDS machinery can be used to treat these other horrible diseases. Just miles away there are state of the art laboratories (and clinics) for HIV/AIDS because of our government gives (but only to HIV/AIDS). Antiretroviral drugs are completely free but no one can get antimalaria medication for free (which is much more pervasive). Or simple antibiotics for that matter. It's strange and sad.

Notes from Africa (Tanzania January 23, 2008)

Pam in the lion's mouth in front of the Kiliminjaro Kempinksi Hotel.
A view of the pool on the roof deck of the Kempinski.
Michelle in the pool.
A glimpse of out hotel suite in the Kempinski.

Jambo!
We arrived in Tanzania this morning (took the red eye from Uganda). We haven't done/seen much but freshen up for an afternoon of introductory meetings. I got a chance to peek at Mt Kilamanjaro on the way to Tanzania. It was an amazing snow-capped thrusting of earth. Tanzania is arid and much hotter than Uganda (102 degrees today in Tanzania vs. 80 degrees yesterday in Uganda). These east African countries are so different.

The earth in Uganda is rust colored clay and densely overgrown with intensely green tropical trees (acacia trees, banana trees, coffee trees, palm trees, etc.). Tanzania, in contrast, has lots of low scrabble trees and bushes in muted greens and is sandy and beige.

We're in Dar es Salaam -- the capital. I'm ashamed to say we're in five star hotel in a suite with two flat screens and over-the-top amenities.

P.S. 1/29/08 Am realizing after 24 hours of being back in the States how liberating it was to be where everyone is black and brown in spite of the intense poverty. All the advertisements, all the authority figures, all the service people -- all the faces: black and brown. For two glorious weeks I had a reprieve from the hard, hostile, fearful, face shrugs that some white folks try to pass off as smiles. I was openly gawked at throughout Uganda and Tanzani but the looks were curious, affirming and friendly. Everywhere I was greeted with: Karibou (Welcome!) and Jambo (Hello!). Am saddened by the condescending looks I get here in my library, in Trader Joe's, at check-out counters and on the walk to work. Racism is so tiring.

Notes from Africa (Uganda January 22, 2008)

A glimpse of Kampala, Uganda.

Makerere and Harvard colleagues.

Children enjoying their school vacation.

Apparently bouncing and behaving hair is important everywhere!

A glimpse of Kampala.
Views of town life on the outskirts of the Kampala.

January 22, 2008

it's hard to imagine we're on the same planet since the NE is experiencing sub zero weather. it's warm but not hot in uganda (maybe 75 -80 degrees) -- very tropical. pam says it feels like barbados circa 1970. but the colors and the smells are very different.

the earth is a rich red color. the trees are dark dark green (and everywhere there is something growing. interestingly it's not as overgrown/land of the giants as in hawaii (where you can probably get a stone to bud). the air often smells burnt. many live without indoor cooking facilities and have outdoor cook fires enclosed in a hut made with with hand-made red dirt bricks, sticks for framing and mud. socio-economic status can be revealed by the roof -- those with grass thatched are lowest on the rung, tin a few steps up, brick even higher.

these structures as you can imagine are not permanent. there are collapsed huts everywhere returning from whence they came -- to the earth. but because the materials are easily accesible, families simply rebuild. i'm trying hard not to judge. fundamentally we share the same core values: we pray for the health and well being of our families and we want to live a purposeful life.

fires are also constantly going in the rural areas. the farmers burn the land to clear it for sowing:-( leeching the land of it's sustainability for short term gain. who's to say i wouldn't do the same if i had many hungry mouths to feed and no money to buy it. the average woman bears 6.9 children. uganda has the fastest growing population on the planet. there's no such thing as birth control here and in non christian families men can have up to 4 wives.

kerosene is a popular transport fuel so it always smells like kerosene in the urban areas (also almost nobody uses deodorant:-( i'm stealing a few moments to be alone with my thoughts. our group is meeting for dinner at 7 pm. even though i am eternally grateful for this experience i want to be alone and quiet. i pulled one of our hosts aside to insist that he schedule some time for shopping today. he agreed to 30 minutes at the end of the day before our dinner meeting so far our days begin at 8 am and end at 11 pm.

the place we shopped today was a craft market where there were 25 or so booths of things of variable quality. i'm not convinced i couldn't have found most of the things on the streets of NYC (for quadruple the price). i was hoping to find a beaded watch band that i saw one of the scientists wearing (no luck!). it was difficult to fully appreciate the wares given the short time alloted (but i made do). now i'm acting out by not showing up for dinner on-time:-)

today i met with my couterparts at makerere university. i was truly impressed with them particularly since i've been warned again and again how incompetent "the administration" is. they are career administrators like myself wondering mostly how to make a dollar out of fifty cents (and how to gain the cooperation of their faculty -- sound familiar?). i gave them a few ideas on how to stretch their resources and how to streamline. they seemed truly grateful. after our break out session we returned to the larger group. my colleague presented a summary of our discussion in an eloquent, energized and cogent way. again, i was impressed.

there were two scientific break out groups who presented their findings too. i was bored stiff! am hopeful something with come of it. this ends our uganda trip. tomorrow we're tanzania bound. our flight leaves at 5 am:-/

Notes from Africa (Uganda January 20, 2008)

Map of the Nile.

Michelle at the Source of the Nile.

Wild monkey feasting on jackfruit (I tasted it -- has the mouth feel of calamari and the flavor of papaya).

Pam with Makmoud first wife.
Makmoud house geocoded.

Typical rural Ugandan home (framed with wood branches, secured with mud, roofs made of tin denote higher SES).

Colewaters with Makmoud family and some village children.

The trip is as expected in one respect - meeting filled! Our colleagues in Uganda are clamouring for what I know (as well as what the faculty have to offer). Tomorrow I'll be facilitating a session on grants management/administration (Pam will help!).

Today we visited a hospital and a demographic surveillance site (DSS) in rural Uganda. The need in that hospital quieted me to the core. There was only one doctor servicing 100s of people in the entire hospital. Deep despair was simmering in many of the faces. I didn't want to pretend the people were invisible as we toured the facility but I couldn't smile either. I tried to look at everyone purposefully and with respect as if to say: I see you! The air was thick, hot and rank with human body odor. For a time I tuned out so as to remain conscious (the sickness and the stench made me think I was going to pass out).

This is all exacerbated by the fact that we are staying at a four+ star hotel on the Source of the Nile in Jinja. We slept with mosquito nets last night out of necessity. As we were walking around the compound last night I was delighted to see a few turquoise blue-balled monkeys. They were like the deer in the Poconos and the pigenons in NY -- at once endearing then gross in their lazy meandering.

This afternoon we visited a DSS in Ianga -- here they collect data on families (births, pregnancies, deaths (including verbal autopsies -- medical autopsies are unheard of, illness, marriages, migration, socioeconomic status, number of people in households, etc). This data is coded and assigned a geocode based on the longitude and latitude of the family's house. Then the household is tracked every four months (sort of like a detailed census). Each reported house has a number painted on the front of it (so that surveillance workers know who lives there and all their business). We then went out into the country side to visit one of the tracked households.

There we met the Makmoud (sp?) family headed by a Muslim man of about 70 (who was quite handsome and in good health). He was from Busoka, of the Basoka people and spoke Lusoka (this is a common linguistic practice in Uganda - Bu=region, Ba=people and Lu=language). He had three wives and thirty children! We were welcomed to sit on wooden benches in the red dirt courtyard in front of their compound (a series of mud and brick structures with no electricity or running water). His wife sat behind him on her knees, the second wife sat behind her and so on. The girl children sat behind and around them as he spoke through a translator. The sons sat on benches that encircled the courtyard along with us. Immediately I was overwhelmed with emotion at the sight of these beautiful, very different women, men and children. I couldn't help it -- I began to cry!

Our "delegation" numbers about 10 -- we introduced ourselves to the family after the father introduced his wives, his head daughter (the eldest unmarried daughter) and his sons. When it was my turn to speak again I was overwhelmed with emotion and became a little weepy. Mostly out of gratitude to have the opportunity to experience this family in such a genuinely open way.

Al Gore supports gay marriage

click HERE for the full story.

Trace your ancestry

With the Cole-Waters traveling abroad I have been thinking a lot about ancestry...Has anyone here traced their ancestry?? Here is a website I am considering using later when I am finally a grown up with a grown up job to trace my ancestry: http://www.africanancestry.com/index.html

VERY interesting debate-race and gender in politics

did you all read the NYTimes editorial by Gloria Steinem? Well, it has caused quite the uproar...here is a link to a debate between Ms. Steinem and a professor from Princeton. I saw the link on Jack and Jill politics..read the whole thing..very interesting perspectives presented.

http://www.democracynow.org/2008/1/14/race_and_gender_in_presidential_politics

Dare to Hope the World Can Be Different

Who would have thought we'd be wondering who's won the New Hasmpshire Democratic Primay: a black man or a white woman? Things have changed! I'm beginning to permit a seed of hope sprout: maybe the the citizenry don't have their heads buried in the sand.

Read this interesting commentary in this Sunday's NY Times:
"Whether the results of the Iowa caucuses on Thursday will be seen by future generations as a threshold moment of change or a footnote to a story yet unwritten is anyone’s guess, of course. The victories by Barack Obama, the Democratic senator from Illinois, and former Gov. Mike Huckabee of Arkansas, a Republican not in the traditional mold, are tiny steps on a long road that may not lead to the White House for either man.

But there’s no doubt that for one night, in one state, Americans dramatically changed the subject. Race didn’t matter — even though Mr. Obama was an African-American running in a nearly all-white state — but talk of unity and common ground did, as Mr. Obama galvanized his supporters by promising to toss historical and political division aside."

See more at: http://www.nytimes.com/2008/01/06/weekinreview/06johnson.html?scp=1&sq=negro+

Do you think we can turn the political scene around?

Power!

OK, I don't mean to whine about California's winter weather (how can I when I've got a good 40 degrees on you guys today??), but jeez, these people don't have a clue how to deal!

We've got a big winter storm hitting today (big for us means lots and lots of rain--7" in Napa Valley & expecting 10 ft of snow in the Sierras), and everyone's freaking out and hunkering down in their homes.

Honestly, I would be too, except I have a call to do & we have no power at home. How inconvenient!

Stay warm!

Feel the Fear and Do It Anyway

We challenged ourselves to take a flying trapeze lesson on New Year's Eve. Here's a photo of Miss Pamela flying with our instructor, Scout. It was an exhilarating experience. Each time I stepped on the platform to prepare for my flight I was terrified. My fear never dissipated -- but I did find it easier to face. With each jump I felt myself becoming strong with the knowledge that I could face my fear and succeed by flying.

I've been telling myself for years that fear is a normal part of life. It's constant work to permit myself to be afraid and to move forward anyway. The smile on Pam's face reminds me that facing fear can be joyful, exhilarating and empowering.