Essentially, in my mind, the decision appeared to be between failure and surrender, two words, linked to two concepts that I would never like to associate with my efforts. Effort, is an understatement. I poured my heart and soul into arranging a project dealing with Neurocysticercosis since February, and one dead end after another did not deter my interest. I wrote hundreds of emails, began researching NCC diligently around February. If I were to make it my project, I would make myself an expert. This is what I wanted, and this was the contribution I was committed to making.

Unfortunately, my experience with the bureaucracy of Tanzania has done nothing but leave a bad taste in my mouth. To say I am disappointed is true, but to say I am disillusioned has a pinpoint accuracy that even truth typically lacks. My experience has been rife with unrequited effort, full of people looking to line their pockets at the expense of me, science, and I believe – NCC in Tanzania. I feel like this shouldn’t just be my problem, but the problem of humanity. Dramatic? Not at all, let me explain.

I learned that for about $30,000 I could buy a prime piece of ~45acre property in Tanzania; at the base of Kilimanjaro, where land is both highly fertile and at a great location for building a hotel/restaurant/spa. If I came with the money in hand, the transaction would take just several days and I would be wise to engage a Tanzanian businessman or lawyer simply for the simplicity of communication. Essentially, were I to buy African land with the intention of growing coffee, opening a resort, or simply building my own villa, the system would work very quickly…and everyone would be happy at the end.

Instead, I traveled to Tanzania with the technical capability, training, and equipment to undertake science that has never been done there before, for a disease that has agricultural, economic, medical, and community ramifications. I don’t want to overestimate the importance of my own research, as there were so many variables that could impact the success of the project – perhaps it would not have been as useful as I imagined. Nonetheless, the principle is the same. I offered, free of charge to the government or people of Tanzania, an opportunity for discovery, and in a distant (and hopeful way), an opportunity to be, if not disease free, than at least recognized. It was an opportunity for consciousness-raising, solution – proposing, science.

I hit every roadblock imaginable. Passes, visas, medical research clearance, then the special medical research clearance needed for foreign researchers. Most of what I needed was a nod, and a payment to individuals sitting at various levels in the system…an acknowledgement of the way things are. Most of the resistance I met was inertia, or the expectation of something for nothing. While my ideas were exciting to supervisors and committees, when it came time to do something – make a phone call on my behalf, show the initiative to host a student researcher – the system, and the individuals failed. Instead, I was required to figure out how the system in Tanzania worked, and those that knew how it worked were either uninterested, lacked the professionalism to keep dates and times of meetings, and expected my eternal submission to their status.  No one did anything.

Finally, I realized that leaving was not slinking back to the developed world with my tail between my legs. Leaving was realizing that the failures of the Tanzanian scientific community would not be my failure, and I would not stay in Tanzania as a nod to my own ego. I have disappointment, disillusionment, and millions of observations about the “state of Africa” and “barriers to self-sustainability,” but more than anything, I still have ideas, intention, excitement – and the effort needed to see them through. I drew the line between Africa and myself, and I began looking for tickets to London; an opportunity for redemption in a laboratory. I learned I would be starting a new project from the ground up, and its success would hinge on my ability to work diligently and deliberately in what is now a very small amount of time.

I packed my bags, and left behind Arusha, but not all of the bitterness that dampened my bones, and made my feet no longer feel connected to the land I walked on. I made the 11.5hr budget bus trip from Arusha to Dar es Salaam, tried to change my ticket – and in one more twist, discovered I was to spend an extra week in East Africa. A chance to change my mind, return my spirit to the state of hopefulness that made me extraordinary. I would go to Zanzibar.

Generally speaking, Arusha is what you expect of every large city in a developing country that serves as a tourist hub. This is the place where foreigners come to rest and organize their mind-nummingly-expensive safari tours to places I only dream of going; Ngorogoro crater, Serengeti, Mt. Meru, Soda Lake, the list goes on.  There’s a strong association between the foreigner and the dollar sign. While I hesitate to say that it’s a race-based association, it just so happens that the foreigners are usually white or some derivation therein. While the black tourist might be able to blend in until spoken to, it usually takes little more than the flash of a fanny pack, wrists full of Masai jewelry, sunglasses, or a hat to scream, “I’m not from around here.” There are plenty of pushy artists and salesmen on the streets, but I find Arusha far less dangerous than reported in any of the tourist guides or online. I won’t tempt things though. I steer clear of packs of men, and make sure I’ve returned to my lodgings by nightfall at about 6:30. That might sound like an early night, but Arusha is vibrating with life by 5:30 in the morning.

Having been stuck in Arusha for the past few days, I have done little more than shoot emails to my supervisors and individuals I could ask for advice in terms of getting my project clearances and getting this thing off the ground. For the amount of effort I continue pouring into it, it seems to be a black hole; little, if any, returns.

While preparing for my 6 weeks in Tanzania, I imagined it to be a very different experience; one where I would have been on-site and working almost immediately, not one where I carried very heavy luggage with me from one city/hotel/hostel to the next. I imagined I would be located at a guesthouse, which would provide me with a home base from which to shoot off on various adventures on the weekends, and where I could comfortably kick back and relax during the evenings. I imagined that there would be plenty of time for reflection, and that it would be a place where I could manage some much needed self-improvement; running, eating healthy, writing, meditating.

Alas, none of that was true. I’ve been living the backpacker’s lifestyle with way too many possessions and devoid of that pre-established sense of discovery and decision to live on the fringes. Regardless, I could no longer let the opportunity for self-improvement slide right past. I have been dealing with all levels of inner turmoil, watching my sanity, hopefulness, and what little patience I have, escape me. This was the moment. I would seize it. I would put down the plate of rice and chicken, fish and fries, and eat more fruit and vegetables.

There were a few things that had kept me from doing this in the past. For starters, I am a parasitologist with a very heavy background in microbiology. I’m frightened by fruit that grows on the ground and fruit that has edible skin. I carry around a bar of Dettol antiseptic soap that smells like PineSol. When I think of lettuce, I think of amoebas, gut nematodes, and open defecation. Also, few places here serve salad (assuming I felt confident in the preparation). It seems strange that that would be the case, as the land grows the most delicious vegetables and fruit – everything you could imagine just spills from the ground and drops from the trees.

Side note: The staple food here is Ugali, which is the Tanzanian version of Fufu or Luku, just a little more white, and a little more disturbing in the smooth and mushy dumpling-like texture that frightens me. So, you can get Ugali with chicken, beef, or goat, occasionally pork (I came here to study worm-infected humans because of the high rate of worm-infected pigs. I’m not eating pork). Each time cooked in a sauce far less flavorful and spicy than their Congolese counterparts. For the foreigner, you can substitute Ugali with rice or fries.

Another consideration was that I had nothing to cut the fruit with and nothing to put it in. The room I’m staying in is about 10” x 5”. Between the bed and my luggage, I’m pressed for a preparation surface.  Since I’m low on funds, I decided that I would buy a Tupperware container in which I could prepare my fruit and veg lunches/dinners in order to save the 5/6 dollars it costs for dinner. For a knife, I would use the pocketknife contained in my very compact utility tool.

I then went to the market, and confidently sought out the fruit that I wanted – struggling through the basic numbers and niceties – I walked away with 2 enormous avocados, 2 oranges, 1 cucumber, a few hot chilies, and 2 mangoes. Pretty proud of my gatherings, I came back to the hostel and washed their exteriors thoroughly with antiseptic soap. I then went back to my room and proceeded to cut up 1 of each with my 2-inch blade. When I got to the mango, I realized that I had been hoodwinked – and sold one with multiple soft spots. In the true spirit of eating what I had been given, I tried to work around the bruises. When I had removed the skin from ½ and scored the meat, I then went to make a fillet slice near the seed.

As I did this, I lost all of the length of my knife and noticed a brown juice spilling out and into my Tupperware container. Completely out of character, I then went to make the fillet slice not so close to the seed – losing some meat but not condemning the entire mango. Generally speaking, this went rather well. Looking down into the plastic container –I recognized that using a pocketknife really sacrifices presentation. I was hungry (having skipped lunch), so I sat on the foot of my bed and dug in.

The avocado/orange/chili pepper combination was what I was aiming for every time I dug my fork into the salad. There is nothing on earth as delicious as the giant, buttery avocados grown on this continent! Every time I ate a bite of mango, I noticed an unusual taste, but chalked that all up to a psychosomatic type of reaction. I looked at the smear on the duvet next to me where a slice of mango had dropped during the preparation process, and low and behold, saw the ghostly flesh of a maggot crawling out of the goo. I was disgusted, and began gagging on the fruit I had in my mouth. Having been trained in maggots (after all, I am a parasitologist), I brought my eye inches from the forest green duvet. Surely, it was a maggot! And I was just as disgusted by this maggot at 25 as I was by maggots crawling out of the bloated body of a squirrel when I was 5!

I stared into my fruit salad, imagining how many maggots I must have eaten. Then, in a flash, I poured my remaining salad into a plastic carrier bag along with the scraps left over from preparation. I grabbed my bar of soap and the trash bag, and ran to the communal taps. I opened the trash can in the communal shower area, and dropped the heavy and tightly tied carrier bag right in, then proceeded to scrub the Tupperware, my pocketknife, spoon, and fork with lukewarm water and Dettol. I tried not to get all worked up about the fact that the water wasn’t hot, but even that was a test of character. I then hurried back to my room with toilet paper (no paper towels to be found!) and cleaned the maggot and mango out of the duvet, ripping it off of the bed.

I then took stairs two at a time into the restaurant/bar that is at the roof of the Backpacker’s Inn. Calming myself down, I ordered a coke (which I drink as a replacement for water) and settled on the grilled Nile Perch. The restaurant/bar is beautiful with a great ambiance. When my meal arrived – Nile Perch, fries, and candied onions & tomatoes, I was impressed. It was absolutely delicious beyond anything I have eaten in the past month. It convinced me to budget a little more carefully such that until I had a permanent place to stay, I could enjoy a good meal at dinner. I slept in 2 pair of trousers, a long sleeved shirt and my fleece, using only the bed sheet for cover in the 35degree Arusha night. After all, personal growth is what you make of it!

The journey was very scenic, taking passengers near the eastern coast of Tanzania rather than cutting through the middle of the country, which would certainly be faster. Nonetheless, even the view from the aisle seat was well worth it. For those who have driven through the Western United States, the topography at times resembles Utah, at others, the Mojave, and other times it cannot be described in any way but African. You pass the Masai plateaus, and several mountain ranges. Truly, Tanzania is a beautiful country.

The beauty of your surroundings quickly wears away because you’re far too worried for your safety. Road laws here in Tanzania are really lax, and I believe it comprises 1 law – “do what you want, just don’t hit anyone.” These giant buses careen down the road at minimum speeds of 80-90 miles per hour, pass in no-passing zones (hills, curves, windy roads, narrow bridges), drive on the wrong side of the road and get dangerously close to 18-wheelers or other vehicles. They are known for being particularly frightening to the Westerner, and for their reputation of leaving no survivors in the event of a crash.

There were the usual discomforts of a long bus ride, and those laws of the universe that guarantee that the person that sits next to you hogs all of the space, and that somehow you’ll be able to not pee on an 8 hr trip apply. The trip was uneventful; no iPod and I ran out of reading material.

Moshi is the last large city at the base of Kilimanjaro, and serves at the kick-off point for tourists arranging trips up the mountain. Meaning, the small city pulses with tourists, vendors, louts, and aggressive tour guides.  Honestly, I had been hassled, propositioned, and all but accosted within 30 minutes of arriving in the town.  I had the fortune of being approached by a Rastafarian, Rasta Shungu, who offered to help me find a place to book for my two colleagues and myself. He was kind and respectful beyond anything I could have dreamed, and offered me his life-long knowledge of Moshi. Including budget accommodations to avoid because of a lack of safety, previous thefts, or minimal interaction with the city. After finding a place, he showed me to the city market (clean, and brimming with delicious fruit and vegetables), a great place to get coffee, a budget (though clean and tasty) restaurant, and a place to get salad.

I was a bit skeptical of his kindness, just because I was unsure of what he wanted in return. Its terrible to believe that everyone wants something, but I had already mistaken someone’s kindness for being genuine and been ripped off a couple of times. Truth be told, Rasta Shungu didn’t ask for anything from me and he wasn’t creepy either. As we passed friends of his, he introduced me, and found ways to help me kill the time before Rachel and Ian showed up. While asking him for things to do there in Moshi that don’t include the 6-day, $900 trip up Kilimanjaro, I learned that Rasta was a tour guide and owner of a small company known as Pack-&-Go, and could easily take us on a cultural tourism trip of the first 2,000m of Kilimanjaro, or through the National Park at a very reasonable rate. He said this completely free of pressure! What luck.

Rachel and Ian arrived later that evening, and being in familiar company was an absolute breath of fresh air. It is truly a blessed thing to be in the company of individuals who need no explanation for your time in Tanzania, and are able to commiserate with your joys and frustrations. We spent the next 36 hours discovering Moshi, occasionally finding the Western-leaning coffee shop as a safe house from all the pushy selling. The only downside to this was that it was absolutely packed with tourists – many of whom have far more money than character. In a comical sight, we looked out the window to find Westerners trotting towards the Tanzanian Coffee House, and the sidewalk in front of it equally packed with salespeople determined to corner someone either on their way out or in!

We had the fortune of a connection there in Moshi, Rick, a graduate of the London School of Hygiene and Tropical Medicine from the year before, had been working in Moshi as a researcher for a few months of what would be approximately 3 years. On Sunday, when most of Moshi shuts down, we were invited to an expatriate HASH on the 60-year old estate of a British couple. There were maybe 40 expatriates and their families in attendance, and while we largely kept to ourselves, the walk through the estate was one of the highlights of my time in Tanzania so far. There was a sprawling coffee plantation, a tree plantation, cornfields, flower fields, a river that ran through the land, and remarkably – our first view of Kilimanjaro since our arrival.

Nothing I could say or write could capture the moment when you look high into the clouds, and see the peak of Africa’s tallest mountain. It was one of those times where you are flooded with emotion, you feel the magnificence of God, and everything seems right with the world.

Apparently, the Ulugurus are rarely climbed and this is reflected in how poorly kept and how clearly treacherous the trail has become for lack of climbing. The total height was only 2,180m, but the hike took 4.5 hours up, and 3.5 hours down, a testament to its difficulty. I believe that to call the adventure “hiking” is a gross misinterpretation of the definition, as it was nearer to an obstacle course where, at times, a slip of the foot (on a ledge no wider than a balance beam and far less sturdy) would doubtlessly be the last time your brain sent signals to any part of your body!  The terrain went from agricultural land (banana and coffee plantations) to tussock grassland, then to rainforest before reaching the splintered rock peak, Lupanga.

The cost to climb the Ulugurus is pretty ridiculous, comparatively, and particularly ludicrous of you take into account the fact that the trail to Lupanga (the highest climb) is not maintained whatsoever.  The climb through the agricultural land was beautiful and informative – who knew that pineapples grew on the ground or that one could find ducks running around with chickens where there are no lakes/ponds or bodies of water?  The tussock grassland was dangerous because of the combination of how steep the climb is, how exposed you are to the sun, and how readily the plants and leaves grab onto your clothes or slice at the skin on your face and arms.  We finally reached the height where grassland meets rainforest, and sat at the pinnacle of the Morogoro river waterfall. While nothing special, I discovered the eggs of Simulium blackflies in the fast flowing water. They are not supposed to be there, but I inspected carefully, and am relatively certain that they were not Similium nevii, which means that this is a different and unexpected disease vector!

The rainforest/forest was an experience! The trees shaded us, the ground was soft beneath our feet, and the clouds created the feeling of a magical fog.  One of the guidebooks on the Uluguru Mountains claims that the forest that is found there is millions of years old, and in many ways, it felt like it. Some of the exposed roots were 12-14 inches thick and provided the lattice upon which both the rocks and the earth built themselves.  The rainforest portion was both steep and slippery such that it felt more like rock climbing (using roots for hand and foot holds) than hiking, forcing me to climb largely on all fours.  Felled trees created further obstacles, requiring me to climb over one, through the other, and use a thick vine to get back onto what Westerner’s typically consider a “trail.” Well worth the experience.

The two large boulders that make up the summit left something to be desired and the dense cloud cover compromised the view. Nonetheless, it felt like an accomplishment to make it to the top.  The ascent was only half of the challenge of Lupanga.  By the time I finally made it down the mountain, it was clear I descended the mountain using every extensor-flexor muscle pair I had; I was covered in mud, taking home a collection of splinters, and different from any other hike I’ve ever been on – it wasn’t my quadriceps that ached the most, but my lats and arms, bearing testimony to the number of times my foothold failed me and I was quickly dependent on my ability to grab at the nearest vine, branch or stump!

We cycled along one of the main roads out of Morogoro that was tarmac for about half of the journey. At this point, the challenges were avoiding the other road traffic and managing the hills – as a road cyclist, I was on form.  Then, the tarmac ended and we used the ex-Peace Corps TREK mountain bikes for what they were designed for.  While the snotty mountain biker might believe that a road might not provide the necessary challenges, I challenge them to a boulder and pothole riddled red dust and clay path. This was a challenge of leg strength, stamina, and sturdiness of one’s own seat. There’s a reason why the Zambians joke that one could not see a dog lying in Tanzanian potholes.
At one point, I convinced myself not to look down at my hands, that had been clutching onto the handlebars with a death grip, for fear that I would find all that remained of my svelte arms would be bone and sinew.

Despite the challenges, the ride was fun and beautiful, the perfect foreshadowing for what the orphanage would have in store.  The orphanage, and the entire village it is in, is run by nuns of the Roman Catholic church and sits at the base of the Uluguru Mountains. As part of the village, there is a brand new primary school, secondary school, medical clinic, infant/toddler quarters, printing press, and carpentry house as well as the obligatory convent and Chapel. The schools are immaculate; the landscaping is well maintained, their roofs are brightly colored in blue, green or yellow, every child is well generally well groomed, with uniforms that are clean and intact, shoes and socks, backpacks and their own desks. The teachers and nuns are both passionate and attentive, and the children absorb their education with a tenacity that puts Western grade school students to shame.

The children have a mid-morning meal of porridge, which includes a number of high-nutrition ingredients such as rice grain, wheat, beans, and sugar. While I looked around I was touched, impressed, and a little surprised by some of the identifiable medical conditions that are easily remedied. Among these are scabies, ringworm, a lazy eye, and in the case of one, the beginnings of trachoma in his right eye. Each of these things is a quick fix in the developed world, but just one more challenge to their potential success.

Feeling a little exhausted by our fame in the primary school, we headed down the road to where the infants and toddlers are kept, and I braced myself for what I imagined could be a really traumatic encounter. While I generally pooh-pooh children, I have a particular affection for those that have nothing but the smile on their face and the belief that the people surrounding them reflect some sort of hope, comfort, or positivism. We first walked into one of two infant rooms. The smell of 12 babies in cribs is the first thing you notice, as well as the gloomy gray of the room. Contained therein were 3 sets of twins – 2 pair of fraternal and one pair of identical premies.

Each child had their own crib, was clothed and clean.  The room was visibly free of insects and the temperature was comfortable. This was a point of relief for me, as I imagined something much worse. A few of the babies were hungry for attention – their eyes growing with anticipation as you looked into the crib, while about half of them were disinterested in our presence. There were two in particular that stole my heart.  One was the male half of a fraternal twin, with a chubby infant like face (sounds obvious, but many of them had a face that belied their age), and skin the color of milk chocolate. He watched me with keen eyes as I walked around the room, hesitant to pick up any of the babies. This hesitation was borne out of not understanding the orphanage policy regarding picking up the children, and the fear of acclimatizing a baby to being held.

Nonetheless, as I approached his crib, I was drawn in by his eyes and could not resist caressing his face and his downy hair. His instant reaction was to close his eyes and lean into the touch, moving his chubby hand to hold my own against his head. I was shocked, but smitten. I did realize the danger in this, and moved myself to leave the side of his crib. Unsurprisingly, he cried and I almost did too.   I then wandered to a crib in one of the corners where another baby boy laid.

This time, he was uninterested in my presence, and sucked on his very long fingernails.  As I continued to stand there and look at him, he finally locked eyes and began to rock back and forth. I’ve only seen such a thing on human physiology documentaries where the commentator talks about the importance of human touch to the development of infants.  I was saddened, but knew that other than trimming his fingernails, I could do nothing to change his life.  Meanwhile, the first baby still howled at the top of his lungs so I moved back towards his crib.

I knew that he had backed me into a corner where I would have to pick him up to assuage him, and I did. Instantly, the crying stopped. Happy for the peace, he and I stood there for a while, even after I realized that he was wet and my shirt was now soaked through. Taking care not to hold him for too long, I put him down and we left the room. With us gone, the room was silent.

We helped out with feeding time, where the under 5s help the nuns and 3 of the older girls feed the younger toddlers. It was an event to behold. Quickly, the 3-5 year old children began pushing picnic tables against the walls and placing the toddlers in the seats pinched between the walls and the table, others passed out bowls of rice, beans, and milk. Everything in place, one of the 4/5 year olds stood at the end of the table and recited the catholic blessing for food. Then, the feeding commenced.

The orphanage is one of the best I have seen while traveling through economically disadvantaged areas. There are no diapers as we know them, but pieces of women’s traditional cloths are cut into squares and used. The children are fed and changed 3 times a day by a small staff, and care is taken to educate them on colors, shapes, and the alphabet. Clearly, the nuns love the children and are passionate about the work they do.  I have never been to an orphanage in the US or Western Europe, and imagine that the feeling you get when there are large numbers of unwanted children is always the same. The only failings I noticed were the lack of bednets for mosquitoes and the dental hygiene of the toddlers.  However, they are doing the best they can with what they have, and the result is impressive.

The difference is that what lies in front of you at 25 is no longer a world filled with possibility, but a narrow path, limited by reality. Your inadequacies – the illogical fear of speaking in public, the inability to type more quickly on a computer than you can on your cell phone, the fact that you write how you speak and have never shown an ounce of independent initiative in all of your 25 years – those are your limitations. And the reality is that you have bills to pay. That’s mine.

When I set off for London 1 year ago, I had been compelled to do so because I asked my coworkers a very simple question. To each individual, I asked, “If you had your life to do all over again, what would you do differently and where would you be?” These were people that I knew, at least, felt a since of purpose in their work. In each response was a tone of regret for the life not lived. This was not asking the usual questions of what superpower one would choose if given the ability to possess any superpower. No one answered that they would be in the place they were standing in if they had it to do all over again. Seeing my own narrow path, and the opportunities allowed my by virtue of age and not having any responsibilities to anyone else – I made my narrow escape, into the life I had dreamt of as a child.

When I was young, I used to collect bugs I found in the yard and my dad would poke holes in the tops of jars for me. When I tried to make soap out of paper and some other ingredients, they gave me a chemistry kit for Christmas. When I became interested in bacteria, they gave me a “young scientist kit” for my birthday, complete with slides and children’s microscope. When I wanted to be an astronaut, my parents encouraged my interest by bringing home books or reading mine with me. My mom cut a deal with me. If she were to allow her daughter to ascend into space, then I would have to grow her spinach on the moon. I agreed.

Turns out my parents were really different in that way. We didn’t have spare money growing up, but rather than add another Barbie to my Barbie/Ken pair, they encouraged my scientific interests. Actually, they encouraged all of my interests (athletic, academic, etc.) to the best of their abilities, and taught me that I could be anything I wanted to be. Anything I could dream of, I could become. The world was mine. They taught me to consider the world even beyond what I could imagine, and grab onto something that excited me, challenged me, and maybe even helped others.

They were, and continue to be, the best cheerleaders someone could have in their life.

During my time in London, when I was writing letters to the various medical companies I owed money to, begging them to understand that I was in graduate school and good for the money once I finished, I committed myself to never being in that position again. Just like the door to a big-time modeling career closed because I was an inch too short, I realized that I would be unable to live a happy and comfortable life even if I worked for my morals. I found myself standing in a place where I realized the importance of money, of love, of family, of personal satisfaction, and aligned myself in a position where I would be honest about needing a life’s work that appealed to that – as well as the dreamer in me. After all, isn’t it a bit of a fantasy to think that you could have a life that fulfilled you in all of those ways?

I acknowledged that life pulls on me in many ways. Not least of which are enormous loans that require paying back and two beautiful nieces that I would like to see grow up. In the way that I realized the pieces of my life that are important to me; I looked hard down the path I’ve trod, and I was not surprised to find the grass was tall and the footprints were few. Looking back from whence I came, I acknowledged for the first time that I just might cut across the arid mountains that have separated my path from the other ones, probably to find many others stuck on the route between here and there. As for me, I just might head back to a life less extraordinary. In the meantime, I love the view of the mountains from where I am standing.

I used to collect bugs, and cut a deal with my mom to grow spinach on the moon. Today, I killed a mosquito on my arm, “male Anopheles gambiae.” Next week, in the Tanzanian highlands I will be chasing a parasite enemy of the people, and using my microscope whenever needed. It’s just the life I intended to have.

At any point, it can become unapologetically less extraordinary.

My estimation of the weekend based on Saturday’s events turned out to be incorrect. Sunday was spent watching Nigerian soap operas, re-visiting old papers, and corresponding with Nathanial.  It’s easier than journaling, as you have a target audience in mind, but whether or not you actually share your musings, that’s a different issue all together!  Nonetheless, the day went relatively quickly and I chose to venture out to dinner to a place highly spoken of in my guidebook “Footprint Tanzania.”

A Greek/Portuguese family runs the restaurant/hotel with deep roots in Morogoro.  Known for the pizza, Italian food offerings, and various other dishes, I chanced the dusky skies and took a walk over to “Mama Perina’s” which is on the edge of town.  No sooner had I ordered shish kebabs than Demitra (the owner) and a female guest (early 20’s, Londoner in Africa for 8 months) came and joined me on the porch!  What luck. I was able to negotiate a book trade and learn about Morogoro, as well as things to do while here.  They were both fantastic, and I look forward to joining them again this evening.

Today started with a different tone, one of familiarity and positivism, that wasn’t damaged by the Immigration Office’s “shakedown” of the hotel this morning.  I was called by the reception desk this morning and told that immigration officials were here and wanted to see me “immediately.” In a hurry, I fumbled to get all of my necessary paperwork, valuables and electronics stuffed into my backpack and all of my other belongings put away and locked up. In a stroke of brilliance, I collected my receipts and list of important phone numbers.  When I arrived in the courtyard, they asked to see my passport and paperwork – one of them pointing to my special “Visitor’s Pass” (the one that cost me $100, what was the point of paying for a visitor’s visa?) and asking me, “Did you pay for this?”  Confidently I said, “yes,” and presented my receipt! After a few mumblings of clear disappointment and frustration, they handed me back my paperwork and welcomed me to the country.  Welcome indeed.

I wonder if there are US immigration shakedowns in Kansas hotels?  Seems strange to do something like that, but maybe its done under the assumption that foreigners are tourists or people that otherwise have money.

The highlight of my day is always the morning.  Although my hotel has breakfast included in the price, I learned pretty quickly that I wasn’t actually welcome to it. The first day, I was only given ½ piece of bread and watered down juice while others had more options.  So, I’ve been going to the Classic High Hotel which is close to my hotel and was introduced to me by my supervisor a few days back.  The food is good, the service is good, and the price is low.  In the mornings, I order 3 beef samosas (piping hot, delicious, and an excellent alternative to sausage), 1 omelet (1 free-range egg), a glass of fresh juice (mango, guava, orange mix), and a large doughnut-like fried pastry. My total comes to 1,700 Tanzanian Schillings, and with 1,200 TSZ to a dollar – it’s the best deal ever! Even though I was given a fly-copulation show on the window sill next to my table yesterday morning, few things could be better than breakfast at the Classic High Hotel.
Generally, I only eat breakfast and an early dinner because night falls around 1830, which means that I try not to be out much later than that.

I then took the dalla-dalla bus to SUA to look through the Master’s and Ph.d theses of my supervisors and roam the library.  So far, not a bad day.  I’m getting a little more brave in terms of practicing my Swahili and I’ve woken up quite a bit, which might have been part of the problem in the first place.  For Tuesday, I am hoping to go to a nearby orphanage for an afternoon of volunteering, and on Wednesday I hope to climb the Uluguru Mountains.

A little resourcefulness, a lot of sleep, and a friendly face make all the difference!

Today felt like a never ending day, and the next few promise to be the same.  I had a classmate that Facebooked that she was “bored” in Kenya, and I, being in London at the time, was incapable of seeing how she could be bored in Nairobi.  From Morogoro, I completely understand her sentiment. Had I been here with a friend, classmate, colleague, or anyone to share the language and stories with, it would be a different experience all together. But, I sit in this hotel room, held captive by my own incompetencies.  My prison is the aggravating color of pale Dijon mustard, about 13”x10,” replete with bars on the windows, and heavy door (although wooden). I am held here for lack of anything else, anywhere else to go, or anything to say. Although I cannot understand Swahili, I do understand that I become the topic of heated conversation every time I walk from my room to the main gravel and tile courtyard of the hotel.  I stay in my room.
I’ve taken to walking with a look on my face that somehow crosses vacancy and scowling.  Thus far, it has served me well.  When my facial expression crosses to amusement, engagement, or confusion, I call harassment upon myself. Generally, I do not use this look in restaurants, with the elderly, or with children – mainly just with teenagers and the middle aged.  As a general rule, I treat men that I don’t know very similar to dogs that I don’t know.  Sounds awful, but it is true.  If a man is walking alone, I use general caution – don’t hold a stare, maintain a safe distance, and repay kindness with kindness.  In pairs, I’m slightly more cautious, knowing that if one becomes erratic – the other will follow suit.  With dogs, as in men, groups of 3 unknown all moving together in a pack generally mean they are looking for trouble or mischief. I cross the street and walk on the other side, make sure I’ve planned a last minute escape route, know what my options are for safety, etc. Have you ever heard of a single Rottweiler mauling someone just for the fun of it?  At least in pairs.  I’d rather not be the mischief they choose, especially having no ability to defend myself in the local language.
I realize that there’s danger in alienating the men in my life by my above observation, but I know that they would rather me be safe than sorry. It is not true for all, as a group of fantastic boys/men typically won’t look for trouble, I have yet to know of a pack of Golden Retrievers that are responsible for a random attack!  I’m not paranoid, I’m cautious.
Some things will drive a woman to craziness, i.e. hissing and kissing noises.  While I’m intense, I take pride in being well-mannered, but for those that know me, catcalls will propel me to a level of anger almost unparalleled an any other random interaction!  Like I asked the soldiers in DC Congo; has a woman ever responded with interest to the sound of hissing?  It has cooled quite a bit, as Morogoro is only about 100,000 people, and I am no longer a new face.  I suppose the look on my face coupled with my continual lack of response has led them to believe that I might be stupid.
It rained pretty hard in Morogoro last night, so there was very little dust in the air this morning.  The potholes were painted a brick red, the ground was solid beneath my feet, and the visibility allowed for the Uluguru Mountains to loom in the background of the city.  It was beautiful.  The only downside is that the rain dampens piles of trash, and the scent is released into the air with a freshness that belies how long it has been sitting out in the open.  I suppose the hot dry heat desiccates the trash, and on the warmest days, I take no notice.  Generally speaking, Morogoro is relatively clean, with a good drainage and sewage systems.  Last night’s rain was a much appreciated respite from the dust.
Actually, I was back in my room at 1030 this morning, so I’m not sure how it played out in the afternoon.  Having finished the one novel I brought with me, I was left only to re-read, take notes, and continue planning my project and thesis.  Most of these papers I have read before, some many times.  I watched time slowly pass by, and allowed myself to waft in and out of sleep. My supervisor, Dr. Mathias Boa was kind enough to call me during the evening to check if my research equipment was working adequately, and I took the opportunity to coax him into keeping me company for a few hours.  For tonight, I didn’t have to eat dinner on my own.
Tomorrow promises to be more of the same, only worse.  My supervisor heads down to southern Tanzania with a group of his students for a field course for the next 7 days, leaving me in Morogoro to go absolutely nuts.  I continue to curse Air Kenya’s luggage weight limit, as I couldn’t bring more books to read or materials to study while here.  The idea is that during the next week I can travel into SUA to have access to some of the materials I need to write my thesis, study protocol, and create data templates.  I don’t know how much time I need to do all of that, but I do know that 7 days of stumbling through 2 meal excursions but otherwise keeping to myself is not something that I look forward to.
For an introvert, this is like forcing a teenager to smoke packs and packs of cigarettes until they have grown sick and nauseated.  I love my introversion because I choose it, and because I’m one of the few people that admits to tiring of the constant company of others (there are a few exceptions!). No decent television, no movies, no books, limited Internet access, no friends, no world news, no family, no phone calls!  I devour emails and cherish the distant interaction built through this time I spend before going to bed each night.
On the positive side of things is that I am learning to slow down. Before moving to London, I suffered from the compulsion to always get things done – to be on the move constantly, always looking for a way to maximize my output in the hours I had available.  Europe and Nathan succeeded in taking that down a few notches, and part of my excitement with returning to the States and the working world was that I could throw myself into a million different things.  Here, there is no time and all the time in the world.  I can hardly measure its passage; already feeling like this always was and will always be. In 2 weeks time when I am at the field site, I will wish for the days when I could lull in and out of sleep and one day rolled into another – each with no beginning or end. This is Morogoro.

While this might seem mildly disappointing, the advice was that I should head for Arusha on Friday morning, spend Saturday and part of Sunday there before heading to Mbulu Hospital, where I would spend Monday traveling and introducing myself to local health officials, and leave on Tuesday for Haydom Lutheran Hospital.  What a journey!  The idea of leaving Morogoro turned into an obsession as I threw myself into my Tanzania guidebook to look for inexpensive places I could stay and a few things I could afford to see and do while in Arusha.

My sleep was restless.  Turns out that the bar my window faces turns into a pretty active night club/dance spot.  It is not an enclosed structure and the music played until about 1am, followed by the drunken activities of those trying to get home.  Since the fan in the hotel room was not working, I drowned myself in my sweat – refusing to sleep in anything less than insecticide treated scrub pants and a long sleeved t-shirt.  Every moment I was cognizant of where I was, I feared that a mosquito had entered my bednet, braved my pyrethroid impregnated clothing and repellent slathered skin, pierced my skin and injected Plasmodium. 

The sound of morning prayers at the local mosque were welcomed as they ushered the dawn before the cocks did.  I could sleep in relative peace knowing I had made it to daybreak.  With a bounce to my step I prepared for a shower.  My excitement was tempered by the ice-cold water and standing above the toilet.  No thorough shower was ever had in ice-cold water.  I packed my bags, ate breakfast and waited to meet Dr. Boa.

He is tall with a friendly face, soft spoken, and the gray streaks his hair and beard right at the midline.  This man knows how to get things done.  Under his care, we worked out the proper research paperwork with Immigration and found me a new hotel to stay in.  Cheaper than the last, with hot water, a clean bed, secure and quite building.  I am to make this place my home, as I will be here for the next week.  During this time, I am to make proper arrangements at Haydom hospital and set up spreadsheets, entering and organizing all of the data that exists up until this point.  Dr. Boa will be out of Morogoro in the south of the country for all of next week, and I am not to head to Mbulu without him – at least not initially.  He is well known in the area, has an excellent research reputation, and importantly, can communicate properly!

Tentatively, this is what I am doing.  I am working to solidify/establish the relationship between porcine cysticercosis, neurocysticercosis, and taeniasis in Mbulu District. Essentially, science dictates that there is a relationship between all of these things, and this is how it works.  The tapeworm, Taenia solium, also known as the pork tapeworm, only exists in humans and pigs.  Officially, it would be called the human tapworm, but humans are really adverse to titling a tapeworm after them!  The adult tapeworm, what we all think of as being a tapeworm, can grow to about 7m and lives in the small intestines of infected human beings.  Note that the adult is only found in humans.  The adult is filled with/produces millions of eggs, and releases segments filled with eggs into the feces, which then pass with the fecal waste products.  In areas with poor sanitation, these eggs get into the environment.  Pigs are known as “feco-phagic” which means that they have the disgusting habit of eating poop.  When they eat poop that contains T. solium eggs, they develop cysts all through their muscle tissue.  This is of great economic and agricultural importance, but for human parasitology, the story continues.  When a human consumes this infected, undercooked, unprocessed pork, these cysts rupture in the stomach and the hooks contained in the cysts attach to the small intestine, which will grow to be an adult.  Adults are innocuous and do not make people sick, other than the potential for an itchy bottom when passing the worm segments that contain the eggs.  T. solium is complicated by the human ingestion of eggs.  Note that only other humans pass eggs, as adults do not grow in the pig. By some manner of fecal-oral contamination, the human becomes an accidental intermediate host (naturally the pig).  The cysts develop in the human much in the same way as in the pig, but they have a predilection for the central nervous system, a condition known as Neurocysticercosis.

NCC  can present with an array of symptoms ranging from nothing at all to personality changes, ataxia, epilepsy and everything in between.  NCC is the number one cause of adult onset epilepsy in the world, and is affectionately known as “the most neglected of neglected tropical diseases.” For now, it is my parasitological disease of choice.

So, to summarize.  Individuals that carry adult worms are the source of infection in an area, and the condition is known as Taeniasis.  Pigs infected with cysts, which are the fluid filled sac of T. solium larvae, are the intermediate host – because a human must eat infected meat to have an adult. Infected pigs are known as having cysticercosis. Humans with cysts, often presenting as Neurocysticercosis, are a dead end host in areas were cannibalism is not practiced.  Clearly, the relationship exists between these three different interdependent disease states.

In Mbulu district, extensive research has gone into discovering that porcine cysticercosis is endemic, and there are confirmed NCC cases.  To date, there has not been any success in locating individuals that are carriers of the adult worm.  They exist, doubtlessly.  My task is to combine all of the existing data into a geographical information system to locate areas that are at high risk for NCC and PC, thus deducing the predicted areas in which there are individuals with taeniasis.  Then, through various parasitological analyses, I am to try and confirm the presence of carriers.  Excellent.

You’ll have to excuse the lengthy explanation.  Now that its out of the way, I don’t have to go through it again.  My research is top secret and proprietary, so I won’t be able to share the details in public forum, but I will share some of the adventure along the way.

My time in Morogoro today has been more pleasant, I am re-settling into Sub-Saharan Africa and remembering my affection for this part of the world. After all, I am, at the root of it all, an African girl.  Although ½ of my genes are Scandinavian, 2 generations of my Swedish family call Africa home.  While I don’t think that ancestry or origin automatically make someone a part of something, in my case, it does.  The adjustments will come slowly, but I am looking forward to being a little bit more at ease and diving headlong into my work.

Morogoro is at the foot of the Uluguru mountains, and this provides a beautiful backdrop for a city so dusty the leaves appear filled with autumn. The mornings begin with with the beautiful shine of chocolate at every turn – the sign of good shower, excellent moisturizer, and active equatorial melanocytes.  As the day wears on, the skin becomes more ashen, and the hair a medium brown. It makes me smile (doubtlessly with grit in my teeth), thinking of my firstborn niece – whose beautiful dark skin her mother and I love to lotion to a healthy shine. Ah, an afternoon in Morogoro!

 
While checking out of the hotel, I noticed that there was a large van/small bus marked “Sokoine University of Agriculture” that all of the Americans were having their luggage loaded onto.  How fortunate! Sokoine is in Morogoro and is the University that I am collaborating with while here. Their professor and the African professor from Sokoine were both very kind to me and offered to take me, free of charge to Morogoro (I saved about $12 and a lot of frustration).  The ride was comfortable, the roads were in excellent condition, and the company was good.

 
In Morogoro, the nutrition/pre-med students were dropped off at Morogoro Hotel, which is a collection of small bungalows all spread through a very beautiful property across from the local “country club,” very similar to Hotel Karibu in Goma, DRC. On our way to the hotel, I received a text from my hosts saying that there was no space for me in the university guesthouses and that I would be staying at the Mt. Uruguru Hotel. Kindly, I was dropped off there after the other students had settled into their accommodation. Mt Uruguru is smack in the middle of Morogoro, near a bustling market and commercial area.  The hotel, at one point, could have been quite nice – the rooms have ensuite bathrooms which prevents me from complaining too much.

 
Other than that, it’s pretty awful (having been spoiled by both the Peacock and taking a look around Morogoro hotel). The music from the center of the city is loud, mosques and the market are nearby, whether or not the doors actually lock is a mystery, the shower is an open space between the sink and the toilet, where one is expected to sit on the toilet to shower, the drain is a hole drilled into the concrete floor (which is partially flooded), and the bed sheets are perma-stained with little droplets of blood – serving as an all too useful reminder about using the mosquito net and spraying yourself down with insect repellent to ward off the likely bedbug situation. No use noticing the overhead fan doesn’t work and you’re being suffocated by the warm stench of the city.  Last night, as I thoroughly enjoyed the A/C at the Peacock I realized that it would probably be the last time for such niceties, clearly, I had no idea how true that would be!  Nonetheless, I’m paying only $16/day and on a very, very limited budget. Beggars can’t be choosers!

 
Hopefully I will track down a bank and Internet provider in the next several hours before I am to meet with my collaborating professors this evening.  I will push to get out of Morogoro as quickly as possible and out to a field site. Mbulu district, to my understanding, is near Arusha and quite a bit colder than here due to the elevation. I don’t have the money to have high-class taste, so I look forward to hopefully getting to a place that is more “guesthouse” and a little less “businessman-rents-a-room-for-several-hours.” Not to mention, wide open spaces are the true beauty of almost any country I have been to. So, keep your fingers crossed that I leave from Mbulu by Friday/Saturday at the latest. That will probably be one of the last times I have access to an ATM machine for a while (looks like that will likely be the case with Internet also).

 
I will update you all with some of the ins and outs of my project after I have had the chance to discuss everything with the University staff tonight. Unfortunately, it looks like I will be doing a lot of GIS mapping (which is what I wanted to do initially), but I was unable to get the program loaded onto my computer before leaving London. My guess is that what will happen is that I do a lot of data collection and collating here in Tanzania, as well as whatever diagnostic work I can squeeze in, then I head back for London/USA at least a week or so sooner than expected (maybe 2weeks as all of the mapping and statistical analysis is very labor intensive and all 10,000 words are due by noon on the 24^th of August).

 
Again, thank you for all of your support!

p.s. The other really lucky thing that happened to me: When at Heathrow airport and already being charged $300 for a change of ticket to Monday, I had no more available money with which to work, and Kenyan Airways is notorious for really laying into passengers for luggage overages – I had witnessed it with 2 passengers. They charge around £120 for 10 kilos, which should be illegal.  I was already tense and on the verge of tears, thinking that Tanzania was more a pipedream than anything that I should follow through with and under incredible stress whenever I thought about the logistics of my trip and my sparse funds.  If I was charged for luggage, I wouldn’t be able to go – that simple.  So, I put my bags on – and 2 bags totaled about 31kilos, the limit for check-in and carry on is 30 kilos total and this didn’t include my carry on.  After a brief and whimper-y explanation from me, they decided that they were in too big a hurry (me being the last standby flier) and just pushed me through. No charges.