Monday, July 2, 2012

Dominican Republic

I'm sitting in a little cafe in our Casa de Campo resort, taking advantage of wifi and air conditioning, an entire world apart from where I've been working all morning. Along with a handful of other med students and a pediatric resident, I've been spending a good portion of the day walking through Bateye 16, home to a few hundred or so migrant Haitian workers. The setting is similar to the communities in Guatemala where I worked previously, populated by coffee plantation workers. This time however, the men work on a sugar cane plantation owned by an absurdly large and overarching company called Central Romana.

I'm a week in to this trip and continue to feel as though I learn so much about the people around me and their countries--both home and adopted. My project endeavors to sketch a portrait of their lives, specifically within the context of healthcare. I'm interested in their relationship with various healthcare providers--hospitals, clinics, health promoters--and what barriers keep them from accessing such care, be they monetary, personal, or work-related. In my interviews, I ask each person about their lives, when and why they moved to the DR from Haiti, feelings about their job and their health, thoughts about their families and moving back to Haiti.

I've found myself in some rather interesting conversations, some disheartening, some entirely outside the realm of logic (these data points might have to be thrown out for unreliability). I think I'll try to take some photos of the more intriguing stories and type up little blurbs when I'm stateside next.

During these daily community survey visits, we've encountered some interesting clinical cases. Annie, another med student and good friend of mine, is working on a hypertension study. As part of her interview, she measures blood pressures of each of our subjects. The number of HTN cases we've found is almost unbelievable. I've heard our translator run through the Creole version of HTN management so many times now, and every time am disappointed by our inability to provide medication or any sort of support other than dietary and lifestyle modification tips.

Toward the end of last week, we interviewed a middle-aged woman, at the end of her 10th pregnancy. Her BP was 230/110 which is absurdly high, pointing toward preeclampsia. We took her to the hospital that afternoon and spoke with the big boss man about her case. The treatment for preeclampsia is to deliver the baby, if he/she is viable. Turns out our patient was full term, though she had reported being 8mo pregnant. There was talk of preemptive and non-consented tubal ligation to prevent future cases of pre-eclampsia...the medical ethics part of me is throwing a fit just thinking about it. At the same time however, I can understand his perspective--families living in the bateyes can't generally afford quality healthcare, nor do they have enough time away from work to seek it out. Hospital visits tend to occur in the most emergent of cases, and issues that don't impact their ability to work rarely gets the clinical management it should. Still, a secret tubal is probably not the best policy.

When we went to visit her the next morning, she asked about her baby whom she hadn't seen since the delivery. We checked in on her newborn and found her to be doing well, tucked away in one of the two incubators in the tiny one-room NICU. She was one of the most beautiful little babies I've seen. I wonder what would have happened had we not interviewed this woman that day. Having worked in the public health field for some time, I am not as affected by the situations I see as I once was. Even in my early, though mild, case of cynicism, I found our encounters with this woman to be heartwarming. Getting her to the hospital, seeing her through the process and safely home again, gave me such a sense of fulfillment as I haven't felt in awhile. I only wish solutions were so easy to come by in all of the other cases. I'm curious to learn more about how this whole event fits into this woman's life, from a social standpoint. We essentially kidnapped her and within 24 hours, she had a baby girl and her family had yet to find out. And what about the tubal? What implications will that have on her life?

It's been an interesting experience working with this community. I've learned a lot from their stories and am always left wishing I had the power and the means to do more than just nod sympathetically. I am learning a bit of Creole though. It's been fun. The guys we're working with are great--helpful, fun, and committed to their community. It's really nice to see.

Impoverished and vulnerable communities like Bateye 16 are far from lacking in the world. Having worked in similar settings does not make it any less upsetting to hear about and see the difficult lives they lead. But my interactions with such communities fuels my motivation to learn about the body, medicine, healthcare, in the hopes of changing the world one life at a time. I read something once that comes to mind now:

"Certain things catch your eye but pursue only those that capture your heart."

I think I've found that thing, and I fully intend to do just that. Sometimes school just gets in the way of learning.

Haven't uploaded pictures yet, but will do so when I'm stateside!

Pura Vida

Despite the last post, it turns out I've had plenty of opportunity to travel since April. I made it to Costa Rica twice in April and May, and am currently in the Dominican Republic working on research project.

In CR, I had ambitious plans for my last-minute trip, to make it to both the Caribbean and Pacific coasts. I walked up to the beach in Puerto Viejo de Talamanca on the Caribbean coast, and never left. When it came time to leave, I almost didn't leave, being so enraptured by this place. It was absolutely gorgeous. It gave me an opportunity to step out of the crazy responsibility-laden life I normally lead, and to simply live in the moment, on a beach with some great people. I could go on forever about how much I love CR, but it might turn into rambling. I went the second time with the man friend, which was equally enjoyable in a very different way. It doesn't quite exude the romance of Kenya, but the beaches stretch for miles, the beer's served up cold, and the people are lovely. The water is incredibly warm at all times, perfect for those of us who like a little night-time swim every now and again.

The coconut rice on this coast is tannnn rico. If you ever find yourself in Puerto Viejo, might I suggest staying at either Cabinas Larry or El Dorado...they're both great little hostels, the first at $12/person/night in a private room, the second $10/person in a more hostel type setting. Both have free wifi, though it's relatively easy to come across wifi in this awesome little beach town.

Ben and I also rented bikes for less than $10/day and biked down the coast, stopping at different beaches along the way. It's a great way to get around and check out the nearby playas. The next time I get down there, I'm hoping to get down to the Panama border, as well as the other coast. I'd love to talk more about it if you're interested mes amis, but don't want to bore y'all with details. So as always, email me if you want to hear more!

Monday, April 2, 2012

I'm back!

I realize it's been almost a year since I last updated this blog, as some of you so kindly pointed out. Normally, I would be embarrassed about my slackage, but since I was never the blogger type, I don't feel so bad. My last post was after the amazing Masai Mara safari in Kenya. I still have very fond memories of that trip, and I look forward to the next time I'll be traveling in Kenya...hopefully next time, I'll have a travel buddy. Any takers??

As an update on the rest of the trip, I traveled up the coast of Kenya, stopping in Mombasa and the little island of Lamu. Mombasa was this sultry, coastal city full of history, exuding a mysterious and fun-loving vibe against a traditional, religious background. I met friends of friends here, enjoyed a massive seafood dinner on a boat, and stayed in what seemed like a miniature palace. Then there was Lamu. If only I could've spent more time here. The entire island was pedestrian and donkey-only (unless you count the sole tractor I've seen around). The streets were uneven and narrow, lined by tiny storefronts hiding what might have been secret treasures long forgotten. The beaches were empty and the water a clear blue. I befriended a guy named Moses who showed me around and made sure I wasn't bothered excessively by the sleazier types. The food was great, and the views beautiful. If you're headed there soon, I highly recommend the hostel I stayed at. The rooms were clean and huge, the staff super friendly. They even had a mini library which was convenient for my lazy beach days.

 My trip back to Nairobi was a little more eventful than it should have been. The short story? I hitchhiked my way back down the coast, felt the fight-or-flight response engage when we pulled off onto an unfamiliar dark side road (to explore some shared mansion, it turns out), and crashed at a complete stranger's house. But, I survived.

Uganda was next up on the itinerary, where I met up with a friend/ex-lover-type of mine. We whitewater rafted up the Nile--yes, so touristy--but oh so much fun. It was a neat feeling to float up the river, imagining the centuries of history that had happened around that spot. 
Our next stop, Lake Bunyonyi, "the place of many little birds," was easily one of my favorite places during the trip. We had a bit of a transportation disconnect, so ended up on a dock at 4:30 in the morning. What could have been a terrible situation turned out to be really peaceful and serene. Here's a shot I took as the night started to lighten. We spent a couple days here, rowing aimlessly around the lake, and just lounging and catching up. This is another place I would add to any Ugandan itinerary.

Rwanda was my final stop before a return trip home from Nairobi. I saw parts of Kigali and Rwinkwavu, Partners in Health HQ. We had an interesting tour through the hospital, where I was acutely reminded of the motivation behind these med school dreams of mine. It was a nice end to a good trip that I wish could have gone on longer. I'd love to make it back some time. But now that I'm on med school lockdown, it may be some time before I get either the time or the dinero to make it happen. One day...

In the meantime, it looks like las aventuras de crystal are going to be much more domestic. There's a potential Dominican Republic trip planned a few months from now, but before that happens, I'll keep you posted on the life of a struggling med student who's rediscovered an obsession with working out.

Three main motivations:
  1. Diabetes sucks. and it's a risk factor for everything else. (for all my friends with diabetes, I feel your pain and promise to be a compassionate MD to all my DM patients)
  2. Anatomy. Have you seen what fat looks like inside the body? Not a good look. Also, muscles. Sexy.
  3. Gotta stay on that grind if there's even a slight chance my residency will resemble Grey's Anatomy. Helloooo, McSteamy.

Tuesday, June 7, 2011

Maasai Mara Safari

I'm currently safari-ing in Maasai Mara, easily one of the most stunning places I've ever seen. The views alone are worth the trip. I flew here from Nairobi in a tiny 12-passenger plane, getting the chance to fly low over much of the park, seeing everything from buffalo to impalas, giraffes to elephants. I'm staying at the &Beyond Kichwa Tembo tented camp. I can't recommend this place, or Maasai Mara strongly enough. The staff is awesome, the accommodations couldn't be cooler, the food's great, and the views are impressive. My tent is a bit raised, so I feel like I'm literally sitting in a really swank treehouse. The tents are an ideal place to stay because they're comfortable with nice beds and nice bathrooms, but you're definitely still in the bush (albeit, a very comfy one with wireless every now and then). There's no electricity in the early evenings, so you use candlelight, which I's a pretty romantic setting, in the middle of the jungle with only candles to light the room. (For the more practical, there are real lightbulbs in ceiling lanterns and stylish bedside reading lamps when the electricity's on after 6:30pm.) Funny thing about being in the jungle--they only allow 15 kilos of baggage on the small planes, so I took only my backpack, scrambling a bit to switch just what I needed from my hiking pack to the backpack while in the airport. In my rush, I forgot to pack PJs, so I slept mostly naked. It was a surprisingly primal feeling to go to bed half naked in a tree, in the middle of the jungle, listening to the sounds of monkeys moving about the surrounding trees and lions and cheetahs roaring not too far off. The only thing more primal-feeling I'd think (short of sprinting out barefoot for a quick hunt, spear in hand, Maasai style), would be to, ahem, get intimate with your baby, baby, baby (a la TLC), in a tree in the middle of the jungle, to the sounds of monkeys, lions, and cheetahs. Haha. Anyway, like I said, this place is amazing. They go out of their way to make you comfortable. In fact, last night when I was ready for bed, I shimmied my way under the covers and my foot hit something soft and warm. Scared the crap out of me, thinking it was some animal that had snuck in and burrowed deep in bed. It was actually a hot water bottle (which is perfect, cuz my feet are always the last to warm up) that had been placed there when my guy turned down the sheets for me and rolled down the tent windows (don't need any peering monkey eyes in the middle of the night). And the wake up call before breakfast/the morning game drive involves tea or coffee with biscuits brought to your tent...of course, since it couldn't be left outside (lest the monkeys get to it first), I was in a bit of a scramble to find some article of clothing before receiving the best tea ever.

But enough about the lodge. Long story short, if you're ever in Maasai Mara, the Kichwa Tembo tented camp is where it's at. And let me know you're coming so I can come too! Another plus about this place is that a portion of the funds you give are funneled toward their conservancy efforts here in Maasai Mara. The park itself is absolutely amazing. It's the stuff dreams (and Disney movies--shoutout to Rafiki and Simba) are made of. Stretches of tall grass as far as the eye can see in every direction, dotted by solitary trees and herds of all kinds of animals. Mara is a Maasai word for "something dotted," in reference to the appearance of the savannah from above. I've been here less than 24 hours and have seen giraffes, hippos, lions, cheetahs, impalas, antelope, warthogs, all kinds of birds and small game animals, crocodiles, elephants, etc etc. The zebras here are super affectionate. I saw tons of what I like to call zebra kisses, and several of them could be found with their heads rested on the neck/upper back of another, and vice versa. Adorable. The hippos on the other hand, were so mean to each other. There was a big group of them that kept chasing away one lone guy...they first started wagging their short tails really fast. Then, one of them approached this poor dude, turned around so his butt faced him, and wagged his tail. Finally, they converged on him, forcing him out of the Mara river. The group next to them actually had one bully chase him across the bank of the river. If giraffes are the basketball players of the animal kingdom, hippos are the biggest, meanest linebackers. They're HUGE but holy crap, they can run. Other than that, the cheetahs were pretty awesome. I saw one with his freshly caught kill, a little antelope. A leopard has left the head of his prey strung across a branch in a tree. (They can carry three times their weight up into the trees!). The lions were super lazy, just chillin in the tall grass.

Had a little chat with a real live Maasai dude. Their village is 2km from the lodge, so they wander in and out sometimes (so do the warthogs who apparently are primed for mating season right now, sprinting across the garden after each other). They'll be putting together a little performance of sorts tonight before dinner (tourism has reached its claws into the Maasai tribe, too...and I am embarrassed to say I'll be indulging myself). The traditional diet of cow milk and blood is what gives them mad hops, apparently. I remembered that little fact from a random children's book about the Maasai that I read multiple times in elementary. However, homeboy said a lot of the younger generation that go to school have stopped drinking as much blood. The rest of the community sticks to the traditional staples, though.

Man. Neither words nor pictures could describe this place. It's an experience you should definitely add to the bucket list. The internet's super slow here (we are essentially in the bush), so I won't upload pics til I get back to Nairobi, but check the fb album in a few days. I've still got another day and a half here, before I'm headed to Mombasa, so I should have a ton of pics.

After this, Mombasa, Lamu, Uganda, Rwanda. Yes, I got my yellow fevs vaccine at the Nairobi Hospital. Ha. Wayyy cheaper to get vaccines here than at PAMF. And the kids in the vaccine clinic are the cutest things everrr. And don't worry, I'm also prophylaxing, unlike in Burma/Thailand. Oops. Now I've got lunch, then another game drive. I've already fallen in love with Kenya. Can't wait til my next trip back.

Asante sana for reading, btw!

Sunday, June 5, 2011

Madaraka, Lake Nakuru, and Safaris

I've been in Nairobi for a few days now, and have loved it more and more as I see new things and meet new people.  The first night I was here was the day before Madaraka day (Kenyan independence day) so Nairobi was crazy. Expats and Kenyans alike were out celebrating that night, into the early hours of the morning. Despite all the warnings about the crime here in "Nairobbery," I've felt pretty safe walking around where I'm staying. Of course, like any big city, you'd be asking for trouble if you walked around at night and flashed them dolla bills, or shillings, I should say.

Post-Madaraka, I tagged along on a one-day safari to Lake Nakuru with a guy who's visiting from Chicago. It was pretty amazing, to say the least. We saw all kinds of animals, up close: rhinos, buffaloes, flamingos, giraffes, baboons, hyenas, antelopes, gazelles, Pumba (warthogs), etc. There are several lookout points that offer surreal panoramic landscapes of acacia forest, savanna, and water, dotted with herds of animals. Even the dirt here has this really rich red color that makes the different plants pop.

I spent half a day hitting some of the tourist stops in Nairobi. This little adventure focused on getting up close and personal with giraffes and crocodiles. Pretty cool. Giraffes are one of the neatest animals I've ever seen. They're like the basketball players of African wildlife--tall, lanky, with a swagger in their gait. Although, their eyeballs are much bigger than I expected and their tongues are ridiculously slimy--antiseptic, I learned. Crocodiles have really soft underbellies, no tongues, and a suction-like snap to their grill that cracks big bamboo sticks. Oh! They've also got two eyelids, allowing them to keep the inner translucent one closed underwater, so they can see excellently. We also stopped by Karen Blixen Museum, the second Kenyan home of the author of Out of Africa (inspired the movie of the same title with Robert Redford and Meryl Streep).

Other than that, I've just been hanging out here, meeting a ton of people, mostly expats, but some Kenyans. Went out for nyama choma last night with Kanyi, a Kenyan from Stanford--so good. Literally, a kilo or two of grilled meat on a platter with ugali and some version of salsa, eaten with your hands. Paired with a cold Tusker or Pilsner--excellent. This place, Njuguna's, I believe it was called was definitely not an expat spot, which was refreshing. The bars and clubs that cater to expats also have a much different vibe than those that have a primarily Kenyan clientele. Both groups however, go hard. I mean, until 4 or 5am regularly. And Kenyans can drink.

Other fun foods I've tried here in Nairobi for the first time ever were not actually Kenyan, but Ethiopian and Korean bbq. Both good, but only Ethiopian was eaten with the hands. That's basically what's been keeping me busy in Nairobi--people, food, and drinks. I did stop through Kibera, however, to check out Josh's work with Carolina for Kibera. Literally a bike ride away from a nice part of town, this place was heartbreaking to see--all the buildings made of mud and those corrugated tin/aluminum sheets, packed with people, covered with rubbish. But the work that CFK does there is pretty admirable. Also went to Blankets & Wine, a little music festival at Mamba Village the first Sunday of every month. Pretty low key fun.

Tomorrow, I'm off on another safari--this time, a serious three day, two night lodge stay in Maasai Mara. Then, it's off to the coast for Mombasa, Diani, and Lamu, before I head out to other East African countries for a week or so. Hoping to find people to wander around with, because without all of you back home, it gets pretty lonely sometimes. Maybe on the romantic little island of Lamu I'll pick up some new friends. Ha.

The pics take too long to upload onto the blog, so check the facebook album if you're curious:

Monday, May 30, 2011

New York to Istanbul

I'm sitting in a little cafe with wifi in the airport in Istanbul right now, sippin on my tiny Turkish coffee, munchin on this amazing $15 salad (balls...should've checked the Turkish exchange rate), and listening to "Don't Go Breakin My Heart" and "Stand By Me" (love). I was expecting something a little more...Turkish, but this is amusing.

I should probably start taking cooking classes, but it turned out alright
I've officially signed the lease on my new apartment. Forgot to take pics, but I'll get some up when I can. The rest of my time in NY was crazy and unreal, as usual. Wandered around Manhattan taking pics of anything and everything that caught my eye (not as many people as I would've liked though, to limit my creeper status), bought some new shoes (Hil, you'd appreciate these 5-inchers), and busted my knee in my clumsiness. One day, I'll be graceful. One day. But don't worry--the bartender at the place we ended up at later that night cleaned it up with 151. Excellent idea. Burned like a sunburned eyeball. Quickly running out of bandaids...I knew I should've brought more. Damn.

Every kind of person is here at this airport--American, French, Turkish, Asian of sorts, backpackers, business men. Kinda wish I could explore Istanbul a bit...but I'd only have three hours or so...and if I missed my flight to Nairobi...well, I guess there are worse things, but it certainly wouldn't be ideal. 

Currently making friends in this little airport joint. Landed myself an invitation to hang out in Turkey. Interesting fella. His parents are from Iran, he was born in Israel, and he now lives in Turkey.

tiny Turkish coffee packs a punch
Well, I'm gettin kinda antsy sitting here, so I think I'll go wander around a bit. Maybe one day I'll come back specifically to see Istanbul. Looks gorgeous.

Friday, May 27, 2011

Up Nextttt

So, I've actually been home for a few weeks, and have had no travels to tell you about...and I've probably seen you in person since I was home for so long, so I'm sure you weren't checking this as often. But now...I'm jetsetting again. A la neyo: jet setter, go getter, nothin better. I'm currently in New York in search of my new home, and I think I've found it: a generously sized hardwood studio...but not just a dinky's actually big enough to make into a one-bedroom, which I intend to do, obvi. Floors are newly polished, windows let in a ton of light (the view is limited to a parking lot, but it's not Manhattan, so I was kinda stuck), and I get a huge walk-in closet. Excellent. And, it's only 37mins away from Manhattan by train. Super.

Spent my last weekend in the bay exploring the Portola Redwoods--pretty incredible. And the drive's not bad, either...just make sure you don't eat too much beforehand if you plan to sit in the backseat. There are some good 12-milers, but we didn't have time for that since we started around 3pm or so. Still plenty of redwood and sunlight. There aren't any steep uphills, so I wouldn't head here for a workout. The banana slugs (yes, they're real animals) are pretty cool finds, though. Definitely worth a look...especially when Half Dome's still unroped. One day, I'll make it back to the bay to do that. 

So tomorrow, I sign the lease to this place and after a night out in NYC with some old friends (some that I've seen recently, and some I haven't seen in years), I'm headed to Kenyaaaa. So excited. It'll be my first time in Africa, and hopefully not my last. Don't have any fixed plans yet (don't freak out) but playing it by ear has sorta worked for me in the past. First, I'll find my homeboy's taxi dude at midnight in the airport...then I'll spend the day getting myself oriented in Nairobi and outfitted with a working Kenyan phone, etc, while homeboy's at work...then apparently we're going out (during which karaoke will be happening. uh oh) because it's a Kenyan holiday the next day. Beyond idea. Roughly on the books for the three and a half weeks: safari (giraffes, hippos, lions, oh yes!), Mombasa, Diani & Tiwi, Lamu (all beach towns, including the latter which is an island that sounds pretty romantic--my fave kinds), and I was thinking of Malindi, but someone tells me people have been stabbed there. Super. Too bad I'm not traveling with a body guard. So, I'll keep you posted, if I have internet! So pumped. Wish you all could come with me!