My first two weeks

As most of you may know, I’ve been in Lusaka, Zambia for two weeks now though it feels like much longer. The journey was tiring. I flew from Indy to Chicago to London to Lusaka with two overnight flights. I arrived very early in the morning on October 16. From the sky, it's evident how few paved roads there are, and much of the land appears undeveloped. Although you arrive at an ungodly hour (well, 6:30am used to seem ungodly) if you take the British Airways flight from London, it’s the perfect time to arrive. The sun has just risen and the side of the airfield looks straight out of NatGeo. I half expected to see an antelope dart past (sadly, I didn't see one). I took a deep breath stepping off the plane, my first steps onto the continent, but arriving in the middle of October, it’s the dry season and my nostrils were immediately filled with dust. I felt coated in it as I walked the short distance from the airplane to the airport. I spent most of my first day trying not to fall asleep, and for the most part, I succeeded.

I’m currently staying in Petra’s guest house. She’s the lab coordinator at ZAMBART (Zambia AIDS Related TB) where I’ll be working. She has 3 kids (Bob, Ilsa, and Wouter), 3 cats (Mimi, Tiger, and Rakker), and 2 dogs (Moto and Kalu). There’s also Frida the nanny, Gift the gardener, his brother Rafael, Kift’s wife Maureen, and their 3 kids (Catherine, Irene, and Chris). It’s a very full house. All the kids are always playing together so sometimes it’s hard to tell exactly how many kids Petra has. The dogs are a bit bipolar, superexcited one minute and too lazy to move the next. They’re very fond of jumping on people, so it’s nearly impossible to stay clean around here.

The house is just outside Lusaka, which makes driving a must. The only forms of public transportation are taxis and mini buses (large blue and white vans with about 3 rows). If you’re walking down the street, someone in a minibus will inevitably honk at you and scream at you to get in. I haven’t ridden in one yet (baby steps), but they don’t go as far as I live anyway (and Petra says it’s a vehicle for TB transmission). One funny thing about driving in Lusaka is that when you’re stopped at a light, people run into the streets to sell you anything you could possibly want, from fruits and veggies to talk time (for your cell phone) to floaties for your pool! I’ve been relying on friends (well, mostly Barry who also works at ZAMBART) for rides and also Petra’s driver, Richard. Richard drives one of Petra’s cars when he has to take us places. If he has to pick me up in the morning, he walks to the house, which takes him from 45 minutes to an hour.

My second night in Lusaka, we went to an Oliver Mtukudzi concert at the International School of Lusaka (ISL). He’s a very popular Zimbabwean artist and the father of Tuku music. He uses a lot of traditional African instruments. I’m not sure how to describe the music. It was very soothing and upbeat. It’s definitely worth a listen on iTunes or YouTube. The Zambians love him! If you were standing within the first few rows of the stage, you had to dance or you would eventually get pushed aside. I was still jet lagged, so my dancing was a bit half-hearted but good enough that I wasn’t too jostled.

I’m starting to get a feel for the city. There are a couple popular shopping centers – Manda Hill and Arcades - where there are supermarkets, bookstores, cafes and such. Zambia is actually quite expensive (most things are imported from South Africa), so only the rich can afford these places. If you drive through the compounds (kind of like neighborhoods), you can see the vegetable stands and hair salons frequented by the people who live there. There doesn't seem to be a lot of homelessness; most people live in these compounds, but the standard of living is extremely low. The only ones I’ve been through are Chawama and Kalingalinga. Barry started the Kalingalinga Foundation to provide peanut butter sandwiches and milk to patients at the HIV clinic (the extra fat and protein is important during ART). There’s also a project to provide school supplies like desks and books to kids. Here’s the website: http://www.active.com/donate/kalingalinga. Right now, he’s basically paying for everything out of pocket, but he’s found some good deals in Lusaka. There’s a wildlife conservation group called It’s Wild that supports rural markets from whom he’s started to get peanut butter in 20kg drums (imagine all that peanut butter!).

I haven’t really started working yet. So far, I’ve been visiting the lab, observing and helping out when I can. The lab is actually a very small part of ZAMBART, so I’ll be spending the next couple weeks visiting sites where TB/HIV interventions are in place. My only exposure with the health care system so far is at Care For Business (CFB), a private clinic. I had to get a chest X-ray for a study permit (even though I have a negative TST). I went in on a Monday and the receptionist said that I could get the X-ray, but that there were no doctors available on Mondays to read it. And everytime I said I needed the X-ray for a study permit, people would ask me where I'm going, and I had to explain several times that I wanted to stay in Zambia! It's possible that they thought I was Zambian since there's a large Indian population here, but I definitely don't have the accent. CFB is actually quite nice. I don’t know what the other hospitals and clinics are like. Part of the ZAMBART lab is in UTH (University Teaching Hospital). To get to the parking lot for the lab, you have to drive by the trauma center and the BID (brought in dead) section where mourning families are given no privacy. I have yet to see the rest of the hospital.

I’m still getting used to everything. People often discuss how difficult it can be to get something done here, which I am slowly discovering. Zambia is not a place for the impatient. At one restaurant, I had to wait three hours for my food. I think the best example though is when I went to a mailing center to post a letter and they didn’t have stamps.

My most exciting adventure so far and perhaps of my entire trip was last weekend at McBride’s. It’s a bush camp in Kafue National Park. Chris and Charlotte are the owners and they run the place with a staff of eight. Chris has a degree on lions which he’s been tracking since the 70s and Charlotte practically grew up in the bush so they’re the perfect pair to have on such an adventure. Chris is quite eccentric and much of his humor is probably not appropriate for this page. I went with four other people: Ranjit and Shilpa (who I know from Purdue), Barry (who used to work with Ranjit at CIDRZ - Center for Infectious Disease Research Zambia), and Annika (who currently works at CIDRZ and used to live with Petra). I’m coming to learn that the HIV community is quite small in Lusaka and everyone knows each other, but that may also be in part because all the expats find each other. It was about a six hour drive and half the time the roads were just dirt, smooth in some areas, a bit marshy in others. The closer we got to the camp, the bumpier it got. At some point after entering the park, hundreds of flies and butterflies started to hitch a ride on the car so we had to keep the windows up. We soon discovered that the flies were tsetse flies and we got bitten a few times once we got out. Tsetse bites are nasty and painful for the first minute or so, but then you hardly notice it. Don’t worry – these didn’t carry the trypanosome for human African sleeping sickness. These only affect cattle, which is why most of the land is uninhabited by humans. As soon as we arrived at the camp, we saw hippos in the river and elephants on the opposite bank. And if you like birds, this is the place to be! As some of you know, I have a slight bird phobia but I managed quite well. The birds in the wild don’t care for humans, so it was quite easy to avoid them (except for the one that Chris was trying to condition with bacon to come when he called). We saw so many animals in such a short amount of time (we arrived on Friday afternoon and left Monday afternoon). We saw puku, impala and oribi (all types of antelope), hippos, elephants, crocodiles, lots and lots of birds, leopards and lions!

By the second day, Sunday, we were a bit down that we hadn’t seen a lion yet, but then we had three sightings! The first one was after our morning walk and we heard there was a lioness on the bank, so we took the boat out to observe her. We had a pretty good view, but unfortunately, a family of warthogs did not and walked straight into her line of vision. Within seconds, she snatched up a baby warthog! The others squealed loudly and ran in various directions. Later that afternoon, Ranjit, Shilpa and I were sitting outside the main chalet and the lioness walked within 20 feet of us! Shilpa freaked out a little which made me freak out a little. Chris and Charlotte weren’t there and we had no way of defending ourselves if she decided to attack, but I think she was as wary of us as we were of her. Later that day, we saw her with her three cubs. They’re eight months old and almost her size, so they were big cubs, but we still couldn’t tell the sex. We thought they were going to attack some pukus, but they decided not to pursue after the puku ran away. That night, on our evening game drive, we also saw a beautiful civet cat. Our last morning at the camp, we woke to see the lion cubs resting at the bank of the river as the hippos waded in. The cubs were playful at times and we watched them for about an hour before heading out on the boat. From the boat we saw some leopards near an area that’s known as NHB (nasty hippo bend). We disembarked and followed as quietly as we could (we had 16 feet altogether, so not that quietly) as Charlotte and the guides tracked them. We didn’t have much luck, but as we headed back to the boat, they ran past very quickly (I heard them, but didn’t see them). Also, during that last night at the camp, I woke up around 11:30 at night to the sounds of heavy breathing, growling, and breaking branches. I was sure that whatever was outside would break down the little chalet! In the morning, we saw the damage that the elephant had caused during the night – some trees on end and lots of fallen branches. The growling turned out to have been its stomach! It’s a lot harder adjusting to the city after the bush than the other way around. On the way back, every sound I heard was an animal!

As you can see, my first two weeks were quite packed. Next week will also be busy as I go to Livingstone (home of Victoria Falls) to visit some of the Zamstar (a ZAMBART study) intervention sites. Please write and let me know how things are going on your end!