I’ve always held the belief that people have the right, and should be, informed of all medical information pertaining to their health.
However, a recent experience at the lab has called this assumption into question.
On our first ELISA plate testing for Chagas disease we hit a strong positive corresponding to a middle aged women. My first reaction was, “we need to let this lady know!” However, Manuel (the MD/PhD I work with) put forward a few ideas that made me less sure.
1) The woman is from the Orient, middle of the rainforest, and it is very likely she has no idea what Chagas disease is or what it does. Her almost certainly limited knowledge of human physiology and disease processes would severely limit the effective transfer of information about her condition and thus…
2) …We would be scaring her immensely and giving great cause for additional worry concerning a chronic, relatively untreatable disease, of which she may never suffer from end-stage symptoms (only around 40% of infected individuals develop chronic symptoms) and that at best we could only offer limited symptomatic relief.
3) Financially, and this point is really frustrating, she is not likely to be able to afford any treatment herself and getting the state to pay for it here is almost hopeless. We may be able to help her, but we don’t have the funds to assist everyone we diagnose with the disease. Our research is ultimately aimed at reducing transmission, not initiating a widespread treatment program.
So, in conclusion, are we really acting in the woman’s best interests by informing her that she has Chagas disease? I for one am not so sure anymore and am open to the possibility that sometimes, in very difficult cases with multiple issues factoring in, not telling the individual may allow them a better quality of life.
Friday, November 30, 2007
Monday, November 26, 2007
Baños
This past weekend I traveled to Baños, adventure capital of Ecuador, with my friend Laura and her sister + another friend who are here visiting Laura for a few weeks.
(Our group, with a guide. L-R, Laura, Melanie, Carlos, Julia, me.)
The escapades started as soon as we excited Laura’s front door to catch a cab to the bus station. It was raining, harder than I’ve ever seen it here in two plus months and we were soaked within a block… with umbrellas. One quickly learns in Quito that the harder it’s raining, the harder it is to catch a cab; they’re all busy! Thus, we waited a good while, watching a torrent of water flood down the street before finally catching about the 10th cab to pass us. Unfortunately, his trunk was not available and so we crammed four soaking wet people and their large hiking packs into one very small taxi. Then we found out there was a protest blocking the main road to the bus station so we got to enjoy the close company for an extra 20 minutes as the taxista found an alternative route. Great start!
Our first day in Baños we went river rafting. One of the girls had a waterproof camera that a safety kayaker used to take some amazing pictures, I promise to post them as soon as I can get copies.
That night we hit up the famous local hot spring baths, renowned for their curative effects. I’m can’t attest to any curative powers (in fact, as I write this I am suffering a nasty little head cold) but they were a nice way to relax after a day on the river.
On Sunday we hired a local guide, Carlos, to take us around in his truck and show us the best sites in the area. It ended up being well worth the fee, as the following pictures demonstrate.
(A view of Banos and the river gorge it borders)
(A deep river gorge, cut straight into the rock.)
(At the edge. I thought the $10 charge to jump/swing was a bit much, but the gals wanted to see someone go and were willing to pay; I couldn't refuse that offer.)
(Me jumping off the bridge, actually the guy sort of throws you off, no time to be indecisive!)
(Above a huge waterfall in a rickety cable car, yes!)
(A view of El Pailon del Diablo "the Devil's Cauldron")
(Looking farther down the same falls. It is ranked as one of the top 10 most impressive waterfalls in the world!)
The scenery was nice but I couldn’t help but also notice how much cleaner and nicer looking Baños was in comparison to Quito. It wasn’t a night and day difference, there were still people begging for money and rundown houses, but overall the quality of life for most residents seemed to be higher. All the tourism money flowing into the town has certainly been a boon for the residents. There are currently hotly-contested arguments about whether to drill for oil in Yasuni National park but if one takes Baños as an example of what can happen when eco-tourism is chosen over eco-destruction, I think it makes a compelling case for withholding drilling. Oil companies’ promises to share the wealth with those whose lands they use have proven to be hollow promises again and again. Thus, the people whose lands are exploited for oil are left with minimal compensation, if any, and a polluted landscape. If you are interested, there is large quantity of informative material on oil development in Ecuador, by and large it is very depressing. A history of oil exploitation in Ecuador can be found at: http://www.thirdworldtraveler.com/South_America/Perilous_Prosper_Ecuador.html
(Our group, with a guide. L-R, Laura, Melanie, Carlos, Julia, me.)
The escapades started as soon as we excited Laura’s front door to catch a cab to the bus station. It was raining, harder than I’ve ever seen it here in two plus months and we were soaked within a block… with umbrellas. One quickly learns in Quito that the harder it’s raining, the harder it is to catch a cab; they’re all busy! Thus, we waited a good while, watching a torrent of water flood down the street before finally catching about the 10th cab to pass us. Unfortunately, his trunk was not available and so we crammed four soaking wet people and their large hiking packs into one very small taxi. Then we found out there was a protest blocking the main road to the bus station so we got to enjoy the close company for an extra 20 minutes as the taxista found an alternative route. Great start!
Our first day in Baños we went river rafting. One of the girls had a waterproof camera that a safety kayaker used to take some amazing pictures, I promise to post them as soon as I can get copies.
That night we hit up the famous local hot spring baths, renowned for their curative effects. I’m can’t attest to any curative powers (in fact, as I write this I am suffering a nasty little head cold) but they were a nice way to relax after a day on the river.
On Sunday we hired a local guide, Carlos, to take us around in his truck and show us the best sites in the area. It ended up being well worth the fee, as the following pictures demonstrate.
(A view of Banos and the river gorge it borders)
(A deep river gorge, cut straight into the rock.)
(At the edge. I thought the $10 charge to jump/swing was a bit much, but the gals wanted to see someone go and were willing to pay; I couldn't refuse that offer.)
(Me jumping off the bridge, actually the guy sort of throws you off, no time to be indecisive!)
(Above a huge waterfall in a rickety cable car, yes!)
(A view of El Pailon del Diablo "the Devil's Cauldron")
(Looking farther down the same falls. It is ranked as one of the top 10 most impressive waterfalls in the world!)
The scenery was nice but I couldn’t help but also notice how much cleaner and nicer looking Baños was in comparison to Quito. It wasn’t a night and day difference, there were still people begging for money and rundown houses, but overall the quality of life for most residents seemed to be higher. All the tourism money flowing into the town has certainly been a boon for the residents. There are currently hotly-contested arguments about whether to drill for oil in Yasuni National park but if one takes Baños as an example of what can happen when eco-tourism is chosen over eco-destruction, I think it makes a compelling case for withholding drilling. Oil companies’ promises to share the wealth with those whose lands they use have proven to be hollow promises again and again. Thus, the people whose lands are exploited for oil are left with minimal compensation, if any, and a polluted landscape. If you are interested, there is large quantity of informative material on oil development in Ecuador, by and large it is very depressing. A history of oil exploitation in Ecuador can be found at: http://www.thirdworldtraveler.com/South_America/Perilous_Prosper_Ecuador.html
Wednesday, November 21, 2007
Thanks
Tomorrow is Thanksgiving and even though I am in a country where that means about as much as Ramadan does in the US I am still reminded of all that I have to give thanks for. Living here in Ecuador, with far less luxurious conditions than my WA home, has helped hammer home the basic things in life that I feel grateful for and I feel compelled to list them. OK, a few aren’t that basic but I really enjoy them☺ In no real order…
- Caring relationships
- Lots of healthy food
- Rain-proof shelter and warmth
- Hot shower with soap
- Fast internet:)
- Time to exercise
- Health care access (+ dental)
- Riding bikes
- Feeling “safe” (present and future)
- Adequate sleep
- Learning/education
- Toilets (that work)
- Toothbrush + toothpaste
- Clean water
- Being clothed
- Opportunity
Now, how many of these do the “bottom billion” of our world also enjoy? Caring relationships can be had, maybe some shelter, some clothes, but that’s about it, at best. My list isn’t too extravagant; does it seem wrong to anyone else that so many have so little? That should be an easy question, I hope. What isn't so easy to answer is what are YOU going to do about it?
Happy Thanksgiving
- Caring relationships
- Lots of healthy food
- Rain-proof shelter and warmth
- Hot shower with soap
- Fast internet:)
- Time to exercise
- Health care access (+ dental)
- Riding bikes
- Feeling “safe” (present and future)
- Adequate sleep
- Learning/education
- Toilets (that work)
- Toothbrush + toothpaste
- Clean water
- Being clothed
- Opportunity
Now, how many of these do the “bottom billion” of our world also enjoy? Caring relationships can be had, maybe some shelter, some clothes, but that’s about it, at best. My list isn’t too extravagant; does it seem wrong to anyone else that so many have so little? That should be an easy question, I hope. What isn't so easy to answer is what are YOU going to do about it?
Happy Thanksgiving
Sunday, November 18, 2007
Church
Today I went to church for the first time in the Southern hemisphere. As you may or may not know I am not a regular church attendee in the states, but my infrequent pilgrimages have been mostly to Lutheran (or similar-type) congregations. My friend Taty, from the lab, had invited me and I was curious as to what church would be like here.
Bottom line, I was blown away; a night and day difference from pretty much all I’ve seen before. Let me tell you why. First off, they have over 5000 members, but only a “small” facility right now, and thus hold about six different services spread out from Saturday through Monday. The place was packed to say the least, and very, very warm. This leads into my next observation. The people in this church like to worship in a manner popular among youth in the US right now, except people of all ages get in on the action, from grandma, to wee little ones. This type of worship involves lots of singing along to Christian rock, arm waving (often with eyes closed, one lady kept hitting me in the chest), jumping up and down, crying, looking at the ceiling, and sweating. Nothing like a packed, active church to demonstrate the efficiency of the human body in producing heat! Oh, and guess what? Their main pastor, and church founder, is an American who came to Ecuador about 20 years ago; I met him at the end of the service and he seemed like a pretty down to earth kind of guy.
They had a guest pastor from Colombia do the sermon today, and let me tell you, Colombian Spanish is not nearly as clear and slow as that spoken in Quito. Thus, I had a hard time understanding him but the bottom-line of his talk was beware the dangers of excessive pride; humility is the way to go. Always a good lesson to keep in mind.
Upon reflection I don’t think this was a good representation of a traditional Ecuadorian service, i.e. Catholic, although in all honesty I have never attended a Catholic service. The church I was at today was non-denominational.
However, I was glad I went, lots of new things to experience; that’s why I’m here after all!
(My friend Tatiana "Taty" in the lab.)
Bottom line, I was blown away; a night and day difference from pretty much all I’ve seen before. Let me tell you why. First off, they have over 5000 members, but only a “small” facility right now, and thus hold about six different services spread out from Saturday through Monday. The place was packed to say the least, and very, very warm. This leads into my next observation. The people in this church like to worship in a manner popular among youth in the US right now, except people of all ages get in on the action, from grandma, to wee little ones. This type of worship involves lots of singing along to Christian rock, arm waving (often with eyes closed, one lady kept hitting me in the chest), jumping up and down, crying, looking at the ceiling, and sweating. Nothing like a packed, active church to demonstrate the efficiency of the human body in producing heat! Oh, and guess what? Their main pastor, and church founder, is an American who came to Ecuador about 20 years ago; I met him at the end of the service and he seemed like a pretty down to earth kind of guy.
They had a guest pastor from Colombia do the sermon today, and let me tell you, Colombian Spanish is not nearly as clear and slow as that spoken in Quito. Thus, I had a hard time understanding him but the bottom-line of his talk was beware the dangers of excessive pride; humility is the way to go. Always a good lesson to keep in mind.
Upon reflection I don’t think this was a good representation of a traditional Ecuadorian service, i.e. Catholic, although in all honesty I have never attended a Catholic service. The church I was at today was non-denominational.
However, I was glad I went, lots of new things to experience; that’s why I’m here after all!
(My friend Tatiana "Taty" in the lab.)
Friday, November 16, 2007
Running with Teachers
A week back I was invited to speak about Thanksgiving and what it means to me at an event held by Universidad de las Americas here in Quito. The big event was today, and proving a common theme of my time here, it was nothing like I expected.
First off, I couldn’t find the place! Urban campuses are often spread out and this one was no exception; finally, after asking two guards and a random lady, I managed to find the lecture hall. Second surprise, it was an event for all their English teachers to hear a few native speakers (there were four of us gringos), not a student in sight… I had though the whole thing was for students, but I was there, they had free food, the people seemed nice, and so I went with it.
We ended up getting in a big circle (maybe 25 people total) and initiated a Q and A session along with gringos sharing personal T-giving experiences; it worked out pretty well. After that we watched a slide show about basic Thanksgiving facts and then, this is where it gets really weird, we split into two groups for “game time.” I have never seen anything like it among scholarly types in all my life.
Essentially, each team elected a champion of the round and they moved to the center of the room to stand behind the “start-line.” A question about Thanksgiving was then read and at the conclusion of the question the champions sprinted for a set of keys about 15 meters off on a table. The first person to get the keys had first shot to answer the question; failure gave the other team a chance. One lady body-checked a guy into a chair! She got the key. At times I wasn’t exactly sure what the rules were, people would start running before the question was finished, the previously mentioned physical contact, lots of screaming, but a good time was had by all. Definitely a new experience to say the least! And yes, of course I got the key and the question☺
On a completely different topic, I have realized as of late that during my time here in Ecuador I have not see a single obese person… Yes, there are overweight people, but the epidemic of obesity currently afflicting the US apparently hasn’t reached Ecuador. I am not sure exactly all the reasons playing into this, but I imagine diet is one of the largest factors.
In the lab we continue to make progress, I recently got my first look at the “enemy” in real life. Amazing how such small organisms can cause so much misery.
(Stained slide of a Trypanosoma cruzi cell culture, the infectious agent in Chagas disease.)
First off, I couldn’t find the place! Urban campuses are often spread out and this one was no exception; finally, after asking two guards and a random lady, I managed to find the lecture hall. Second surprise, it was an event for all their English teachers to hear a few native speakers (there were four of us gringos), not a student in sight… I had though the whole thing was for students, but I was there, they had free food, the people seemed nice, and so I went with it.
We ended up getting in a big circle (maybe 25 people total) and initiated a Q and A session along with gringos sharing personal T-giving experiences; it worked out pretty well. After that we watched a slide show about basic Thanksgiving facts and then, this is where it gets really weird, we split into two groups for “game time.” I have never seen anything like it among scholarly types in all my life.
Essentially, each team elected a champion of the round and they moved to the center of the room to stand behind the “start-line.” A question about Thanksgiving was then read and at the conclusion of the question the champions sprinted for a set of keys about 15 meters off on a table. The first person to get the keys had first shot to answer the question; failure gave the other team a chance. One lady body-checked a guy into a chair! She got the key. At times I wasn’t exactly sure what the rules were, people would start running before the question was finished, the previously mentioned physical contact, lots of screaming, but a good time was had by all. Definitely a new experience to say the least! And yes, of course I got the key and the question☺
On a completely different topic, I have realized as of late that during my time here in Ecuador I have not see a single obese person… Yes, there are overweight people, but the epidemic of obesity currently afflicting the US apparently hasn’t reached Ecuador. I am not sure exactly all the reasons playing into this, but I imagine diet is one of the largest factors.
In the lab we continue to make progress, I recently got my first look at the “enemy” in real life. Amazing how such small organisms can cause so much misery.
(Stained slide of a Trypanosoma cruzi cell culture, the infectious agent in Chagas disease.)
Monday, November 12, 2007
Exiting the Building
Normally this isn't difficult, I rarely give a second thought as I push open the door, hop on my bike, and peddle home. However, today was different.
After saying goodnight to Manuel I headed for the small side room where I store my bike and quickly changed into my bike-ware. Heading for the door I arrived just in time to see Manuel locking the door and heading out. No biggy I thought, I have a key too. The problem with my copy is sometimes it’s a little bit sticky and today was no exception. After trying a minute or so I felt it slide into place and gave a hard turn. Looking down I saw I was holding half a key, the other part wedged firmly in the lock, doh! I then realized Manuel is about the only person in Ecuador I know who doesn’t have a cell phone. There is another side-door but it’s locked with keys I do not possess. I saw his office’s light was still on and figured he’d be back soon, no one else was left in the lab.
Forty-five minutes later he finally came back, my planning on where to sleep proving to be in vain. I walked out to greet him and saw he couldn’t open the door… Apparently my broken key-half had jammed the door from the other side as well. Luckily he was able to get into the side-door and I was free from my self-imposed prison. One of those funny in hindsight experiences☺
I have another story worth sharing as well. In immunology class today we were doing “group” presentations; this works a little differently in Ecuador though. You work on the material in a group (in this case summarizing an immunology paragraph in English – I was the hot commodity!) but for the presenting part one group member is called in front of the whole class and told to “lay it all out,” all the while barraged by tough questions from the prof… in front of all 70 students! Stressful? I thought so, then to make it all “better” the first group to go ended up being called up one after another, all failing to do well, and at the end were told their presentation was horrible and they needed to prepare more. It was the truth, but wow, harsh!
I figured Dra. Estrella wouldn’t call on me, and sure enough she picked my best class-buddy, Marco (the first person I met on the first day). He was doing well until the last third of the material when he seemed to forget what he was talking about. The awkward silence began to stretch… Almost before I knew what was happening I found myself walking to the front of the class. I grabbed the dry erase marker and drew the class a picture of how non-methylated DNA containing CpG pathogen associated molecular patterns escapes dying bacteria and is picked up by TLR-9 receptors on dendritic cells, initiating a signaling cascade which results in the release of pro-inflammatory cytokines, all the while trying to explain what I was drawing in Spanish. Nothing like being nervous to make one forget a second language! I think I got enough of the point across as the prof said “good” at the end as we were sitting down. I’m not so sure it was that good but I think she was too surprised I was up there to be too objective☺
Random pic to share:
(Shirley and me chilling in my room the other day, we were doing a little head-gear swapping. She looked killer in my helmet but I just couldn't pull the little pink beanie:)
Hope you’re all well.
After saying goodnight to Manuel I headed for the small side room where I store my bike and quickly changed into my bike-ware. Heading for the door I arrived just in time to see Manuel locking the door and heading out. No biggy I thought, I have a key too. The problem with my copy is sometimes it’s a little bit sticky and today was no exception. After trying a minute or so I felt it slide into place and gave a hard turn. Looking down I saw I was holding half a key, the other part wedged firmly in the lock, doh! I then realized Manuel is about the only person in Ecuador I know who doesn’t have a cell phone. There is another side-door but it’s locked with keys I do not possess. I saw his office’s light was still on and figured he’d be back soon, no one else was left in the lab.
Forty-five minutes later he finally came back, my planning on where to sleep proving to be in vain. I walked out to greet him and saw he couldn’t open the door… Apparently my broken key-half had jammed the door from the other side as well. Luckily he was able to get into the side-door and I was free from my self-imposed prison. One of those funny in hindsight experiences☺
I have another story worth sharing as well. In immunology class today we were doing “group” presentations; this works a little differently in Ecuador though. You work on the material in a group (in this case summarizing an immunology paragraph in English – I was the hot commodity!) but for the presenting part one group member is called in front of the whole class and told to “lay it all out,” all the while barraged by tough questions from the prof… in front of all 70 students! Stressful? I thought so, then to make it all “better” the first group to go ended up being called up one after another, all failing to do well, and at the end were told their presentation was horrible and they needed to prepare more. It was the truth, but wow, harsh!
I figured Dra. Estrella wouldn’t call on me, and sure enough she picked my best class-buddy, Marco (the first person I met on the first day). He was doing well until the last third of the material when he seemed to forget what he was talking about. The awkward silence began to stretch… Almost before I knew what was happening I found myself walking to the front of the class. I grabbed the dry erase marker and drew the class a picture of how non-methylated DNA containing CpG pathogen associated molecular patterns escapes dying bacteria and is picked up by TLR-9 receptors on dendritic cells, initiating a signaling cascade which results in the release of pro-inflammatory cytokines, all the while trying to explain what I was drawing in Spanish. Nothing like being nervous to make one forget a second language! I think I got enough of the point across as the prof said “good” at the end as we were sitting down. I’m not so sure it was that good but I think she was too surprised I was up there to be too objective☺
Random pic to share:
(Shirley and me chilling in my room the other day, we were doing a little head-gear swapping. She looked killer in my helmet but I just couldn't pull the little pink beanie:)
Hope you’re all well.
Sunday, November 11, 2007
10K at 10,000ft*
*Almost, Quito is really only about 9,300ft but hey, titles can have a little artistic liberty, right? This morning was the day I had been preparing for almost 2 months now, a 10K race around central Quito with almost 5000 participants; concurrently run in eight other cities throughout Latin America at the same time.
Dimas and I picked up our shirts and electronic chips the day before and headed to the line at about 6:30am this morning. The chip system was new to me but essentially each chip is programmed to go with the number on your shirt and you must pass through 5 checkpoints in order to finish the race with a registered time.
The running part went quite well, I ran the 10K (approx. 6.5 miles) in 45 minutes and 22 seconds. This put me at 492/5021 total participants. However, my original goal was just to finish the whole thing without slowing to a walk and I more than accomplished that. Funny memory, at one point I was running near two other gringos and not a single Ecuadorian was close, like a race within a race; I made it my mission to beat the other gringos and after several kilometers I finally pulled away. Gotta relish the small victories in life☺
During the run there were numerous entertainment areas, music, dancers, stilt walkers, and things I am at a loss to explain. At the finish line in Parque La Carolina there was a huge stage with music and people dancing/waving flags. The whole event was on an impressive scale and seemed part race and part concert with the atmosphere of a huge street festival. Definitely something I was glad to participate in.
(Dimas and I after the race)
(The main stage of the "after-party")
After eating, resting, and showering I decided to see what Carlos was up to. Not too much it turned out so I offered to show him my Cuenca pics as he had never been there and expressed a desire earlier in the week to see them. When I got back to his little station it looked like rain so we both crammed inside his guard booth and I busted out my comp. We ended up going through all my highlight pics; it was great to share my family, friends, and experiences with him. He had a lot of questions about the “strange” things in my pictures☺ We chatted a bit more after picture-time before I had to head back for lunch; I am really fortunate to have met some of the people I have.
(Carlos on a sunny day, aka not today, with the guard station we crammed into behind him; it was cozy!)
Take care.
Dimas and I picked up our shirts and electronic chips the day before and headed to the line at about 6:30am this morning. The chip system was new to me but essentially each chip is programmed to go with the number on your shirt and you must pass through 5 checkpoints in order to finish the race with a registered time.
The running part went quite well, I ran the 10K (approx. 6.5 miles) in 45 minutes and 22 seconds. This put me at 492/5021 total participants. However, my original goal was just to finish the whole thing without slowing to a walk and I more than accomplished that. Funny memory, at one point I was running near two other gringos and not a single Ecuadorian was close, like a race within a race; I made it my mission to beat the other gringos and after several kilometers I finally pulled away. Gotta relish the small victories in life☺
During the run there were numerous entertainment areas, music, dancers, stilt walkers, and things I am at a loss to explain. At the finish line in Parque La Carolina there was a huge stage with music and people dancing/waving flags. The whole event was on an impressive scale and seemed part race and part concert with the atmosphere of a huge street festival. Definitely something I was glad to participate in.
(Dimas and I after the race)
(The main stage of the "after-party")
After eating, resting, and showering I decided to see what Carlos was up to. Not too much it turned out so I offered to show him my Cuenca pics as he had never been there and expressed a desire earlier in the week to see them. When I got back to his little station it looked like rain so we both crammed inside his guard booth and I busted out my comp. We ended up going through all my highlight pics; it was great to share my family, friends, and experiences with him. He had a lot of questions about the “strange” things in my pictures☺ We chatted a bit more after picture-time before I had to head back for lunch; I am really fortunate to have met some of the people I have.
(Carlos on a sunny day, aka not today, with the guard station we crammed into behind him; it was cozy!)
Take care.
Wednesday, November 7, 2007
Official FB Update
Thought I’d post my second official FB report for you all to see; it gives a good idea of how my project is progressing.
--
Wow, what a month; where to start? I’ll go with the lab first. Things have progressed nicely since last update. Even though there was another strike they didn’t lock the gates and as we have our keys the only major change was a quiet campus. I have been working on two projects at the lab, Onchocerciasis and Chagas disease. For Onco we have continued to decapitate flies for the incumbent DNA extraction. The head separation is necessary because if we find parasite DNA in the bodies versus the heads it tells us two different things. A positive body shows the fly was infected while discovering parasite DNA in the head means the fly was able to infect humans. The sheer number of flies is daunting (25,000) but we are making good progress and have separated over half at this point.
In the Chagas project we have run ELISA tests (a great new technique I have learned!) for all 246 samples from Arajuno in Pastaza province and at this point we have 5 putative positives. In addition, we have started growing a live T. cruzi cell culture to use for the next round of testing. In order to further analyze our preliminary results we will be running an ELISA test for total antigen and a Western blot using the live parasites from the cultures as a positive control (these additional tests are to confirm if the patients really do have the disease). At the conclusion of these studies we will be making a short trip to Arajuno in order to inform the people of their condition, administer chest X-rays and EKGs to look for parasite mediated damage, and provide treatment if chronic manifestations are encountered.
At this point I have been taking an Immunology class for about three weeks and I am already very glad to be pursuing studies at UCE. I was apprehensive before starting, being the only gringo there (definitely not USFQ!), and wondering if my Spanish would be sufficient in the demanding atmosphere of a medical school curriculum. So far, while not easy, things have been going very well. I understand more each day and the whole experience is really pushing my Spanish forward. The material is fascinating to me and even more exciting I am making friends with many of my classmates. On Tuesday I was put on the spot to translate an English word into Spanish in front of the whole class of 70 and pulled it out well enough☺
Making friends here, which Susana made out to be nigh impossible, is really going quite well. My family, the local street guards, neighbors, coworkers at the lab, and now in class! I’ve gone biking, to lunches/dinners, played baseball and soccer, and have plans to go to church, attend a lab get-together, and play a gal in chess. I’ll be sure to let you know how much actually comes to fruition!
One big highlight of the past month was visiting HCJB/Hospital Vozandes with Theo (a fellow lab-worker/missionary from Switzerland). Here I met the National Onchocerciasis elimination team. They used to be conducting the lab work we currently do, but delegated it and now focus on fly collection, ivermectin dispersal, patient treatment, and other logistics of coordinating with OEPA (Onchocerciasis Elimination Program for the Americas). It was great to meet with them and learn more of the big picture; knowing what I am working for and how it is improving people’s lives makes the sometimes tedious lab work worth every second.
So, what’s next? As laid out above, the Chagas project is really taking off in the coming weeks. Onco work will continue as well. At this point I have suspended the idea of volunteering at a hospital or tutoring anyone in English; I am quite busy and like to do fewer things well than to do many at half-effort. That being said, my class ends in early March and I hope to pursue my other ideas more at that time. Another long-term goal is to spend a week or so volunteering in Hospital Vozandes Shell, located in the Orient. During my visit to HCJB I was given contact information for the director there and after talking with Theo about the facility in Shell I feel this would be an invaluable experience.
Until next time, Michael
--
Wow, what a month; where to start? I’ll go with the lab first. Things have progressed nicely since last update. Even though there was another strike they didn’t lock the gates and as we have our keys the only major change was a quiet campus. I have been working on two projects at the lab, Onchocerciasis and Chagas disease. For Onco we have continued to decapitate flies for the incumbent DNA extraction. The head separation is necessary because if we find parasite DNA in the bodies versus the heads it tells us two different things. A positive body shows the fly was infected while discovering parasite DNA in the head means the fly was able to infect humans. The sheer number of flies is daunting (25,000) but we are making good progress and have separated over half at this point.
In the Chagas project we have run ELISA tests (a great new technique I have learned!) for all 246 samples from Arajuno in Pastaza province and at this point we have 5 putative positives. In addition, we have started growing a live T. cruzi cell culture to use for the next round of testing. In order to further analyze our preliminary results we will be running an ELISA test for total antigen and a Western blot using the live parasites from the cultures as a positive control (these additional tests are to confirm if the patients really do have the disease). At the conclusion of these studies we will be making a short trip to Arajuno in order to inform the people of their condition, administer chest X-rays and EKGs to look for parasite mediated damage, and provide treatment if chronic manifestations are encountered.
At this point I have been taking an Immunology class for about three weeks and I am already very glad to be pursuing studies at UCE. I was apprehensive before starting, being the only gringo there (definitely not USFQ!), and wondering if my Spanish would be sufficient in the demanding atmosphere of a medical school curriculum. So far, while not easy, things have been going very well. I understand more each day and the whole experience is really pushing my Spanish forward. The material is fascinating to me and even more exciting I am making friends with many of my classmates. On Tuesday I was put on the spot to translate an English word into Spanish in front of the whole class of 70 and pulled it out well enough☺
Making friends here, which Susana made out to be nigh impossible, is really going quite well. My family, the local street guards, neighbors, coworkers at the lab, and now in class! I’ve gone biking, to lunches/dinners, played baseball and soccer, and have plans to go to church, attend a lab get-together, and play a gal in chess. I’ll be sure to let you know how much actually comes to fruition!
One big highlight of the past month was visiting HCJB/Hospital Vozandes with Theo (a fellow lab-worker/missionary from Switzerland). Here I met the National Onchocerciasis elimination team. They used to be conducting the lab work we currently do, but delegated it and now focus on fly collection, ivermectin dispersal, patient treatment, and other logistics of coordinating with OEPA (Onchocerciasis Elimination Program for the Americas). It was great to meet with them and learn more of the big picture; knowing what I am working for and how it is improving people’s lives makes the sometimes tedious lab work worth every second.
So, what’s next? As laid out above, the Chagas project is really taking off in the coming weeks. Onco work will continue as well. At this point I have suspended the idea of volunteering at a hospital or tutoring anyone in English; I am quite busy and like to do fewer things well than to do many at half-effort. That being said, my class ends in early March and I hope to pursue my other ideas more at that time. Another long-term goal is to spend a week or so volunteering in Hospital Vozandes Shell, located in the Orient. During my visit to HCJB I was given contact information for the director there and after talking with Theo about the facility in Shell I feel this would be an invaluable experience.
Until next time, Michael
Monday, November 5, 2007
Cuenca
This past Thursday through Sunday was spent in Cuenca with 7 of my fellow FB compatriots. Vikki happens to be living and working there and thus we all had a free place to crash! It was a full apartment to say the least, Martin and I slept in a large closet, but hey, cozy can be a good thing.
Cuenca is a fair ways from Quito, about 10 hours by bus, but Panamericana offered a night bus departing at 10pm for only $9 that was just too hard to pass up. You can just sleep the whole time and arrive to enjoy the day! This is in theory, in hindsight however, the $50-60 dollar plane flights might have been better for me. Let me explain; buses in Latin America were not designed for anyone over about 5’8” and being a hair under 6’3” resulted in my knees being crammed against the forward seat while the headrest hit squarely in my shoulder blades. I may have slept an hour total; this being the optimistic estimate.
Our first foray into the city later on Thursday offered some great views of the historical center. I’ll let the pictures do the talking.
(Standard Cuenca street)
(Church spires)
(Front view of Cuenca's most impressive church)
(More cool looking colonial buildings seen from the central square)
Friday morning we decided to forgo any attempt to catch up on sleep, got up at 6:15am, and caught a bus up to the nearby Paramo of Cajas National Park. The weather usually turns nasty by mid-afternoon but with our early start we hit it perfectly.
(Puya plant with lake view. The puya's stalk is a once-in-a-lifetime reproductive thrust from which the plant dies shortly thereafter.)
(Sweet view!)
(It's amazing how much water is in the Paramo, it really is a giant sponge. The Cajas park area provides over 60% of Cuenca's water.)
Later that night we took two taxis to get into town for dinner. Our group beat the other one by about 15 minutes in what should have only been a 15-minute drive to begin with. How is this possible you may ask? Well, traffic was abysmal, so our taxi took a “shortcut,” backing the wrong way down a one-way street with his parking lights on, cars whizzing by us in the other (correct) direction. Another only in Latin America moment.
Saturday morning Martin and I went on a half hour run, exploring the town. We found the local outdoor goods market, apparently THE place to be on a Saturday morning. After returning and breaking our fast with the others Emma, Juliet and I headed to check out the local rock climbing gym. As it was feriado (Festivals de Cuenca celebrating its independence) the place was nearly deserted and free of charge for the weekend, score! We climbed for an hour or so before joining the others for lunch. It’s amazing how sore one’s forearms get from climbing if you haven’t done it in oh, a few years or so☺
(Me, climbing.)
Saturday had the most concerts/contests/people gatherings and we checked out a few. Colorful, loud, and exciting sum them up quite well.
(Whole-roasted pigs, they were everyone, I ate some, it was good, and I'm not sick from it, yes!)
(The next act, ready to go!)
I caught another night bus back on Sunday, didn’t sleep hardly at all, and then went almost straight to the lab from 9:00am till 5:30pm. As I finish writing this I really don’t know how I haven’t passed out yet. Should sleep well.
Goodnight.
Cuenca is a fair ways from Quito, about 10 hours by bus, but Panamericana offered a night bus departing at 10pm for only $9 that was just too hard to pass up. You can just sleep the whole time and arrive to enjoy the day! This is in theory, in hindsight however, the $50-60 dollar plane flights might have been better for me. Let me explain; buses in Latin America were not designed for anyone over about 5’8” and being a hair under 6’3” resulted in my knees being crammed against the forward seat while the headrest hit squarely in my shoulder blades. I may have slept an hour total; this being the optimistic estimate.
Our first foray into the city later on Thursday offered some great views of the historical center. I’ll let the pictures do the talking.
(Standard Cuenca street)
(Church spires)
(Front view of Cuenca's most impressive church)
(More cool looking colonial buildings seen from the central square)
Friday morning we decided to forgo any attempt to catch up on sleep, got up at 6:15am, and caught a bus up to the nearby Paramo of Cajas National Park. The weather usually turns nasty by mid-afternoon but with our early start we hit it perfectly.
(Puya plant with lake view. The puya's stalk is a once-in-a-lifetime reproductive thrust from which the plant dies shortly thereafter.)
(Sweet view!)
(It's amazing how much water is in the Paramo, it really is a giant sponge. The Cajas park area provides over 60% of Cuenca's water.)
Later that night we took two taxis to get into town for dinner. Our group beat the other one by about 15 minutes in what should have only been a 15-minute drive to begin with. How is this possible you may ask? Well, traffic was abysmal, so our taxi took a “shortcut,” backing the wrong way down a one-way street with his parking lights on, cars whizzing by us in the other (correct) direction. Another only in Latin America moment.
Saturday morning Martin and I went on a half hour run, exploring the town. We found the local outdoor goods market, apparently THE place to be on a Saturday morning. After returning and breaking our fast with the others Emma, Juliet and I headed to check out the local rock climbing gym. As it was feriado (Festivals de Cuenca celebrating its independence) the place was nearly deserted and free of charge for the weekend, score! We climbed for an hour or so before joining the others for lunch. It’s amazing how sore one’s forearms get from climbing if you haven’t done it in oh, a few years or so☺
(Me, climbing.)
Saturday had the most concerts/contests/people gatherings and we checked out a few. Colorful, loud, and exciting sum them up quite well.
(Whole-roasted pigs, they were everyone, I ate some, it was good, and I'm not sick from it, yes!)
(The next act, ready to go!)
I caught another night bus back on Sunday, didn’t sleep hardly at all, and then went almost straight to the lab from 9:00am till 5:30pm. As I finish writing this I really don’t know how I haven’t passed out yet. Should sleep well.
Goodnight.
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