Wednesday, May 29, 2013

Soy Camba

"I am a person of Eastern Bolivia"
Last day, final post. Thank you everyone for reading and experiencing the good times and bad times with me. Please go back through old posts and enjoy learning about the fantastic place of Santa Cruz, Bolivia!


Me pongo triste a escribir este ensayo, y ahora quiero escribirlo en mi lengua adoptada, castellano, sin traductor/ diccionario.  Los que no pueden leer espanol, supongo que ya pusieron en Google Translate (un milagro para nosotros este año).

Santa Cruz es la ciudad mas grande de Bolivia, y la mas fuerte economicamente.  Ademas, muchas personas vienen de ancestores de España, entonces la gente tiene piel mas blanco y son mas altos (en cambio, las personas de el occidental- como la capital La Paz- tiene raices de grupos indigena como Inca y Aymara).  Y se nota que la cultura del oriente es totalmente diferente- los vestidos, la agricultura, asuntos politicos, etc.  Pero falta un industria de turismo, entonces de afuera nadie no sabe del oriente y la vida construida en un clima tropical.

Pues, hasta hoy dia he vivido aca 9 meses, como si yo viniera para crecer un bebe jaja, o en cambio una persona nueva de mi misma.  Y estoy diciendo algunas palabras Cambas, como “poquitingo” (en vez de poquito) y “pegar la puerta” (que significa asegurar con llave, o sea “lock”).  Leo El Deber (el mejor periodico).  Y jamas podria rechazar un majadito batido (pero no me gusta el seco) y cualquier jugo/trago que contiene papaya o maracuya.  Me encanta las verduras de Mercado Abasto, pero todavia me pierdo en Los Pozos cada vez.  Cruzo las calles si fuera yo un coche (sugerencia de Omar), reclamando mis derechos de transeunte en las calles sin reglas.  He encontrado mas personas con Chagas (no solo pacientes, pero taxistas, amigos, y otros conocidos) que queria encontrar en mi vida… ahora que los gobiernos den cuenta como grave es la situacion.  Bebo el agua de grifo (que juro es sano!), y solo me enferme con gastroenteritis despues de comi en la calle de Oruro (nunca mas...!).  Yo tiro mi papel higenico al lado del inodoro (en EEUU botamos en el inodoro).  Ahora sé cuanto cuestan mis pasajes en taxi, pero siempre elijo el microbus cuando hay uno (y anos despues, voy a contar como si fuera viejisima “yo recuerdo cuando aumentó el precio desde 1.80 Bs hasta 2 Bs!”).  Sin embargo, todavia no me acostumbro al clima y sigo sudando todo el tiempo- en clase de baile, cuando estoy sacando muestras de sangre, y muchas veces mas.  Me pone feliz a ver ese arbol tipica con la panzita en su tronco con las flores rosadas que se caen y cubren el suelo (siempre me olvido del nombre, pero me quita el aliento a verlo- es tan hermosa).  Yo suelo ver los jovenes besando en la noche en la plaza de estudiantes.  Yo podria fingir como bailar cumbia y reggaeton (dobla las rodillas a acercase) pero mas de todo estoy buscando un hombre cuando el DJ toca bachata y salsa.

Si no les molesta, me pongo orgullosa a declarar que por este ratingo, soy Camba : )

Fin.
Los Pozos... pues lo que creo es. The
map of what I believe the market to be, based
on how much I get lost... it's actually a grid)

Banda Camba tocando.
Classic Cambas in a band. 



No soy ciudadana, pero cuento!
I might not be a citizen, but I count in the census!

Mercado Abasto- no existe precios mas barato, ni verduras mas frescas! The Abasto Market- fruits and veggies straight from the fields
Si me gustara futbol mas, seguiria Oriental
If I were a soccer fan, I'd be for Oriental!



Enfermedad de Chagas, despues del tiempo.  Algunos necesitan marcapasos.
Chagas Disease,  many of which end with pacemaker need.  Note the big heart.

Jugos en Bolsas/ Smoothies in Bags

Majadito Batido!  The classic dish here- delish!
El Micro 10- Vamos a Hipermaxi!  That's our bus to go to the supermarket
El arbol con panzita y las flores!
The tree has a classic belly in the trunk
Que deberiamos hacer a las 10 am?  Saltenas en Hamacas!
Getting a midmorning snack with Paola- classic thing to do.

muchisimas gracias

Many thanks are in need...
-->  Jackie, Yacks, Yackie, Jacqueline-  My partner in crime and in this crazy project to recruit and manage ekgs/labs/echos/info for 425 patients in less-than-ideal situations.  And, a little bit of fun on the side.
-->  The Milton B. Rosenbluth Foundation and the NYU School of Medicine for unbelievable financial and logistical support. 
--> Dr. Bertelsen for your advice on international projects.  That I always remember to give the benefit of the doubt to others, for some socio-economic-cultural awareness.
--> Dr.s Caryn Bern, Bob Gilman, and Dr. Eva Clark (!!), for trusting Jackie and I to run this study and providing the groundwork, knowledge, and project funding.  And leading a fantastic team!
--> My family and friends back home, especially Misa, Daryl, and Nate, for always being there for a Skype call this year
--> Omar, nuestro primer amigo, realtor, tocador de bongos, guia del campo y los lugares de SC, y claro DJ Ogan
--> Gerson, Lisbeth, Mauricio, Jeong, Paola, Roxana, y todos del lab.  Sobrevivimos- los paros, falta de reactivos, venas delgaditas y escondidas, muestras diariamente, y mas trabajo que pensaba yo que era posible…!
--> Malasa, Toria, Lulu, Jillian, Nicole, Christina for creating an awesomely cohesive group of executive vinchicas : ) Not to mention catching vinchucas, growing up cultures from chronic patients, and looking fabulous in sparkly dresses!
--> Dr. Flores, Dr. Gomez, Dr. Gandarilla, Dra. Vargas y todos por invitarnos y incluirnos en su hospital y su trabajo
--> Todos mis amigos de clase de baile, incluso Tadashi hehe – siempre estan listos a bailar y aprender mas.  Gracias por incluirme en un clase tan especial.  “No te confundes.  No es amor… Es Bachata”
--> Fernando- por siempre ofrecerme un baile, su musica (estoy escuchandola ahorita), y su amistad
--> Junior que siempre podria explorar conmigo, desde Ateneo hasta la cabanas
--> Raul y Jose por la paciencia a ensenarme a bailar.  Ahora llevo mis figuras a nueva york!
--> Victor - mi amigo, maestro de luz y sombra, y a veces terapista jaja
--> Carlos, por contenta a Jackie con la vida aca, carnival y su amistad
--> Insook (Barista), Dona Rosa (Jugos en Mercado Florida), Walter (Papel Cruz), Pablo (Fotocopias), Yosita/Walter/Fernando (Megatlon) – por siempre saludarme con una sonrisa conocida
--> Los pacientes de San Juan de Dios- por su paciencia con nosotros y cooperacion.  En los situaciones mas graves, sobrevive el caracter.  Ademas, Rosario, Carlos, y todos que nos extendieron una invitacion, regalito, y sus bendiciones.  En realidad, les debemos mas que todo, y de todos modos selo agradecemos otra vez.


Y por fin, Las Cruceñas (toda la gente de Santa Cruz).  Por prestarme un momento a vivir en sus vidas. 

Tuesday, May 28, 2013

Pensamientos

Some daily thoughts of the last day, to bring with me:

-Watching sweat beads off my shins during the gym class, Krank (it's like a bicycle for your arms!).  Yes, it's still quite humid here.

-An elderly man walking out of the hospital, carefully carrying his chest X-ray film against his chest (as if the film was seeing right through him, and yes they use film here)

-My majadito lunch, which is a delicious dish of meat, rice, and sauce topped with an egg and fried plantain.  It was less than $2, and included a great squash soup.

-Pablo, the copy guy, sitting behind his desk waiting to greet us with a smile.  We bargained the cheapest copies from him, what usually costs 50 centavos we got for 10 centavos, even when not copying in bulk!


I have moved far too much in my life.  A very near and dear friend just sent me this quote, which really hits home.  For everyone out there who has up and left, then left again.

“You get a strange feeling when you're about to leave a place...like you'll not only miss the people you love but you'll miss the person you are now at this time and this place, because you'll never be this way ever again.” -Azar Nafisi, Reading Lolita in Tehran

Victor!

Please meet Victor.  A few months back, I decided to take painting lessons, so we started drawing straight lines, circles, shaded blocks, vases, fruits, and eventually people.  Then to painting, where he taught me to use colors that shine, and not be afraid with art.

Victor became my three times/ week friend.  Spending two hours of the evening chatting about the city, the news, his childhood, my family, relationships, work, and of course how to improve my artistic skills haha.  To all the teachers and instructors out there, I hope you know how much your clients appreciate you as people, we wouldn't spend so much time with you otherwise : )

Maybe some day I'll post some of the scratches I made, but here's the final piece.  Thank you Victor for the idea (it's a replica of one of his paintings) and the friendship : )

ganas de resplandecer (temp title).  Emi Okamoto and Victor Villaroel Cespedes.   3 pieces, made with texture, acrylic, and love.  

Pictures from our Despedida

It's that time... we're going back Stateside. So what else to do than throw a party?  Activity list and pictures, note only the food was planned ha.  A huge thanks to everyone who made this possible (Carlos, Christina, Jillian, Omar) and came out to have a great time : )
--> Tabu (Taboo, in Spanish!)  Fantastic party starter
--> Food- American home-made hot dogs, pasta salad, guac, and chorizo
--> Salsa and bachata dancing
--> Jeong and us doing Gangman Style dance
--> Bongo/guitar/singing from Omar and Mauricio
--> Speech by me (I love giving speeches, 70% of the time)
--> Fantastic Cake
--> Sparklers (they were a dud)
--> Teaching all the Bolivians the Electric Slide (as most are dancers, they found it ridiculously easy and got really bored haha)
--> Flip cup
--> The remaining 6 of us went out to Elegua, to dance the night away : )

christina and the balloons!  everything is better with balloons!


Edgar couldn't make it, but we had a
fantastic lunch together : )


very typical.  obviously thinking the same thing
but as jackie says i am hiding it better hah

Grupo de Baile y Junior y Omar!  
: )
fernando making the moves!
Jackie is, well, not impressed
Raul!  My dance teacher : )

Carlos learns flip cup!
Jillian!  Our sparklers were humid and mostly
 duds, unless you lit a whole pack at once! 
Jackie tried to take a bite of the cake
before it was served!  That's what you get...
Amigos del Proyecto- We owe them tons for all the help they gave us, from translating to finding a dentist to running each and every one of our samples!
Insook and her FANTASTIC cake!

tabashikun, my bolivian-japanese counterpart ^ ^

Sunday, May 19, 2013

I caught a Vinchuca!

Mid-dissection from Lulu
This one has not had a recent
blood meal, seen on intestines
So Chagas disease is caused by a parasite, Trypanasoma cruzi, which is transmitted by a bug.  The bug is called reduviid (scientific name), "kissing bug" (fun name for unclear reasons), or vinchuca (local name here).  The bug lives in the wild and bites animals, but it also lives in houses that are very poorly constructed, ie of mud/dirt.  It hides in the the earthy holes (see pictures), and the bugs come out at night to feed on people when they are sleeping.  Which, now that I have seen the size of these things, is terrifying.  They seem to have the same size range and crunchiness (I imagine with their hard shell) as cockroaches.  

The parasite circulates in the blood stream like malaria, and similarly is picked up when the bug takes a blood meal.  Unlike malaria (transmitted by the saliva), the parasite is transmitted through the bugs feces.  Thus, transmission only occurs when a person scratches at a bite with feces nearby, brushing the parasite into the skin.  So transmission of the disease is about 1 per 1000 bites, but these things used to be all over houses.  One patient said he could kill 50 bugs/night with a pin when he was a chile, and starting about the 1950s they learned that the vinchuca transmitted Chagas so fumigation schedules/ campaigns for better housing began.

Anyways, per patient reports Santa Cruz hasn't had vinchucas in the city for about 30-40 years.  Other smaller cities have also changed their housing structures.  However farther outside the city in the farmland (the campos), there still exists this mud housing where vinchucas can live.  So we went vinchuca hunting... 

The first couple days the girls went to houses that had (fortunately) just been fumigated, so no vinchucas.  However, I came for day 3 to a house even further outside the hospital post, and look what we found...



this is the kitchen, where the vinchucas live
we rolled up in an ambulance.  on the way back I sat in
the front and greeted everyone with fun noises it makes
the living quarters of the house.
vinchucas (likely from the neighboring kitchen)
were seen at night in some larger cracks

The process:  spray with bug spray to irritate the bugs, but
not enough to exterminate them (Lulu needed the bug and
parasite as alive as possible to try and extract DNA for analysis)
Catch them by the legs with tweezers!  Pick up any small eggs,
which don't have T. cruzi but would likely soon pick it up from
the livestock and others in the house

Toria and Malasa- the Camiri project heads
Thanks so much for all the organization!
the way out to the communities.  they are 2 hours outside
Camiri, which is four hours outside Santa Cruz.



Ew!  We found their exoskeletons all over the house, too
We ended up catching 15 and collecting many eggs to start a
new lab colony.  There must be hundreds of vinchucas living in
the housing, and the house is scheduled for fumigation soon.
Likely that everyone already has Chagas, but there are small
kids, and also a theory of "superinfection" where infection
with more strains produces worse disease.

Lulu!  The inspiration for all of this.
PhD candidate from London School of
Tropical Medicine.  This chica is a T. cruzi
expert, who is dating a T. brucei
(African Sleeping Sickness) expert!
Ducks.  The previous survey group in
the area found them to be associated with
increased Chagas transmission.  Many
animals are also hosts (they get bit by the
blood-thirsty vinchucas too).  The number one
spreader of sylvatic (wild) Chagas to
humans is... armadillos!
the lovely vinchicas!  family pic : )
back: Nicole, Malasa, Toria, me.  front: Lulu, Jillian
thanks Nicole for this great photo! 

Friday, May 17, 2013

who runs this thing anyways?

So every 2-3 months our PIs (principal investigators, people who dole out the ever-scarcer funding: Caryn Bern of UCSF and Bob Gilman of Johns Hopkins) come down to help us continually fine-tune our research projects, and mainly to make sure we haven’t wreaked havoc.  Bob and Caryn are like the old married couple who fight over academics.  Bob is the idea guy (most of which are crazy/ingenious/both) and Caryn then reins him in, tossing the bad ideas and then fine tuning the good ideas into brilliant science.  They study everything from children’s diarrhea to tuberculosis to neurocystercercosis- so if you know any medical professional looking to come down to South America, please let me know!

They came down for the last time during our stay, and luckily we had a great crew to great them.  Jackie and I started as the only gringas (foreigners), although others had come before us.  But now there are tons of friends!  So we celebrated Bob’s birthday, and had a wonderful time.  We’ll be forever indebted for Bob and Caryn for welcoming us on board, funding the research (even though Bolivia is cheap, running a project sure adds up!), and being downright fantastic mentors and astounding researchers.  And the whole team for being executively excellent : )

Everyone at our place!  (Jeong, Caryn, Bob, Nicole, Jillian, Lulu, Toria)
the best yardstick of teamwork- not so much
working to accomplish international research
but rather solving a human knot
Malasa's home-made apple pie!  with a Bolivian sparkler

Caryn, looking either really skeptical about
research methods... or excited about that pie!
Bob and Jeong, right after Jeong went out to talk to
prostitutes about free HIV testing and condoms!