Bangladesh, Part I.

“The first condition of understanding a foreign country is to smell it.”

- Rudyard Kipling

As soon as we stepped outside of the airport in Dhaka, my coworker Saumil, who lived in India as a child and has been back several times visiting family, stopped and then said to me, "Do you smell that? Now I know I'm in south Asia."

There are many smells here. Some good, like the smell of curry and other spices. Some not so good, like the smell of burning garbage or traffic fumes (so much traffic! at all hours!).

There are days I have curry for breakfast, lunch, and dinner, so if I come back smelling a little differently, you'll know why. Either that or smelling like my hotel room does after the nightly mosquito spraying (which I guess is better than getting dengue, although on the days I'm actually in the room during the spraying I'm not so sure).

Perspective.

I work in public health, not medicine. I've had people ask me why I didn't just go to medical school. Because they're different things, I usually respond. I didn't want to study medicine, I wanted to study public health.

We focus on health at the population level, not on treating individuals. By learning which factors affect different diseases in populations and then how we might be able to modify them, the goal of public health is to prevent those diseases (or complications) from occurring. In many ways the goal of both medicine and public health is the same -- reducing illness and suffering -- but the approach is different.

This can be frustrating at times. On the one hand, it can be hard to see the impact of public health. When a doctor treats a sick patient and they get better, that may be obvious. But it's not always so easy to show that someone didn't get sick in the first place because of what you do. On the other hand, because I'm not a physician dealing directly with patients, I don't always have the opportunity to personalize it.

Today was one of those opportunities. We went to the clinic at the field site here (a very poor urban area on the outskirts of a poor urban Dhaka), and did rounds first with the doctor, before meetings. We stopped for a bit at one patient... a 13-year-old boy with a recurrent case of active TB, and now likely with a secondary case of pneumonia. By all rights, he should be hospitalized, but was refusing. Thus, they were making due at the clinic, with a daily injection of IV antibiotics. The clinic is not designed to be the area TB testing or treatment center, but the alternative was he would stay home and die.

Injecting antibiotics can be painful, though he was sitting there patiently. He has come back for six days now, but was very, very thin, and clearly still struggling to breathe. I am not sure how many times he will be back.

I'm not usually one to get outwardly emotional, but watching this was sobering. Childhood pneumonia is what I have been spending a large part of my work on lately, and what I am researching more here. Pneumonia is the leading cause of death worldwide in children under 5, and although I know the statistics, a small boy today helped give me some extra perspective.

The fifth continent.

I have a goal of visiting all seven continents. Arriving in Bangladesh this week, I have now marked off Asia as my fifth. Two more to go: Australia and Antarctica. Not bad, considering I didn't even get a passport until I was 22!

On the road again...

Said effort (see below) will have to wait. Over the last two months of 2008, I will be in the ATL for a total sum of about 2.5 weeks. I enjoy traveling, though this may be a little much all at once. The homebody in me likes a little downtime between adventures.

On the other hand, you may actually see some regular blog updates, now that I will have things to show for my time. Destinations should include: Washington DC, Bangladesh, Hong Kong, New Orleans, and... Mesa, AZ. Updates to follow.

Edited to add:
I believe this is the most well-medicated international trip I've ever been on (and this is just the pills... not the ointments, creams, bandages, and rehydration salts). CDC is nothing if not thorough.

Which is fairer, flower or leaf?

(A little Robert Frost aside there, this time of year makes me nostalgic for New England).

While living in Boston, apple picking became an annual fall tradition. I missed last year, but got back on track the other weekend during the annual apple festival in Ellijay, in north Georgia (though Southern apple picking is far too hot!). So far, products from the weekend spoils have included: apple pie, apple butter, apple dumplings, apple crisp, apple sauce, apple bread... (And I still have some apples to use up!).


Some observations:

1. I love autumn. It is by far my favorite season. Leaf over flower, for sure.

2. I need to explore my current home more. During the years in Boston, I was all over New England. Cities, small towns, cemeteries, parks, forests, neighborhoods. Massachusetts, New Hampshire, Vermont, Maine, Rhode Island, Connecticut, New York... I'm starting to realize how little I have explored since I moved to Georgia.

I've been thinking a lot about this lack lately. I may be here in Atlanta for 8 more months, or I may be here for years. Neither is a very good excuse for it. To quote another favorite author:


"At least in geographical terms, the frontiers have been explored and crossed. It is probably time we settled down. It is probably time we looked around us instead of looking ahead."

And later,


"Neither the country nor the society we built out of it can be healthy until we stop raiding and running, and learn to be quiet part of the time, and acquire the sense not of ownership but of belonging."

I definitely don't belong to Georgia yet. But, I should make more of an effort.

Thinkin' Incan

I went with my friend Andrea to help her look for Asian markets in the ethnic area of Atlanta last weekend, and we found a great international market that carries both Asian and Hispanic foods. This was a great find, because the (fabulous!) international market near my house has very a limited Hispanic food selection. While there, among other fun finds, was a shelf of Inca Kola (La bebida del Perú!) that was calling to me. Having just finished a bottle, I've been reminiscing about my summer spent working in Peru a few years ago.

I'm behind on the blog, and I've not got much time now, but I thought I'd share a memory. Actually, now I can't find the pictures I wanted, but here are a few random ones:

This is Las Pampas, the shantytown outside Lima where I worked half the time (collecting poop in a cup, but that's another story).
That is actually the well-developed part of town... there at the base of the hill are power lines and a few brick buildings. The farther you climb up the hill, the worse it gets.

I lived in a neighborhood in Lima near the NGO office. "La casa de gringos" housed anywhere from 8-17 people at a given time, all working on various projects with this NGO. This was the extra room built on the roof of our house (affectionately deemed "Little Pampas", see the resemblance?), where I bunked for a few weeks before a bed opened up in the main part of the house.

As you don't see from these, Peru is a beautiful country, and I have actual pictures of more fun and scenic things somewhere, but I can't find them right now... Anyway, point is I'm ready for another good travel adventure. I think one may be on the horizon this Fall. Stay tuned.

Charleston.

Since the 4th of July fell on a Friday this year, I had a nice long weekend off of work, and it seemed like a great chance to get out of town and explore this Southern world that I live in now. I'd heard great things about Charleston, so some friends and I decided we would make the trek to coastal South Carolina.

This was also my first beach trip in two years. I didn't get to the beach last year before moving from Boston, and then I was too busy settling into Atlanta to get out. I don't have pictures of the beach, but I do have a very sunburned left foot to show for it. I clearly managed to put sunblock everywhere except one foot, walking sunblock advertisement that I am.

After some sun and relaxation (and crabcakes and hush puppies), we went into town to look around. Settled in its current location in 1680, Charleston has quite a history, as it was a player in both the American Revolution and later the Civil War. Charleston was also a major hub in the slave trade, as it was one of only two ports in North America where slaves could be unloaded for quarantine before being sold.

I have a fondness for all things Colonial since living in Boston for six years, and Charleston was no disappointment, with its historic buildings and cobblestone streets. Downtown Charleston has some absolutely beautiful historic neighborhoods. Originally built in the mid-1700s, Rainbow Row marks one section of row houses near the waterfront.

Quoth Wikipedia: "After the Civil War, this area of Charleston devolved into near slum conditions. In the early 1900's, Dorothy Pocher Legge purchased a section of these houses numbering 99 through 101 East Bay and began to renovate them. She chose to paint these houses pink based on a colonial Caribbean color scheme. Other owners and future owners followed suit, creating the "rainbow" of pastel colors present today. The coloring of the houses helped give the area its name."

You can tell the really old buildings by how much the foundation has settled over time. This one was particularly noticeable, as the door has obviously been cut down a few times to fit the adjusted door frame.

The mansions at the tip of Charleston in the Battery Street area are a little younger (1800s), and much more extravagant. I am in love with the porches on all the houses:


Charleston is also where the first shots of the Civil War were fired, though we did not have time to get out to Fort Sumter. We did, however, get to the USS Yorktown, a retired WWII aircraft carrier that is anchored across the river from downtown Charleston.
On board is a museum of naval and maritime history, and you can also climb through all of the sections of the ship, through the 'guts' of the engine room and the brig and the living quarters, up to the mission room, the navigation rooms, and the flight deck. In the hangar bay and on the flight deck are dozens of retired fighter planes from WWI to near present-day, and one you can get inside.

Finally, we went to Magnolia Plantation which has some beautiful gardens, but unfortunately we were not there long before we got chased by a major thunderstorm.
There was plenty more to see and learn about Charleston, and since it's only five hours away, I may need to trek back. Though, I will think seriously about doing it again in spring or fall when it's not quite so hot and steamy!