Al-Azhar Park

In the middle of Cairo, right in the midst of all the brown buildings and smog and pollution and crowds, is a park called Al-Azhar Park. Even though we drive past Al-Azhar every day going to and from work, I had never actually been to the park until tonight. After work we took a couple students who are in town for the summer out to dinner at one of the restaurants in the park. There were a TON of people all over the park, but the view of the city was pretty nice, and the sunset was beautiful!

Muneeb abattoir

Well today I did something I certainly have never done before and never thought I would do.

I may have mentioned before that I've been doing a lot of work with vector-borne and zoonotic disease (viruses and bacteria that can infect people but are carried mostly by insects and animals). One of my projects in this area is to develop innovative surveillance systems to detect outbreaks of these diseases before they spread and affect a large portion of the general population. This project therefore targets populations that are at high risk of being infected with these types of diseases, populations that have close interaction with animals and are in areas with high vector density. Specific examples include employees of abattoirs (slaughterhouses), live animal markets and animal quarantine facilities.

The first project that's actually getting off the ground is going to take place in an abattoir here in Cairo. Today I had to visit the abattoir to do an assessment before we actually begin work. Definitely something I never thought I'd do. I'll spare you the details and just leave it to say that we were given a tour of the facilities by a representative from the division of the Ministry of Agriculture that oversees the abattoir and then had to watch a couple animals being slaughtered. It wasn't quite as bad as I had expected but I certainly felt a little queezy by the end of it.

I have to go back three times next week so perhaps I'll write more then...

Mmm mmm good

Now THIS is how you start a weekend off the right way - cheese grits, Jimmy Dean sausage, scrambled eggs, mango juice and Rwandan coffee!!

Paul Kagame and Peace Corps

Recent Rwandan President Paul Kagame spoke up about the meaning of the U.S. Peace Corps' return to Rwanda in November of last year. His articulate and touching (poignantly so, in a way, to me) words can be found here.

"The Culling Fields"

I have an email subscription to a publication called ProMed that sends daily emails with updates about disease outbreaks around the world. This week an article came out with an update of the H1N1 influenza situation in Egypt, specifically discussing the government's actions to cull (unnecessarily) all the pigs in the country. You can find the article here.

Discrimination on the metro

I've never been afraid to ride the metro in Cairo...until tonight. This afternoon I took the train from Damanhour to Cairo and decided that it would be easier to get home from the train station on the metro than in a taxi during rush hour. But I was nervous. I had heard stories from several of my American/Canadian friends in the past week about unpleasant metro experiences.

As H1N1 influenza has been identified in Egypt in recent weeks, the Ministry of Health has, unfortunately, done a terrible job of communicating with the public. Most Egyptians - including even physicians and Ministry of Health officials with whom I've talked - believe (1) that H1N1 is deadly, (2) that the virus comes from swine, and (3) that foreigners are the ones spreading the disease in Egypt. Please note, not a single one of these statements is true. Yet this is the message that the Ministry has spread and it's what the public believes.

So American/Canadian friends of mine have told stories in the past weeks of stepping onto the metro and having crowds move away from them, pull out Kleenex to cover their mouth and nose and giving disapproving looks. It's certainly nothing threatening, just alienating and uncomfortable. I was really nervous about being the target of such discrimination and fear.

But thankfully, my ride on the metro was smooth. No one moved away or looked disapproving or pulled their children away or stared (well, at least not anymore than usual). I even had the good luck to be offered a seat after only two stops and was able to sit for the remaining eight or nine stops until I made it home.

But I am still amazed at yet another example of the power that the Ministry has had to control the information that is disseminated in the country and the beliefs of the public.

Football and fish

It's been a while since I've felt this relaxed AND I can't stop smiling. I'd say it's a good night!

I'm spending a few days this week with our project in Damanhour district (more details here), which finally got off the ground about three weeks ago. We've begun surveillance for severe respiratory disease at the three main hospitals and things are off to a great - albeit hectic - start. The days are crazy while in Damanhour, so tonight we decided to drive into Alexandria (which is about an hour away) for dinner. Our driver, Khaled, who is like a big brother and guardian to all of us American girls who come up to Damanhour for work, had been going on and on about a fish restaurant in the city, so we decided to take him up on it.

We parked on a sidestreet and walked up to a large tent in the middle of a courtyard. The tent was filled with tables and as we walked up we heard a roar of excitement from a group of men who were standing huddled together. It only took a few seconds to notice the television in front of them and we soon learned that Egypt was playing Brazil in football. Just as we arrived, Egypt had scored, bringing the score to 2-1, Brazil. This was a HUGE deal, since apparently everyone in Egypt was expecting their team to be crushed in the match and lose 6-0.

We took a seat at one of the tables where we were sure we could see the game while Khaled walked up to a storefront nearby and picked five fresh fish out of a huge ice bucket. He rejoined us just before Brazil scored and made the score 3-1. Soon a waiter brought two huge plates of fresh Lebanese bread and about a dozen plates of mezza - hummus, tahina, babaganoug and many others that I can't name but know are delicious. We began stuffing ourselves and were chatting together when our fish arrived. The fish had been grilled whole, with tomatoes and onions, and was incredible. We all continued stuffing ourselves until Khaled about jumped out of his seat to cheer as Egypt scored again. The score was 3-2. Almost before he could settle back into his seat, there was another goal for Egypt; they had tied Brazil, 3-3!

By this point, we had all finished eating. Khaled, worried that his girls would be bored, cautiously asked if we wanted to take tea. We all knew immediately that he was just trying to stall so he could watch more of the game and immediately called him out on it. He blushed and laughed, and we explained that in our culture, women enjoy watching sports and so we would love to take tea and continue watching the match. I'm not entirely sure whether he believed us or not, but he ordered a round of tea for us all. And so we all sat around, relaxing in the fresh air, full of fish and mezza, watching football and drinking tea.

The match continued, tied, until, literally, the final seconds, when Brazil was awarded a penalty kick and was able to score. The game was over. Egypt had lost, 4-3. I expected the crowd to be disappointed, but there were smiles all around. I was confused until Khaled explained that losing by one point to Brazil in such a close match was a tremendous accomplishment, especially when everyone had expected Egypt to look pitiful against the South American powerhouse. My smile grew even bigger when I realized that the night didn't have to end with disappointment.

With my stomach full and my heart happy, I think I'll sleep well tonight!

University of Ghana

NAMRU-3 has a detachment in Ghana that is currently running studies in acute febrile illness and leishmania but will most likely begin work in acute respiratory infection, diarrheal disease and zoonotic pathogens in the very near future. So I've been in Ghana this week working with the local team to get set up for all these upcoming studies.

The detachment is housed within the Noguchi Memorial Institute for Medical Research (NMIMR) which is part of the University of Ghana, so tonight, after a long day in the office and the laboratory, one of the Ghanaian professors with whom we were working invited us to join him for a drink. He's the head of one of the five colleges within the university (the University of Ghana is set up on the Oxford model) so we joined him at the faculty lounge of his college. After a brief tour of the college, we sat back and relaxed with he and several other faculty members.
There were a few things that made this experience - which would have been completely normal in Rwanda or any other African country - noticably different from any situation one could imagine in Egypt:

1. It was quiet and peaceful, and we were surrounded by greenery.
   
2. Everyone around the table was drinking beer.
3. We (by which I mean myself and my colleague, Lisa) sat down at a table of seven men (all Ghanaian except one) and no one batted an eye or treated us as though we were any different from any of them.

It was perfectly lovely.

Seatd

This was the sign on the seat in front of me on my flight today:
Although I'm used to seeing misspellings on signs and trucks and flyers and papers, and I can usually accept these mistakes with the excuse that English isn't the author's first language, I found this one disconcerting. I mean, if you're not even checking your spelling when you put the airplane together, what else are you ignoring?

H1N1 in Egypt

The Egyptian government announced today that the first case of H1N1 in Egypt has been confirmed. An Egyptian-American girl traveling to Egypt to spend the summer with her family was stopped at the airport (apparently they're checking the temperature of everyone who arrives and quarantining those with fever) and tested positive for the virus.

In my opinion, though, it was only a matter of time before the virus made its way into Egypt, and, really, I'm not convinced this is the first case to enter the country. It's just the first case the government has identified. I do feel a sense of relief though. After the scandalous rumors a couple months ago about NAMRU-3 being responsible for bringing H5N1 to Egypt, I'm glad the Egyptian government found the new virus before we did so we can shirk any responsibility for its introduction to the country and, for that matter, to the continent.

A baby named Khaled

A couple days ago, I decided to take my visiting friends to one of the large hotels downtown for drinks on the rooftop bar overlooking the Nile at sunset. The view is impressive and I was excited to share it with them, so I was thoroughly disappointed when we found out the bar was closed for a special event later that night. Sadly, we took the elevator back to the ground floor and hopped in a taxi to go elsewhere.

After only about a minute or two in the taxi, though, our driver's cellphone rang. He had a quick conversation in Arabic and then turned around to us with a huge grin on his face and shouted "Wife! Baby boy!" It didn't take much to realize that his wife had just had a baby boy. We asked a few questions and found out that this was his third child (but the first boy), that his wife was at Ain Shams Hospital (one of the hospitals we partner with for research studies) and that he would go to see her as soon as he dropped us off. We then asked what the baby's name would be and were shocked by his response:

"Name the baby!"

We assumed there had been a misunderstanding and quickly assured him that we were not trying to name his child. But he would have none of it.

"Name the baby!"

Suddenly I was panicked. Even though he was clearly in a great mood, I didn't think we shouldn't be the ones naming the baby.

"Name the baby!"

What if he didn't like the name we picked? Did he want an English name or an Arabic name?

"Name the baby! Mohamed, Ahmed, Mahmoud, Khaled..."

Thankfully he made it clear that he wanted an Arabic name. So I spoke up and suggested that the child's name be Khaled. My friends agreed that it was a good name and our taxi driver was thrilled. Immediately he was back on the phone, calling his wife and friends with more Arabic conversations from which I could only pick out small pieces. But those few pieces definitely included "Americans in the car" and "his name is Khaled".

We had actually named the baby.

E-bulletin on Djibouti

I just found out that the April issue of NAMRU-3's e-bulletin (which of course came out in April, but I'm only just now seeing) focuses on Djibouti. Check it out here for a few pictures and a better understanding of some of the initial work we're doing in the country.