Zinc treatments for diarrhea

TIME published an article this week called "Can one pill tame the illness no one wants to talk about?" which discusses results from some research I had an opportunity to help with while I was in Bangladesh a couple years ago. It's pretty awesome to see that research turning into results and action that may truly make a difference in peoples' lives!

Dead Sea

On our way back to Amman from Petra, we made a detour to drive by the Dead Sea. I already had the opportunity to see the sea from the Israeli side and to float on the surface of its buoyant water last December (see "Dead Sea Spa"), but I had heard that the view from the Jordanian side was quite different. I was curious to see if it really was. When I visited the Dead Sea in Israel, we had to walk from the foot of the mountains down a long, long boardwalk over salty mineral deposits to reach the water. In Jordan, though, the water came right up to the foot of the mountains and there was very little mineral deposit along the shore. It looked completely different from the Israeli side, but was still a beautiful site!

Petra Kitchen

After a long day of walking around the ruins of Petra, three of us decided to take a cooking class at the Petra Kitchen, a restaurant in Wadi Musa (the modern town next to Petra) that offers nightly cooking classes in Middle Eastern cuisine.
Our course was taught by a Jordanian chef and his Egyptian assistant, who were both great and made the evening a ton of fun. We had quite a menu to prepare. For mezza, we fixed green wheat soup (chicken stock, wheat, onion and spices), Arabic salad (tomato, cucumber, mint, parsley), baba ganuj (eggplant dip), galaya bandura (spicy sauteed tomatoes) and foul (a common dish made of fava beans). The main course was sawani dajaj (a pan-roasted chicken dish with potatoes, tomatoes and onions). We had such a blast fixing all the dishes and then sat down to enjoy the delicious meal. At the end of the night, we were even given copies of the recipes to take home with us to try to duplicate on our own. I can't wait to give them a shot!

Petra

Perhaps the most famous site in Jordan is Petra, the "ancient rose-red city of the Nabataeans, Arabs who controlled the frankincense trade routes of the region in pre-Roman times" (according to the Lonely Planet). This weekend I hopped a plane to Amman, the capital of Jordan, met up with a friend who was there for work and rented a car to drive three hours south to see the ancient city.

I had been so busy with work during the week leading up to the trip, that I hadn't done much reading about the site before I arrived. Pretty quickly, though, I decided that wasn't necessarily a bad thing. Rather than knowing just what to expect and just what I was going to see, I wandered through the ancient ruins encountering surprise after surprise. It was a perfect example of one of my favorite Paulo Coelho quotes, "at the same time, since all things are new, you see only the beauty in them and feel happy to be alive."

Just inside the gate that marks the entrance to Petra, there are a few caves carved into the rock walls lining the path. Not too far down the path is the Obelisk Tomb and Bab As-Siq Triclinium, which was an impressive first sight to see (though not nearly as impressive as the things to come, I later realized!).
From the Triclinium, we passed a few more caves before arriving at the entrance to As-Siq. The Siq marks the ancient entrance to Petra and is an impressive, narrow gorge between rock walls that rise up as high as 80 meters! The Siq itself is 1200 meters long (appx. 12 football fields!) and was formed by tectonic forces that literally pulled the rock apart to create the passageway.
The journey through the Siq was incredible, with beautiful rock colors and formations, tons of twists and turns in the path and even tiny alters carved into the walls along the way. With so many things to observe within the Siq, its end comes seemingly out of nowhere. And just as you exit the Siq, you find yourself face-to-face with Al-Khazneh, also known as the Treasury. There are not words to describe how impressive the Treasury is, especially when it appears before you after a long walk through the Siq. The building face is carved into the stone wall and was created as a tomb, though it has been misnamed the "Treasury" by a local belief that an Egyptian pharaoh hid his treasure here. (Another random fact, the Treasury was made famous by "Indiana Jones and the Last Crusade.")
Beyond the Treasury, the path that began as the Siq continues, though the path is much wider and the walls less towering here. This area is known as the Street of Facades and is lined with over 40 ancient tombs.
Just past the Street of Facades are the Royal Tombs, carved higher on the rock face with more ornate and impressive details than the tombs of Street of Facades. Unfortunately these tombs have been affected by erosion over the years, so they show a little wear and tear, but they are still stunning. The largest of the Royal Tombs is the Urn Tomb which was carved around 70 AD and used in the fifth century as a Byzantine church. We spent a good bit of time climbing around and through this tomb and marveling at its beauty.

The Urn Tomb (on the left side of the picture)

Main chamber inside the Urn Tomb
The natural colors of the rock on the ceiling inside the Urn Tomb

On the first level of the Urn Tomb, looking up to higher levels

When we were satisfied with our exploration of the Royal Tombs, we continued toward the city centre of ancient Petra. The road leading to the city centre is called the Colonnaded Street and was once lined with temples, public buildings and shops.

Colonnaded Street

Looking up to the Great Temple

Inside the ruins of the Great Temple, facing the main altar

Inside the ruins of the Great Temple, looking back toward the Royal Tombs

After passing through the city centre, we continued our journey toward the furthest site from the entrance to Petra (appx. 6 kilometers, or 4 miles, from where we had started at the entrance gate). Ad-Deier, or the Monastery (named for its use by the Byzantine church), is perhaps the most impressive (in my opinion) of the sites at Petra. The hike from the city centre to the top of the hill where the Monastery is found takes around 45 minutes and includes over 800 stairs, but the trip is most definitely worth it!
Further past the Monastery are a couple view points that look out over Israel and the Palestinian Territories. The views were nice, but I think the most impressive view was looking back toward the Monastery, which really put everything into perspective.

Looking back toward the Monastery

With Israel and the Palestinian Territories in the background

After visiting the Monastery and view points, we were exhausted from the heat and the hiking and hauled ourselves back down the mountain, where we took a quick break and then headed back toward the entrance. It was a long day, but so nice to be outside in fresh air and seeing so many incredible ancient sites!

Hear ye, hear ye

This morning I received word that the Egyptian government had issued a decree (thus the "Hear ye, hear ye" title) related to the control of H5N1, also known as highly-pathogenic avian influenza (HPAI). For just the very briefest of moments – and I do mean the very briefest; the thought couldn’t have lasted more than perhaps half a second – I was excited.

You see, Egypt has been hit by the H5N1 influenza strain harder than any other country in the world outside Asia. When the total number of cases is considered, and even when Asia is included, Egypt still falls third on the list, after Indonesia and Vietnam. However, unlike Indonesia and Vietnam and most other countries where H5N1 has been reported, the number of cases in Egypt is not decreasing. Already this year there have been 30 cases. Compare that with 18 cases in 2006, 25 in 2007 and 8 in 2008, and it’s not hard to see that over a third of all cases of H5N1 in Egypt have occurred this year – and it’s only the beginning of August! Not only that, but there hasn’t been much H5N1 reported elsewhere in the world in 2009; over 80% of all cases of H5N1 reported this year are in Egypt.

Another interesting fact about the cases in Egypt thus far this year is that only 4 patients (13%) have died from the virus. Although this may still seem like a high mortality ratio for an influenza virus, it’s very low relative to the average for H5N1, which is around 60% (or 64% if this year’s cases in Egypt are excluded).

Still, perhaps the most interesting aspect of this year’s cases of H5N1 in Egypt is the demographic affected by the disease. The vast majority of cases have occurred not among young men working on poultry farms or young women slaughtering chickens at home. Most cases have been among children and toddlers as young as eighteen months. Although there are a number of theories circulating about this shift in the age distribution of cases, the most believable (in my opinion) is rather simple. In rural areas of Egypt, where many families raise chickens and other poultry in their households for food and sustenance, it is common when it gets cold to bring the poultry inside the house for protection against the cold. Once inside the house, the children, who often already consider the chickens their pets, play with the poultry in very close quarters. Thus they are exposed to H5N1 and contract the virus. Voilà.

So, in summary, there’s a deadly disease circulating in Egypt that’s killed a high percentage of the people it’s infected and now it’s infecting a lot of very young children. And the government issued a decree today that it’s going to do something about it. As I already said, I was excited.

But then I realized that this decree was coming from the same government that ordered the culling of all the swine in the country when H1N1 – a strain of influenza that has never been transmitted from a pig to a human, that has never even been isolated in swine – broke out in the United States. I immediately knew the decree was going to be disappointing, and I was right.

The government of Egypt has now decreed that all official poultry farms will be moved out into the desert (a.k.a. the middle of nowhere) so as to eliminate any proximity to humans and strict biosafety measures will be implemented. At the same time, all unofficial poultry farms will be closed.

Now, if poultry farmers were the ones being affected by H5N1, this might seem like a logical and effective plan. Unfortunately, however, it seems to be just another attempt by the Egyptian government to show that they’re doing something, whether or not that something is appropriate.