viet in nigeria

on HIV

2006-09-14T06:39:00.001+01:00

i am back in berkeley. i've been in the states since before the terrorist plot was "foiled" by the british. the day before, actually. my journey here was not the most pleasant, and my time in between has had its ups and downs. but i am safe, and left reflecting back on this summer, as i have been invited to an international internship class discussion to share my experience, tomorrow. shortly afterward, i will share my story with my colleagues in one of our classes.

i wish to close out this blog with an entry about the most important topic i never really discussed while i was in nigeria. it's the reason i was brought to faith alive in the first place: HIV.

nigeria is the most populous nation in africa, making its nearly 5% HIV prevalence an incredibly daunting number. combine this with its reported top ranking on the world corruption index, malnutrition, extreme poverty, lack of infrastructure, political instability, and the product is a disaster in public health. not only is HIV a burden, but many other communicable diseases, vaccine preventable diseases, and other atrocious mortalities frequent nigeria.

fifty percent of nigerians that come to faith alive for an HIV test are positive. and i am pretty sure that the other fifty percent will become positive at a later date. it's just a matter of time. HIV is ubiquitous there. all of the new friends i have made are HIV positive. their husbands and wives are positive. their children are positive. many have had only one sexual partner in their entire lives. many have had a destructive and abusive lifestyle before coming to faith alive. many are hiding their disease from their loved ones. many have been rejected from their villages. many go to church on sundays. many pray daily. many go to work. many go to school. many sing in the mornings. many want to have children. many will get married. many will get sick. many will get well. all will die. they will all die earlier than they were meant to.

at times i felt myself become desensitized to the tragedy that goes on there. the hearts that were broken when news of HIV statuses were given. at times i felt myself become desensitized to the miracle and life that goes on there. the hearts that were mended after being told that the medicine will rehabilitate their lives. it's certainly a lot to immerse yourself with. i admire the physicians and nurses that deal with this everyday for much longer than i have. and i admire dr. chris and dr. mercy for being such amazing human beings.

as for my work at faith alive, i wrote a short scientific paper that summarized my research study. i have a soft copy if anyone wishes to read it over. just comment. dr. chuks looked it over and didn't want to make any changes, but wanted to submit it for publication. i am not too sure about the publication thing, but it's nice to hear nonetheless. the results of my study showed about a 9.4% prevalence of HBV and HIV co-infection in our sample, which consisted of 106 patients. more startling, only 21.5% reported that they were even aware of HCV, while a 65.4% were aware of HBV. my recommendations included increased investment of funds and time into health education, immunization, and treatment of co-infections was necessary for the patients at faith alive.

i had an amazing learning experience designing and conducting my own research study. i enjoyed all the people, and learning more about HIV. i only hope that we will see the end of this public health crisis. we are certainly long from it.

on faith.

2006-08-06T11:23:00.000+01:00

faith alive, as the name implies, is a faith based organization. it is funded by christian organizations (outside of PEPfAR funding, but if you are like me, you might even consider PEPfAR a christian grant). as some of you may know, i am not christian. in fact, i am buddhist. which is fine. i grew up in a christian world my entire life, and i know what i believe. when i decided to work at faith alive, it was not due to its religious component, it was because of the actual work they are doing. outside of "the students" (as we were constantly referred to), the other americans here are missionaries. although we are here for different reasons, there is good work to be done. this entry is written through the eyes of someone who is not christian or muslim (the two very dominant religions present in jos and nigeria).

today is sunday. an important day in jos. in fact, i have read that jos means "jesus, our savior." it is primarily a christian city. although statistics have reported that nigeria is 50% muslim (mainly the northern areas), 40% christian (southern areas), and 10% indigenous beliefs. a typical sunday morning includes much more singing than usual, and NEPA (the power company) is on the entire morning. this is due to the fact that people need to go to church, which requires a lot of power, as i will get into later.

usually i will hear the preacher in the morning, who is really just the town nuissance with a giant megaphone who preaches late in the night or early in the morning, depending on the type of person you are. usually, you cannot make out anything he shouts into his megaphone, except a few words. jesus!, praise the lord!, christ! even the devout christians despise his wake up calls. it's so LOUD and one time, i swear it sounded as if he had satan inside of him, like linda blair sans split pea soup dripping from the mouth. he is usually at this for hours on end, until most people are up and ready for church, work, or starting a ban on public street preaching. when i first arrived in jos, he did this nearly everyday. i suppose he had a stern talking to since then, because i usually only notice him on sundays or saturdays, which i do not mind as much.

everyone sings. EVERYONE. and i've come to realize that very few nigerians (or at least the ones that live around me) have a good voice. bible songs and hymns are frequently heard in the streets of jos, whether it's in a church or outside by the laundry line, music is everywhere. it makes the city come to life, and to be quite honest, it is a bit unnerving when the city is silent.

religion is VERY important in jos, unlike in most areas in the states. it's a part of everyday life. it's so easy for me to go through a typical day in the states without having to hear preaching (in fact i don't think i've ever experienced preaching to the extent that i have in nigeria). here is how a typical conversation goes for me:

nigerian: did you read the bible this morning?
me: no.
nigerian: why not?
me: because..
nigerian: are you not a christian?
me: no.
nigerian: you are a muslim?
me: no.
nigerian: you are a pagan?
me: no. i am buddhist.
nigerian: ohhh.. how do you worship? do you believe in god?
how do you pray? what is it like to be pagan?
me: i am not pagan.
nigerian: oh yes, right. what is it again?

as you can tell, this is the type of mentality i am up against. but despite all this, i am not judged horribly for not being christian (something i have grown used to, especially living in apple valley throughout my high school years). people just don't understand. they think all americans or white people are christian. and when i first arrived, i got an overwhelming amount of "praise the lord!" and "hallelujah!" thrown at me at the end of each sentence of each conversation. i suppose it began to leak that "the students" (although some of us are christian) are not missionaries, and do not care for constant references to jesus. as my time in jos ends, a lot of the religious talk has also ceased (at least to me), and i find myself having normal conversations with people.

it is certainly interesting to go to church here. i have been to a few churches, and they have all been very different from each other. most baptist services last for HOURS. there is much sitting and standing, sitting and standing. no matter how big the church is, there is always a microphone and a band with a LOUD sound system. despite the fact that you can hear the pastor perfectly well without the mic, they will immediately turn on the generator if NEPA happens to fail during a church service. and when they pray, it can go on for a while, as well. one time, i found myself praying for nearly 25 minutes, and i am pretty sure i fell asleep somewhere in between.

i have been to tiny churches composed of about 25 people and consist of one room buildings with white patio chairs and metal slabs used for roofing. i have been to giant churches with several floors and sunroofs. i have been to churches in tiny villages, which are just mud huts, but with 80 people crammed into them. i have been to services in english, hausa, and yoruba. i haven't been to any catholic services, but supposedly, they are shorter.

since i work for a christian organization, most of my exposure to religion is through christianity, of course. however, i have met a few muslims (including some who work for faith alive), and i have ventured through the muslim part of town. athough jos is relatively stable as far as religious battles are concerned, there is still a hint of animosity i have noticed. i have heard both sides bad mouth the other in a subtle sense, especially in reference to politicians. the president is christian and the vice president is muslim. i do not know much about muslims, but i would love to learn more, possibly on my next visit. here is a picture of the mosque, which is visible from my flat. it's beautiful!

to anyone wishing to come to nigeria, be aware that religion is very important and a part of life in this country (especially women who visit the northern states where sharia law is in place - this means cover up and observe the roles between men and women, but it also means for everyone, no drinking, theft, etc., or strict punishments will ensue). it's everywhere. in music, television, billboards, schools, the marketplaces, in everyday conversation.. everywhere. i am pretty sure they do not know the meaning of the word secular.

but the people, regardless of religion, are very gracious here. and only one person has tried to convert me, but it's ok because he is a very nice person.

on race.

2006-08-02T17:31:00.000+01:00

i live about three blocks from the clinic. so i walk everyday. it's a nice walk. all the neighborhood kids shout at me every day, chanting oyibo! bye bye! (meaning: white person, in the yoruba language) over and over until i wave at them. some run up to me and tag my body, usually my hand or leg, just because they think they can have wealth by touching a "white person." all of the adults who do not know my name refer to me as oyibo, as well. i frequently get a, "oyibo, good morning!" from the neighbor who sells corn near my apartment. i also get called bature (meaning: european or white person, in hausa).

i am vietnamese. no surprise there. but if you are like most nigerians i have encountered, it is a surprise. the first week i arrived, i had the pleasure of meeting hillary and ryan who are a married couple just ending their stay in jos. they both worked on a some different projects at FA and had already been there for almost two months when i arrived. hillary happens to be asian, as well. to this day, i still get people talking to me as if i were hillary, despite the fact that i feel i look nothing like her. they would ask me where my husband, ryan, was. and they would assume i was a doctor. when i begin to not follow a conversation with someone, i have conditioned myself to start convincing that someone that i am not the same person as hillary. but i don't really mind.

i am frequently referred to as "white" by many people, including friends and colleagues at the clinic who very well know that i am vietnamese american. this all goes back to my first blog and my reaction to the inquiry of my complexion. i should have written fair only. i am very fair compared to nigerians here. should a foreigner decide to come to nigeria, words that s/he will hear as a "white person" will be bature and oyibo. in addition to being "white," i have also had the following shouted at me on the streets: china! japanese! also, in conversation with people, i have been asked where i am from and always get a strange look when i answer with, "the united states." i then go into an overly rehearsed explanation about how my parents came from vietnam, a country south of china (this is the part where the look of confusion immediately melts away for a brief moment, at the familiarity of the word china.), and came to the U.S., where they married and started a family. after this explanation, i usually get a, "oh, you look like china." i have also been called korean after i refused to answer to china and japanese, for some reason. when i list asian countries near vietnam, the closest one that garners a response (that is not confusion) is the phillipines.

there is simply not a strong vietnamese presence in nigeria. a shame, i say. when i was in yankari, i noticed that they attempted to keep a record of all the visitors that came. among the questions asked was country of origin. i listed america like all my travel mates before me. in fact, i didn't even write the word, i just wrote tick marks underneath that area. but in hindsight, i should've written vietnam, because i found a plaque that had all the countries that visitors came from and nowhere on this extensive list was vietnam. a shame, i say.

to explain this lack of knowledge about vietnam, i go to the world cup, which i had the pleasure of watching nearly every day the last month. football (soccer). that is the key. vietnam isn't known for soccer! if it was, people would be yelling vietnam! at hillary when she was here. or i just suspect this would be so.

in addition, there is a strong chinese presence in nigeria, mainly chinese businessmen. there are chinese restaurants in nearly every major city. there is also a strong lebanese presence in nigeria.

another person who volunteered for a short time during my stay here, who happens to be of indian decent, was asked if she was from ethiopia or zimbabwe. i am not sure about the implications of these questions. but it is certainly interesting to observe.

probably the most surprising thing to me, is the amount of celebrity i have gained just by being a foreigner. when i say i am from america, people jump at my feet. i have never been treated so well in my life my strangers. i no longer need to be a rock star or royalty, because i have already had that experience in jos. it's certainly interesting to experience. nigerians love americans. love them. it's quite odd, having traveled to areas of the world where americans are hated. i have had the luck of escaping that backlash by my vietnamese features. i was just so used to the stigma of being an american in a volatile world. coming to nigeria is like being in a time warp where colonialism is the norm and whites are god. there is no separation of color, like in south africa though. not much differentiation between light-skinned and dark-skinned nigerians. they do call mixed children "half-casts" though.

i have been asked if black people walking down the streets in america would be pointed out by the americans, chanting some equivalent of oyibo! or bature! at them. i chuckle a little, and politely respond, "no. probably not."

on eating

2006-07-29T19:18:00.000+01:00

i am currently learning how to speak hausa in my final days in jos. i have picked up a few phrases, but the most important and most frequently used phrase i have mastered has to be bana cin nama, meaning i do not eat meat. i'm a vegetarian, and to be frank, it is quite difficult to eat well in nigeria.

nigerians eat pounded yam, simply put. this requires a giant mortar and pestle that is the size of a child and more strength than i can ever muster up. it's quite a process. after the yam is pounded, it is grainy and powdery. next, it is placed in boiling hot water until it is thick and smooth. yam is also eaten in different forms like fried yam, but pounded yam is the one item that every local answers with when i ask, "what is your favorite thing to eat?" i've had pounded yam, and my taste buds do not find it all that impressive. it is usually eaten with "soup" which is basically a stew usually with a fish-based stock and other mystery items. there are several different "soups." first of all, vegetable soup has meat in it. a lot of meat. i was tricked into this at the local restaurant across the street from my flat. it sometimes has fish bones. add a lot of palm oil (nigerians love to cook with this), some spices, maybe tomatoes, onions, and some leaves i have yet to identify. voila! vegetable soup. it was ok when i had it, but the fish thing really got to me towards the end of my meal. vary the soups a little: a favorite is pepper soup, which is actually pretty tasty, save the goat head. it's not so fishy as other soups. you can probably guess the main ingredient of melon seed soup; just grind up the seeds and add them in with meat and spices.

all of the soups are eaten with a starchy carbohydrate. this makes your meal extremely heavy and most nigerians do not eat many times a day (as i do). they believe their diets make them strong to work all day. i've already mentioned pounded yam. other favorites are gari (a grain that has a similar consistency as pounded yam when prepared) and sumavita.

the proper way to eat it with your hands. at restaurants or "chop houses" (chop means to eat or it refers to food. eg. chop is ready or come chop pounded yam), there is a bowl with clean water where you can wash your hands before and after you eat. do not expect a menu or a reliable one, anyway. you just need to ask what food or chop is ready. when there is a sign saying food is ready it means the meals for the day are prepared. food is very cheap in your average local restaurants. maybe about a US dollar for a giant meal.

jollofrice is also a popular dish, which is fried rice with many spices in it. it usually comes with a giant piece of meat, but i eat around that.

breakfast is more vegetarian friendly. usually bean cakes and a type of custard are eaten. also, eggs and chips are a favorite (omelettes and french fries). and oatmeal is readily available. tea and bread is usually served, also. for you coffee addicts, do not expect fresh ground beans. the readily available nescafe instant coffee is what you will probably end up drinking. milk also comes in powdered or condensed form (good for coffee and tea). if you are in a city, like jos, you can easily pick up cereal at a grocery store. breakfast is my most favorite meal of the day. our cook, baba, makes excellent crepe style pancakes every saturday morning. fruit is readily available. mango season just ended, sadly enough. but they have plenty of bananas, oranges (which are not orange), apples, plantains (fried plantains are one of my favorite things to eat here), watermelon, and even avocados.

however, my situation is a bit different than most in that we have a wonderful cook, baba sunday (baba is a generic term for a grandfather or an elderly man). he prepares western dishes for us, including pasta, mac and cheese, and garlic mashed potatos. also, he loves making cous cous and curry.

as far as meat, i can write about what i've been told. goat is very popular here, as there are many goats walking around the streets. the cows are all strangely thin. nigerians like their meat very tough. they like their chicken deep fried.

there are plenty of restaurants in jos that are a bit more "high end." afri one is an excellent western style restaurant that serves fresh salads and our personal favorite: hummus and pita bread. they also have ice cream and a great bakery. there are also lebanese and chinese restaurants in town.

there is also street food. my favorite is boiled corn. they also roast it and eat it with coconut for some reason. ground nuts or shelled peanuts are also a local favorite. i always eat buns, which are basically fried dough. all of the street food is extremely cheap and if you are careful about which places you patronize and what types of food you eat, you should be ok in the GI department.

my favorite local nigerian dish is goti, which is made from a seed called acha. there is no oil or meat used and you add ground nuts, spices, nigerian spinach, and other ingredients that escape me. it's like a spicy porridge and it's very tasty. however, i find that many locals do not like goti for some reason. they are all about the pounded yam and fish head goat something or other.

as for drinks, all the local drinks i have tried have not been very tasty, at least for me. i usually just drink water or mineral (aka soda, which is very cheap here). there is also good juice.

in abuja, there is a little rumor that there is a thai restaurant. this means i know what my dinner will be before i fly out to london.

on health

2006-07-26T14:30:00.001+01:00

thursday, july 13th. i took the day off from work to join some co-workers from the lab to visit a village about 90 minutes out of jos. the day already proved to be complicated by the type and amount of preparation required for this trip. in hindsight, i should have taken that as an omen for things to come.

the plateau state produces and distributes bottled water all over the country, called swan water. it is primarily the drinking water that everyone drinks, save eva water and "pure water." (advice to anyone traveling to nigeria. "pure water" comes in little bags and costs about 5 naira which is pennies to americans. although they look refreshing and are inexpensive, they are rumored to be tap water which is not safe, especially in larger cities. bottled water, when sealed, is very safe to drink.) the village where swan water is bottled is called kerang and happens to be rachel's village, a co worker in the lab. she invited andrew, rod, and i to visit her village and take a tour of swan water's factory. they bottle their water at the foot of volcanic mountains, which provide beautiful scenery.

although i did not get much sleep the night before, i felt fine as i waited around for our taxi to arrive, late as usual. after picking up our lunches and sorting out the taxi business, we headed out to kerang. when we arrived at the factory, we were greeted and expected by the workers. we got a special tour of the factory. in the middle of this special tour, i started to feel extremely faint and my abdomen was feeling very sore. i had just eaten a snack in the car so i was pretty sure my weakness was not due to lack of food. i attributed my aching muscles to carrying too many buckets of water around and tried to make it through the tour. towards the end, i could not handle standing any longer. i did not feel nauseous; just extremely weak. instead of wanting to try to climb the volcano with the others, i wanted to lay down in the taxi, which was conveniently waiting for us. everyone, including myself, thought i was just tired and needed food or water or something. so they all went to climb the volcano as i layed in the taxi's back seat in complete agony. i began to feel very warm but i thought it was because it was about 100 degrees in the car, as the sun was beating down my neck. i had to cover it with a shawl i brought to keep from getting sun burned, so i felt even hotter. i could not move at this point. i could not eat. i could barely drink water. i just layed there, in the most pathetic way possible. finally, after what seemed hours, my travel companions arrived and we headed back to jos. since we were taking a taxi, we stopped several times to pick up other passengers on the way. everyone taking a glimpse at the oyibo in the back seat who could not move. everyone began to get worried about me. i took 2 advil that one of my co workers had and began to feel a bit more mobile when we arrived at the apartment. i was able to step out and make it up stairs.

i slept for a few hours and by the evening, i had extreme chills and a high fever. i went to bed but would only sleep for an hour or two at a time. i would wake up very hot or very cold. i was tossing and turning the entire night and by morning, i still had a fever. i could not move out of bed for a few hours. i finally gathered the strength to walk to the living room where i would collapse on the couch (also known as my "sick haven" where i spent most of my time). i could not move. it hurt to breathe. it hurt to talk. it hurt to think. my entire body was in extreme pain.

baba, our cook, got worried that i did not show up for breakfast and sent for one of my room mates to check up on me. then a slew of people came to visit, including dr. prince, dr. chuks, some of the lab techs i work with, and several other visitors from FA who were worried about me. i merely said two sentences to dr. prince and he immediately diagnosed malaria. dr. chuks came to take a blood sample and the lab confirmed it. plasmodium falciparum, trophozoites in my blood.

luckily, i got treated right away and in about two days i was feeling better. i was well enough to even go out to dinner. the next day, i got dysentery. it was horrible. i couldn't sleep the whole night without needing to go to the bathroom. the next 24 hours i was back to my "sick haven" and i could not keep anything down. i didn't eat the entire day. alicia, my room mate, also got sick with something similar. we are not sure what caused it, but we were both in complete agony. i was very dehydrated. i could not move, again. but this time it was because i was weak, not because of the body pains. dr. mercy had me take the cipro that i brought and that very same evening my dysentery was gone. i guess cipro really is a miracle drug.

i find it kind of ironic that i was taking my anti-malarial prophylaxis at the same time as my treatment for malaria.

anyhow, i felt better by the next day. and i was going back to work that week. at the end of the week, however, i got some allergic reaction and broke out in mystery hives all over my body. i had just finished my treatment for both dysentery and malaria. i took two benadryl and it immediately started to clear up. that was last week. this week i am fine. at least i hope so. i am not sure what caused the hives, since i never get allergies to anything.

on the bright side of things, i am well enough to tell the tale. i am now officially a nigerian, as malaria is just a way of life here. the doctors who treated me get it about once or twice a month. of course, they have a bit more immunity than i do, but i am slowly working on that one.

also, i would like to extend my deepest gratitude to all the doctors and FA staff and friends in jos who have visited me, taken care of me, and prayed for me. i am so lucky to be working in a wonderful hospital. i suppose if i had to get malaria, the best place to get it is at FA.

sannunku (greetings to you all)

2006-07-09T20:20:00.000+01:00

faith alive is going through a lot of change and i am lucky enough to be a part of the transition. a few weeks ago, faith alive celebrated its tenth anniversary with the dedication of the newest volume of FA's magazine called touching lives, the social services graduation ceremony, a music concert, the dedication of the new building, and many more events. it was a chaotic time, but full of great memories. many americans and nigerians united in the weekend long celebration. dr. mercy is pictured here greeting guests to the new hospital building constructed after the fire. the building is not finished, however, and there is not enough money to finish it as of yet. FA is already in debt and cannot continue construction or furnish the rooms until funding arrives. the half finished building is immaculate, though, and it is the talk of the town. i was developing photos the other day and one of the employees commented on how beautiful the building is. dr. chris mentioned that they had to reduce the number of hospital beds in the new building because patients get too comfortable in the hospital and do not want to leave. this is certainly a contrast to the states where most patients would want to leave the hospital as soon as possible to enjoy the comforts of the average american home. FA's hospital is much cleaner than any local nigerian home i've visited, with clean water available at all times and NEPA (the nigeria electrical power authority which supposedly provides electricity to the country) backed up by a generator providing consistent power in the works.

the magazine dedication as well as the music concert were held jos university's auditorium. the magazine turned out to look wonderful, with plenty of color photos of the staff at FA, as well as an interview with dr. mercy. i spent most of my time socializing with all the new friends i've made in the FA staff. florence, the sewing school teacher, has become a great friend of mine who i visit often. she is an incredibly strong, intelligent, and gorgeous woman. she also makes me fabulous nigerian clothes!

although i do not work at social services, i visit often because of all the friends i have made at the sewing school. some of the ladies graduated during the anniversary weekend and i was fortunate enough to have a sewing school dress made for me so i could feel like i was part of the team. the entire weekend was full of activity and shuffling from one place to the next. i anticipated the normal pace of life in jos during the anniversary and welcomed monday with open arms.

last weekend, amos the architect for FA's new building, took us on a tour of jos. it was a great day, despite some rain. he drove us all over town to some places we have never seen. jos is on a plateau and is surrounded by scrub plains and giant rocks. check out that rock to the right. it's balanced by the smaller rock on top of it. amos told us that if it moved, the giant rock would not be able to keep balance there. amos then drove us to the wild life park in jos. it's more of a zoo, since most of the animals (including the birds) are in cages. i saw a lion, an elephant, monkeys, antelope, and other animals. all in cages. it was pretty pathetic. it certainly discouraged me from visiting jos' zoo, which is supposedly worse than the wild life park. i had fun spending time with my room mates, though. i suppose i was very spoiled in yankari where "you are in the cage."

last week, blessing took me to visit the barracks. we traveled on a "bus" which was basically a minivan with three times the capacity recommended for a 15 to 20 minute ride on the outskirts of jos. the trip cost 40 naira a person (current exchange rate is 128 naira to the dollar). once we arrived, we met blessing's friends. there were surprisingly quite a few female soldiers. here is blessing with some of the soliders we met. blessing used to live at the barracks because her in-laws were here. she told me all about the soldiers' quarters and we got to see a rehearsal parade for army day, which happened to be the next day. we then visited her old neighbors in one of the apartments, which were quite nice. afterwards, we went home on the same bus. it was certainly a great trip! blessing is a wonderful person with an amazing story. she was rejected from her family when her husband passed away due to aids-related illness. they kept her two boys in the village. she got treated at FA and graduated from the sewing school. she opened her own shop down the street from the clinic and has been living at the transition guest house. she traveled back to the village and snuck her two boys out to jos. she is currently moving into an apartment she found and is running her own shop. she has a great sense of humor and is teaching me pigeon english, which is a common form of speaking that "africanizes" english. for instance, when you want to say "i'm coming" in pigeon (which ironically means you are leaving), you would say: "i de come." i find myself following a conversation with a local and then losing it because they sometimes break into pigeon. i'm learning!

one of my favorite things to do in jos is go to the market. although the meat market is my least favorite market due to the smells and the fact that i am a vegetarian, it is certainly the most interesting. you can guess which meats come from which animals in this picture. my favorite part of the market is the "fabric district" as i like to coin it. nigeria is known for very bright and colorful patterns. both men and women dress in elaborately designed clothing. jos is also known for being particularly fashion conscious. it is very common for locals to buy fabric of their choosing and have clothing made by a tailor. with my connections at the sewing school, i am able to have plenty of beautiful dresses made.

today, i went to amos' thanksgiving service at his church. it's always interesting to see the locals on sundays. church is a huge event in jos. there is much dancing and singing. the thanksgiving service was in honor of amos' 20th wedding anniversary. there was a reception afterwards at his house, which is in the same compound as dr. chris' house. it was wonderful being a part of amos' wedding anniversary.

as for my research, things are picking up. the hepatitis prevalence is much higher than expected so far, but we still need to increase the sample size. i am learning a lot and meeting great people every day. i received a visit a while back from a representative of an NGO that advocates women's rights, who wanted to use my data. i am happy my research will benefit this organization as well as FA.

as they say in hausa, sai an jima (see you later)!

yankari, the haven

2006-06-18T18:12:00.000+01:00

this weekend, i had the honor of being the guest of his excellency, alhaji ahmadu adamu mu'azu, governor of bauchi state in yankari national park. several of the volunteers made the 3 hour drive from jos to yankari and stayed at the governor's guest house, which always has electricity and running water. it was certainly a treat, since it also came with a cooking staff, flat screen tvs, jacuzzi bath tubs, and air conditioning. the entire trip was provided for by both the governor and the blattners. we arrived friday and were off right away on safari. we hopped on the back of an old, beat up truck and drove around the park for about 90 minutes. our tour guide, david, worked at the park for many years and knew the name of every species found in yankari.
we saw a handful of animals in their natural environment. the highlight of the safari was the family of elephants, including baby elephants! we almost got attacked by one of the older male elephants, but david did some magical spell and the elephant left us alone. we also got a chance to see water buck, several species of birds, antelope, monkeys, and wart hogs. no hippos or lions this time. at our compound, tons of baboons would play jokes on the tourists. especially at the wiki hot springs, where they stole kevin's (one of the volunteers) shirt while he was swimming, defecated on it, and returned it to him. prince, dr. chris' son, liked to run up to them from time to time.
the entire trip, i got to spend a lot of time with memuna, the daughter of one of FA's patients who is very sick in the hospital. dr. chris is taking care of her while her mother recovers. she grew up in the village and had a difficult time adjusting to city life, but really shined on this trip. she stole my heart! luckyily, i decided to bring my bathing suit last minute, because the wiki hot springs were heaven on earth. the water was always crystal clear and warm. i spent most of my time this weekend in the water, despite some odd circumstances due to culture. but that's a story i can save.
all in all, a fantastic getaway in nigeria! here we are in front of the governor's guest house.

on our way back, we saw a fulani tribe migrating with their massive amount of cattle on the side of the road. it was an indescribable sight. the fulani are nomadic peoples located in many parts of western africa.

the night before we left yankari, the governor sent for a tailor to come out and take all of our measurements. the next day, we drove to jos to meet him at one of his many homes. he was in a hurry to catch a flight, but fed us and gave us traditional nigerian outfits that were all made in one night! impressive. his excellency is very charming and charismatic; it was an honor to meet him and be his guest. here we are at the governor's house in jos all decked out in our wonderful gifts.

this was definitely the best weekend so far in nigeria!

Jos, the haven

2006-06-10T14:53:00.000+01:00

I am learning an incredible amount in my short time here, and have been adjusting to the simple life provided for me. Last Sunday, I traveled to a small village outside of the busy city of Jos to participate in an HIV/AIDS awareness outreach that FA puts together. Along with the usual FA support group members, Dr. and Mrs. Blattner also joined us in this village’s church. The service was very entertaining, consisting mostly of singing and dancing. Nyazi, a support group member, translated the service and songs to me from Hausa (one of the predominant languages spoken, especially in northern Nigeria) to English. After their service, FA members put on a skit about HIV awareness and gave their personal experiences with HIV and FA. Dr. Blattner, one of the world’s experts on HIV and head of the Human Institute of Virology in Abuja, answered questions that village members had about HIV. A lot of interesting questions arose, including transmission questions and vaccine/cure/prophylactic treatment questions. Dr. Blattner answered these questions very well and compared HIV to diseases and conditions they understood, such as malaria and hypertension. After the service, the village invited us to lunch where we had delicious spicy rice and mineral (soda).

Throughout the week, I had the opportunity to visit the many areas that FA runs. There is a skills acquisition program that includes the sewing school, knitting school, and computer school. Probably the most outgoing group of students lies within the sewing school, but everyone is very welcoming. I am having many things made by the ladies at the sewing school, including a traditional Nigerian blouse and skirt. I picked out my fabric the other day at the market with Florence, one of the sewing school teachers. Often, the ladies bring their children. Jennifer is my favorite.

The lab is going through a transitional phase at the moment since the fire destroyed most of their equipment. They hope to move the lab from the sewing school to the new clinic by next week. I spent a day in the lab learning how things work around there, and I learned a lot from the staff, particularly Rotimi. He has been at FA for a few years and is very helpful.

I've also gotten the chance to check out pre and post test counseling, a very intense place to work. This is where the patients get told that they either tested positive or negative for HIV. Probably over 50% of those who come in for an HIV test are positive.

This past week I have been getting used to the way of life in Jos and developing my project. I expressed my interests with Dr. Chris, and he assigned me to Dr. Chukwuma, or Dr. Chuks for short. Dr. Chuks is an amazing physician who heads Team E at FA. The patients under PEPfAR are all separated into different teams. There are about 7 teams that consist of a doctor, nurse, counselor, treatment support specialist (who is always HIV positive), and an adherence counselor. The first 6 teams all deal with naive patients. This means that the patients have never been exposed to ARVs, and are easier to treat. The last team, Team E, deals with all the patients who are a bit more difficult to treat for a variety of reasons, that includes failing first line therapy. Dr. Chuks heads Team E and is very good at what he does. I shadowed him the first day, and saw a lot of pathology that, before now, I have only been exposed to through text books and pictures. The study I am designing and conducting with the guidance of Dr. Chuks (who is also head of research at FA) consists of determining the hepatitis B/C and HIV co-infection prevalence of patients in Team E and comparing this prevalence to one of the naive teams' co-infection prevalence. I hope to make recommendations based on the data we will collect in these next two months that can impact FA's screening methods and drug treatment regimen for co-infected patients, since certain ARVs are more toxic to the liver with HBV/HCV co-infection than HIV mono-infection. Also, this study can provide more insight to the patient constituency of Team E. We'll see what happens!

Switching gears, I went to Jos' museum yesterday, which basically consists of shops that sell local artwork and crafts. I plan on buying most of my gifts here. They are magnificent. There is also a zoo next to it, but we did not get a chance to visit just yet. Although this area is in the center of Jos, it seems like it's on the outskirts; very quiet and peaceful. This is a certain contrast to the loud and polluted streets that comprise the rest of the city. I felt like I was in an Indiana Jones movie with all the huts around.

After the museum, we headed out to the orphanage which is run by the Plateau State government. Adoption is rare in Nigeria, since the phrase "it takes a village to raise a child" is taken very seriously here. International adoptions are non-existent and culturally taboo. There are about ten children at the orphanage now. At times, only one person will look over all these children. They are all very cute and loving. I held Gloria most of the time, who I hear is a bully. She wasn't acting up around me.

In other news, I am learning how to play guitar. I am pretty bad at it. Ryan was teaching me until he left for Germany with his wife. Now I will probably turn to Dr. Prince to teach me for the rest of the summer. I am also convincing Dr. Prince and Dr. Chuks to apply for an MPH at Berkeley!

the basics

2006-06-04T18:57:00.000+01:00

greetings from jos! i haven't had a chance to sit down and collect my thoughts. when i tried just now, i realized i couldn't. maybe it's because i am still in temporary transition mode. thus, i apologize in advance if this entry seems a bit scattered.

i thought i would just put up a few pictures i took over the past couple days. i haven't been able to take many, because i've created this overwhelming cultural sensitivity rule in my head that mitigates me from bringing out my camera. so mostly, i have been taking pictures of signs and baby animals. i have been told, however, that the children love having their pictures taken. and this probably makes me the happiest girl in jos. i don't have any of random nigerian children on my laptop just yet, but that is what the rest of these ten weeks are for.

i am currently staying in the bayside apartments, in a wonderful 4 bedroom/2 bath that i share with 5 other people as of now. volunteers keep shifting around, so i never affirm anything with certainty. i love it here; the apartments have personality and very hard furniture. our living room is very feminine.

i share a room with lani, another student from cal. my bed is near the window. before and after shots of the bed net. there aren't too many mosquitos here at all, though.

the exchange rate has been declining steadily over the past few days. we were told it was around 140 naira to the US dollar. when we got around to exchanging money, it was 137 naira to the dollar. only exchange money on the black market. the banks overcharge and you get more money here than in the states or at the airport.

if you are calculating along, $100 US is worth 13,700 naira. i never had 13,700 of anything before. the other student volunteers from left to right: andrew, alicia, rod, lani, and yours truly.

tomorrow, i begin working at the clinic. i'll have a better idea of my project tomorrow, i hope. there are so many projects i can work on. i am very anxious about finally getting to work. we've been lounging and exploring for the past week. although i have some stories to tell already, i think i am going to reserve them for a painfully hot day.

i've arrived!

2006-05-31T22:17:00.000+01:00

supposedly, i should be in bed. but i am on california time. i haven't been able to get a good night's sleep in about three days. i am hoping that i can wake up in time to go to the clinic with the others. but something tells me that i will be sleeping in.

dr. chris greeted lani and i at the airport with a nice big hug. the reception here has been astounding. dr. chris, and everyone else along the way, have been the most hospitable people i have ever met. i keep hearing the words "you are welcome." the people are beautiful here.

there is so much to absorb right now. more later.

packing list

2006-05-29T06:42:00.000+01:00

through the advice of some helpful folks and the magic of google, i came up with a packing list that i am almost finished using. i have some minor things to pick up at the store, but other than that, i am just about done packing for jos.

- 7 shirts
- 2 long skirts
- 4 pairs of pants
- 2 pairs of shoes
- 1 pair of sandals
- 1 pair of flip flops
- 7 pairs of underwear
- 7 pairs of socks
- raincoat
- 2 long sleeved shirts
- 1 cardigan
- 1 hooded zip up sweater
- toothbrush, toothpaste
- dental floss
- contact lenses, case, solution
- glasses
- eye drops
- lotion
- DEET
- bednet treated with DEET
- clothesline, clothespins
- laundry detergent
- shampoo, conditioner, face wash, soap
- deoderant
- razor
- spf
- peanut butter
- trail mix bars
- dry noodles
- summer reading
- MC literature
- vitamins, anti-malarial pills, antibiotics
- hand sanitizer
- batteries
- digital camera
- laptop
- hat
- travel documents, phone numbers, money
- gifts

i am hoping to have just one carry-on and one bag to check. but my mother wants me to pack another carry-on "just in case." i really don't want to carry a lot of things with me, but i suppose i could redistribute my things instead of add more to pack. this is probably for the best. mothers always know.

anyhow, i fly out of LAX tomorrow night. my flight is a total of 16 hours, not including my 7 hour layover in london. and for those of you keeping track, nigeria is 8 hours ahead of california. i land in nigeria's capitol, abuja. i will probably stay in abuja for a night or two, depending on how many others arrive. then we will drive for about 4 hours to our final destination, jos. jos is the capitol of the plateau state in nigeria. from what i've read, and been told, i am very excited and anxious about this trip. hopefully, i'm on the right track.

suggestions?

2006-05-23T21:30:00.000+01:00

i am in the process of packing up my current apartment and moving to my newer apartment. with all this fuss, i will not have a chance to pack for nigeria until the very few days before i fly out of LAX. i have begun to think about what i should bring with me, though. my goal is to pack very lightly. but how does one pack lightly for a 10 week stay? i would appreciate any and all suggestions.

stick me once, stick me twice.

2006-05-03T06:05:00.000+01:00

i went to the travel clinic today and left with a sore arm. it went by very quickly and i have some scheduling to do with my oral typhoid and malaria pills, but all in all, a very good trip. the MD also gave me some informational travel flyers on diarrhea and such. in my right, sore, little arm i received vaccines for: yellow fever, meningitis, polio, hepatitis A, and tetanus/pertussis. i also received mefloquine for malaria, that i'll start taking the week before i leave for nigeria, and oral typhoid pills that i'll start taking possibly tomorrow.

i spoke with two of my internship coordinators last week (kevin specializes in international internships to africa and amy specializes in infectious disease and epi/biostat internships). together, they are a big help to me. my concern with the recent fire at faith alive was put to ease when i spoke with them. they gave me possible solutions to all of the concerns i shared and encouraged me to contact dr. chris. i promptly emailed him with a list of questions to which he responded by the next day. needless to say, i feel much better about the academic component of my internship, especially with dr. chris' guidance. i hope to produce a paper from this experience, and i hope to become more involved with faith alive and international health in my future.

i also heard from sally again, and i managed to get a mailing address. however, she did warn me of the reliability of postal mail in nigeria. so if anyone wishes to send me anything over the summer, i ask for it to be a postcard (in hopes of the decreased desire to steal it). also, an email to give me a heads up would be nice; i'll be sure to keep a look out for anything. snail mail makes me too happy sometimes. here is the address:

Faith Alive Foundation
P.O. Box 745
Jos 930001
Plateau State, Nigeria
ATTN: VIET NGUYEN

tomorrow, i am meeting with one of my international health professors, julia, to discuss specific projects i can design or work on while at faith alive. i have much research to do in the next few weeks. it helps that i am writing a 15 page research paper on drug access in nigeria as a final for my international health class, however stressful it may seem.

less than one month before i land in abuja!

more challenges on the horizon.

2006-04-18T05:09:00.000+01:00

this morning i received an email from sally, the US coordinator for all things concerning faith alive, and the person who got me on board with this organization. she is an excellent source of information, and her passion for faith alive, as well as for nigeria and drug access is inspiring. i certainly feel a depth of gratitude for her work and involvement, which is a shining example of altruism at its finest. of course, i always retain a bit of excitement for any emails i receive from her, as they are a reminder of the adventure that awaits me over the summer. however, this particular email was the bearer of horrible news.

to summarize, faith alive's main building suffered a damaging fire due to a power surge in the laboratory. fortunately, no persons were harmed, but the already humble clinic is in dire need of resources to compensate for the losses of this accidental catastrophe. if you would like to contribute any donations, please comment or email me at vtnguyen(at)berkeley(dot)edu and i will be happy to pass along the information. here is the complete mennonite central committee news release:

----------------

MENNONITE CENTRAL COMMITTEE (MCC) NEWS RELEASE

Blurb: Faith Alive Clinic, a free HIV/AIDS clinic supported by MCC in Jos, Nigeria, was destroyed by a fire in the early morning hours of April 13.

April 13, 2006

MCC-supported clinic in Nigeria is destroyed by fire
By Tim Shenk

Faith Alive Clinic, a free HIV/AIDS clinic supported by Mennonite Central Committee (MCC) in Jos, Nigeria, was destroyed by a fire in the early morning hours of April 13.

No people were harmed in the fire, but everything in the clinic's main building was destroyed, including its pharmacy, medical equipment and computers. The clinic's antiretroviral drugs which prolong the lives of AIDS patients survived the fire.

The fire was apparently caused by a power surge in the clinic's laboratory, reported MCC country representative Joanna Bergen, who is from Winnipeg, Manitoba, and lives in Jos.

MCC is providing $12,700 Cdn., or $11,000 U.S., to Faith Alive Clinic for immediate needs after the fire. MCC is also providing the clinic with 12,000 HIV test kits to replace kits that were destroyed.

Faith Alive Clinic provides free medical care to thousands of HIV/AIDS patients in Jos, a city of about 800,000 in central Nigeria. It is a Christian organization and is staffed largely by volunteers, including physicians, counselors and people with HIV/AIDS.

MCC provides $59,000 Cdn., or $51,000 U.S., in annual support for Faith Alive Clinic. MCC is appealing to its constituents for additional funds to help Faith Alive Clinic recover from the fire. The exact amount needed is yet to be determined.”

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if you want to see more pictures, you can utilize a free kodak account and view them here: http://www.kodakgallery.com/I.jsp?c=15pynp2t.o2vlwqd&x=1&y=-h0hsh1

the implications of this event on my future are two-fold: with the destruction of the lab, my infectious disease emphasis with my internship at faith alive needs to be more creative and rudimentary in a sense; and my presence at faith alive has never been more of a necessity than now. aside from helping the clinic get past this event, i will be faced with a situation that has extremely scarce resources to aid me in problem solving. this is precisely the career path i wish to take, with my interest in infectious disease issues in developing countries. the frustration of obtaining knowledge without the resources to implement a solution will be an encompassing theme of the career path i have chosen. i am not sure what this paragraph of rambled sentences has revealed about my thoughts on what happened in jos a few days ago, but i am curious to see how this situtation will pan over the course of the summer.

in much more pleasant news, another berkeley student has come on board to volunteer this summer. alicia (a graduate student from the school of social welfare) will be joining lani and i in jos. she is in my international health class this semester. i am definitely relieved that i will be sharing this experience with other students at cal. it will certainly make the transition a bit smoother, if that's at all possible.

why i start things and never finish them.

2006-03-05T03:31:00.000+01:00

today i put the final touches on my visa application. hopefully, i've got everything down. one question i found interesting asked me to provide my complexion. i've never been asked that before. i didn't know what to write, so i wikipedia'd it. i decided to write down: fair to medium. i wrote fair because i was comparing myself to nigerians. i will be particularly fair compared to the lot, i wagered. although that part of the visa application struck me as a bit odd, i decided that it was even more bizarre that i made no mention of the fact i am vietnamese. when asked my nationality, i had to write american. no mention of ethnic background or groups i identify most with. just nationality. i guess i thought about it a lot since i work (or soon to be worked) with surveys/questionnaires and the like; which forced me to be particularly conscious of every word used in a survey. i suppose nigerians don't care that my parents are vietnamese refugees. i suppose they care even less that i jump at the chance to represent asian americans in every questionnaire i fill out.

first time in this nigeria experience (of hopefully many to come) that i stepped out of the bubble that is the united states of america. lesson learned: the melting pot doesn't matter in the real world.