Friday, August 29, 2008

I'm here for your blood

Sorry for not writing for a long time; this has been due to a mixture of sampling trips, tiredness and laziness on my part. Anyhow, before going into more detail on my sampling trips, I figured I’d give a few more general impressions.

Indonesia is not actually the third world. I can tell this because their stores sell Coke Zero. Nowhere truly third world ever sells diet anything. Though, it’s also odd because in the small, isolated villages I sample in, one can buy Sprite and Strawberry Fanta but not Coca-Cola. It’s perhaps the only place I’ve been except deep in the Congo where one can’t buy Coke. Also the only flavor of Fanta I’ve found in the entire country is Strawberry, which is definitely not the best flavor of Fanta. I had to choke down 1.5L of the stuff to get my sharps container.

Indonesia does, however, have several quirks. For one, despite having large tubs of water (from which one scoops water out to shower or “flush” the toilet) above/next to their toilets, they have neither flush toilets nor actual running water showers. They’re 95% of the way to them, but they seem not to care. Why?

A bigger concern, though, is their lack of TP. In general, one is expected to wipe with one’s left hand then rinse it off by scooping water out of the vat of water next to the tub. And then one is expected to do everything else with one’s right hand. Why waste an entire hand on wiping? You could use both hands socially, which would be especially nice as you also generally are expected to eat and serve yourself with your hands---which makes it hard if you’re a lefty to avoid a major faux pas of sticking your left hand into the dish. The store in Ketapang even sells toilet paper. They don’t have a large stock, but clearly it’s possible to get it here. These people, while relatively poor, own mopeds, nice cell phones and apparently buy diet sodas---they could afford the 17 cents a roll of TP costs! I understand some things are just cultural differences, but this just seems inefficient.

Speaking of odd, while most people own chairs, tables and many even own couches (all of which are nasty 70s-looking red monstrosities), they do almost everything on the floor---eat, entertain, etc. My legs are very sore from trying to sit Indian-style so much, especially after my futsal injury (I bent my left knee forward). They could have TP if they wanted, they do have sitting apparatuses and they also have silverware (at least I think most do); why not use them? I don’t get it. They also strictly forbid shoes in their homes, but they bring their motorcycles in at night (and their homes are full of smoke all the time). Heh.

A timely note: there are many ethnic Chinese here; they came about 100-150 years ago and fulfill the roles that the Indians fulfill in Uganda or the Jews fulfilled in medieval Europe. There are also some simmering tensions between them and the various Indonesian ethnicities like in those other places, though mostly people seem to get along quite well and be very opening. In any case, the way that this impacts me is that Andy’s house is in a relatively nice neighborhood in Ketapang (he’s paying $400/year in rent which is at least twice what he’d probably pay for the same house if he were Indonesian) and so we are surrounded by ethnic Chinese people. This would be great except that they blare the worst music every morning around 7am. Let’s just say that I’d rather have a dozen roosters placed in my bedroom at 7.

Our little trash heap for our neighborhood has been the site of a soap opera for me. There are, alternatively, people, dogs, cats, chickens and goats picking through the trash. I’m still trying to work out the hierarchy between them all.

So I’ve spent most of the last week sampling or traveling to sample. The day before I was supposed to leave, my counterpart student (a student from an Indonesian university who I am supposed to pay and give academic credit to ideally for helping me but sometimes it works out that you have to just drag them along) sent me a text message saying he wouldn’t be coming with me and good luck Sir. Great. Now he gave off the impression of being a pretty boy so in many ways this was a good thing, but still it was a big setback---I can’t go to these villages alone saying “I want blood” or “I need blood” (two of the few Indonesian phrases I know---I also know “I take dog blood now”) and expect anything but being burnt at the stake. So I scrambled and thanks to the help of an Eli here, I found someone who is quite good. But still---he f*ed me over by text! It’s like breaking up with someone by Post-It…

So after a couple days’ delay, I got going. We rode our mopeds out to the first village; about a 3 hour drive given road conditions. The main road is pretty good (by third world standards), but the side roads can be treacherous. Imagine playing a game that was a mixture of bull riding (for obvious reasons), slalom (dodging various particularly large rocks, potholes, missing bridge elements, mud mountains often while going down San Fran-like gradients), chess (you have to plan at least 5 moves in advance) and motocross---then imagine doing it with a 30 kg bag strapped precariously behind you and another 20 kg bag on your back (pushing you into an uncomfortable almost standing position) AND doing so just after a rain has slickened the course and added up to 2 foot puddles. You’ll start to get the picture. The bridges were the most interesting part---off the main road, they were composed of two long planks spanning the distance with some cross beams at 90 degree angles. Pretty normal stuff, except most bridges were missing some/several of their cross beams. So the only way to cross was by going balance-beam style on the long planks that span the distance, looking down at the rushing water beneath. Let’s just say that driving off the main road here has a steep learning curve. Driving on the main road does as well, but for different reasons. Not only are there all manner of vehicle/farm animal on the road, but directionality of lanes is only followed sometimes. Frequently you’ll find yourself with people going the opposite direction as you on both sides of you if it makes it easier for one of them.

This pales in comparison, though, to the second major sampling trip I took. It wasn’t that the roads were bad, but the directions were quite interesting. First we drove 85km to visit the Western doctor who runs an NGO here. We got some phone numbers and names from her employees and called to make inquiries as to the road condition. We decided to take a boat instead. So we drove another 20 km to a dock area, found a person to watch our bikes and found another person to barter with over the boats. We got in a little speedboat and traveled upriver. We got let out at a dock and carried our bags up a hill to a snack bar on the road. We made friends with the people there and then got their help flagging down a passing truck. We piled ourselves and our things in the back. Then they wanted to extort us, so we ended up paying $6 to go now instead of “sometime later”. We went to the main village. We walked to the head of the village’s house. We made friends with him. Then, we (along with one of his sons as a pseudo-guide) started sampling. The next day, repeat approximately the same thing to go to another village along the river.

We’ve been staying with the village leaders in each place. So at least it’s the nicest house in the village, but still has generally not been the Hilton. Though I have gotten to watch several local football games, some Indonesian soaps and one Oprah on TV during this time. I thought maybe the Oprah was just some weird thing going on, but later I heard my employee and a different village leader talking about Oprah. We generally have managed to find small pads to sleep on, though in one place we slept on the floor (and there was no place to put up a mosquito net). So that night I didn’t get to sleep until 4am from a mixture of discomfort at the sleeping arrangement and the itchiness of a couple dozen mosquito bites. Lately though I’ve been really tired---I even fell asleep at 7:15pm at the last place.

The actual sampling involves going house-to-house (after getting permission from the village head). We ask to come in, invariably get permission and sit on the floor with the man of the house and frequently a couple of his friends or sons and/or his wife. We smile, exchange pleasantries, and then my employee (Deddy) explains why we’re there. Reactions are quite varied; most people are at least somewhat interested though some are very afraid of even tiny needles. About half the time we get permission and take anywhere from one to eight samples in the house. We ask questions that relate to their history with malaria and their risk factors for getting malaria and I poke them in the finger and get a couple drops of blood for later analysis. Per person it only takes about five minutes. Then we give them soap, shampoo and toothbrushes (I am the Hygiene Fairy---this is what happens when one asks the doctor servicing the area what one should give out) and some candy for children and are on our way again. I tend to get more samples from adult men than any other group (which is a good thing for my research); adult women are a close second. There are some places where the men are wimps though. One that sticks out in my mind is a house with five or six adult guys, a 21-year-old woman and her 4-year-old son. The men were all too afraid of the needle but the woman and her son participated. I’m a little worried about my results because I don’t think this is the high malaria transmission season, though in a couple villages we did find people who were sick with malaria. Really only 2 or 3 of the 5 villages visited so far had a good number of mosquitoes, though.

Meal times reinforce the sharp gender disparity. Deddy and I usually eat with the village leader. It is just the three of us. The women serve us and then sit on the other side of the room while we eat. When we’re done, the cats come and lick our plates clean (they let their cats get away with everything. It’s a nation of cat people. They treat their dogs like crap and some of them eat them). There are also sharp distinctions in smoking; basically every male over age 14 smokes but I have not even once seen a woman smoke here. I asked Deddy and he says no Indonesian women smoke. Probably overstated, but not by much.

In the villages we usually have to bathe in a river or drainage ditch. For all this is a mostly Muslim place, they are remarkably willing to allow expedience to take over frequently. People of bot genders will go down to their underwear to bathe as anyone walks by.

At this point I’ve collected 155 samples from 5 villages. I am trying to hit 3 more before I’m done. I’ll try to post more frequently over the next couple weeks, though probably not again for 5 or 6 days. I’ll try to upload a few photos later today though if I can.

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