viet in nigeria

this blog chronicles my internship in jos, nigeria. i will be working at faith alive, one of the few sites in nigeria that provides antiretroviral drugs to HIV positives. this free clinic was founded in 1996 by dr. chris isichei and his wife, mercy.

i am a uc berkeley graduate student in the school of public health, studying infectious diseases with an international health speciality area.

Saturday, July 29, 2006

on eating

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.

Wednesday, July 26, 2006

on health

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.

Sunday, July 09, 2006

sannunku (greetings to you all)

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)!