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natalietravels

Follow my travels in Tanzania!

Finding my place

Hello world of Facebook friends, family, and UCLA colleagues!

Wow, this journey has been a bit of an… adjustment. Last summer, I had dotted all my I’s and crossed all my T’s in preparation for Nairobi. Everything was in place, and I found myself settling in fairly easy to life in the bustling capital of Kenya. This time around (I am a bit ashamed to admit), I packed the day of my flight, nearly forgot to enroll in the STEP program (through the U.S. Embassy), and have forgotten to pack a few items (not super important, more just inconvenient). I walked into this trip with expectations high, based on my experience in Nairobi. Which has kicked me in the behind. The apartment I am staying in is beautiful, but there are no restaurants or big supermarkets nearby. I’ve been struggling with anxiety and worry that makes me want to stay in the apartment all day, and also knowing that getting out and doing things will be the only way to settle in. In reality, I don’t have a lot to complain about. I have money to use taxis for wherever I want to go, I have A/C (which is the best, considering I am living near the coast), friends and family I can call at almost any time, and an important position within the research team I am working with at Muhimbili University.

Enough about my adjustment (I just needed to vent). Why am I here?

I am a Qualitative Research Consultant for the formative portion of the “Dyadic-Based Diagnosis, Care, & Prevention for HIV Discordant Couples in Tanzania” study. Basically my job here in Tanzania is to help coordinate qualitative research training for our interviewers, support the placement of systems for collecting and handling qualitative data through focus-group discussions and in-depth interviews, and analyze the data as we collect it. We are going to be working in Kisarawe, a small town about 2 hours West of Dar es Salaam, and collecting qualitative data on what people think about PrEP, HIV self-testing, and early ART initiation. In short, pre-exposure prophylaxis (PrEP) is a pill that a “high-risk” HIV-negative person takes daily to prevent getting HIV. Self-testing is what it sounds like – you get a kit, do a salivia swab, and within 15 minutes, you receive a result about your HIV status. Antiretroviral therapy is the medication you take after you become HIV+ that helps you stay healthy for as long as possible. Right now in Tanzania, you have to have a CD4 count lower than 300 to be eligible for ART, which means your immune system is already losing the battle to the virus before you get on medication. The goal of early ART initiation is to begin ART as soon as someone is diagnosed with HIV. The problem here is people being willing to take a pill (or multiple) every day, when they are experiencing no symptoms. ┬áThat’s the quick and dirty.

I’m really interested to see what the results of this qualitative data will tell us, and I have to continually remind myself of my passions and my purpose here as a burgeoning HIV researcher. As long as I keep my eye on the bigger picture, not having a big (Western) supermarket nearby seems less and less of a problem.

XOXO,

Natalie

 

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Lost in Translation

Hello world,

Well – it’s been a busy weekend and week! On Friday (after a 2-day holiday on Wednesday and Thursday) our team of interviewers began reviewing the guides for our in-depth interviews and focus group discussions. There are English and Kiswahili versions, and I quickly learned the challenges with translation. There were many questions that made sense in English, but the Kiswahili translation was a bit off. Some of the short questions in English needed a much longer Kiswahili counterpart. And vice-versa. So, during the weekend I compiled all the comments (we made these suggestions on the paper copies), uploaded all the guides to Google Docs, and marked up everything we discussed. On Monday, the study coordinator, interviewers, and myself all sat and combed through the guides to make edits and ensure a smooth-flowing conversation.

I have been learning how many logistical things need to be in place for IDIs and FGDs to run smoothly, from making sure all the paperwork is printed out, exactly what order to collect what in, making sure that rooms are unlocked, and the list goes on. I have really enjoyed my role in coordinating the interviewer training, and getting things in place for data collection. I got to visit Kisarawe (the rural town we will be doing the IDIs and FGDs in) yesterday, because we needed to seek official permission from the District Medical Officer to proceed with this formative phase. If all goes well, we should be re-locating to Kisarawe tomorrow with the research team to get this show started. I’m really excited to see what the first few IDIs and FGDs tell us about community views on PrEP, HIV self-testing, and early ART initiation. All the people I met in Kisarawe yesterday were so kind and friendly, and it will be nice to get away from the bustling, loud city of Dar es Salaam.

That’s all for now,

Nat

 

Our team of interviewers reviewing the guides and making suggestions

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Week 1 in Dar

Hi everyone!

So I’ve successfully made it through my first 13 days in Dar, and my first full work week. When I arrived in Dar, I was given someone else’s visa (my picture, but some old man’s information). I finally got that resolved after spending a full 8 hours waiting for the transport, waiting for random people to get their affairs in order, airport bureaucracy, traffic, the list goes on. I settled into my own little office on the third floor of what is known as the “VCT Building” on Muhimbili’s campus. Last week, I worked closely with the project’s study coordinator to hire our data collectors/qualitative interviewers, and developed the PowerPoints for their training. We hired 4 interviewers, and training is now underway! It has felt really good to be put in a position with so much responsibility and trust. For once, I feel like my input and knowledge is actually respected and listened to. During training, I got to explain how pre-exposure prophylaxis (PrEP) and HIV self-testing work, and the benefits of beginning ART early. Anyone who knows me knows that I looovee talking about anything to do with HIV, so I had a blast talking to our interviewers about these new methods of prevention, detection, and treatment.

Upanga, the area where I am living and where Muhimbili Hospital and University of Health and Allied Sciences is located, is a fairly quiet little area with a lot of little shops, kiosks, and street vendors. The neighborhood where I live in West Upanga is connected by a lot of bumpy dirt roads, and has a lot of fairly nice high-rise apartments (like the one I am renting). There are kiosks and street vendors that sell fruit and various other items, so I have been utilizing them to get my daily fix of avocado. As expected, the area around Muhimbili is bustling, with tons of dala dalas (the public bus system), taxis, bodas (motorcycles), etc. There is a really good fruit stand that I frequent, and I have also discovered a nice little restaurant tucked away behind a gate for lunch. My preferred lunch is chicken and rice, which costs less than $2 at the staff cafeteria, and maybe $3-4 outside of Muhimbili. Not bad.

Looking forward with the project, we plan to wrap-up training on the 11th, and we are scheduled to re-locate to Kisarawe (about a 1-2 hour drive West of Dar depending on traffic) on the 12th. We can hopefully get everything in order (meeting with the director of the HIV Care and Treatment Center, the District Medical Officer, etc.) and begin data collection around the 13th-14th. However, as with most research, and especially research in Tanzania – things sometimes go pole pole (slowly), so I am just crossing my fingers and hoping for the best!

That’s all for now!

-Nat

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