Sentia: The Most Beautiful Cry
If you’re getting this through email, watch the video online at http://alexgoodell.com
Merry Christmas from Kigutu
Christmas is quite different here in Kigutu! No doug firs, no Santa. But plenty of drumming! Life here is heartbreaking but full of hope. I’m glad to report that the child pictured in some of my photos, Liesse, has consistently been getting better, and that Sentia, the girl I wrote a short story about (soon to be on the website), has moved on from nutritional milk to eating food! It’s quite the celebration here, and I’ve posted the below video as a testament to what “excitement” means in rural Burundi: energy. Lots and lots of energy.
What I’m doing in Burundi
Thanks to all those who subscribed!
I know this may seem a little strange to finally have a good idea of what I’m doing in Kigutu, Burundi, oh a day and a half before I go, but I think I’ve explained it a few times to others and now have an adequate understanding myself enough to write it down.
First, I’d like to work on making an interesting slideshow with a compelling voice-over. The voice-over, actually, would be best if not planned and recorded. I just purchased a D70s from my friend and am planning on doing a significant amount of photography for Village Health Works, hopefully for their website. I’d actually like to create some sort of photostream on the site so that volunteers and staff can upload photos and keep supports/donors involved. This was all inspired by NYTimes’ 1 in 8 million slideshows, and an amazing slideshow below filmed by Partners in Health.
Second, I’m working with a VHW staff member, Honore, to map VHW’s catchement area with a GPS device. Because the small clinic (~2 physicians) serves a population of over 60,000 people, the PIH Community Health Worker model is essential in reaching out. This is also key because of Burundi’s poor transportation system, where some will walk half a day or more to reach the clinic. VHW hires community health workers (CHWs, currently 60) to reach out into our patient population, administering medication and checking up on patients. Obviously, 60 community health workers cannot cover a region of 60,000 people, and Honore and I will be mapping the areas that they currently cover and looking into CHW expansion.
Third, and surely not least, I’m going to serve as a FrontlineSMS:Medic implementer at Village Health Works. FrontlineSMS:Medic is a software program developed to allow nurses and medical staff to communicate with CHW via SMS, or text messages. We’ll be distributing phones to the CHWs and teaching them how to text, and teaching the software to the medical staff at the clinic. It’s a really great setup for these settings. Imagine patient X, let’s call him Bill, doesn’t show up to his check-in. Perhaps he forgot. Perhaps he didn’t have the money for transport. Worse, maybe he was too sick to walk to the clinic. Instead of waiting until Bill finds the strength, money, or help to make it to the clinic (a half a day’s walk away), a nurse can text a local CHW, and the CHW can go to Bill’s house, check on him, and reply via text. A multiple-day, costly, and life-threatening experience has been averted for a $0.05 text message.
The thing is, we need phones. FACE AIDS is launching a campaign this year to collect these “HopePhones,” and Students for Global Health at U of O are participating. Please donate your used phone when you start to see ads and collection boxes around campus.
Away to Burundi
Dear Friends and Family:
I’m hoping that some of you may have heard a rumor that I was going to Burundi in East Africa. My mother and girlfriend have done a better job than I in telling people, so I’m glad that I’m able to finally sit down and explain exactly what I’m doing. I waited until my tickets were purchased (about 4 hours ago) to write this, because I’ve learned that plans are always somewhat in-the-air when you’re working with non-profits, or when you’re working in a rural, sometimes turbulent area.
Which takes me to the beginning–the nation of Burundi and its civil war. Many of you have heard of the genocide in Rwanda: either you’re my age and remember teachers explaining the conflict, or watched a movie called “Hotel Rwanda”; or maybe you’re older and remember watching the violence on TV, astonished that neighbors would kill neighbors with machetes because of the shape of their nose, or the nature of their build. Perhaps you read a book on the genocide, or have followed the current violence in Darfur, the DRC, or Uganda. For some reason, however, the 13-year genocide that occurred a hundred miles south of Rwanda, in Burundi, which killed upwards of 300,000, remains strangely absent in the American psyche. The causes are arguable–”ethnic strife” is a phrase commonly used to describe the conflict, though these “ethnicities” look the same, speak the same language, eat the same food, and dance the same dances. Colonialism is often blamed, and it is hardly free of guilt. But my initial instinct is that this was a war of inequality and poverty, a war fought over the little resources the poor of our world are allocated. Whatever the cause, the results are clear. A war from 1993-2005 removed the ability of government to govern, police to police, and healthcare to care. In 2006, Burundi was ranked as the world’s poorest nation, with an average yearly income of $86. A nation of eight million, it boasts 200 physicians. This would be the same as if Seattle had 17 doctors, or Portland had 14.
Why would I want to go to such a place? With great need comes great opportunity, and I’ve been blessed in my opportunities. I’d first like to share the story of my friend, Deo, as he’s the reason I’ll be going.
Deo was born to an impoverished life in rural Burundi. He, an energetic and intelligent man, aspired to become a physician–he wanted to build a clinic for the poor of his area. He got top scores throughout his medical schooling, and entered residency in 1992. The next year, his hospital was attacked my militiamen. He narrowly escaped death, hiding under a bed while he heard his fellow doctors and nurses murdered outside. After some time, he escaped. He was on the run, sleeping in the forest for months until he was fortunate enough to get a ticket to the United States. He arrived in New York City with $200. Alone, with no English skills, the top-of-his-class physician slept in Central Park. He got a job as a grocery-delivery boy, but was made fun of for his lack of English. Fate, fortune, perhaps God led him to an ex-nun, Sharon McKenna, and then Charlie and Nancy Wolfe, who let him into their house. He learned English, reading dictionaries at the public library. He decided that he was going to pursue medicine again, that he was going to become an American-trained physician. But, he had to go to college, once more, in the US. He applied and was accepted to Columbia University. He then attended public health classes at Harvard, and continued to medical school at Dartmouth. He took a leave of absence in 2006, when he returned to Burundi to begin work on his life’s aspiration: a medical clinic for the poor. He called it “Village Health Works.” Since its opening three years ago, it has treated 28000 patients, built six buildings, provided clean water to a community, and proven that dignified healthcare is possible even in the poorest areas of the world. Tracy Kidder, Pulitzer Prize winner and author of Mountains Beyond Mountains, just released a biography of Deo entitled Strength in What Remains. It’s available online or at any major bookstore (it’s really popular, most likely in the front of any common store).
I met Deo at the Spring 2009 FACE AIDS conference, and knew he would be a great leader, a true hero, of my generation. When I was in New York this summer, I volunteered at their New York office, and was eventually offered to volunteer in Kigutu, Burundi, at their clinic for the academic year. I’ll be leaving on October 15th, and am currently in New York working in the VHW office.
I’m honored to be able to serve such an important organization fighting for, what in my opinion may be the most important of causes, the right to dignified healthcare. We live in a world where the 100 most rich people have more money than the bottom one billion people, where millions die of starvation and diarrhea every year. I pray that my generation can, and will, end this craziness.
What can you do?
-Sign up for email updates of my blog: http://alexgoodell.com/subscribe
-Read Tracy Kidder’s Strength in What Remains: http://www.amazon.com/dp/1400066212/?tag=villhealwork-20 (purchasing through this links give ~10% to VHW.
-Visit http://villagehealthworks.org
-Donate a used cell phone: http://hopephones.org
-Donate money: This organization is incredibly small (remember, I built the website!). We need money for blankets, flip flops, etc. $5 or $10 goes a long way. http://villagehealthworks.org/donate
Tagged: burundi, deo, global health, tracy kidder, village health works, volunteering
Video on Strength in What Remains by Tracy Kidder
Read my review of the book here. You should also learn more about Deo’s amazing project, Village Health Works.
Tagged: global health, strength in what remains, tracy kidder
Cryptococcus neoformans capsule
I’m done with my poster for my research this summer. Thought I’d post it here.
Characterization of the capsule phenotype in all1∆ Cryptococcus neoformans
Alex Goodell1,2,3, Neena Jain1, Mythri Subramaniam1, Bettina Fries1
1 Department of Medicine & Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA; 2 SURP, Sue Golding Graduate Division of Biomedical Sciences, Albert Einstein College of Medicine, Bronx, NY, USA; 3 Department of Biology, University of Oregon, Eugene, OR, USA
Cryptococcus neoformans is an encapsulated fungal pathogen that infects mostly immunocompromised patients presenting chronic meningoencephalitis, causing upwards of 600,000 deaths annually. The organism has a unique polysaccharide (PS) capsule which varies in size according to environmental conditions such as carbon dioxide levels, iron starvation and pH. Increased capsule size has been linked to virulence in mammalian hosts. By shedding the capsule, excess PS causes agitation of the meninges and is associated with high inter-cranial pressure (ICP). Increased capsule size has also been shown to cause decreased susceptibility to both anti-fungal medication and phagocytosis by immune cells. The capsule character of C. neoformans var. neoformans has been shown to microevolve, undergoing a “phenotypic switch,” from a smooth (SM) to a mucoid (MC) appearance invivo. MC switch variants are more virulent and were shown to down-regulate one gene in particular, allergen 1 (all1), of which homologs have been found in other strains, such as C. neoformans var. grubii. This project analyzes the character of the PS capsule in wildtype, all1 knockout mutant, and reconstituted strains in RC-2 and H99 strains in a variety of medium. Characterization is done through photography and cryptocrit analysis. Results show increased capsule size when incubation conditions have low iron, high thiamine, or minimal media. All1 mutants consistently show smaller capsule size. This suggests that the all1 protein plays a role in capsule formation during inducing conditions. Future experiments on the all1 protein interactions may yield interesting results.
Tagged: aecom, aids, albert einstein, cryptococcus neformans, fungal infections
Tracy Kidder’s Strength in What Remains
When I finally put Tracy Kidder’s Strength in What Remains down, I wasn’t sure if I had actually liked the book. I can’t really see myself loving any book that’s main theme was genocide.
I was fortunate enough to have met Deogratias “Deo” , the protagonist in this moving biography, a few months before I started the book. A youthful man with an infectious smile, he had told me of the misery in his homeland of Burundi, a place where those too sick to walk were attacked by dogs–people living, as he said, in conditions not fit for humanity. I had little idea of exactly how endemic these conditions were in his country, how long they had existed, and what his personal experience had been until I read his biography.
Deo is by all means a modern-day hero, although in his humility he would surely disagree. While studying medicine in Burundi, an often-forgotten genocide began, forcing him to flee his work. He traveled far by foot, witnessing unspeakable horrors, and enduring the limits of physical suffering. His eventual escape to New York City leaves him in a foreign land of imposingly tall buildings and signs in an entirely new language. He, although a trained medical doctor, works menial jobs and is degraded by the racist and unwelcoming experience faced by most new immigrants in the US. The tale picks up hope when Deo encounters some generous Americans who take him in. Years later, after education at Columbia, Harvard, and Dartmouth, he becomes an American citizen.
Tracy follows Deo, using a series of flashbacks, through his journey in Burundi, his American experience, and his first return to a war-ravaged Burundi.
The subtitle, “A Journey of Remembrance and Forgiveness,” seems somewhat misleading. We are not privy to the internal workings of Deo’s mind, and Kidder sheds little light on what the process of forgiveness is like for Deo, or to what extent that has occurred in any of the victims of Burundi’s terror. It is clear, however, even after a short conversation with Deo, that forgiveness has played a key role in the formation of his newly-founded clinic in Burundi, Village Health Works. A US-based nonprofit working in Burundi, they are dedicated to treating anyone, regardless of their ability to pay or their past deeds.
For me, the book is about strength, dedication, and the ability to hope, not unlike Kidder’s last book, Mountains Beyond Mountains. Deo’s journey stretched my understanding of hope’s role in times of extreme tragedy. Although I have no idea what exactly was going on in Deo’s mind during his tragic escape, I imagine he fought his dwindling spirit and health with dreams to be a doctor, build a clinic, and see his family again. Perhaps, I’ve recently thought, strength itself is determined by hope. Someone’s will, the refusal to give up, is dependent on a hopeful future, and strength is largely a function of will. So, what hope remains in a time of tragedy is one’s reservoir for strength.
Deo says, speaking of Village Health Works’ projects treating the sick of Burundi, “Where there is health there is hope” — and that is their strength.
Read it. To learn more about the work of Village Health Works or to donate, visit them at http://villagehealthworks.org or contact me.
Tagged: burundi, kigutu, partners in health, paul farmer, strength in what remains, tracy kidder, vhw, village health works
Integrative to-do list
Every to-do item on my list does not stand alone, but has groups of information that I will need to find to complete the task. Have you ever had something to do, didn’t have time to do, so you put it on your to-do list, only to find 4 hours later, when you got down to that item, that you’d lost the document, email, and phone number you needed to complete it, so spent a good 30 mins looking through your emails? I’d like to create an integrative to-do list as a desktop application. Let’s say I have a to-do something like: “Email and interview Dr. Z.” I remember to add this on my to-do list when Dr. Z emails me a confirmation, his assistant sends me his bio, and my boss sends me the questions I need to ask. So, there are three emails, from different people, most likely with different subjects, that I’ll need to find to get this task done. I would love to be able, once I got those three emails, to select all of them, and drop them into an app which created a to-do and stored that info. I could also drop web addresses, files, etc. Yes–I could also just copy and paste blips to help my memory on an RTM note. I’d just like a simple and fast way to do something I could use a few times daily. Anyone know a program like this, or are interested in making one? I do not have the technical background for desktop apps.
Explaining Ghana’s low HIV/AIDS prevalence
I just finished my paper on this subject for Janis Weeks’ HIV/AIDS CHC colloquium and thought I’d share. I think there is a long way to go, but I think the investigation will continue when I’m there in the Winter/Spring of ‘10. Here it is: http://alexgoodell.com/files/ghanaaids2.pdf
The Two Uses of Twitter
I think Twitter has two basic uses — yes, you heard me, only two. Not three, four, 50, or 1000. For the most part, each of the new invented ways to use Twitter is a mash-up of other functions. The two functions I’ve noticed are (1) it’s primary use, a way to share thoughtful information and news. This is what it functions best as. Its capacity for transmission of a message across communities, its open-source communication style, and its link-crazed culture make it perfect for collaboration across a group of people. However, Twitter was not intended for such uses. Its own website claims its [Read more →]