Six Weeks down

Hello! I'm sorry that I've been missing in action for the past two weeks. I'm here to assure you that I am alive and well. Tomorrow, I will have been in Venezuela for six weeks and I have four more to go!

Jenn Simpson, a third-year grad student from Yale in my program, is here to help me with my preliminary analysis and to make sure that I'm not missing any important components of my field work. It's been wonderful to have a friend here. Last Tuesday was my birthday. At first I was a bit ambivalent about spending it so far away from my family and friends, but it turned out to be a lot of fun! Jenn, Nelson, and Alejandra (the latter two from UCV) cooked up a barbeque and we had ice cream cake and wine with it. They all sang birthday songs throughout the day for me (even at work). Here I am applauding their efforts.

On Thurdsay night, Sarita came in to Mérida to visit Jenn and me. We spent Friday walking around the city and eating vegetables (not a favorite here). On Saturday, we took a bus up into the mountains to go hiking around Lake Mucubají, around 3000 m. We had information from the mucuposada hiking network that told us we could reach the entrance to the park from Apartaderos, so we took the bus there and were told that we were 15 minutes away from the park. That didn't seem too long, so we started walking along the curvy mountain highway. At about 45 minutes, we realized that our informant meant 15 minutes driving. We flagged a truck down and he gave us a ride the rest of way, stopping first to hitch a stalled car behind him as well. The lake was absolutely beautiful though, as was the rest of the park.

After hiking, we went out for pizza and drinks at a café in the center of town. Since our sever was being a bit weirdly exclusive in his attentions, we decided to leave and check out Café Calypso, which is listed in Lonely Planet as having the best mojitos in town. Although my sample size is limited, I will agree that they were truly excellent. We were at first happy just to sit down, but the combined effect of the mojitos and the pounding techno music had us dancing soon enough. Astute readers will note that we were still wearing our hiking gear, including the boots. Graceful we are always.

As a wrap-up to this post, I am still trying to devise a way to keep score in the Meagan vs. Mosquito competition. Number of breeding grounds eliminated for me? Number of houses missed for them? Site-by-site or city-by-city or house-by-house? It's hard to say, and I'm willing to take suggestions. But I have decided to keep a parallel count, which is Meagan vs. Infectious Diseases, personal. This will be on a weekly basis. So far, the count is Diseases = 2, Meagan = 4. Booyah.

H1N1 and other strange things

I don't have much time, but in short, the past three days have been a little crazy. But good. I was asked to help out with prevention for H1N1 (confirmed in El Vigía on Sunday), which is sort of hilarious and intimidating at the same time since I sort of resolutely ignored most of the flu stuff that was going on around me this year. But I'm doing my best to sort through the information out there, to contact people who know more than me, and to give them what I can.

I've done five sites in Mérida in the past three days. On Monday, we started off with a government educational facility where a man insisted on pronouncing "Yale" in the "Spanish" way and continued through a construction site unexpectedly teeming with larvae and on to an apartment where we were denied access since we might kidnap the residents (I know that I look pretty intimidating). Our site yesterday was the teleférico station, which is the longest cable car system in the world but unfortunately closed. In the afternoon, we decided to map out all of the rest of our sites at once, but the office lost electricity and we didn't have a random number table. So I wrote the digits out on ten pieces of paper and had my team pick the numbers, which attracted quite a bit of attention since we were in the atrium in order to use the sunlight. Today, we began with a farm where we found ginormous unidentifiable mosquito larvae, which we brought back to ULA to grow up and identify as adults. Then we went cavorting through the mountains to two other sites, at one point discussing the project with the owner of a trout farm. I have no idea what is going to happen tomorrow.

But here's a picture of Tuesday's team: Ivan (UCV), me, Sergio, and Henry (both Malariología). We're at the teleférico station. Beautiful workplace, no?

Good people

I just received the nicest email from Javier Bastidas, the jefe at Malariología. Basically, he said that he thinks our work is very important, and that his office and their resources are at our disposal. He's contacted the people who will help us and told them to extend every hospitality. He's even giving us office space to use, which means that we don't have to keep hauling our maps around as luggage. He called me "Doctora Meagan" and used lots of exclamation points. I sort of thought that he wasn't impressed with me during the meeting, so this a wonderfully nice email to receive.

As an update on the project, we've decided to stratify our sample sites by parroquias, which are literally "parishes" (a level of government smaller than municipio, which is smaller than estado or state). We'll be sampling one randomly selected area within each parroquia. This helps us spread our sites more evenly across the cities, weighing for area and population. Also, we've decided on our cities. We're going to use Mérida, Ejido, El Vigía and Tovar. This keeps us in Mérida State, which means that our historical data will be more uniform. (Side note: Johann Santana -- pitcher for the Mets, former pitcher for the Minnesota Twins, and probably the only baseball player that I know anything about -- is from Tovar. Everyone here thinks that I have great taste in sports. Thank you, Eric.)

And finally, Jennifer Simpson is coming to visit and help out in two weeks. Yay Jenn! She's a student in Maria's lab who is two years ahead of me in the Ph.D program. I'm super excited about this. While she's here, Sarita is planning to visit from Caracas and we're going to do something outdoorsy and adventurous during a weekend. Yay for friends!

830 Flavors

Last night, I tried to buy a phone but the phone company's computers were down. So instead, we went out for ice cream. We went to this heladeria that's in the Guiness Book of World Records for having the most flavors of ice cream, 830 flavors to be exact. In truth, there are only about 100 out at a time, but it was pretty spectacular. The owner is a Portuguese man who is super sweet (appropriate for an ice cream shop, no? Forgive me, I can't make puns in Spanish yet so I'm feeling deprived). When he found out that this was my first time in Venezuela, he walked along the counter with me and gave me tastes of some of the more unusual flavors, including:
-corn
-caraota (black beans)
-amor eternal (a cocktail)
-regional (a beer)
and several fruits whose names I unfortunately can't remember. There was also an amazingly spicy chili pepper flavor from which we all took very very small tastes. As we all stood there trying to quench the burn with our ice cream cones, he laughed and gave us a ginger flavor that made it disappear immediately. He then gave me a signed flavor list and I took a picture with him and his Guinness books. JC (the prof from UCV) has it and he's on his way back to Caracas, but I'll post it when I get it.

Yesterday morning, we had a meeting with the chief of the Malariology Division in Mérida state. He's in charge of entomological studies. He was very interested in the project, and now we have about 7 years' worth of reactive entomological surveillance information as well as the use of the division's truck and one person to survey with us. In exchange, I may have to appear on TV or radio with him as a publicity thing for dengue control. Given my Spanish grammar, I'm sort of skeptical about whether this last part is a wise move for them. But I'll let you all know if I become a big star in the entomology world.

No Hay Luz

Today I switched cabañas. Previously, Adriana and I were staying in Cabañas Ana Cristina. We had a small apartment with two bedrooms, a kitchen, and a bathroom that was way way high up in Santa Rosa. The pictures are the view from our balcony (the one with me is a bit blurry, since we were trying to get lots of mountains in the pictures while simultaneously providing proof that I am actually alive). However, Adriana went back to Caracas today and is being replaced by Juan Carlos (the prof), Nelson (the lab tech), and Ivan (the nice guy who invited Sarah and I to the beach). They should be arriving any moment now. I hope so, anyway. And later I'll post pictures of the new place!

There have been a series of power outages here in the past few days. Last night, we had an outage for about two hours, and there was another for two hours this afternoon. I found out that the afternoon outage was actually a planned rationing step. It was a bit frustrating, since most of the things that I needed to get done today involved electricity -- light for drawing my map sites, a computer to apply for image acquisition, electricity for laundry. There is a Spanish post-doc here who sat on the bench outside the lab and commiserated with me, and then we were joined by a very nice prof in entomology who starting raving about the Ithaca music scene. He knows the guys in Donna the Buffalo (whose CD Marne gave me) and loves the Trumansburg music festival. He visited Yale in the late 90's and he thinks that New Haven is pretty, if a bit rough. I raised my eyebrows and asked "and Caracas?" and he conceded the point.

When I was packing for Venezuela, Marylee (Ryan's mom) insisted that I borrow her Swiss Army knife. These things are the ultimate in gadgetry, and it has turned out to be the single most useful item that I have ever brought with me on any trip. We've used this one to chop up food, to cut open packages, to open cans and bottles, and to put batteries in our devices. I've even used the magnifying glass to read the teeny print on one of the maps that I have. And yes, I'm pretty sure that using the magnifying glass on a Swiss Army knife to fix a real problem makes me way cool.

Welcome to Mérida!

Hi there, everyone! Thanks so much for your comments and your emails. I'll do my best to keep up!

On Thursday morning, Adriana and I flew to El Vigía and then took a bus to Mérida, which is high in the Andes and bordered on all sides by mountains. It will be my first site for the project. On Friday morning, we met with the aquatic insect group at the Universidad de Los Andes. They were extraordinarily helpful and gave lots of wonderful feedback regarding the project, including potential site changes. We're in the midst of revising that now. Also, they gave us contact information to obtain the offical dengue numbers for the state. We tried to meet up with the doctor who has the information, but a demonstration in the middle of the city made the route impassable. We're meeting tomorrow instead. Also, we went to the mapatecas (the awesome word for map libraries!) and found maps for the cities that we want to use. Unfortunately some are nearly 50 years old, and the region has changed much, but we'll work on supplementing that bare-bones information with Google Earth or other satellite data. We have to return to the mapateca on Monday, since the electricity cut out just as we were about to print. It was a long day, but this was all a huge amount of work to get done.

Adriana has been super wonderful. On Thursday, I was stopped in the airport by the people doing swine flu surveillance and sent to the public health desk. This was despite the fact that I've been in the country longer than the incubation period, but I decided not to argue very much with the nice soldier. Adriana struck up a conversation with the public health woman and got the contact information for the dengue surveillance people in the city. It was pretty awesome. She's clearly very good at convincing people to give us information, and I'm trying to learn Spanish tricks from her.

My Spanish is improving amazingly. Even I can tell. I'm starting to use it reflexively to ask and answer questions, and I no longer hesitate over every word. A very strange thing has also started to happen where the words for things just fill themselves in, even though I thought that I had forgotten them years ago. It's far from fluent, but it's definitely better.

OK, the cyber cafe is closing. Oops. Ciao!

The Plan

Now that I have you all hooked (or a few of you anyway), let's talk about the science!

Dengue fever is a disease caused by a virus which is carried by the mosquito Aedes aegypti. There's no vaccination and no treatment. It can sometimes lead to the more severe disease known as dengue hemorrhagic fever, which usually happens after someone has had a case of dengue fever already from one of the other serotypes. There are four serotypes.

The mosquito lives primarily in cities and breeds in artificial water containers such as water tanks, tires, buckets, and discarded trash filled with rainwater. The mosquito is also the vector for yellow fever, so there was a big push to eradicate it from the Americas in the 1950s and 1960s. But efforts waned, and rapid urbanization provided plenty of breeding grounds, and the mosquito came back in the 1970s and now covers even more area than it had inhabited before.

The point of my work this summer is to look at the distribution of the mosquito in cities in the Venezuelan Andes. We're interested in looking both between cities (what makes the cities different?) and within cities (what makes parts of the same city different from each other?). For these analyses, we'll be collecting data about the climate as well as information about population density, frequency of trash collection, and other socioeconomic variables. We're also interested in what we can learn from satellite data ("remote sensing") about city structure and its thermal properties and the change in the city over time. Oh right, and the mosquitoes.

The real work of the summer will be studying the mosquitoes. I'm going to four cities in the Andes mountain region: Mérida, Lagunillas, Barinas, and Barinitas. The first two are in the mountains, the second two in the plains next to the mountains. The first of each pair is large and the second is small. I'll have square (-ish, let's be realistic) sample sites picked out for each city, and within each "cell" we'll go door-to-door, requesting participation in the study. We have a questionnaire about household information and recent history of dengue, and then we'll survey the house and yard for larvae or potential breeding grounds.

The use of squares or cells is actually a bit new. Usually, surveyors just count 50 houses or 100 houses as they walk up a street and call it a day. However, that method doesn't work well if we want to coordinate our data with information from the satellite images. Remote sensing studies are pretty new in itself, and I think we'll be able to get a lot of information about neighborhood change and its effects on the mosquito distribution from this one in addition to the information about the effect of climate/altitude on the distribution between cities.

Well, that's a lot. So I'll leave it there for now. Let me know if there are any questions, as I could write (and have written) pages and pages more about this project.

On Thursday I leave for Mérida with Adriana, one of the lab techs here at UCV. We just purchased our flights today, which is a bit more of a last-minute approach than usual. I'll be leaving Sarah, the other public health student from Yale, here in Caracas. She's taking on the mosquitoes which carry malaria in the mangroves of the northern beaches. We used to joke at the University of Maryland about "studying beach malaria" during our vacations, and I think I'm going to let them know that it actually exists.