Marvelous October

October was a time of change, which it always is-possibly the world over. Here, rainy season stops; I'm pretty sure I experienced the last rain until May. It's incredibly hot now- the mini hot season. School began - late this year and my travels settled down as clubs began and picked up. Although October itself involved more planning with groups than actually doing things, I'm incredibly excited about the plans, and will talk about them as they progress in future months. In brief, some of the plans include: a health and environmental club at lycee with hand-washing stations, an analysis of certain unhealthy behaviors to find the best way to direct change among students and women who cook/sell food, a "tour" of the prefecture (like a county) to talk about moringa (super food and tree), and a soccer tournament. So, hope your October was marvelous, because mine certainly was :)

THE AMERICAN BUSRIDE
Arguably, the best way to travel in Togo is by bus. Unlike bushtaxis, you have enough room and don’t need to stay in weird positions that are more reminiscent of advanced yoga than a casual roadtrip. And unlike motos, you do not need to hang on for dear life (literally) over the sudden bumps and holes that decorate the roads. So, I almost always sign up for a bus ticket if at all possible. The only negative aspects are the not uncommon bus breakdowns, broken windows, and the long wait. It was during one of these long waits for a bus that I heard people speaking English. Their western jeans, polo shirts, and hats, along with American language nuances like “Man, blah blah blah, man,” and “Hang on” led me to think that maybe they were famous Togolese music artists, who generally seem more Western to me than Togolese. My thoughts were interrupted by the crowd gathering at the bus entrance- boarding had begun. A woman read aloud the name and number of each ticket, and we individually boarded and took our assigned place. I was lucky this time; the bus was airconditioned, and I was seat #1, meaning I had a little table I could put things on. I had experienced a Togolese airconditioned bus only one time previously, but that bus had broken down for three hours in the early afternoon of a scorching day in hot season. Anyway, I boarded, sat down in my #1 seat, placed my water bottle on my table, and people-watched as the other passengers boarded. Soon everyone with a ticket had boarded, but the seat next to me was still empty. “This is nice,” I thought, “I get two seats!” But my excitement was short lived. No sooner had I thought this, than the Western-ish-Togolese –probably-musician guy sat down next to me. “Oh no,” I thought, “I hope he doesn’t talk a lot and try to get my phone number and address and call me constantly”, which is what sometimes happens when you’re a white girl in Togo sitting beside a younger guy who seems “cool” like a musician. He sat down, said “Bonjour,” and then that was it for awhile. “Oh good,” I thought, “I won’t have to worry about thinking of all the excuses not to give him my phone number.” But then he started speaking English – American English – to another Togolese. He turned to me and said, “Where are you going to?,” in French. I responded in French but I guess my accent gave it away. “Do you speak English?” he said. “Yes; I am American” “You’re American? I live in New Jersey!” “No way! Why are you in Togo?” Turns out, he was born and raised in Togo, went to the US nine years ago for college and is currently getting his Nursing degree. He had not returned to Togo since that morning. His father had just died and all the members of his family from all around the world were returning to a small village in northern Togo for the funeral. The whole ride up north we talked. He explained what he thought about development and Togo – it was strange hearing a Togolese speak with a Western perspective. He was saying how the schools are bad and the roads are awful and many other things that I will not mention in this blog. Every time we passed a car, almost hit a motorcycle, or killed a chicken trying to cross the road, he would flinch as if he himself was about to get hit. It made me realize how used to Togo I was- nothing caught my attention as being out of the ordinary, whereas everything caught his attention. Anyway, it was a very interesting bus ride. We exchanged contact info, just because it’s such a small world, and went our separate ways- me the American back to my normal life in Togo and him the Togolese to his weeklong visit to this unusual foreign land.

SOAP FIASCO 
The members of AED-Kante, the local HIV/AIDS group I work with, have been making liquid soap and selling liquid soap. However, recently it has become more difficult to sell it; many people refuse to pay the price that we have chosen which would ensure we make a profit. So, AED has been thinking about making and selling solid soap. The problem is that someone knows how to make it, but she only knows how to make it in large quantities and we can’t buy the large quantities because it is too expensive. The members don’t want to contribute (a little bit contributed by each person could help buy supplies), so we are in a standstill. I personally think that if the members don’t want to contribute, then we should not try to make it- how sustainable would that be? 0.0 We will see- it’s good to have income generating activities, but pointless if no one wants to make the effort to try and get it going. I’m planning to see if there is another type of income generating activity that they may be more enthused about.

SKL-ta!! “N-Kriya!” “Alafia we ya” “Alafia. Ohway sartia” “Alafia” “N walo lo?” “Ma walo skl-ta.” Wal- n –kahn.” “yooo”. “Good morning! How are you? Fine how are you? Fine. Where are you going? I’m going to the school! Go and come back! Ok!” During the “summer” months, school was out of session, and summer was extended and finally- after waiting and waiting- school is back in session. So far I have been working with two schools. First, I am working at the CEG (middle school) where I am focusing on girls (this is the level of education where most girls drop out). I’m working with the librarian to lead a girls club. I’m really excited about this and made a tentative plan with the librarian about what we can do and talk about. The optimist that I am, I hope to create a supportive group of girls where we’ll talk about HIV/AIDS, nutrition, sexual health, hygiene, communication, peer pressure, the environment, gender roles and rights, and of course the importance of education. I’m hoping to incorporate little science experiments (like finding microbes from different things we touch) or studies (like really simple nutrition studies). Anyway, I know nothing will go according to plan, but I’m still super excited just to try.

UNIVERSITY HELP 
Sortof on a whim, my dad suggested I write a letter to a local university in the US. I did, and after months of no response, I finally received a response from a very enthusiastic person and now we have this great collaboration. University kids will help put together an English curriculum for my English club, a personal finance guide in French for the HIV/AIDS patients and donate a bit of their fundraising to girls tuition. I’m so happy and excited to be working with them.

HEALTHY!! 
So, for the past couple months, I have been completely healthy! I don’t know why actually- there is nothing that I am consciously doing differently (diet, handwashing, mosquito net, number of showers/day etc..) Actually, I thought that this rainy season would be more of a risky season, in terms of getting sick. This is just because there is more water which means more mosquitos (malaria and other mosquito-related diseases), more sewage getting in water and possibly in street food (giardia, amoebas, dysentery, other diarrhea stuff) etc… Anyway, usually that means more sickness. But, for me (knock on wood), I am illness-free!! Ironically, it was during this time where I received my official Level 10 Club T shirt. Short recap: level 10 is the level of pooping in which you poop your pants. This obviously indicates some type of illness (the “illness” being related to pooping your pants, not a *mental* illness that may possibly be inferred from the actions of forming a club and making tshirts to celebrate pooping your pants) See some of my first blog articles for more details. ……. (but …… as I am posting this – I have started to get 2 different rashes (1) the allergic reaction rash I get from eating mangos- even though I haven’t had mangos- I think I got it from being a mango tree for Halloween – the mango leaves touched my skin. (2) another rash around my neck and chest and arms that is like heat rash, but different. Maybe it’s a fungus. I will update you if it turns into something weird.)

THE ADVENTURES OF POPPY, QUI SAIT, and BUSTER (aka Grumpy) 
Many of my past blogs have included stories about Poppy, my dog, Qui sait, my neighbor’s dog, and Buster (who I’ve begun referring to as Grumpy). Recently Poppy has taken to finding mud and rolling around in it like pig. He then will find me in town somehow and start whimpering. Everyone knows that he is my dog and everyone knows that he is a “bandit,” or troublemaker. So, whenever muddy Poppy shows up, everyone attempts to send him back home by throwing rocks at him. Sometimes this works, but usually I finally decide just to return home with Poppy in tow, lock him up on my terrace, and then return to whatever I was doing in town. After my work is finished, I come home to locked-up, miserable Poppy, and all the neighbors kids taunting him and prepare to wash him. With the kids, I get a bucket of water, soap, and start cleaning Poppy. This is a great effort; Poppy is not small (up to my thigh), and is strong. So usually, the act of washing Poppy turns into a riot with all the kids and wet dog running around, water and soap covering the floor and providing the perfect place to slip/slide/dance (like pippy longstockings), and Poppy providing free water-sprinkler service with his constant shaking off excess water. The much smaller Qui sait, who I believe is inherently smarter than Poppy, usually stands to the side, knowing that if he gets too close, he too will be washed/tortured. While all this is going on, Buster/Grumpy is nowhere to be seen. It is only when I enter the kitchen that his constant meow-ing announces his presence. I will give him whatever it is I’m eating or preparing to eat, and he will refuse it and continue meow-ing. Then, he will pee on the folded up sheets I have set up to use as a dogs’ bed. I think the only reason why I keep him is because I don’t want mice and lizards running around my house.

BYE BYE RAIN; HELLO DUST 
So, Rainy season has been tapering off. I’ve wished that it would never end, and that it would rain every single day for the rest of my service, but I suppose it’s good to have variety. I will miss the blue-green fertile mountains surrounding Kante, and the mountains of the sky: the dark blue-grey storm cloud mountains. Soon, everything will turn to different shades of brown, including the sky, which will host the wind and sands from the Sahara. Then, bushfires will begin as people burn their fields in search of animals to eat, and you’ll be able to see the mountains around Kante will seem to hold these floating fires against the brown background of earth/sky.

NEW VOLUNTEERS and HALLOWEEN 
New volunteers arrive in Togo twice a year. So, twice a year, new volunteers visit their future villages and all the older volunteers welcome then. This year that visit and welcome fell on Halloween weekend, so all the Kara volunteers –old and new- got together to have a Halloween party. Some people had costumes made, trying to explain to Togolese seamstresses and tailors what Halloween was and what they wanted their costume to be. Other people put together random things to make a costume that was somehow Togo-significant. I, as usual, decided at the last minute what my costume would be. There was a mango tree outside, and I had just learned how to wrap an African headwrap, so I cut some tree branches from a mango tree and attached it to a green headwrap and therefore became a tree. Even the new people were prepared with costumes, which was surprising, since they were new. It is weird that the next new volunteers to arrive in Togo will be here to replace me and my friends who arrived with me. SCIENCE FRIDAY Every Friday is marche day. This is a day (every village and town has their day) when people come from all around to buy and sell whatever they can. Although its exciting and interesting to watch and experience, it can get pretty hectic and there are more outsiders (ppl not from Kante) who don’t know me and more drunk people, so I usually get stared at and yelled at more. So, if ever I feel like that will upset me (I’ve become really aware of my current state of mind and what aggravates me), I just stay away from the marche. This means that most Fridays, there is not much to do besides go to AED for HIV/AIDS patient consultations. So, I have begun a routine in which every Friday, I read and summarize a science article (I have luckily saved a lot of science articles onto my hard drive so I have enough material). Thus far, my favorite has been a review article about how gut microbes, nutrition, and immunology all interact and play a role in one’s health. One super example is fiber. You cannot digest fiber; only microbes in your gut can. So, when you eat fiber, the types of gut microbes that digest fiber multiply (so your gut microbiome changes overall). They digest the fiber to produce short-chain fatty acids, which are important for energy, but especially for your immune system! They also did these incredible experiments in which they first raised mice in a super clean and isolated environment, so that they were “germ free” and had no microbes at all. Then, they took a sample of microbes from the gut of an obese mouse, and a lean mouse, and put them in the germ-free mice. The mice that received the microbes from the obese mouse became fatter that the mice who received microbes from the lean mouse! It was specifically interesting because it referenced Peace Corps volunteers, saying that after having lived in poor (and often unsanitary) conditions, they often develop “environmental enteropathy,” which is just like chronic diarrhea and malabsorption, and they have found changes in the gut epithelium through biopsies. Anyway, I wish I could study my own gut.

WOMENS CONFERENCE 
Last year was the first annual Women’s Conference in Togo. This year, there will be five Women’s Conferences. So, I applied and was selected to help with the Kara/Savannes conference! I’m super excited because I heard last years was wonderful. This year, women from all around the Kara and Savannes regions will come to Kara, stay for a week, learn all about health, money, women’s empowerment, etc etc, and just form a really great support network. This is really rare for women here. Usually men go to conferences and women always stay at home and do allllll the work. They also are the ones who care for family members and the sick, even though they often do not know how to care for the sick. And, they are the ones who can make a huge change in the health of family, just by incorporating good food preparation and handwashing techniques. Anyway, the point is: women are such a good group to work with and I’m super excited about being part of the Womens Conference.

MD/PHD or MD or PHD 
Since June, I have been intensly thinking about what my next move in life will be (after Togo). I am not completely lost; I know I want to do medical research- and, although my interest might change- I would looove to do research involving the gut and nutrition and immunology. However, this may not change; I remember in an interview after my sophomore year of college, I told my interviewer that “I am in love with the digestive system”. That might be a little weird, but at least I know what I like. Anyway, fastforward to now and I am currently interviewing current students and professionals and MDs and PhDs and MDPhDs…. I have met a lot of people and learned a lot of things, but it all just boils down to a few basic facts. (1) an MD is tough, financially costly, and you should like working with patients, and although some MDs do research, it’s more difficult to get into research, and it is much more difficult now to attain a financially stable position (with high tuition fees and all the costs associated with being a doctor) (2) PhD is tough but paid for, and you should like research and science and the lab, it may take awhile and may or may not be incredibly difficult to graduate (depending on your mentor) and find a position (theres a debate about whether or not there is an “overpopulation” of PhDs in the field), it is also reliant on grant writing and constant funding-seeking (3) MD/PhD is tough, will take awhile, is paid for, you should like patients and lab, you should want to do research, may result in you just working as mainly MD or mainly PhD (which some ppl might use to conclude that dual degree is a waste of time), may be the only sure way to get to a tenured faculty position (according to some people..back to the PhD overpopulation debate), may be (debatably) the most secure choice for a research career because you have an MD over the regular PhDs, are associated with other MDPhDs (who are usually leaders in the field), and you have an MD to fall back on-and ppl always need doctors. All options take time (I’m thinking just under a decade, often not including residencies, fellowships, postdocs, etc..), make it difficult to have a family (but doesn’t any job?), and have been described as “you really need to want it, or you’ll drop out”. I just don’t know. When I think about MD, I just really love helping people (as much as I hate how cliché that is). When my Togolese friends-or any friends- talk to me about their medical problems, I want to understand what they have and help them. When there was an awful accident and all the bloody people were carried to the hospital, I really just wanted to help give them stitches and fix their broken bones and see what else is wrong. And just following the medical assistants aroung the hospital, I am always frustrated with my language (they speak Frenchy French as opposed to Togo French) and lack of medical knowledge. When I was in high school, my family witnessed a big car crash. I ran over with my dad (I had just taken a first aid/CPR class) but was so frustrated because I didn’t know what to do. I just heard the guy breathing and it sounded like he was gargling. So often I wish I was a doctor or nurse here. But, on the PhD side of things, I really like the lab and really miss the basic science research articles and discussions and the techniques used to find things- and just all the details and different factors that must be taken into account. It is simpler- like me- and even though the big problem is super complex, you can choose one simple little problem of the big problem and just focus your whole life on that little problem. And I like that. Plus, I really miss electrophoresis gels and microscopes and pipetting. Also, even though I’ve shadowed people and helped out in the hospital here, I think it might be really different in the US, and am not sure if I will like “clinical work” in the US. Then there’s the MD PhD route. But with that, it just takes a lot of time, and many people tell me you end up choosing either to work mainly as an MD or mainly as a PhD- so you still need to choose between the two- unless you’re super human and have no family. Which is a whole other debate. *Sigh*