I had big plans for Saturday: I called a representative from the Zimbabwe Mountain Club and got the details about the hike they were doing in the afternoon. I was excited to get out of the city, even just for the day and thought I’d invite Jake along since he mentioned that he likes hiking (he grew up in Alaska and now lives in Colorado; can you guess 3 things he likes to do? You’re probably right).

Jake told me that he and two other doctors were going to Great Zimbabwe that weekend and were leaving in an hour. They had one space left in the car and would I like to join them? They’d come back on Sunday evening after checking out the area. Well, you didn’t have to ask me twice! I really wanted to see Great Zimbabwe and having something to do the whole weekend was even better than afternoon plans.

I quickly packed some things for the weekend and left a note for Mr. Morales who was sleeping on the couch. Jake picked me up and introduced me to two doctors from Colorado who are here visiting Zimbabwe and giving guest lectures to the medical students. Brian is a cardiologist and has been here for a few weeks and Dave is a semi-retired infectious disease doc who arrived a few days ago and will be here for several more weeks. Great Zimbabwe is about 3.5 hours southwest of Harare so we had a lot of time in the car to get to know one another. Dave asked me a bunch of questions about my project and about people on the Bay Area. It turns out that Dave grew up across the street from one of my professors at Berkeley and they remain good friends. I heard a few interesting tidbits and wanted to ask for some juicier stories but then thought better of it.

We arrived around 3 pm and had a quick sandwich before hiring a guide and staring the tour.

Great Zimbabwe is a World Heritage Site that marks the location of a great civilization that thrived in Southern Africa from 1200-1700 AD. This culture built huge stone works out of the granite in the area that survive to this day. In fact the name “Zimbabwe” means “big” (zi) “stone” (mba) “house” (bwe) and that is exactly what it is.

Situated on top of a hill is the aptly named “hill complex”. There’s a very narrow hand-build stone staircase that winds between boulders and hand-built stone walls to the top of the highest hill in the area. This is where the king lived and commanded his people. There are 6-9 foot high stone walls for protection and lower ones to demarcate various rooms. We ran up a steep rock to the highest point where the king would look out over his kingdom. The walls and buildings are really impressive considering the time period in which they were made and that no cement was used. To make the stones, the subjects (or slaves) would light fires on top of the granite boulders then once they got very hot, they would quench the fires with water, quickly cooling the hot rock, causing it to crack into perfect blocks. They would then carry the blocks across the plain and up the hill to build the complexes. The building process took several centuries.

From the hill complex, we descended and went to a small museum that describes the place in more detail and also features 6 soapstone carvings of birds that were found on site when the buildings were rediscovered in the mid-1800s. One of the carvings is the model for the bird that is on the Zimbabwean flag now.

After the museum we headed to the Great Enclosure, which is also aptly named. It is a huge structure, which 30 foot high walls that are 8 feet thick. Narrow passage ways lead to the interior where there were rooms and cooking areas. This is where the king’s wives lived (he had up to 200). The architecture was truly spectacular and very impressive. My words cannot possibly do it justice so I hope you look at the pictures (that I will post later).

There were many other smaller building between the hill complex and the great enclosure but they deteriorated over time and now there are just piles of rock left and are not very interesting. But during the peak of the civilization it must have been very impressive. The king traded with India, China, and the Middle East, based on the artifacts recovered there.

The park closes at 6 pm and we were the last to leave around 6:30.

The guys had called ahead to make some reservations but when we got to the place there was no electricity and things were a bit dingy so we drove down the road and stayed at this beautiful hotel situated on a hill overlooking Lake Kyle. We rented a cottage for $35 per person and I got my own room since I was the only girl.

We had a very fancy four course dinner with a mushroom appetizer, vegetable soup, grilled Bream (a local fish that is similar to bass) and chocolate cake with homemade chocolate sauce. It was the second best meal I’ve had here (after the fancy dinner at Victoria 22).

The evening was perfect and we sat out on the veranda and talked for a few hours until we finally headed to bed.

As part of our study we want to recruit patients from all over Harare so we don’t have a biased sample. Therefore we’d like to recruit patients from all of the poly-clinics in town (there are about 20) so we picked out the 6 that typically see the most TB patients and we decided to visit each one and describe the study, with our letter of introduction from the ministry. We decided to print study flyers to leave at each clinic to remind the doctors and nurses of our inclusion and exclusion criteria and contact information. We thought we could just distribute these on our own, but Salome made some calls and found out we had to get the flyer approved by MRCZ. If only we had known just a few days before! We could have included it in our packet. So we printed another cover letter and made two copies then headed down to the office to submit it. There was only one person there and she told us everyone else was at a forum and would be gone for the rest of the day. A bit of a strike out there, but there’s always Monday.

I spent the rest of the day working on making this database and making plans for the next week.

At 4 pm we had a Skype call with John scheduled. A 9 hour time difference is difficult to schedule around. It was well before normal working hours for him and after hours for us since everyone leaves at 4 pm on Fridays. Salome stayed for 20 minutes but then she headed home to her family while I stayed and talked to John. A lot had happened since he left and we still had a lot to do so we talked for nearly 2 hours. Most of that was business but we chatted about personal stuff for about 20 minutes at the end. It was nice to hear that my work is appreciated. I think John is very glad I am here organizing everything.

By the time I we were done and I packed up for the evening it was nearly 6 pm and the office was deserted. I didn’t feel like going straight back and spending another evening locked in my room so I walked to an area where I heard there was a mall to check out some of the shops. What I found was a series of grocery stores next to each other with a take away Chinese restaurant thrown in for good measure. Not exactly what I had in mind. I wandered the aisles for a little while to compare prices and waste some time. As it turns out, there are good fruits and vegetables in Zimbabwe; they are just not at the stores that are close to where I stay! I was not feeling inspired to cook, but I bought some yogurt and granola to tide me over for a few days.

I took a taxi home since it was dark and I spent my Friday night reading “The Hobbit” and went to sleep quite early since I only got 4 hours of sleep the night before.

I spent another busy day at work organizing whatnot, correcting forms, and making a database for our study. It was a lot of time sitting, but the day went by pretty quickly. I really wanted to do something that evening since I was feeling trapped at the house so I sent Jake a text to see if he was free. He was also looking for something to do so we decided to go to the Mannenberg, which is a jazz club in town. Since Jake is living in Zimbabwe for a year, he bought a car in South Africa and imported it. And he’s nice enough to pick me up even though I live in the opposite direction from him. My landlord was sleeping on the couch when I left (which is not that odd since he sleeps on the couch every night and is awake and asleep at very odd hours) but I didn’t think anything of it.

The place we went to is on the second floor of a shopping center and there are two places right next to each other: the Mannenberg and the Book Cafe. They are both evening venues and while the Mannenberg is mostly music, the Book Café has music but also open mic nights and poetry readings. We got there around 9 pm and heard good music coming from the Mannenberg so we paid the $5 cover and went in. Near the door I saw a sticker on the wall for Amoeba Music! Someone else from Berkeley or San Francisco must have brought this sticker half way around the world just to place it on this wall. That was pretty awesome. However, when we walked in the place was completely empty!

The security guy assured us it would fill up since they were just getting started so we took some seats and ordered some drinks. A bit later one of the doctors that Jake works with joined us. His name is Golden, demonstrating once again how Zimbabweans know how to name their children.

The music was really good. It was a blend of jazz and African beats with some Caribbean influence as well. After a while we saw the security guy (he was wearing a shirt that said “Security”) go up on stage and adjust one of the amps. Okay, so the security guy doubles as the sound technician. Then a few songs later the security guy and another guy get up on stage and bring out microphones! Jake and I looked at each other with amazed expressions on our faces and said something like, “The security guy is in the band?” And indeed he was! He sang backup while the other guy did lead vocals. They sang in Shona, which was kind of cool but I couldn’t understand anything they were singing about.

Later in the night the lead singer said he wanted to do a love song. He looked over and Jake and me and said, “I’d like to dedicate it to you because I assume you’re together.” We both vigorously shake our heads. “No? You’re not together?” Heads shake. “You’re just friends?” Two heads nod enthusiastically. “Oh okay, well I’m still going to sing it.” I couldn’t understand most of the lyrics but the few that were in English were along the lines of “Girl, you gotta treat your guy right and give him what he wants.” And “boy, if you want to keep your girl, you better buy her nice things.” Classic.

Around 11:30 we were getting tired but it seemed like the band would go on for several more hours so we headed out.
When I got home I pressed the button for the gate, but it wouldn’t open! I thought maybe the battery had died so I pressed it again. I heard the gate motor trying but it wouldn’t open. I pressed the buzzer and woke up Mr. Morales to let him know I was outside. He told me they put a padlock on at night for extra security and that it was locked! Good time to tell me! That would have been good to mention earlier! And because I had pushed the button, moving the gate just a tiny bit, they couldn’t get the padlock off until they manually reset the gate. It took like 15 minutes and it was actually a bit cold outside and I didn’t have my jacket.

So now I guess I have to tell him when I’m going out so I don’t get locked out again. Somehow that makes me feel like I’m 15 again and that’s not a time I want to relive.

Sorry, the link to the pictures didn’t work the first time (thanks for letting me know Jacob!). Hopefully, this will work now…

https://picasaweb.google.com/115644650404072729236/ZimbabweBeginnings?authuser=0&feat=directlink

Here are just a few pictures I’ve taken so far. I haven’t really been outside the city yet so there’s not many exciting things to photograph. You also don’t want to be flashing your camera around town or it will get stolen. I took the last pictures from inside a taxi on the way home last night.

https://picasaweb.google.com/115644650404072729236/ZimbabweBeginnings?authuser=0&feat=directlink

The MDR-TB clinic was this morning and since Wilkin’s hospital is just down the road from me, I was able to walk there this morning. It was a lovely morning to be out: the sun was shining and the air was cool from the storm the night before. The doctors were late to the clinic so we waited for an hour before it actually started. I heard a lot of interesting TB stories but we didn’t enroll any patients; maybe next time.

The afternoon was spent getting the last of the supplies and copying forms and sending e-mails. I wanted to get out early and go to the quarry outside of town where the Zimbabwe Mountain Club meets to climb on Wednesday afternoons, but we didn’t finish work until nearly 5 pm and it looked like it was going to rain. I called a few mountain club members and was advised not to try to make the trip since they would likely be leaving before I arrived. That was quite a bummer because I’d really like to meet some people to hang out with and I’d love to see something outside of the city center even if it is a quarry, but it was not meant to be. Perhaps next week the weather will be nicer.

Instead of heading to the east side of town where the quarry is, I had a taxi driver just take me home and just 5 minutes into the ride I was really grateful for my decision. It started pouring down rain and got extremely dark very quickly.

I guess everyone was trying to beat the rain home because traffic getting out of the city was terrible! It took 15 minutes to travel one block! Everyone was disregarding the traffic lights (called robots here) and the whole place was a clusterfuck. It was ridiculous. A trip that should have taken 15 minutes took nearly 45 due to the traffic and the rain.

I should mention a bit about driving here. I haven’t actually driven anywhere myself, but in general it’s a bit hectic. The driver side is on the right so everything is opposite from the US. The driving is more aggressive than in most US cities and Cape Town, although less than in Nairobi. It’s standard for three cars to run a red light (if the light is working) and for cars to make a two lane road into a four lane road. And pedestrians do NOT have the right away. If you think the car will stop while you cross the street, even if you’re in a crosswalk, you will probably be hit. I’m still a bit unnerved crossing the street and I look both ways several times during the process. Walking here can be like taking your life into your own hands.

It’s very expensive to get a driver’s license here so most people don’t drive. It’s also extremely expensive to own a car (gas [or petrol] is more than $5 a gallon) and if you import a car from another country (which you pretty much have to do since none are made here), the duty can be 60-100% the value of the car! Thus, most people take the combis (the buses) or they walk.

Zim has two official languages: English and Shona. Shona is a bit like Swahili, but there are not enough words in common to be fluent in both very easily. I think every word in Shona ends in a vowel, especially “a” and “e”. The language is very phonetic which makes it easy to pronounce but conjugating verbs is more complicated than English. I’m trying to learn a few words and phrases but I’ve been so busy lately that it’s been hard. Also, everyone speaks English and they (rightly) assume that since I’m white I don’t speak Shona so there’s not a lot of incentive to learn.

This morning I tried walking to work to see how long it would take. Based on my walk on Sunday I thought it would be 40 minutes. I quite misjudged the distance and it took an hour! Luckily it was 7 am and was still quite cool. I was only mildly sweaty by the time I got to the office.

In the morning Salome and I went to MRCZ and finally got all of our consent forms and data collection sheets approved!! That means we can officially enroll patients and begin our study. That only took a year of paperwork; quite fast by Zim standards.

In the afternoon we went around town again, purchasing supplies and getting ready for the clinic on Wednesday. It was so hot!! I drank 1.5 liters of water (not including what I had at breakfast), ran out at 3 pm and was still thirsty. The two bottles that I had frozen the night before were completely melted by 11 am. And our office doesn’t have a fan yet, let alone air conditioning.

The clouds built up in the afternoon and just as we were about to leave work, the heavens opened up and it rained! The rain brought fresh, cool air and the temperature dropped rapidly but no one had an umbrella and many people got very wet. Salome was extremely nice and drove me home, which is completely out of her way, so that I didn’t get soaked waiting for the bus. She says sometimes the Combi drivers (that’s the minibuses here; known as matatus in Kenya or dala dalas in Zanzibar) will sometimes close their doors when it’s raining and not let anyone in, just to see them get wet. I don’t know if it’s true, but that seems very cruel.

The other thing about the rain is that it’s not just rain: it’s a thunderstorm. And the thunder and lightning is big! The flashes light up the sky and what sounds like gun shots echo in the near distance. Living in the Bay Area I’d forgotten what a thunderstorm was like and I was very glad to be indoors.

When I got home, the power was out. At first I thought it was because of the rain, but Mr. Morales said it had been out for most of the day. He also told me that this was the first time the power was out for two weeks. That statement seemed quite ominous. The most unfortunately thing about the power being off is that the water pump doesn’t work and there’s no water pressure to take a shower or brush your teeth. I was feeling gross from the sunscreen and sweat but couldn’t do anything about it. I ate a cold dinner and read by headlamp until the power came back on at 8:30. I took a great shower then read some more before bed.

I’ve read 4 books since leaving home now and I can highly recommend “Mercury Falls” by Robert Kroese. If you like Douglass Adams, you’ll love this one.

Today was Halloween although I didn’t see anyone dressed up and no children came trick or treating. It would be very hard to trick or treat in most neighborhoods due all of the gates and walls with electrified fences or shards of broken glass glued to the top of the wall. I don’t think it’s a big holiday here.

Since not much of note happened today, I thought I would describe a bit more about the culture and people here.

First, I like the women’s dress code here much better than in Zanzibar! In Zanzibar, all women wear headscarves (it’s a Muslim nation) and a lot wear the burrqua in public. Although no one expects a white woman to do that, wearing a tank top or shorts was frowned upon. However, in Zimbabwe women dress very similarly to women in the US: dresses, tank tops, shorts, skirts, pants, etc. This was not always the case though. Salome tells me that in the early 1980s the only women to wear trousers (pants) were prostitutes and a few college women. When the country became independent that changed and now women wear whatever they want, although in general I would say the ones with jobs dress nicer than women in the US; jeans are not very common here. Men typically wear dress pants and shirt and sometimes a jacket and tie. The ties are pretty funny looking because they are *much* shorter than the ones in the US. They are almost ridiculously short.

The people here also have the best names ever! Some of my favorites so far:
Precious
Beauty
Faith
Lovemore (male name)
Moreblessing
Shelter
Tsitsi (female name)

There are very few white people here. On a typical day I might see 3 others so I stand out like a sore thumb. People tell me they exist but I think they just stay in their own areas and that’s not where I am.

Oh, and I saw an albino today! She had the facial features of an African, but had whiter skin than me and had blond hair (under a hat).

There is crazy class hierarchy here as well. Somehow people know their social status and do not go beyond that circle. For instance, last week when John was here and we went for free lunch, John and I thought to sit next to the professors whom we had been working with and later on Salome (who has a Master’s degree and 10 years of experience) told us she would never think to sit at that table because the professors were much above her. Since hearing that I’ve noticed similar situations quite often. And sadly (or fortunately) for me, I am accorded a higher place in the social standing because of my skin. Salome says that people on the street treat her differently when I am walking with her. That dates back to colonial times for sure, but it is certainly not right.

On a different note, Zimbabwe adopted the US dollar as its currency a few years ago. However, when they did that, they only adopted the paper money and not the coins. This is quite often frustrating because it makes it extremely difficult to get changed when you purchase anything that is not a flat dollar value. For instance, at the grocery store you bill will often end with some change. Instead of giving you that change, the cashier asks you to buy something else that will bring the value of your purchase up to the next dollar or they will give you the change in candy or pens. If you are lucky, you might get South African Rand back (at a bad exchange rate) or might get phone airtime but neither of those is guaranteed. Also, you need a lot of small bills because God help you if you try to use a twenty to pay for something that’s $3! Oh, and the bills are crumpled and disgusting, having passed through too many hands while still being in circulation. And don’t even think about using a credit card here unless you are in a major hotel (so much for the cashless society, Jacob!)

I think there are more cell phones here than in America. Everyone has a cell phone and most people have two: one for each of the major networks so you can always be “in network” which makes calls cheaper. Everyone uses the prepaid vouchers that you can buy anywhere on the street and since the plans charge by the second, there’s a crazy system of dialing and hanging up before someone answers that I don’t quite understand yet. People also hang up on someone who’s calling only to return their call immediately to save the other person airtime. It’s quite complicated.

There’s no McDonald’s here, although there is Coca-Cola (that’s ubiquitous). But don’t worry: there are plenty of other fast food restaurants here to clog your arteries! I’ve already mentioned the lack of good produce so I won’t go into that again.

And good luck when you’re sick. Drugs to treat TB and HIV are free to everyone, but cause they are donated by the US and European countries but if you get sick in any other way, it can be quite disastrous. Some companies offer insurance which covers 50-100% of your doctor bill, but 90% of people are unemployed here so they have no insurance. If you fall into that 90% and you get sick, the doctors/nurses will often ask for the money for a procedure *before* they begin it (like an X-ray or EKG). I’m pretty sure they would treat you before paying if you were dying but I’m not totally convinced of it yet.

That’s all I can think of for now, but I’m sure I’ll have more things in the future. Oh, one last thing is that in the ladies bathroom in my office there are 3 sinks and whenever you turn one of them on, they all turn on! How’s that for saving water.

Since I went to bed so early I woke up at 5:30 and realized that it’s already quite light at that hour. After a bit of exercise and breakfast, Mr. Morales drove me around the neighborhood to show me where the nearest grocery stores are located.

I needed to go back to the Bronte Hotel because John forgot to give me his cell phone when he left but realized it in time to leave it at the front desk. John also put me in touch with another American doctor working in Harare and I told Jake via e-mail that I would call him in the morning. I wanted to see how long it took to get to the city center from where I’m staying so I decided to walk. I slathered on the sunscreen (it was already 80 degrees at 8:30 am) and set out.

Harare must have been a very beautiful city in its heyday but now it’s a bit rundown and dirty. Still, it’s cleaner than Nairobi, but not as nice as Cape Town. There are actually a lot of sidewalks along the bigger roads here, which is always a luxury in Africa. However, the roads have not been repaved or patched in many years and there are a lot of potholes so driving is a bit precarious. The major streets are lined with two rows of Jacaranda trees, which are in full bloom right now. The trees are very big so I imagine they were planted decades ago. There are also a lot of palm trees around and some bamboo as well as other deciduous trees. Harare is very flat, even those it’s situated at 4,000 feet, so walking and biking around is very easy.

45 minutes later I got to the Bronte. Google maps told me it was 3 miles, so it was a bit quicker than I thought. I picked up the cell phone from reception but when I tried to turn it on, I found out the battery was discharged. At the gate I saw a taxi driver, Rhodes, who had given us several rides before and I told him of my predicament. He let me put my SIM card into his phone to call but then I realized that John had not left me the pin code to unlock the phone!

Rhodes was really nice and let me call Jake using his phone and we arranged to meet at the hotel at 10:30. Rhodes offered to buy a new SIM card for me in case John didn’t get the code to me. I think I’m now obligated to call him for a few taxi rides. (On a side note, Rhodes has blue eyes which are extremely rare in black people and he told me that one of his daughters also has blue eyes. How crazy!)

I met up with Jake and we went to an upscale part of town called Avondale and got some lemonade and sandwiches. Not many shops are open on Sundays so I wasn’t able to get any postcards like I wanted to, but after eating we walked around the casual market (a typical African market where you bargain for everything) and hung out a bit.

Jake was meeting a professor in the afternoon so he had to get going but he was very nice and dropped me off at my place.

I had a cool drink and put down my stuff then walked to the grocery store to get some food. The stores are very similar to ones in the states but with a smaller selection and higher prices; I was very disappointed in the available fruits and vegetables and I’m very glad I brought some multi-vitamins with me. I think just about everything is imported and I was only able to find some broccoli and apples that looked okay. Maybe another day of the week is better for shopping. I spent nearly $30 on two small bags of food but at least I’ll be able to make some meals.

Even though I wore SPF 50 sunscreen, I was out in the sun long enough to get a bit of a tan today. I’ll have to be careful about reapplying.

In the afternoon I worked on my paper some more and then hung out and relaxed.

Few businesses are open on the weekends in Zimbabwe so there’s not much to do workwise. I tried to sleep in but woke up in the middle of the night after a strange dream and couldn’t really get back to sleep.

I checked out of the hotel after breakfast and John and I made plans for the morning. We only had one meeting but had to go to the bank before John had to go to the airport at 11:30 for his flight home. We also wanted to take my stuff to my new place so John could see it.

The bank trip was successful today (unlike the night before) and we were early to the meeting for once. We talked to Colin, who runs a non-profit research institute that aims to train young researchers and provide lab services to other organizations. He was great to talk to and will be a big help to us in getting supplies and providing some of the equipment we lack right now. He was really impressed with my background and asked me to train his employees in some molecular biology protocols. Although I’m trying to get away from that aspect of research I think it will be very good to help build capacity here in any way I can.

After the meeting, John and I drove out to my new house and looked around. I think the situation will work out really well once I figure out how to get to the office every day. John had to check out of his room so he left shortly after that and I was left to get settled in.

Mr. Morales has two sons that live in California (one in San Diego and one in SF) so he got out some maps and had me show him where I live and work and where John lives and works. Then he showed me pictures of his kids and grandkids and showed me houses he has designed (he’s an architect). I think he’s been pretty lonely since his wife passed away last month but he seems to be doing pretty well.
I also met the guy who lives in the apartment above the garage. Victor and his sister have been here for three months and they work at an NGO in the city center. We chatted for a bit then Victor had to run some errands. Mr. Morales invited me to a neighborhood gathering tonight where there will be karaoke apparently.

Oh, I also forgot to mention that I discovered that there’s rock climbing in Zimbabwe! I found a blog from the Zimbabwean mountain club and contacted two board members. They got back to me straight away and they go hiking every Saturday afternoon and a group goes rock climbing at a quarry every Wednesday at 4:30 and to other places on the weekends. I’m going to go to both things next week and will hopefully meet some nice people to hang out with and do things with on the weekends.

I spent most of the afternoon getting settled, working on a paper I’m writing, and reading. It was very nice to relax for a few hours but it did get a bit lonely. The week finally caught up with me and I got very tired around 7 pm so I didn’t go to the neighborhood get together; I just went to sleep at 10 pm.

Friday was just as busy as the previous days. Since he had scheduled some meetings, John skipped the conference that was still going on so it was the three of us in the two person truck again. After meeting at the office we went to one of the Harare city’s offices where John had to speak to with someone regarding using a room at one of the hospitals. The meeting did not go quite as planned because they wanted John to pay much more money than he thought it should cost so that was not really settled.

From there we rushed to another meeting at a different hospital only to find out that the meeting was cancelled at the last minute because the doctors running the meeting had to help with a typhoid outbreak that had just started in the city. We did get to talk to an infection control nurse who will be a great contact in the future so it wasn’t a waste. I also got to see the room that we were to have access to and which was going to cost way too much. It was practically a large closet and it was filled with junk and old supplies that we would have to deal with. It obviously wasn’t being used for anything so the rent didn’t make any sense.

Since that meeting was canceled, John and I were able to get a ride from Salome to another meeting at a different hospital. We met with some local doctors and two MSF (Doctors without Borders) staff and went over some of the MDR patients that had been reported in Harare the previous week. It was less exciting for me since I’m not familiar with reading chest X-rays and such, but it was very eye-opening to hear about these cases. I also got to see the BSL3 that is being built at the hospital with money from UCSF. It’s a great facility although a bit small for the number of samples that they will have but it has a long way to go before any culturing can be done there.

The conference that we didn’t go to in the morning was providing free lunch so we headed to a hotel to partake of that. I didn’t realize how many people were involved in clinical trials in Zimbabwe, but there were over 200 people there and many more people didn’t attend that day. At least some organization is providing jobs; the unemployment rate in Zimbabwe is 90%!

After lunch John wanted to go out to one of the poly-clinics that we will be recruiting patients from and introduce himself to the nurses that we will be working with. We went to a clinic on the edge of Harare where they see a lot of TB cases. Even though the downtown area of Harare is quite small, the city limits spread out quite far and it was a 45 minute drive out there. The nurses we spoke with were both very nice and incredibly well trained, even with MDR-TB. There are several other studies going on there so they are familiar with research projects. We spent about an hour talking to them and then had to head back to interview a potential research assistant.

The guy we were hoping to interview had car troubles and couldn’t make it that night so we had a few minutes to spare before dinner. I took a quick shower and changed which was great after another hot day of running around.
Originally John was going to take a bunch of people out to dinner but then he was invited for dinner at the home of a master’s student he knows well. Her family was happy to cook for some others so Salome, Tish (another master’s student) and I were able to join as well.

Lucy and her family live in a very nice neighborhood in Harare and must be quite well off since they own 5 cars and a huge house. It was incredibly nice of them to have us all over and they cooked a feast for us.

I have to mention a bit about the food here. Zimbabweans love meat; any kind of meat but especially beef. This will pose a bit of a challenge for someone like me who eats meat very rarely and doesn’t eat red meat at all. Luckily they also eat vegetables so I was able to fill up on butternut squash, broccoli, and mushrooms. Their traditional staple is called sudza and it is ground corn porridge-like dish that is served at every meal. It is the same as pap, if you know what that is. They also really like dessert here. Custards and sweet breads are very popular as is ice cream and Jell-O. I will have to be careful about the desserts.

Once again we got home after 10:30 and I didn’t get to bed until after midnight. Hopefully things will calm down a bit and I’ll get a bit more free time.

John had a conference to go to all day so Salome and I decided to run some errands. We needed to drop off some things at MRCZ, who handles ethical approval for all studies in the country, and then get some office supplies since we don’t even have a stapler or paper clips.

First I went to look at an apartment that BRTI has not too far from the office. It’s in a nice neighborhood and has a guard but the rooms themselves were kind of depressing and I left that I would be very lonely there. It was a very large two bedroom place with a huge dining room but small kitchen but it was kind of sad looking and there was no laundry or internet. I came back to the office feeling like it would be a long two months if I had to stay there.
When we got to MRCZ we were told that several of our forms were not filled out correctly and that we would have to redo them and submit them again. It would have been really nice to hear that the day before when we were there. It was incredibly frustrating because it was a waste of ink, paper and time and I’m still not confident that they told us everything we have to do.

To take a break from modifying consent forms, we decided to do some shopping. We need a locking file cabinet to store the patient’s information so we went to an auction house (very similar to Urban Ore) and looked around. I was so shocked at how expensive things are here. A short, two drawer, used wooden file cabinet was $63! The 4 drawer metal one was $130! And neither one had a key so we’d have to get a lock smith to fix that. We thought it was too expensive so we went to a few other places and found out that the new file cabinets were $340! Then when we went to buy office supplies (a stapler, staples, paper clips, notebooks, etc) I spent $86 on things that would have cost about $40 back home. I don’t know how people afford things here.

In the late afternoon Salome and I worked on revising and printing some of the consent forms but at 5 pm we realized that it would just have to wait until the following day. When we left, the entire floor was empty because most people work from 8 am until 4:30 here (or 4 pm on Friday).

Salome was very nice and drove me to look at the other place to live that I had heard of the night before. Mr. Morales is a widower whose grown children live abroad so he is alone in his giant house. The apartment he has over his garage is being rented out but he had a wing of the house available to rent. The room is large and furnished and there’s a private bathroom and storage area. The house is one a huge lot with a lot of grass and there’s a patio in the back with a small pool. Since I negotiated the same price ($500 per month) as the crappy apartment, I decided to stay in the house. It’s more welcoming and hopefully I’ll be less lonely with other people around.

By the time I got back to the hotel I had just enough time to wash my face and put my things away before going to dinner with John. We got picked up by some other UCSF/UZ researchers and headed to the restaurant we accidently went to the night before. The place is called Victoria 22 (that’s the address) and it is super fancy. There’s a huge chandelier in the lobby and all of the waiters were dressed in suits. We were a large party (25 people) and I sat with some white Zimbabweans at the end of the table. It was amazing to hear their stories of what it was like in the country in the 70s, 80s and 90s. It has changed a lot. I’ll try to include some anecdotes later.

The meal was great and the company good so the evening flew by and before we knew it, it was 10:30. Another late night with little time to really relax.

I woke up at 4 am and tossed and turned for an hour before giving up on sleep altogether. Since I went to sleep at midnight, that didn’t amount to much rest, but what can you do? I read a book for an hour and a half before getting up and going down to breakfast. Breakfast at the hotel is pretty nice; there’s a buffet with fruit, yogurt, cereal, juices, and pastries and they make eggs, bacon and sausage to order.

At 8 am John and I met our study coordinator, Salome (pronounced with two syllables, like Shalome), and the three of us crammed into the cab of her truck (quite uncomfortable since it’s a manual) and drove down the road to MRCZ (Medical Research Council of Zimbabwe) where we had to submit some revised forms for approval. I’ll write more about dealing with these people later.

Next we were off to Wilkin’s Hospital where there is a TB clinic every Wednesday morning.

For the next 4 hours we sat with the doctors and saw the patients that came in with TB. Wilkin’s is a referral clinic so most of the people who come in have been treated for TB before. We saw 12 patients before lunch and enrolled our first patient in our study!

Oh, and did I mention that it was 95 degrees that day and there’s no air conditioning? And of course we were wearing our N95 respirators all morning so we didn’t breathe in any contaminated air. It was less than ideal and my face was pretty sweaty by the time we finished. Most of the patients were doing well on treatment (all TB and HIV drugs are free, being subsidized by WHO and many foreign governments) but one woman recently became pregnant even though one of the first line TB drugs is potentially teratogenic. And another woman just found out that her TB is resistant to all first line drugs. It was heart breaking and a bit scary at the same time.

After the clinic was over we went to the BRTI (Biomedical Research and Training Institute) where we have an office and John introduced me to many of the staff. I met about 15 people, which is not even everyone, and I’m still trying to get all of the names straight. We had some meetings with some of the people and I arranged to look at an apartment the following day.

John had a meeting at 4 pm regarding a BSL3 that is being built at one of the hospitals so I joined him for that. We got very poor directions from someone and although we were only 15 minutes late getting to the hospital where the meeting was, it took us 30 min, 3 phone calls, and asking half a dozen people where the old WHO offices were. Oh, and John’s cell phone only has spotty reception so we had a hard time actually getting a hold of anyone. We finally found the room (which was nowhere near the WHO offices) just at the meeting was coming to a close. Oops.

There was a dinner that evening with some other UCSF and UZ (University of Zimbabwe) staff and faculty that we were invited to and we got a ride from one of the profs at the meeting. However, when we got to the restaurant where we thought the dinner was, there was no one there and the restaurant was not open yet! Then Ross, another UCSF person, checked his e-mail and discovered that the dinner at the restaurant was on Thursday night at 7 and not Wednesday night at 6! But there was a dinner on Wednesday night at a professor’s house and we managed to get an address from someone. We hired a taxi to take us there but the driver had no idea of the way. He stopped and asked for directions half a dozen times but no one on the street knew where the street was either. Finally, we got a hold of someone at the dinner and got directions to the site. As it turns out we were not even late for dinner. We just took a roundabout way to get there.

It was great to have a home cooked meal and meet some of the other people I’ll be working with while I’m here. I even got a lead on another place to stay.

But it was a long day after not sleeping much and being out all day with the heat so I was really glad to come back at 11 pm and get some sleep.

I left home this morning to start my latest adventures in Zimbabwe. I was bringing a lot of lab supplies because they are hard to get in Zim and more expensive. I essentially packed all of my clothes for two months in a carry-on bag that did not need to come back to the US (thanks Megan and Kevin) and bought a new large suitcase for the supplies. The bag was over the 50 lb limit thanks to two reams of paper so I just paid the outrageous $75 fee. Thanks fellowship!
Southern Africa is on the other side of the world and you really realize that when you fly there—it takes a very long time! Here’s a breakdown of my trip:

SFO to Atlanta: 4 hours on Delta (poor service, pay for food, headsets and movies); read a novel
ATL: 3 hour layover: finished book, started second book, worked on paper, texted Jacob
Atlanta to Johannesburg: 15 hours on Delta (better service, free movies, 3 meals, very loud): watched 4.5 movies (Jane Eyre, X-Men First Class, Red Riding Hood, half of Sherlock Holmes and something else) slept for 6 hours, read more book
JNB: 1.5 hour layover: listened to live band, wandered airport being tired, read
JNB to Harare: 1.5 hours on South African Airways; got upgraded to business when a guy wanted to sit next to his buddies. Full meal with drinks served on table cloth with real silver ware and glass; if only I could fly like this always
Arrived in Harare at 9:30 pm Tuesday, Oct 25 (local time).

Phew!

John, my mentor was waiting to pick me up, which was really great. We took a taxi to the Bronte Hotel, a three star hotel in the Harare city center. After checking in and taking a much longed for shower, I sent a quick e-mail then went to bed.

In less than 24 hours I’ll be on a plane, heading to Harare, Zimbabwe. Okay, actually I’ll be headed to Atlanta about now and from there to Johannesburg, South Africa and then Harare. Only 30 hours of airtime, no big deal.

The amount of stuff I’m bringing is quite amazing. I have one checked bag that is filled with supplies and equipment for my project and one small carry-on filled with all of my clothes for two months.

I hope to hear from everyone while I’m away, so please send me an e-mail or a comment.
Love to all!