Archive | April 2012

Tanzania Day 1,2,3

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Third day in TZ. Now that I don’t feel like n octogenarian, I might be able to put together a few comprehensible sentences.

Flew into Dar on Saturday after a grueling flight. Had the pleasure though of sitting next to a group of jolly Hungarian engineers. They were being chaperoned by two Catholic priests who proceeded to repeatedly order whiskey shots for everyone in the vicinity. Catholicism has its finer points.

Dar is bustling. A port town, it is the main point of entry and exit for all goofs bought and sold in TZ. Not nearly as walkable as Blantyre, and not neatly as dangerous as Nairobi. It’s q good mix, plus there’s great Indian food for cheap. TZ has some great seafood.

Left Sunday to make the 20 plus hour trip to Rukwa. Odd seeing zebras and elephants from the highway, but frightening to see the remains of multiple highway accidents. Still, the roads here are far superior to that of Malawi, and the vehicles acceptable.

Road construction is happening at a breakneck pace here , even in the far reaches of nowhere. Trucks line the highways bumper to bumper signaling a rapidly growing economy. Almost everything is available everywhere and it’s only getting better.

Western TZ is gorgeous. Just saw a sign for Malawi. Only a few hours apart but worlds apart economically.

That’s all for now…

Shuji Watanabe, 1972 (?) – 2012

Shuji (on the right) with Maa

I just received news that my friend, Shuji, has finally passed after a very long fight with cancer. In the late 1990’s I lived in Osaka, Japan, a short period that turned out to be a major turning point in my life. In that time, I became friends with Shuji’s older brother Eizo, who remains one of my best friends to this day.

I would talk of deep conversations with Shuji, but the truth is that I only heard him speak once. Despite his apparent linguistic reticence, Shuji was no shut-in. He would kindly greet me with a wave and a nod whenever I saw him, would come out to shows that my band played, and generally treat me and every one else as a friend. Shuji was a constant mystery, though it was impossible to say that he was anything but kind.

The last time I saw Shuji was last year, when I was visiting Osaka, which, as would happen, was the single time I heard his voice. He was busy fighting cancer, but still made a point to leave the house and visit his friends. He had ridden in on a small motorcycle that a social services group had provided him to help him get around. I seem to remember that we chided him for not wearing a helmet.

Apparently, he maintained his quiet but outgoing demeanor until his final days. Eizo contacted me a few weeks ago and asked that I send Shuji a BULB Tshirt immediately, indicating that he wanted one. It’s an odd last request, but I was incredibly honored to do so for a good friend and a generally amazing guy.

I’m happy to have shared this earth with Shuji and happier that I had the opportunity to meet him. I’m sure that everyone he knows is thinking the same thing. He will be sorely missed on my next trip to Osaka.

Rabid bear attack in North Carolina

As an infectious disease epidemiologist, I am on various email alert lists (like this one) which provide news on that state of a number of different pathogens. This one was one of the strangest I’ve seen in a while.

Rabid bear attacks in Albemarle; shot dead by victim
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An attack by a rabid bear was ended by an Albemarle County farm worker’s point-blank shotgun blast, fired from the roof of a Gator utility vehicle, police said.

The bear killed Tuesday [17 Apr 2012] is the first-ever recorded case of a rabid bear in Virginia and only the second case on the East Coast that state officials are aware of, said Jaime Sajecki, bear project leader with the Virginia Department of Game and Inland Fisheries.

“€œIt’s almost unheard of,” she said.

Police believe the bear was drawn by the movement of two men, who were using the vehicle to move stones on a large farm northeast of Rockfish Gap, said county police Sgt. Darrell Byers.

The roughly 120-pound female bear first attacked the vehicle itself, biting one of the tires, before pursuing the men, Byers said.

One of the men climbed into the bed of the Gator, then onto its roof, taking a shotgun loaded with birdshot with him, Byers said.

The other man left the cab, but when the vehicle started to roll downhill, he leaned back into the cab to set the parking brake, according to Byers.

The bear had come into the cab and was climbing into the bed when the man atop the Gator put his shotgun to her head and pulled the trigger, Byers said.

No one was injured in the attack or directly exposed to the rabies virus, Byers said.

The bear was decapitated, and its head sent to a state lab, where it tested positive for rabies, according to police.

Officials will send the bear€’s body to Harrisonburg, where it will be incinerated at the state veterinarian’€™s office.

Sajecki added that, when possible, it’s best to shoot a suspected rabid animal somewhere other than the head, to avoid spreading contaminated tissue.

People encountering a bear should keep a respectful distance and enjoy watching it from afar, according to the department.

[Byline: Ted Strong]

Rabies is a viral disease that causes acute encephalitis. It is transmitted to humans mostly through animal bites, but has been known to have been transmitted through handling infected animal carcasses and contact with bat saliva. If not given prophylaxis immediately, it is almost always fatal. Rabid bear attacks are extremely rare.

Guest Blog (and post 300!): The Joys of Eating at the World Bank

My good friend Kathleen recently picked up a job at the World Bank. She used to work at National Geographic. Getting jobs at really interesting and amazing places is a symptom of having a great personality and living in Washington D.C.

Recently, she sent me a note telling me how great the food at the Bank is. This is the week of the World Bank/IMF spring meetings (please get me tickets) so, to celebrate, I asked her to write a short piece about it. Next time I go to D.C., lunch will be at the Bank, preferably with Kathleen and Jim Young Kim, listening to the beautiful sounds of an employed piano player two floors up.

Anyway, here’s her mouth-watering piece on eating at the World Bank:

Many office buildings house a small store where you can buy soda, gum, and chips. At the World Bank, that store has espresso, refrigerator magnets, and wine. The last thing I bought there was a cucumber, mint, feta cheese tabouleh wrap. And a bag of chips. Well, no, no chips.

The cafeteria at the Bank is famous. Google has an autocomplete for it. It has a Yelp page. You use real plates and cutlery. So grab a tray and come with me! The first station is called whole+sum. You pick a protein and two veggies. Today’s are

—Green Chile Chicken Stew with Potatoes & Peanuts
*Spicy Black Bean Chili with Lime Crema
—Fresh Tilapia in Rich Mole
*Poblano Brown Rice & Beans
*Farro Salad with Orange Cumin Dressing
*Cilantro Jicama Slaw
*Grilled Pineapple Wedge with Honey & Lime
*Sautéed Chayote
*Romaine Lettuce, Mango, Red Onions, Radishes & Buttermilk Avocado Salad Dressing

The asterisks above and the cards by the food indicate what is veggie and what has pork. Today’s general theme is Cuba. The “Global” station is serving “ropa vieja, pollo a la babacoa, moros y cristianos, yuca frita with mojo sauce, jicama salad with avocado, and ensalada rusa.” For the rest of the week we will be seeing jicama. They will work leftovers into the salad bar and sandwiches. (The World Bank building itself is built from buildings they’ve used since the 1940s. Use leftovers.)

The soup station has four kinds. Because this is the World Bank (did she just say “Je prends un bento box,” working three languages?), the stations are named South Asian & African, Pacific Rim, Quiche, Noodle Bowl, Good (“A new station that is good for you, your neighbor, the community, and the planet” that today features lemon herbed chicken, sockeye salmon with herbs de Provence, gingered ahi tuna, beef with cracked pepper and garlic, sage citrus pork [contains pork]), Mediterranean Flatbreads, Pizza, Deli, Everything Vegetarian, Sushi/Sashimi/Bento Box, Salad Bar. The desserts are what you would see at a Paris bakery. There is a frozen yogurt station. At the cashier station, there are cookies, apples, and wine. (I figure this is a French thing. It’s the second most-heard language in the hallways. France is a country that “graduated” quickly from being a recipient of funds to being a donor.)

Each station expands with ever-changing flavors. My Czech teammate, who is studying Chinese, often gets ramen at the Noodle Bowl. You get two or three noodles to choose from, two or three broths (today it’s red coconut curry or tom yum), chopped tofu and green onions, and all that stuff. Three kinds of flatbread at that station. Ever-rotating African street/comfort food.

The building takes up an entire city block. The dining hall nearly does. Because the selections are so many and the dining room so vast, there is a waiting area just past the cashiers. I don’t know how the cashiers do their job, but the food is simply and very reasonably priced (often by whether or not there is meat) and the cashiers are reliably cheerful.

They have eliminated single-serving condiment packets; the waiting area is where you get Sriracha for your noodles, vinegar for your pommes frites. The takeout containers and cutlery are biodegradable.

The walls of the main dining room feature doors of the world. They are beautiful, painted, carved, mostly wood. Many must be surprised to find themselves in a D.C. basement after so many years on a farm in Kazakhstan or a temple in Malaysia. If you don’t want to eat in the main dining hall, you can eat on a bridge over a pool or on a mezzanine. From the mezzanine you can enjoy the sounds of a player piano two stories up.

The diversity continues: There are children. The Bank has daycare and many kids get to have lunch with their parent. Got a picky eater? Take him to the World Bank cafeteria.

Pictures of US Soldiers with Corpses

Recently, a scandal has erupted over pictures of US Soldiers posing proudly with the corpses of dead Afghan fighters. I am reminded of a flight I took last year from DC to Detroit. I sat next to a man from a town close to mine who was returning from Iraq. He indicated that he had been working in a training position for the military in Savannah for the past few months, but was now 100% DAV. He was returning to his wife and an unsure future, though he gets reasonable benefits and full health care.

I have met a lot of these guys and some have even been my students. They are usually pretty sharp, follow instructions to the letter, work incredibly hard and will help out other students when needed. I can usually tell that something is wrong though, particularly if they don’t show up for a couple of weeks.

I was interested in getting his opinions on a small spatial project I had done on conflict events in Iraq and showed him of the maps I had made. He was only moderately interested but answered my questions as to what was where in Baghdad and why some areas are harder hit than others.

In return, he showed me some of his pictures.

The man was personable, but guarded, though he happily showed me pictures of him and his buddies posing with the bodies of Iraqi insurgents. He even laughed at a few of them and remarked that there were good times to be had in Iraq. After a few minutes, he must have realized the public nature of an airplane and quickly closed them up. It was interesting to me that he would carry them around with him in a marked folder.

I can’t claim to understand what happens in war. I have seen what war does to its participants, both soldiers and civilians. I do fault the better judgement of people that pose with bodies, though am interested in a culture of violence that would allow humans to revel in it.

I am drawn (again) to Amartya Sen’s work on the nature of violence and its relationship to identity, a concept I often think about. He posits that violence is only possible when the objects of attack are reduced to compartmentalized categories that remove all others. These photos, which are strikingly similar to that of the widely popular lynching photos in the United States, are no exception. American soldiers gleefully posing with corpses view them not as someone’s son, friend, father or neighbor, reducing them only to one single facet of their true identities. Sen would argue that the true crime is not the violent act itself, but the violence of stripping away the individual identity of the recipient of violence.

Photos of soldiers posing with bodies, though, is at least as old as the camera itself:

Emerging Drug Resistance in Thailand Threatens Malaria Eradication

The Lancet recently published the results of a longitudinal study examining resistance by malaria parasite to the latest and most effective treatment for the disease, Artemisinin Combination Therapy (ACT) along the Thai-Myanmar border.

Parasite clearance rates increased from a mean half life of 2.7 hours in 2001 to 3.6 hours in 2010, indicating that resistance is growing. Resistance was originally observed on the western side of Cambodia, but has now either spread geographically to western Thailand or emerged on its own. The latter scenario is actually the more frightening possibility. If resistant strains emerge in Sub-Saharan Africa, it could be a major setback.

Though research to develop new drugs is ongoing, ACTs are presently the most effective treatment and a major part of the arsenal with which to stop transmission and prevent early childhood death. Past treatment strategies are now largely ineffective.

Vaccines are also in development (most notably the RTSS vaccine), though I have little confidence that it will be of much use for long. It is a long series of shots and difficult to deliver in areas where medical delivery is poor or non-existent and efficacy is strain and context specific. Malaria vaccines are nice in the popular press, but impractical on the ground.

That resistance is growing in this particular end of the world, is in itself significant. Both regions are notable for poor health delivery, sporadic armed conflicts and marginalized populations. Efforts to contain the spread of resistance are likely futile. Even in the best of times, adequate delivery of care and prevention strategies are near impossible. Displacement of people due to conflict always provide ample opportunities for infectious agents, poor health and death. Tens of thousands of people languish in refugee camps along the border.

The subject of resistance in this region comes up often in meetings of malaria researchers, though I am always struck at the absence of discussion of social factors and conflict and how they create conditions favorable for the spread of resistant pathogens. It is no accident that malaria occurs in the places it does, and no accident that resistant strains of Plasmodium are able to fester and evade efforts to reign it in. It is almost as if the malaria research world believes that genetic adaptation happens at random, which it does not.

Discussion of malaria eradication cannot proceed without discussion of how to eradicate worldwide conflict, entrenched poverty and proper delivery and access to basic health care and the global forces which create these conditions. Yet it does.

Medications, vaccines and preventative interventions cannot work if there is no way to delivery them, and people cannot access them unless there is a local economy with which to support such a system. Malaria research has to address this fundamental issue or we’re just talking in the wind.

Jim Kim is Named Head of World Bank

Dr. Jim Young Kim, former President of Dartmouth, has formally been named as the next head of the World Bank. It marks the first time that a Michael Jackson impersonator has been chosen to lead an international development organization.

The naming of Kim is somewhat anticlimactic. Jeff Sachs made a very visible appeal to the position, travelling around the world and obtaining the endorsement of high ranking figures in countries suchs as Kenya and Costa Rica. When the short list of candidates came out, which included Larry Summers, it was obvious that the Obama admin hadn’t even considered Sachs at all.

Kim was quickly named following the rejection of Summers by European members of the World Bank’s administration. Former and current executives at the Bank called to offer the position to either Ngozi Okonjo-Iweala, Nigerian Finance Minister or former Colombian Minister of Finance Jose Antonio Ocampo, both appropriate candidates.

Kim’s appointment is important as it represents the first time that developing countries had any say in who would lead the Bank. The influence of the BRICS is rising, and clearly with good results. The United States will likely be a dominant world power for decades to come, but it’s waning influence should be a welcome change.

Despite so much discussion world wide, it was disappointing that Kim would be offered the job to such little fanfare though this too, could be indicative of America’s more seemingly humble facade on the world stage. I believe that Kim will likely be the last American appointee for a while, though applaud his appointment.

Kim will make a fine leader for the Bank. Let’s hope that he leads it well.

I received the following from an unnamed source.

Statement from Jim Yong Kim

Date: April 16, 2012

Dr. Jim Yong Kim today released a statement in response to his selection by the World Bank’s Executive Directors as 12th President of the World Bank:

“I am honored to accept the Executive Directors’ decision to select me as the next President of the World Bank Group. I am delighted to succeed Robert Zoellick, who has served with excellence and distinction during the last five years, and I am grateful to the Bank’s member countries for the broad support I have received.

I have spoken with Minister Okonjo-Iweala and Professor Ocampo. They have both made important contributions to economic development, and I look forward to drawing on their expertise in the years to come.

It is befitting that I conclude my global listening tour in Peru. It was here in the shantytowns of Lima that I learned how injustice and indignity may conspire to destroy the lives and hopes of the poor. It was here that I saw how communities struggle to prosper because of a lack of infrastructure and basic services. It was here that I learned that we must raise our sights to match the aspirations of those most excluded. And it was here that I learned that we can triumph over adversity by empowering the poor and focusing on results.

As President, I will seek a new alignment of the World Bank Group with a rapidly changing world. Together, with partners old and new, we will foster an institution that responds effectively to the needs of its diverse clients and donors; delivers more powerful results to support sustained growth; prioritizes evidence-based solutions over ideology; amplifies the voices of developing countries; and draws on the expertise and experience of the people we serve.

My discussions with the Board and member countries point to a global consensus around the importance of inclusive growth. We are closer than ever to achieving the mission inscribed at the entrance of the World Bank – “Our Dream is a World Free of Poverty.” The power of this mission is matched by the talent of the World Bank Group staff. May this shared mission embolden our efforts to end the disparities which too often diminish our shared humanity. Let us work together to provide every woman and man with the opportunity to determine their own future.”

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