Counting down

I've wanted to write several times, but unfortunately my laptop crashed because of a virus, overheating, ants and old age. This oldie is now super slow. I cannot open or edit any documents anymore, but I did figure out I can write a new update directly onto my blog page, because I can go online if I have a lot of patience. I wanted to do that several times, but work happened. And I went on a weekend trip. And when I came back it was as if I never left, because there was so much work again. Now, 1.5 week before my departure, I have a little time to give you guys an update.

So yes, a lot of work related stuff. The most exciting phase of the study started. All our participants were previously vaccinated with either the malaria vaccine candidate or the control vaccine (which is a rabies vaccine). Three weeks ago it was time for the controlled malaria challenge, which means all participants got parasites (sporozoits) injected, directly into their bloodstream. That sounds really scary, but you have to remember that the people here have been infected with malaria multiple times when they grew up, and are already semi immune. The thing that worries them the most is if they get their money in the end. Oh, and they are all a bit scared of needles. What I think is very interesting is that is all happens without too much secrecy. I, as a biomedical scientist, work in the lab, but I was allowed to be present when the sporozoit injections happened, including the sporozoit preparation in the lab. The lab was closed for all other people because of safety reasons/protocol. There were 4 people working in the lab, checking each individual sporozoit syringe for accuracy. The protocol was read out loud to prevent making mistakes for each syringe. That means 35 times. They were communicating with the doctors with walkytalkies, because once a syringe is prepared it is only stable for 30 minutes. I was also allowed to see the injections itself. I could talk to the participants. I can also go on field trips, I know where they live. If I try hard, I could know their names and their study ID (which is actually there to secure their privacy). Sometimes participants recognize us when we go out for dinner and they come to say hi.

Discovery of the month:
this is the difference between cold and room temperature urine.
No panic. Everyone is healthy.

Field trip

Field trip

Lunch with the GMZ team

Sporozoit preparation

Sporozoit preparation

Sporozoit injection

Dinner after the malaria challenge

Since day 5 after the injections we see all participants every day. We take a tube of blood for later detection of DNA and RNA from the malaria parasites, and we make a blood smear on a glass slide for microscopy. We do the microscopy on the same day, to see if they have developed malaria already. It takes about 10 minutes to 'read' one slide, and every slide has to be read by 2 readers. When their results are similar its okay. When there is a big difference in parasite counts we need a 3rd reading form an expert reader. Since I am an expert reader I am allowed to do third readings, but most of the time I help with the first of second reading. We are now at day 25 after sporozoit injection, and so far 15 people got malaria. Once they have symptoms and their blood is positive for malaria parasites we take a whole bunch of blood samples for analyses and give them a 3 day treatment. Usually they are already negative for malaria the next day. It is also possible that they are already positive for malaria but don't have symptoms yet. In that case they go back home and we wait. If we are unlucky they start having symptoms in the middle of the night and we all get called out of bed to start working. I have the night shift this week, but no phone calls till now.

Besides all the working I have also made a decision. I'm coming back home and I will not come back to Lambaréné to work here as a PhD candidate or any other position. I think the institute has very interesting studies, but I don't feel at home here. It's kind of isolated, and I guess I'm a little spoiled too. I miss the close by supermarket, warm shower, washing machine and always access to decent speed internet. I am still not really good at French, which is definitely something that is holding me back from feeling at home here. But since I already decided not to stay here I cannot find the motivation to learn more French. So yea. But being here for 3 months was definitely a very valuable experience, since I got to do, see and experience many things. I made some important decisions too. Everything will fall into place :).

For a moment I thought I would no see anything else than the institute and Lambaréné during my 3 months here, but 2 weeks ago I was asked to join a group of girls (all colleagues and their friends) to go camping with an ecotourism organisation. At first I said no, because I had to work. But than I thought; if I don't go now, I will not see anything else of Gabon. So I started arranging things, asking people to take over my weekend shift, and thankfully they did. It didn't go smoothly, but that's not important. In the end I got to leave. We left by boat, and soon after we left my phone was unable to connect to any networks, so yaaaay. No messages, no phone calls, nothing. Although I kept thinking about work.

Fruit bats under the bridge

Monkeys!

Pelicans nesting in trees

Hippos

It took about 1.5 hours to reach the island in the lake, called Tsam Tsam (named after the sound a small stone makes when you let it bounce over the surface of the water). On the way we saw hippos, moneys, birds (pelicans nesting in trees, that was an interesting sight). We also crossed a big lake, one of the 4 big lakes in the country. Our guides (a Gabonese guy and his American wife) told us that ever lake has a genie, a spirit. And you have to wash your face with the water from the lake before you cross it, otherwise bad things will happen. So we all washed our face. Eventually we reached an island in one of the smaller lakes. Because the rainy season is just getting started the water level hasn't risen much yet. The island has several platforms on poles with tents on them. Usually the water is almost as high as the platforms, but now there was a little beach below. We enjoyed our stay so much! There were comfortable chairs and all of the food was arranged for. 

So tired. I just fell asleep..

We went on 2 walking tours to spot wildlife. Sadly we didn't see any animals, but we did see many traces. Elephant tracks, mud on trees where elephants passed, gorilla poop. Our tour guide, who was born in this area, also showed us some of the trees that have their purposes in traditional ceremonies. Like this one tree with reddish fluid inside. It looks like blood, so it is used as medicine for people with anemia. It's a very special tree. You have to ask it if you can take some of it's juice by cutting of a piece of the bark. By the way it falls you can see if the tree says yes or no. Of course you also bring the tree some offers, like food and drinks. If the tree says no you can try again. But if it says no the second time you have to find yourself a different tree. After you've collected the juice you have to say thank you and close the 'wound' by rubbing sand on it. That will actually stop the 'bleeding'. There was also a very big liana with a lot of water inside. If you cut it you can drink from it, which we did. It tasted a bit funny, but I can imagine it can be very useful. 

Our tour guide (I don't know how to spell his name..) also took us to the village where he was born. We met his father and his grandmother. The grandmother was complimenting us at first, because we (all 8 girls) look so pretty. Then she warned Heather, the American woman, that her husband will marry all of us, because that is what her husband did. He married 5 other women after he married her. They showed us how they prepare the smoked fish, how they signal with drums to the people on other islands (different signals for 'Elephants!!' and 'Hey, come over. I wanna talk') and what plant they use to get high during ceremonies. It was very interesting. In the evenings we had amazing dinner with fish (yes I ate fish. And I also ate meat. This is the end of my vegetarian era. Oh well.. 1 vegetarian year). And afterwards we played werewolf around the campfire. We slept in tents, and I slept so well. I didn't realize I was so tired from all the working. Starting at 7 or earlier for at least a month, and working till at least 7pm every day, also during the weekends. So this was a well deserved trip I guess :). 

The Elephant Alarm System

The Ninja Game

This is a nest made by a fish.. but this is the dry season.

I hope I can upload the pics later, because the internet is shit again. I will be back on the 25th of October, freezing to death in my beloved but cold home country. I'm looking forward to warm showers. Or bath tub even! And on the couch with many pillows and blankets and a cup of hot chocolate and cream :)

So here is an update: it is already the 8th of December. I've been back in the Netherlands for over a month, and I have settled again. Thanks to my brilliant uncle my laptop survived. Or revived, actually. And I hate to leave things unfinished, so I decided to upload the last pics and write the last bit of the story.

After Tsam-tsam I still had a 3 weeks to go. As I already mentioned before, it was as if I never left when I came back, because we still had loads of work. Slowly but surely the participants got malaria and dropped out of the study, so we had a little less to worry about. Since I was going to leave soon I had to make sure everyone could continue after my departure, which was actually a bit complicated, since my laptop wasn't working. I was also trying to look and apply for jobs (on my phone!!) and I had an interview as well. I also went to the Canadian hospital where we - Julie, Angelique, Anita and me - got a tour from Sabine, who works there. The hospital looks much better organized than the Schweitzer hospital, but Sabine also mentioned they actually need more doctors. When doctors graduate they are placed at certain hospitals where they are most needed, but everyone wants to stay in the capital and they just don't go. Which is really sad! The group also convinced me to go dancing on Saturday night in Isaac. I was surprised to find people dancing with their own reflections in the mirror. Seriously. There was this bar with a wall full of mirrors. And people just stood in front of it and made really sexy moves. It was so strange, but apparently this happens everywhere. Angelique also told me people are really scared of mermaids in Gabon, and they are not supposed to have a reflection.. Right. And last, but not least, I started organizing my farewell party. I've been told my farewell party was the best house party in months! There was food, music, dancing, a bit too much alcohol if you ask me, but hey.. people enjoyed! I got gifts; a collage with personal messages written on the back, and a Gabonese dress. On the last day I really had to say goodbye to everyone, which was more difficult than I expected. I was looking forward to go home, but I also got so attached to the people there. So if they read this, I am still missing you all!! 

Okay, I will just leave you with the last few pictures from my trip to Gabon. Love you guys!

Watching the Lion King in Gabon

The multidrug resistant TB section