Lumo

Before coming out here I had to complete an exhaustive fieldwork risk
assessment detailing every activity I planned to undertake and how to
minimise the risks that it entailed. When it comes to transport I am
supposed to travel only in well maintained MRC cars driven by a
reputable driver. Travelling by mule cart would not, I expect, have
been an alternative acceptable to Rothamsted's health and safety
adviser.

Shivonne and I had Sunday off and decided to visit the local lumo or
Sunday market. As this is held in a field some distance out of town,
and as our drivers also had Sunday off we went the local way, on a
two-wheeled metal frame to which a few wooden slats had been attached
which doesn't really deserve to be dignified with the name "cart". We
tried to pick one pulled by the healthiest looking mule we could find
- most of the horses, donkeys and mules here are in shocking
condition, emaciated and with open sores on their sides. It seems a
bit silly to care about the condition of the animals here when the
people are living in poverty, but the people look happy and the draft
animals certainly don't.

We hopped up onto the cart and set off, picking up more passengers on
the way. I tried to take a photo of the driver but as I did so he
whipped his mule. The poor beast put on a sudden burst of speed and
the cart lurched, almost making me drop the camera. I decided to
concentrate on holding tight from that point on. After a
bone-rattling ride we reached the lumo and clambered unsteadily down.
I went forward to pay the driver and the cart promptly ran over my
foot. Thank you Roxana, Imogen, David et al., without those army
boots I'm sure I would have broken it but as it was I just felt a bit
sore and like a total tit. Note to parents: I will not do this again.

The lumo seemed packed and chaotic, and it was often hard to tell who
was the customer and who was the vendor. Sacking and tarpaulins were
strung overhead for shade, often a few inches below headheight, so I
spent much of the time stooping.We quickly discovered that there was
an underlying order though, clothes here, homeware there, car parts at
the back, vegetables at the front and next to them the dried fish
section which we steered well clear of because of the smell. I
bought a cooking pot (there was only one in the kitchen), some
homemade local soap which looked nice but turned out to be incredibly
harsh, some veg and a pretty headscarf (I could really get used to
this fake Muslim thing) before finding another cart to rattle us home.
This time we didn't have such a choice of horses and the poor beast
we picked was in very bad shape and farted all the way back, not great
for the passengers downwind.

At least I assume it was the horse, I suppose it could have been the driver.

Setsetal

One of the things a naive European visitor to The Gambia (such as
myself) finds most shocking is the rubbish strewn by the roadsides -
plastic bags, tin cans and other unidentifiable detritus mingle with
animal filth and the occasional rotting cow or horse carcase,
contorted and bloating in the sun. It's enough to make a naive young
entomologist realise that fly control may be more of a challenge here
than she had thought.

The drivers simply fling their used bottles and wrappers from the car
windows. One of the workers here has instituted a rubbish bags in
cars policy, but it does seem a bit pointless as as far as I can tell
there's no rubbish collection here - the cleaners would just take the
bags out to the bush anyway.

The President is apparently also not a fan of litter, but instead of
providing rubbish collection and recycling facilities he has
designated the last Saturday of every month as a Setsetal or clean up
day. Everyone in the country is meant to stop whatever they're doing,
indeed you can be arrested for driving between the hours of nine and
twelve, and clear up litter. I'm not sure what you're then supposed
to do with it, but I saw a lot of smoke and smelled burning plastic on
Saturday.

There is actually a form of recycling in operation here; the children
will pick up anything they can possibly make toys out of. I've seen
broken glasses frames, machine parts, a tin can lid fastened to a
stick with a rusty nail - anything sharp or broken or dirty that would
give a British mother nightmares the kids'll pick up and probably put
in their mouthes. I actually snatched a rusty wire coat hangar away
from a small boy because he was trying to stick the end in his ear,
then gave it back because he'd probably only have gone and started
playing with a razor blade instead or something. This recycling
actually worked in our favour once, when the landrover broke down in a
village. My knowledge of cars doesn't go much further than the fact
that you push the pedals and magic pixies under the bonnet make it go,
but apparently a wire had snapped. OUr driver asked one of the
village elders for help and explained what he needed, the elder
whipped a wire out of the mouth of a passing child and bingo, the
magic pixies started working again.

The problem is I think that Gambians are used to using materials that
do break down when they're discarded; houses are built from bricks cut
from the earth in pits outside the villages, and roofed with reed
thatch or palm leaves. The spiny, grey-purple stems of the same palm
make a goat-proof fence, neatly tied with bark ropes. Halved gourds
are used to serve food alongside the new enamel dishes on woven grass
mats. Gambians are accustomed to using things taht will return to the
earth if left outside for long enough, and simply have not yet adapted
to the fact that plastics will not do the same, but then again it's
not like we've got used to this fact either. When something is built
or made in the west no thought is given to how it can eventually be
disposed of, the only difference is that it goes somewhere we can't
see and don't have to think about. So of course a far more sensible
solution than leaving rubbish lying around the countryside where it
won't biodegrade is to dig a big hole somewhere out of sight and drop
it in there where it won't biodegrade. Because our system is
obviously far more sustainable.

Sprogs and swabs

On Thursday I finally got to start the work I'd come here to do -
taking samples from the eyes of kids with and without trachoma. The
first step was to actually find some kids with an active trachoma
infection, and to this end Shivonne (the doctor volunteering with the
project, who is the one actually poking the kids in the eye), The
Professor and I drove out to screen some local villages. On the way we
picked up our fieldworker, who is the spitting image of Samuel L
Jackson and so that's what I'm going to call him from now on. This
bloke is incredible; he's been working on the trachoma project for
some time and is able to identify Muscids in the dark and identify the
signs of trachoma from 500 metres. I exaggerate slightly but
certainly he should be the one getting the PhD, not me.

The children were summoned, lined up and the Samuel L turned the upper
eyelid inside out and checked for visible signs of infection. This
isn't painful but it is quite an unpleasant sensation and although the
kids didn't enjoy having it done to them very much they thought
watching it happen to others was brilliant entertainment. Some of the
older boys, unbidden, took it upon themselves to capture their
screaming peers and drag their sacrificial victims to the examining
stool. Some kids fought all the way, some looked resigned, some seemed
to enjoy the attention, some bawled as soon as they looked at us and
one little girls stamped up to the stool, crossed her arms and scowled
at Samuel L through the whole procedure before stomping off again with
a "hmmmph!".

Some of the kids struggled so much they had to be held down, which
made me feel rather uncomfortable. There's a rather different
attitude to discipline here - in Britain a crying child undergoing a
procedure like this would be comforted, here they were physically
restrained and often thumped or hit with switches if they cried, which
apart from being unpleasant to watch was rather counterproductive as
it just made them squirm and fight more. Usually it was the mothers
who held the children down, but in one village the Alkalo or headman
took on the task and performed it with a gentleness that I found very
moving, soothing instead of chiding and gently stroking the children's
eyelids closed with his thumb once they were done.

When not being sampled the kids were great fun, scared at first of the
white people but quickly gaining courage. One little girl in
particular stands out in my memory; four or five, shy at first, when I
smiled at her she came up to me and held out her hand. I shook it
gravely and she beamed, then started dragging other children forward
to shake my hand. As we left she shouted what sounded like "Send me
email!", and as neither Samuel L or our driver knew of anything in a
local language that sounded like that I can only assume it's what she
said. I doubt she could read or write, there was no electricity let
alone a computer in her village and as I have discovered internet
cafes are incredibly scarce here, but someone muct have taught her
that phrase and she wanted to stay in touch.

As we pulled out of the last village I saw two boys playing at doctors
trying to turn each others' eyelids inside out.

Having identified suitable clusters of trachoma, we returned the next
day to actually take the tear samples and the swabs that would tell us
whether the children had an active trachoma infection. (The symptoms
of trachoma can ake a while to develop and so can lag behind the
presence of the bacterium, and may persist once the infection has
cleared, so what you see on the childrens' eyelids may not correspond
to what you see with a PCR test for the presence of C.trachomatis
DNA). Shivonne took swabs by rubbing a cotton bud on the inside of
the eyelid and stciking another cotton bud up the children's nostrils
- I was amused to note that some of the dirty little perverts seemed
to rather enjoy this step. After the procedure was completed the
children got a "mintie", a boiled sweet, and it was amazing to see how
a child who had been crying inconsolably a second earlier suddenly
quietened down when a twist of luridly coloured cellophane was
deposited in their mitt.

Next to one village The Professor spotted a rocky outcrop rising a
good thirty metres into the air, unusual in a country that's mostly as
flat as me in a bikini. He asked the local villagers about it with
rather unsatisfying results ("What do you call that?" "A hill.") and
was informed that some missionaries had once climbed it, in a way that
suggested that this was only one of the crazy things missionaries did.
Not wishing to be beaten by missionaries he immediately decided that
we should do the same.

By this point in the day I had a thumping headache (usually we found a
place to sit in the shade for sampling, but something had gone wrong
in thelast village and we'd spent the afternoon sitting in full sun)
and couldn't think of anything less appealing than scrambling thirty
metres up baking rocks, but The Professor is a very singleminded man
and I don't think anything less than a stampede of hippos would have
stopped him. I reached the top feeling pretty awful and had to sit
for a few minutes with my head between my knees. Then I looked up and
the climb was suddenly worth it - the view was amazing with lush
swampland to the south soaking into the river Gambia and stately palms
rising above the dusty plains to the north, and the the thatched roofs
of villages we had visited dotted all around is.

Coming back down I snagged the back of my shirt on a rock and Samuel L
had to free me. He then decided it would be helpful to hold the back
of my shirt up and out of the way all the way down, so we came of the
hill like a slightly surreal bridal procession.

We set out again the next day and repeated the sampling operation.
More villages, more children, more screaming and smiles, resistance
and resignation. In the last village we met the Gambia's answer to
Richmond's pushy mothers. In Britain this woman would have been the
first to fake Christianity, move in with her sister to get into the
catchment area, anything to get her son into the right school. Here
she was determined that he should be included in our study. She dug
out his clinic card and kept trying to give it to me, and even went as
far as lifting poor little MOhammed onto the sampling bench ahead of
the other children we'd picked - Samuel L would then argue with her
until she took him away to make space for our sampling subject, then
she'd try it again when we changed child. Pushiness works -
eventually we included Mohammed in the control group just to give
Samuel L a quiet life. I took a picture of Mohammed, which I'll
upload when I get somewhere with a good enough connection. I'm
surprised she didn't ask me to print it out and frame it.

Coming back The Professor treated us to lunch at a small shack
restaurant next to the Kerouan bus garage, or rather treated everyone
else as I had no idea how coeliac-compatible the rich, spicy-smelling
stews were and declined. It was pleasant sitting in the shade under a
tree by the garage, even if the diesel fumes were occasionally a
little overpowering, and though the food smelled wonderful I was
really too hot to feel hungry and so didn't feel I was missing out.
In fact as I watched a pair of grubby small boys washing their hands
in the uncovered water bowl used for cooking I was suddenly glad I
hadn't eaten anything.

We have a few more vilages to sample, and then start the fly work on Monday.

The Missionary Position

After a variety of sickly soft drinks containing enough tartrazine to
send a whole class of eight year olds hyperactive, the most popular
drink in The Gambia is attaya, a very sweet, frothy green tea. There
are rituals around the making of it, involving pouring it from glass
to glass to make it foam, and around the drinking of it; the first,
weak cup is for the children, the second for the women and the third,
after it has stewed for some time, for the men. It's not unpleasant,
once you get used to the fact that it's brewed in what is basically a
saturated sucrose solution, and it gives you a welcome caffeine kick
in the soporific, scorching afternoons. The trouble with attaya is
that it's the reason I can never get a bloody shower.

I am staying at the Catholic Mission in Farafenni, as the missionaries
have all left now and are renting it out to the MRC. The compound
gets water twice a day, in the morning and evening, and this is pumped
into two storage tanks held high above us on scaffolding towers. In
theory this should mean that there's running water on tap, as the
water in the tanks should last until the next time it's available to
pump. In practice however the compound guard station is situated just
next to the tanks, and when they fancy making attaya they open the
storage tank drain tap to fill their kettles rather than walking the
extra ten metres or so to the water tap. As they usually forget to
close it again the water drains away, and then we have no water until
the next pumping period. Apparently there is nothing that can be done
about this, as every other firm of security guards in Farafenni is
crooked whereas ours are just incompetent, but coming back from a
dusty drive to find there is no water is enough to make me wonder how
bad the others could really be.

The guards' other job, apart from failing to open the gate when we try
to get back into the compound, is to switch between generators. We
have 24 hour power here to keep the sample freezers running, but it is
only provided by the grid for a few hours a day. Because of the
timings the guards have to switch on the backup generator at three
ever morning, but they will not do this unless someone wakes up at
three to tell them to, no matter how many alarm clocks they're
provided with.

Staying here is a strange mixture of hardship and luxury. Water is
scarce and the fan in my room doesn't work, so I'm typing this in the
coolest place I can find, the senior kitchen (or rather the "senior
chicken" as it says on the key fob). On the other hand we eat off
fine china and silver tray; the visiting Bishops, coming to check on
how the conversion of the heathens was progressing, apparently liked
their home comforts. I have a fridge in my room, although it's
currently full of dirty dishes that I haven't been able to wash up
without water (it's the only way to stop them smelling). We also have
the amazing Sarah, who comes in to clean our rooms and somehow manages
to leave everything spotless with barely any water, no mean feat given
the thick red dust that settles on everything. She will also take
away your filthy clothes every morning and return then, immaculate,
ironed (no Tumbu flies for me!) and neatly folded, in the early
afternoon. She even managed to get the Deet stains out. I think I
could get used to this.

Driving up to Farafenni I needed a bush, the African equivalent of a
Starbucks, and had no sooner started performing my official business
when I felt a sharp pain in my left buttock. My first thought was
that I'd been bitten by a snake and that I was just going to have to
die from it as the alternative was asking my driver or the Professor
to suck the poison out. Fortunately, or perhaps not, it turned out
that I had simply flooded a red ants' nest and they were now biting me
in all sorts of amusing places and indeed everywhere else. It took a
great deal of thrashing and a fair bit of nudity (luckily it was a
very secluded bush) to dislodge the majority them, and I was still
finding them in my hair several hours later.

The wildlife at the mission is rather friendlier. Jewel-bright yellow
and blue lizards bask on the trees and scuttle across the verandas and
the ground is pitted with ant lion traps. There are three potter wasp
nests on the bathroom doorframe too, but they seem to be abandoned at
the moment. The mission also has two semi-feral cats, Clair (mostly
white with black bits) and Vas (Mostly black with white bits), named
after two previous researchers here. Claire is the friendlier of the
two and keeps trying to get into my room, but I have a policy here of
not getting too friendly with anything that could give me rabies or
fleas and have learnt to open the door very quickly and make a dash
for it before she goes between my ankles. This mode of exiting my
room does of course look ridiculous when there's no cat outside, but I
just have to live with that.

The strange thing about Claire and Vas is that half-starved, scrawny
creatures that they are they're just as fussy about food as a pampered
pussycat back in the UK. The first time Claire ambushed me she did
get into my room and under the bed, and proved impossible to
extricate. I was finally forced to make up some dried milk in a tin
to tempt her out, and although she followed it outside she took one
lick of it then turned her nose up and walked away. She also refused
to eat a perfectly good dead yellow and blue lizard. I know that it
was a perfectly good dead lizard because it was a perfectly good live
lizard until I didn't look where I was going and put my fat hoof on
it.

Anyway, shower time, let's see if there's water today.

Shaken and stirred

It's something of a cliche to say that travel in developing countries
makes you appreciate things you had previously taken for granted, but
it's said so often becaus eit happens to be true. Clean water.
Internet access. Roads with more flat surface than pothole. The road
to Dakar had so many potholes in that leaving it altogether and
driving cross country would probably have been a smoother.

I went to Dakar in search of solvents - another thing that I have come
to appreciate is things turning up when people say they're going to
turn up, as the six litres of hexane I had ordered a month before
coming had somehow failed to materialise at MRC Fajara. Such things
aren't available in The Gambia so I got to see two west African
countries for the price of one and head to the Senegalese capital
Dakar, where The Professor remembered a shop selling lab supplies and
reagents. I found this quite remarkably as I don't think there's
anywhere in London where you could just walk in off the street and buy
a couple of litres of analar grade solvent.

I'm still accompanied by one of the world's leading experts on
trachoma, over whom I fortunately failed to vomit on the flight. I'd
met him in the UK before and found him rather shy and awkward, but the
transformation here is amazing - he seems far more at home in The
Gambia than he did in London. Everyone here calls him Professor. At
first I assumed that they called all white people that, but I have
since realised that he does actually know every single person in The
Gambia personally. So I'm calling him The Professor in this blog too,
mostly so he never finds out that I called him shy and awkward.

Dakar appears to be one huge traffic jam with a city wrapped around
it. The locals see this as a business opportunity rather than an
inconvenience though, attempting to flog sim cards and cheap watches
to the vehicles' captive occupants. We arrived at twelve to discover
that Fermon, the lab supplies shop, didn't open until three, so went
for some lunch. We got chatting to the restaurant owner, who asked
where I was from. She was very surprised when I said I was from
Britain, and said she'd never have known I was English from my accent.
I felt very flattered that my French was so good until she added "I
thought you were German".

Dakar is a curious blend of French elegance, vibrant African
streetlife and abject squalor. We visited an air conditioned, marble
tiled patisserie that wouldn't have looked out of place in Paris and
were served by elegant women in crisp uniforms, then stepped out on to
a street lined with beggars, most of whom seemed to be missing at
least one appendage. My headscarf, which had worked like a charm in
The Gambia, suddenly meant I got the worst of it.

I've been wearing a headscarf since I got here, not only because it's
a Muslim country but because it keeps the sun off my ears and neck. I
put it on at the airport and it was like flicking a switch,
immediately stopping men from hassling me. It's also gone down very
well with the local staff, who The Professor says are very impressed -
certainly everyone's gone out of their way to help me. There are
downsides though, I'm tying my scarf the Arabic way rather than the
West African way just because that's the only way I know how to do it
but I've discovered that here wearing it this way apparently means
that I've been to Mecca. The Professor finds this hilarious and tells
anyone who asks that I have indeed been - I'm dreading the day when I
meet someone who speaks enough English to ask what it was like. There
are also certain things that the local people would forgive a "toubab"
for, but expect a "Muslim" to know better - I got a filthy look off a
woman for handing her the hat she had dropped with my left hand. And
in Dakar the beggars expected more charity from a "Muslim" than from
the others, following me down the street tugging at my headscarf and
shouting at me to remember my obligations.

We returned to Fermon at three, and over cold Fantas purchased a
bottle of solvent for the equivalent of seventy pounds, more than
twice what we would have paid in the UK. I hugged it on my lap like a
baby all through the bone-rattling ride home.

MRC Fajara

I'm accustomed to waking to the Hounslow dawn chorus; the scrape of
metal on metal of the next door shop's ventilation fans, punctuated by
the sporadic roar of planes overhead and with a baseline provided by
the rumble of traffic. So it was a pleasure this morning to wake up
to the hoots and shrieks of Fajara's exotic birdlife. Some of the
calls didn't even sound like birds; it took quite an effort to
persuade myself that there are no monkeys here, but I'm certain that
there are no squeaky wheels or wobble boards in the mango trees
outside my window, however insistantly my ears may tell me otherwise.

Today is a public holiday in The Gambia, giving me a chance to settle
in before starting work in earnest. (Tomorrow may also be a public
holiday but this hasn't been decided yet - presumably it depends on
how hard the people who make these decisions party today.) My main
task for the day was therefore to change some money and to this end
one of the MRC drivers, Omar, picked me up at ten in the MRC jeep.

The journey into town was picturesque to say the least, past scenes
that I'd only seen in National Geographic magazine. Donkey carts
shared the road with trucks seeming to defy the laws of gravity with
impossible amounts of baggage pled on topof them, and with people
dressed in vibrant waxcloth hefting equally improbable loads on their
heads. The buildings appeared to be in the process of either
construction or disintigration and sometimes both simultaneously, but
gaily flapping laundry hanging from balconies showed them to be
inhabited. Splashes of green were rare in that dusty red landscape
but insted sprays of red or purple hibiscus flowers hung over the
whitewashed walls. The smells too were incredible; sunbaked earth,
roasted meat, unwashed bodies, dung, diesel fumes and underneath it
all the tang of the sea. This cocktail should have been unpleasant
but I actually found it triggered pleasant memories, of festivals and
childhood holidays on the Isle of Wight (I'll let you guess which
smells were which).

Sadly I seem destined to be an observer rather than someone who has
much interaction with the local people for some time yet. My
relationship with Omar feels rather awkward - I forgot about the
formalised greetings (a scripted exchange of "How are you?" "Well"
"How is your family?" "Well, praise Allah!" "How is the day?" "Good")
when we first met which must have come across as incredibly aloof and
rude. My subsequent attempts to make small talk foundered against a
wall of either disinterest or incomprehension ("Why is there so much
building work here? Is the city growing?" "A lot of people are
building houses") and I was a little startled by the scope of the role
of a driver; I had assumed that he would simply take me from A to B
but instead he took my money and bartered for the best exchange rate
then changed it for me, and then when we got to the supermarket
insisted on pushing my trolley, packing it for me and taking the
shopping to the car. I felt that the effort he had put in to changing
my money for me went a long way beyond the call of duty - I could
certainly never have got such a favourable rate on my own, so
afterwards I offered him the equivalent of £15, which seemed
reasonable as I had changed several hundred. The reaction was not
what I had hoped for. He seemed shocked, then slightly insulted,
before finally taking the money with a mumbled "God bless you" that
was hard to read. I'm going to be spending quite a lot of time in his
company, so I'm going to have to find out pretty quickly from someone
how to deal with someone who seems more like a manservant than a
driver.

Returning to the compound I met some of the other people sharing my
accomodation block,including the luckiest placement student alive who
was sent out here to work on hepatitis for his undergraduate project,
and two women from the university of Iowa who I recognised from my
flight. I got chating to one of them, who was working with a group
trying to reduce the incidence of female genital mutilation in The
Gambia. This sounded amazing, and I raved about how worthwile her
work sounded before turning to her friend and asking whether she
worked on FGM too. "No, I'm a statistician." she replied. Oops.

Anyway, off to enjoy the comfort of my air conditioned room and
ensuite shower while I have them - I won't get this sort of thing
upcountry. Night all.

Long blog post is looooong

I've only just got internet access, so am going to upload the blog
posts I've been saving individually rather than as a whole novel at
once. Enjoy.