departures from normality

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Entebbe Botanical Gardens on the shore of Lake Victoria.

After our work in Uganda was finished, I flew to Nairobi to spend the weekend visiting Oliver and Maggie, the directors of Agape Hope Children’s Center. My trip to Nairobi was a very last-minute idea; I had planned to spend the rest of my time in Malawi, but when I realized that most flights between Entebbe and Lilongwe connect in Nairobi, it seemed like I had a perfect excuse to stop by and say hello. 
I don’t have any picture of giraffes or lions or stories about spider-killing Maasai guards this time, because when I landed at the Kenyatta airport, I headed straight to Agape (well, mostly straight, if you skip the part where I confused the driver with my directions and we had to call Maggie). I had a great experience at the center in the summer of 2012, so I was really excited to go back, if only for a few days. 
There has been a lot of progress at Agape since I was last there. Most noticeably, there has been a great deal of construction. There are additional dorms, storage rooms, toilets, and classrooms; the church now has walls and doors, and one section of the land is dedicated to the center’s agricultural projects. There is a greenhouse tent where rows of tomatoes are growing (some to sell and some to eat), and there are pens for several animals, including two cows, two clumsy calves, a couple of pigs, and a few chickens. The primary school, which used to be a decent walk away, has moved onto the plot behind the children’s home. Oliver and Maggie hired more teachers so that the oldest children can continue their education at Agape, so the dining room (which was being constructed as I was leaving) doubles as a secondary school classroom.
Rachel Fiske, if you’re reading this: this one is the softest. 
The transformation has been positive, but it has been motivated by demands which even the expanded facility can barely accommodate. When I was volunteering at Agape, I think there were 50 or 60 children in Oliver and Maggie’s care. Now there are 127. Maggie and Oliver hope to move the home and school to a bigger piece of land further from the city center so that they can expand their agricultural activities and ultimately become self-sufficient, but the land is priced at around $30,000—an amount that isn’t easy to save while trying to meet the immediate needs of 127 children. 
A number of the children who were there in 2012 are still at the home, and it was so great to catch up with them. I was surprised how much some of the kids remembered—not only me and my name, but things like my siblings’ names and a song that I had taught them (to the delight of my mother, who wrote the song). Several of them were pretty surprised that I remembered their names, too! During the past year, I took Swahili classes at UNC, so this time I was able to communicate with some of the younger children who had not yet started to learn English. My Swahili skills also gave a pretty comedic shock to some of the older children.
I took out my camera for a quick picture with Simon…image
…and we were soon ambushed!
Rebecca, just out of the hospital but sweet and sassy as ever

Michael, briefly abdicating his role as photographer 
Maggie and Oliver and their three girls are doing well (and even have consistent electricity in their home now, sponsored by a church group who visited in the dark ages!). As before, they are quick to count their blessings, secure in their faith that God will provide all that they need. Walking around the Agape plot with Maggie, she punctuated every sentence about the center’s growth with a phrase of gratitude: “The children had fruit when the tomatoes were ripe; it’s all God’s doing… We were able to fence in the school so that it is safe there; Grace, God is so good… We sell milk so that we don’t worry as often about buying food for the children; thanks be to God.” I’ve had a lot of conversations in the past year about why I believe in God. If only I could show everyone what is happening at Agape, I think I’d have less to explain. 
Maggie and Oliver teach love and faith tirelessly and by example. They have three biological children, they have talents they could use elsewhere, and sometimes they’re pushed to their limits by the weight of their work. They could have chosen a life with much more financial security and much less worry and responsibility. They have so many good excuses not to do what they do, but every morning, they drive their old white car down a dusty dirt road and honk their horn at the Agape gate. 
I’m just about to finish my whirlwind East Africa trip, and while I am sitting in the UNC guest house on my last day in Lilongwe, I thought I would take some time to do I usually do when in Africa: write.
Because I didn’t have much time before the trip to tell people that I would be traveling, it might be best to start with a recap of where I’ve been and what I’ve been doing. I’ll throw together some details about the latter portions of my trip later, but for now I’ll start with the whole impetus of my travels.
My trip began in Uganda where the research team for a study I have been working on was meeting to prepare for a national data dissemination event. This study is the most recent and largest implementation of the Priorities for Local AIDS Control Efforts (PLACE) method developed by Sharon Weir, an epidemiology professor at UNC Chapel Hill. Since mid-May, I have been cleaning and analyzing data gathered by the team in Uganda and preparing data summaries to aid in the understanding and implementation of the results. I am aware that that sounds really meticulous and nerdy, but conveniently, I am really meticulous and nerdy.
Given the scale of the study and the goals of the project team, I spent most of the month of July at the office. I was in the office every weekend, overnight for several nights, and for long hours during the day. That probably sounds really unhealthy, but I promise that I enjoyed it. I was interested in the work, was learning a lot, really liked the research team, and believed that what I was doing was of value. I am really grateful that my professor had ambitious ideas, trusted me with the data, and was willing to let me work as much as I did. I’m also really grateful that as the date of the meeting to disseminate the findings in Uganda approached, she invited me along.
We started the trip to Kampala on the morning of July 23rd. The trip was, in one word, long. I had forgotten what it’s like to spend two days in planes and airports! When we arrived in Uganda, it was warm and dark and it smelled like Africa. Well, maybe it just smelled like Tarmac in the heat, but it was the same smell as every other time I’ve landed on the continent and stepped outside the plane to walk down a tall metal staircase, across the pavement, and into the arrivals hall. We spent a few minutes navigating through the tiny Entebbe airport and gathering our luggage before heading to our hotel in Kampala about 45 minutes away.
The next morning, we met the fantastically friendly and outgoing Uganda-based research team at the hotel. As we all worked on data and presentations, we heard numerous stories about the data collection phase, which sometimes involved steep hikes and boat rides to reach remote locations. Sharon and I spent most of the next several days at the hotel and the Makerere School of Public Health preparing for the meeting.
On the day of the dissemination, about 70 people gathered to learn and discuss the findings from the study and to share ideas for improving local HIV prevention efforts. Most of the attendees were district officials and representatives from health agencies who embraced the opportunity to talk (sometimes at great length!) about their efforts and ideas for improving health in Uganda. The meeting highlighted how engaged the district leaders and staff were throughout the study, and it illustrated how the project had already had an impact on local capacity, even before all the data were analyzed and arranged into graphics and pasted into documents that achieved the team’s desired “cuteness factor” (…I may have set a record for the number of edits to a single document in Microsoft Publisher).
We did get to see one place outside of Kampala after the meeting was over; on the following day, a few of us traveled to visit a site where the PLACE surveys were conducted (a PLACE place, if you will). The venue was a combination restaurant/pool hall/hotel/video hall, complete with a megaphone blasting the audio of the selected samurai movie from the front of the building. Other than the difference in language, this place looked like many of the roadside towns I had seen in Western Kenya, with its dusty sidewalks, shallow storefronts, and brightly painted buildings sporting the logos of popular grocery items. As I sat in the restaurant area in a dress and black tights, a few children darted in and out of the entrance to speculate about the mzungu with black legs.
Taking selfies with Susan at the venue
On the last night, we all got together for an end-of-project party, where the team reflected on the experience, swapped gifts, and said goodbyes. The project coordinators surprised everyone with personalized Uganda soccer jerseys, which they presented while explaining each person’s position on the PLACE “football” team. The event was really sweet and a great way to highlight everyone’s individual efforts and all the teamwork involved.
Milly and me at the PLACE party


Susan and Steven, “team captains,” handing out the jerseys with Dr. Freddie (PLACE Project Director)

Pictures with the siblings!

Christmas “morning”

Tonight, we first-year MSPHers got together to bake and decorate cookies before everyone leaves for winter break.

Happy end of fall semester!

A full house for Thanksgiving!

Tiffany and I were werewolf-bitten (a=1, Y=1) and unbitten (a=0, Y=0) counterfactuals for Halloween.

…or, you know, math-loving zebras.

(In case you can’t tell: We’re really cool.)

In the epidemiology MSPH/PhD program at UNC, first-year students are enrolled in a seminar that encourages philosophical discussion of epidemiology and public health, provides an additional opportunity to interact with faculty and staff, and has unofficially become a biweekly occasion for junk food consumption (because calories don’t count during academic seminars). This semester, the seminar has mostly required regular readings, a few forum posts, and sharing articles. An additional assignment, which we are completing over the course of the semester, requires us to interview epidemiologists.

As someone who appreciates the value of networking and is always looking for new sources of advice, I was excited to see this assignment on our seminar syllabus. Staff and students alike have encouraged us first-years to “go forth and meet faculty,” so to speak, but the whole idea of showing up at someone’s office without a clear agenda is a little uncomfortable for me. I don’t think that I’m all that socially awkward (though perhaps that’s debatable) and I’m rarely intimidated by professors, but I tend to be very concerned about imposing on other people’s time. For this reason, I don’t usually make my way to a professor’s office, at least for an initial meeting, without a good excuse.

This personal hesitation about scheduling informational interviews isn’t much of a revelation for me. In all four years and 165 credits of undergrad, I only attended faculty office hours twice. On both occasions, I was completely comfortable stopping by, because those meetings had a clear objective: seek clarification on some homework problems. Homework questions weren’t a reliable impetus for me to meet professors, though, since I was independent (or stubborn) enough that I rarely had questions to ask. I could figure out most answers of the answers to my assignments through thought, Google searches, course materials, and crowd-sourcing.

While it might often have been easier to consult a professor about my questions, it seemed disingenuous to go to office hours “unnecessarily,” without first consulting these other sources. My undergraduate advisor actually joked about how I only visited when I needed his signature; I would stop by with the appropriate forms already filled out and only asked questions after I had scoured every resource on the College website. I struggle to justify taking up someone’s time just to get on their radar screen or to ask questions that might be answered elsewhere, and I worry that people aren’t interested in taking the time to entertain inconclusive conversations on abstract, philosophical questions.

Given my resistance to unfocused meetings, I was grateful for an excuse to speak with people I may have otherwise not approached. I have conducted two interviews so far, and both have illustrated something that I really appreciate about the program at UNC. As at Virginia Tech, the faculty, staff, and students I have encountered here are friendly, open, and unpretentious despite their many accomplishments. I learned a lot about my interviewees’ careers and their motivations for their work, but through these interviews, I also gleaned a lot of personally relevant advice.

One comment that stood out to me was a professor’s reassurance that it is not necessary to figure everything out right now. I have a strong impulse to commit to projects early and deeply for many reasons: to demonstrate commitment, to gain an additional source of feedback, to connect to another group of people, to apply what I’m learning, to immerse myself in the jargon… all that and more. I generally do enjoy those benefits, but I know that I have a tendency to go a bit overboard (and a bit crazy) trying to prove and improve myself in this way.

The interviewee who told me not to worry about finding my ideal project right away explained that her thesis did not come out of her first couple of projects. She said that she did, in fact, do some work that she didn’t enjoy on the way to her first really gratifying research endeavor. Maybe this is not Earth-shattering news to anyone else, but it is good for me to hear. I stumbled upon what would become my undergraduate thesis in the second month of my freshman year; the path to success that I experienced with that was a little serendipitous. Talking with someone successful who didn’t immediately stumble upon her ideal project reminds me that success doesn’t always depend on being as lucky as I was in my first research experience.

Another interesting point from my interviews was one about maintaining perspective. One interviewee mentioned how easy it can be to buy into the opinions of your professors. In the classroom especially, she explained, students receive positive reinforcement for aligning their values with the values of the instructor. If your professor regards one aspect of research (e.g. literature review, methods, application) as most important, it often is most rewarding to conduct your own research in a way that is consistent with the professor’s preferences. My interviewee thus warned that you need to be vigilant about what you think will make you the best researcher and resist focusing solely on what earns the most approval.

More advanced students have explained that the program (and research in general) will often necessitate that you make choices between perfectionism and having a social life and healthy habits, so during the interviews, I asked about strategies for balancing those aspects of graduate school life. One recommendation that seemed particularly useful is determining how much time specific tasks are worth. An interviewee explained that she often decides that a paper is worth “x” hours of her time, and so she will write for that amount of time and then stop, even if the product is not perfect. This hearkens back to a line commonly uttered by a Virginia Tech professor (Paul Heilker) during one of my study abroad modules last semester: “lower standards, crank out text.” So far, I have been maintaining my standards and just relying on tried-and-true method of late nights, coffee, and naps, but in situations where this won’t work, setting time limits for less essential tasks seems like a smart way to manage a busy to-do list.

It might just be a mirage, but from these interviews, I get the impression that my classmates and professors are actually real people. They have attained success despite their own challenges and uncertainties when they were starting out. They figured it all out eventually; so will I, and so will my classmates, no matter how clueless we may feel at times!

I’ll keep thinking about how to reconcile my desire to talk with people and my desire to respect people’s time, but for now, I still have at least one more “get out of awkwardness free” card left. Though I don’t know who my final interviewee will be, I’m already looking forward to it, because I find that I finish every conversation with an epidemiologist with a renewed sense of excitement for what I am getting into.

Last weekend, Tiffany and I went to the North Carolina State Fair. We ate cotton candy, candy apples, kettle corn, butterfly fries, and candy corn, and we got to see some pretty cool things, including a giant lawn chair and a giraffe-patterned gourd. We enjoyed walking around for a few hours, but as we had plans for after the fair, eventually we decided to head back to Tiffany’s car.

We wandered through rows and rows of vendor stalls selling the same seven fried and candied items as we tried to find our way back, but we slowly realized that neither of us had any idea where the exits were. We weren’t too proud to ask for directions (eventually), but it turns out that “nearby bleachers” is not an adequate descriptor when trying to identify a fair entrance. We continued to meander around, but instead of finding more exits, we kept stumbling upon various forms of livestock and giant produce. Eventually, prepared with cotton candy and kettle corn to sustain us, we decided to exit the fair through the only gate we had been able to locate and to walk around the perimeter of the fair until we found our appropriate gate. After wandering through some dark residential areas, discussing contingency plans, and applying epidemiological terms to our situation (e.g. “getting lost reduces selection bias!”), we were able to find our gate.

The gate was very inconspicuously marked, so that was at least a little validating. …and there were bleachers nearby.

As we set off towards Tiffany’s car, our triumph was celebrated with a spectacular fireworks display, which we enjoyed while discussing the probable morning-after recall biases for a nearby drunk man in a Tigger hat. I think I like North Carolina.