Well, here it is – my very first blog post.. after all these many years….Really, this time of travelling I had intended to set up a blog before I went away…but in the maelstrom of activity since, well since as far back as I can remember somehow this idea got shelved temporarily. Anyway here we are.
Back in a Brothel?
As I write I sit watching the blinking red electricity bar above my red lit room lamp at 1 AM in my grimy little hotel room in the centre of Janakpur. Next door there lies a man who’s snores I have never heard anything like. Yesterday, I was concentrating on something when I remarked to myself “I wonder what they are drilling at 11 PM at night?” – Today I realise that that great cacophony, mercifully becoming more intermittent as the gentleman slips towards progressive sleep apnoea, eminates from the rotund occupant of my neighbouring room. The whole place has an air of a brothel, at least from my perspective sitting in the corner of this shabby room and it’s curious red light, with my belching companion next door – I am sure my old companions Laura and Catherine would revile this a trip down memory lane here (Glouchester place 164a 2009 – The Brothel). However the rest of the hotel is fair, if a little quirky, so I shan’t complain too much. After all I am only paying £4.60 a night for two beds hot water and electricity which in the grand scheme of things is pretty okay by me. I have certainly stayed in far more expensive abodes with far more inferior specifications… (I do miss my lovely room in the hotel Courtyard though)…. (Hotel Courtyard). I’m sure I’ll write more in the future about the bourgeois foreigner lifestyle of living in a hotel for three months but for now I’ll crack on.
So, I’ll be up and about six hours to get ready, answer a few e-mails and head across town to the office. I’m here in Janakpur working on my SSC ( student selected component for those of you who are not up with the medical school lingo) a research SSC performing a calibration study children on who are in the process of a second follow up trial being followed up having themselves been being born to mothers who were enrolled in a trial looking at the effects of supplementary micronutrients in 2003 and 2004. (Lancet). The organisation is I’m working alongside and under the auspices of is called MIRA (LINK) or Mother and Infant Research Association. They are a non-governmental organisation, working towards the general betterment of health for women and children in Nepal. I’ll talk more on this subject later I guess but for now saves me just the need to say that things seem to be awfully complicated at work but we are making progression and with a little luck and hell of a lot of organistation we should get the work done in the next few weeks.
My role here really is to assist my supervisor Delan Devakumar, a paediatrician by training but now Ph.D. student and soon-to-be public health trainee who currently undertaking his monster of a Ph.D. here in Janakpur (follow-up study of over 1000 children who are scattered across many different districts in this incredibly rural part of the world). Some years my senior, he’s taken my help, for what it’s worth, in conducting this calibration study. To cut a long story short essentially this “calibration” directs the wider study (the 1000 children follow up) by creating a specific equation for one particular machine which we are using here in Janakpur to follow up the children. The technical for the equipment in question is a bioelectrical impedance analysis (BIA) machine, brand “Tanita”, Japan. Some of you may be familiar with these machines from your local gym… it would be the machine which you step on in the corner (possibly charging you £1 for the privilege) which gives you all sorts of remarkable statistics about the percentage body fat and bone mass etc etc. It’s incredibly cheap and efficient once you’ve bought the kit to keep rolling off data from these machines (providing you buy the right one mind as the cheap ones really are a waste of time) – they barely have any running costs and are really not that hard to use… although we have run into quite a comically ridiculous situation with the first group of children we run through the study (more on this later – it has something to do with the arm position of the children holding the paddles on the machine ….Insanely frustrating situation we find ourselves (or rather Delan finds himself) in!).
The science (sort of)
So… You might wonder how such fabulous information is gained just by standing on a machine which sends an imperceptible amount of electricity through your body and prints out detailed results within seconds. Essentially it’s a derivative process, the machine takes the resistance pattern in your arms, body and legs and combines them through a series of complex equations to produce all of this supposed percentages in weight. This being said, depending on the machine, the actual accuracy of this really can be anywhere from questionable to downright wrong. This is not to say that the machine we using is completely useless it’s just that it has to be taken for what it’s worth which is very much derived process. The calibration I am performing involves using a far superior technique “total body water analysis by deuterium dilation principle ” aka “the heavy water test” (well, maybe it’s not known by that but anyway that’s what it is). Using this technique, we measure 100 children of varying body mass indexes and also do the “body composition analyser” test with this group. Working with the results we get from the one very accurate test we are able to “train” and equation for the wider study population. Quite a clever way of getting around the problems with the BIA machine.
Once this study is done, I’m also set to help my fellow medical student although also in reality senior colleague Suzanne. Suzanne has got an impressive history in academia, having already completed a Ph.D. in epidemiology and has since found one of the most interesting target routes to completing medical training that I’ve come across to date – it’s not quite clear to me but it seems to involve veterinary medicine, several different schools and have a lot of hard work! She’s an incredibly efficient worker and in many ways a polar opposite to me – she will be up in 3 1/2 hours precisely to go for her morning run! She exits Nepal earlier than I do, so I’ve agreed to carry on her primary data collection after she leaves to help here add to the mountain of data she’s already collecting on indoor air pollution.
The main Point
But, I feel I digress from my main point and probably for those of you reading the main interest. Life here in Janakpur is good so far. I am set up and enjoying the work so far. The noxious smog which tends to build up in a Nepalese cities isn’t so present in Janakpur. Instead there’s the lively smell of filth, stagnant water and mulched organic decay kicked up from the roadside piles that line the street or indeed are simply generally placed for you to navigate as you bring your way through the crowds, rickshaws, cows, dogs, pigs and screeching motorbikes. It certainly adds interest to journey to work and I can’t help but smile at the local citizens who stare absolutely dumbfounded at my white face, wondering perhaps, “what on earth are you doing here… I mean really – what on earth?”. I try to stroll confidently along, all the while drinking in the sights and smells and occasionally, capturing them on my oversized camera which seems to bring equal amusement as my peculiar features. My leaden arm extension does not just bring amusement to the local denizens but also to my colleagues.
To be continued…
So…hopefully in the coming days and weeks I’ll be able to continue this blog, and perhaps also begin to start recanting my initial foray Kathmandu which was quite an adventure in itself (although really a testament of long and heavy work rather than any of the usual travel stories – certainly a different style of travelling). I’ll be sure to post regular photos and to try and entertain you with quips and anecdotes from this quizzical country.
Best wishes to you all and welcome to my blog!
One thought on “2012-01 Nepal: Three days in rural Janakpur”
If you decide to visit Janakpur hospital (government), meet two pediatricians, Dr Pramod Yadav and Dr Baliram Mishra who have graduated from Kanti.