Tag Archives: Janakpur

2012-01 Power cuts and the perfect place to study

It’s Friday night and I’m sitting once again in my hotel room.

The brothelFirst of all I have some good news. I went shopping yesterday and bought a 35 W bulb. This may not seem like much for those of you who used to burning your 60 Ws back in London but in here it makes a huge difference. My room is now clinically bright – and the pleasant news – is not as dirty as I’d feared it would be when suffering this illumination. I did buy a bottle of “Colin” cleaning solution (this seems to be the only one you can buy in Janakpur) a mysterious blue substance which professes to give a winning shine to any surface. I half suspect that the chronic dust from the streets here in Janakpur precludes any real use in committing to thorough cleaning. For the minute however I am satisfied that I have a certain degree of autonomy over this space for the next five weeks and as such will try keep it as the French say “propre”. Take home message: Starting to feel at home.

The Palace of Light
After installing a 35W bulb

Things are progressing nicely along at work. It’s been quite a busy week getting to grips with planning the project ahead but we have made real progress and seem to have established a plan of action for getting the study done. If, and this is a big if, things go to plan directly we could even have the project finished within two days. Experience, both my own, and that of Delans, Suzanne’s and pretty much anyone else have spoken to tells me however that things are less likely than more to go to plan – but even if we manage to get 50% of the project done through this scheme then we are well on our way to early completion.

The basic plan is to invite a large number of children who are present in the wider follow-up study to the centre to conduct the test on one of two coordinated days in which we will have most of the staff members from the office at our disposal. In addition my old supervisor Prof Jonathan Wells, one of the world experts in paediatric body composition (handy to have on the study no?!), is flying in to visit the site and to help us on these two days. With such a narrow window of time for him to be arriving it is just our luck that the days in which he is around our three national holidays one of which “God of students” day, means that none of our participants are likely to be outcome to the centre. Factoring in possible delays due to problems with taking off from Kathmandu (domestic flights are very frequently delayed or cancelled because of difficult takeoff and landing conditions), there exists even the possibility that he won’t make it down to the site having come all the way to Nepal. I sincerely hope this doesn’t happen as I’m very much looking forward to having him join us here and to experience this incredibly interesting part of the world.

Life here in Janakpur is remarkably regular. I am in for work at 10am, leave at 5/6pm, join Delan and Suzanne for dinner in the hotel (apparently the best restaurant in town) at precisely 7:30pm (although I am always late of course!) and then retire back to work from 9:30pm till 2am before getting some shut eye.

I once dreamt a few years back but being allowed to be left alone to study and work. It may seem strange but this is one of the closest environments to which I’ve been able to achieve this. In London my life is fettered by numerous tasks, administrative or otherwise which are a constant distraction and impediment to progression. A Spider network of social connections, I find myself as I flip between tasks being something of a social butterfly, and a manic family makes life awfully complicated at times. The upshot is that my desired output in photography, film, design, websites, research and of course my ability to study for my medical degree is reduced as compared to some potential imagined maximum. Don’t get me wrong, I still am able to get to grips with most things but often be juggling so many balls and being so snowed under that I can barely see for looking as to the way ahead. Somehow Janakpur for seems simpler. There is a defined job for me to do here – all of my worldly needs and comforts are addressed by living in a hotel – Things are cheap so I don’t have to worry about money – people are friendly and I am left in peace to get on with my work. The only mild discomfort is the frequent “load-shedding” (central electricity power cuts) as I type we’ve just flipped over into “load-shedding” so I have flipped on my recargeable LED side light. For a guy who travels with 2 multisocket adaptors – I have had to become something of an expert at managing the power consumption of my laptop juggling battery recharging versus the schedule of power cuts.

Film Training team
Filming training team: Delan, Chaube, Sonali and Sushil

If the current rate of progression continues I should come back to Kathmandu in five weeks time with lots of lines scored through on my to-do list which believe you me is many miles long. We will see as we go on this topic but suffice to say that this week I’ve been able to finish one film, click the study rolling and organise a complicated photography shoot (as well as training) and have tackled two websites to the content building stage (the structure, the wireframe is in place, we are on a testing server and we are ready to start throwing content onto the pages. This is actually one of the simpler things in website building it seems – design something I’ve taken up the last six months in earnest and has been studying really could extensively but have only now reached the stage where I feel confident in building robust websites. Adding to my work list in the coming weeks will be my own website which is currently a flash creation which is no use to anyone with an iPhone, and iPad or anyone on anything slower than superfast broadband (takes me about 10 min to load my homepage here from Nepal).

Lots to do, lots to do.

So – tomorrow is a video shoot. We’re shooting the “explanatory” film for the calibration project. I had the pleasure of training three of the MIRA staff members, Sonali, Sushil (also tomorrows star actor) and Chaube today in the rudiments of filmmaking and photography. We went over the principles of aperture and shutter speed, focusing and basic sound recording (Delan’s going to be my dedicated sound man tomorrow). It was great to see their interests and desire to get involved. I’m incredibly keen on the idea of providing training in developing skills the names of staff here at the centre so that they can increase their portfolio of skills and hopefully in future (with the right equipement) using this to promote the work that is done down here. I’ve also had several radical ideas about website development of local institutions here. Specifically I think the local hospital could use good website. I was wondering if they might use it to advertise their services and also to link with other institutions, both within Nepal and internationally, perhaps to gain donations to help investment in hospital medical technology and general service provision. If this idea materialises, and if I have time in my spare 5 min, I will write something on it (and hopefully show the finished product when it’s done!).

For now of a few more changes to make to Kanti Children’s Hospitals new website. And then planning to curl up with the intriguing Stephen D Levitt “Freakonomics“. More on easy reading with the iPad in future I’m sure but for now adios.

2012-01 Nepal: Three days in rural Janakpur

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.

Working hard

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 job

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.

Polluted air

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.

Janakpur Cow Driven carts

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!