Hi all,

What a fascinating week. I've been trying to fit into this week all the things I wanted to see around ICDDR,B that I couldn't see before because I was busy working on my study protocol. On Sunday, I went to the Kamalapur field clinic, the site of much of ICDDRB's respiratory disease surveillance. Today, I went on rounds in the HIV ward of ICDDR,B hospital (I'll need to post about that later). This coming Sunday, I'm going out to visit the Mirpur slum area again, but this time to see where women for the Mother's Gift vaccine trial was conducted (the study for which my current protocol is a follow-up).

Here's a picture of recordkeeping in one of the two Kamalapur buildings (and a map of the slums where respiratory disease surveillance is being conducted).














At Kamalapur, ICDDR,B has been conducting respiratory disease surveillance for something like 12 years, and is currently following something like 7,000 households in the area. ICDDR,B has an old and a new building a block apart, both of which have clinic space on the bottom floors and research team offices on the upper floors. Interestingly, in the old building, the landlord's family lives on a floor in the middle of ICDDR,B on the 1st-3rd and 5th floors. In the morning, I toured the clinic of the old building -- where families enrolled in surveillance come in for scheduled and unscheduled visits, mostly for respiratory diseases.

Later that morning, I went to Out Fall part of Kamalapur - an area of the slums where drug addicts used to congregate - with a field research assistant and field research officer. Runa (the FRO) told me that the area used to be very dangerous, and that it took time for the local community to accept researchers. From the looks of the community's reception of them now, it appears that they've been abundantly successful at winning the respect of the residents. We did some routine home visits and some follow-up visits for people who had been sick with a respiratory disease recently. The surveillance system is really incredible - FRAs visit all their assigned homes once per week to monitor respiratory disease in family members. When a household member is sick, he/she is referred to the ICDDR,B clinic and then the FRA visits that household every day until resolution of symptoms.

The families I met during these home visits were so welcoming and sometimes HILARIOUS. :) One grandmother wouldn't stop comparing her grandson's arm to mine; he didn't really seem to get it at about 2 years old, but she was just giggling away, calling me sister and hugging me. In every house, the women insisted that I sit down, and made it absolutely clear that they would offer me food if it wasn't Ramadan. After about 6 home visits with the FRA, Runa and I walked around more of the area before heading back to the ICDDR,B building... but not before she took the chance to pop into at LEAST 6 more houses to show off the foreigner. Ha. That was really entertaining. She has worked in the area for 5-6 years, so everyone in the community knows her well; she would lean into someone's door and, I presume, announce that she had a foreigner with her if they wanted to see. Not that that's a new experience for me here. :)

In the afternoon, I toured the new building clinic and research rooms, and was VERY excited to see some of the rooms used for vaccine trials out at Kamalapur. There aren't any trials going on right now, but I got to see the rooms used for vaccination, monitoring of kids and mothers after vaccination (kids and mothers because usually it's childhood vaccines or, in the recent past, maternal immunization that's being tested here), and facilities for keeping the vaccines. Can't wait to see more of this type of thing out at Mirpur this weekend.

In other news, lots of students are leaving or have already left for the summer, so there's just a couple of us left here. We're trying to work out a boat trip out of Dhaka this Saturday. It should be amazing to finally get out of the city; I've heard that it's a radical change from the city, and beautiful. Also, under the topic of keeping things real, we found out that our housekeeper has Hep E. There are outbreaks of that, cholera, and dengue around the city right now.

Catch you later...