How the U.S. got accused of sending canned goods that cause cancer (aka notes from the field)

For the most part we've been relatively well received by the different groups of women that our contact has been able to drum up from different settlements. We have them take a survey and after give a 10 minute presentation about breast cancer in the Bahamas and the importance of getting mammograms for early detection. Last night was a different story; it started off well enough, despite the fact that some of the participants were rather snarky and shrugged off any offer of help (some were looking blankly at their surveys for over 15 minutes) and would look at us and laugh behind their hands.

After the presentation, during question and answer time, a more outspoken lady with a mohawked, bleached stripe of hair running from her forhead to the nape of her neck, started to ask us why breast cancer was becoming so much more of a problem now. Without giving us any time to address her question, she started going into this rant about radiation and how foods from the U.S., including our produce, were making people sick; she claimed that the canned goods from the U.S., with their labels of "export only," were the reasons the Bahamas shouldn't buy food from the U.S., and that they never had this problem in her granny's day (I guess granny lived to be 92). She did a good job stirring up the crowd, which started getting heated and talking all at once, not giving us a chance to say that 1). it's way better to eat fresh vs. canned anyway, 2). a big part of the reason people are so fat and unhealthy here is because they don't eat any fruits and vegetables whatsoever (lay off the conch fritters people) and 3) that people should stop inbreeding in order to prevent the BRCA gene mutation from spreading (we'd never actually tell them to stop inbreeding but seriously, with such a small island and cousins marrying cousins, that's the bulk of the problem as far as genetics goes).

this is pretty much how I felt last night. via

Now I don't know about this whole U.S. "export only" thing, but maybe the reason why white stripe was so unhealthy is because she's a major smoker (believe me I could smell her and heard that phlegmy smokers cough). She also didn't feel any qualms about taking a huge plateful of the free cookies we have for after the presentation. In general, with a thing like cancer it's hard to give people one definitive reason for the cause, which many have found frustrating. I'm hoping that overall we at least reached one person in the crowd last night, and that we won't find ourselves run out of any more meetings.

It's a Bahamian thing, mon

Some updates from the field: Bahamian time has started to become the bane of our existence as we really attempt to get our project off the ground and running. It's that relaxed, island time mentality that's clashing with our U.S. sense of urgency, but can anyone blame us that we want to arrive on time (and even early) to the survey sessions that we've scheduled? Meetings with stakeholders that should take 30 minutes at most end up lasting over 2 hrs because of tangents and long-winded stories. I'm definitely going to have to learn to let it go and accept the fact that things aren't done very snappy here.

The list of things to go into our limitation section definitely keeps growing. If it even looks like it's going to rain (which it has practically everyday this week, we are in the rainy season after all) then people will not show up to any meeting that you may have scheduled. Every rain is the first rain here it seems, ironic since we are on an island that's all too familiar with hurricanes. Literacy is also an issue which we've tried to solve by offering to read surveys if the lady happened to "leave her reading glasses at home." It's worked really well and has increased the completeness of our surveys tremendously. Next hurdle to tackle is to make sure that everyone is taking their surveys by themselves; I've seen way too many surveys with the exact same answers as I've imputed the data for comfort.

From the Caribbean (left) to the Atlantic (right)

Last week/this past weekend we did about 3 beach days in a row; our sunburns were an indication that we should probably take a few days off. I already feel like I'm much browner than normal, and I've certainly gone to the beach more in the 2 weeks here than in an entire year back home (terribly sad). We visited the Glass Window Bridge, the thinnest strip of land in the world, where on one side you see the Caribbean and on the other, the darker blue of the Atlantic.

Potcake Paradise

The strays here break my heart. They're called pot cakes (apparently named after the peas [aka beans] and rice mixture left at the bottom of the pot that local residents would feed to the dogs). Even though they are a little mangy looking they all look to be in pretty good condition and seem super friendly. I was nervous to go running around the neighborhood at first (not alone of course) because I didn't want any of the dogs to chase us, but even though Blackie (the local black lab looking dog I caught swimming in the ocean) and a pal ran with us for a bit, you could tell they were just playing and soon gave up after a while. The only dog that gave us a problem were owned by locals, who were nice enough to shoo them away for us. Apparently you can take a part of the island home with you by adopting your own pot cake; there's a nonprofit that adopts out puppies from the island and ships them free to the states http://www.potcakeplace.com/.

Some neighborhood potcakes

It took a few days of adjusting but I now really like where we are staying. Though hot, buggy, and in a rougher part of the island (I think in general the southern part of Eleuthera is poorer) it has its charms. The houses are colorful (if somewhat faded) and the people are really nice. Everyone waves and says hello. The neighborhood kids have become our new best friends. I'm still getting accustomed to this neighborhood camaraderie. The other day at a nearby beach, a local Bahamian man came up to me while I was looking for shells and gave me the most beautiful conch shell I have ever seen. I was really taken off guard, thinking "am I going to have to pay him for this?" but no, he just wanted to tell me about it and give it to me as a gift. He then offered to take us out on his boat to go snorkeling or fishing anytime we wanted. And even though I was still a little suspicious and guarded, I'm really starting to get the sense that people here are just nice and do things with no ulterior motives or hidden agendas.

Fresh from the ocean, all he did was brush it off. 

Now before you think that I'm just here goofing around in paradise, I will say that we finally got preliminary approval from the Bahamian Ministry of Health and will begin work today. We are doing surveys of local women in 18 of the settlements up and down the island in order to find out the barriers to women getting mammograms. As I've mentioned, the Bahamas, and Eleuthera in particular, has the highest rates of breast cancer in the world. It's partly a combination of bad diet and all the normal causes, but what's particularly key is that Bahamian women have a higher than normal prevalence of the BRCA-1 and 2 genes, which are also associated with breast cancer. Eleuthera doesn't have it's own mammogram machine so women have to be flown to Nassau to get tested. The Cancer society has a program to help those who can't afford the test on their own; however, because many other islands also need to fly their residents to Nassau, Eleuthera has been only able to send 45 women to get tested. So we are going to see why women aren't signing up for this program (past research indicates a disinclination to even getting tested and a fatalistic attitude towards a diagnosis of breast cancer) and what can be done to promote this mammogram program. Our results could even be used to bolster the argument that the island itself needs its own mammogram machine. Finally some public health in action (in addition to some tanning).

Not your momma's Bahamas

I've finally made it to paradise! It's been a whirlwind these last couple of days trying to get oriented to my new surroundings. I'm still getting used to the heat and the fact that most of the places around here don't have air conditioning, our house included (though we have a small unit that we use at night). Needless to say I'm sweating a lot and between the sunscreen and the bugspray (which I wonder is even working as I still find myself covered in bug bites) I've just resigned myself to being one big disgusting grease ball these next 6 weeks.

our home for the next 6 weeks. 

I'm definitely experiencing a bit of culture shock here. First off, I'm an obvious minority (the few white residents definitely look a little backwoodsy, complete with leathery skin), and although English is the language spoken here, I sometimes wonder if people are speaking in a foreign language because I have such a hard time understanding. Think a mixture of Jamaican and native Hawaiian and you'll get a sense of what I'm talking about.

view from our porch

Second, the poverty here is striking. As I've said, this is not your momma's Bahamas. I should've realized this, as the institute giving out the research grants is giving them for projects being down in low resource countries but somehow it didn't even register. I'm living in Tarpum Bay, a settlement in the southern part of the island of Eleuthera; this is a poor area, with a 75% unemployment rate. Stray dogs roam the streets (called pot cakes), joined by the occasional goat or chicken owned by one of the residents. There's trash, the houses are run down, and abandoned buildings are common. But despite all this, the people are friendly. Everyone waves and the kids, though shy, are excited to talk to us (and recommend Miss Mary's as the best place to get ice cream).

our local pot cake (stray) dubbed Blackie taking a swim

someone's pet goats

The beach is obviously beautiful, and conch salads and grouper burgers are common. We've experienced sticker shock in the grocery store though because everything is so damn expensive. I don't know how people manage when the median income is $15,000 a year. We definitely have our work investigating the barriers to getting mammograms cut out for us. The Bahamas, and Eleuthera especially, has the highest rate of breast cancer in the world (around 20% of women get it); 1,300 women need to be getting mammograms, but only around 45 a year end up utilizing the Cancer Society's assistance program (patients have to be flown to Nassau to actually get screened as there's no machine on the island, a whole separate issue). So there you have it, a nice contrast of poverty and paradise.

How to get bikini ready (according to Buzzfeed)

http://www.buzzfeed.com/hnigatu/the-only-thing-you-need-to-read-to-get-ready-for-bikini-seas

I love this!!! Perfect since I will be in one in t-minus one week! And when in doubt remember this quote:

via

Enjoy it while it lasts and quit being a playa hater

So I'm now half-way through grad school...

via Tumblr

Boy time flies! I finished my last final today (boo epi! I'm so a words person, risk and rate ratios just mean nothing to me), and it's just scary to think that this time next year, I will be getting ready to graduate (and either looking for, or hopefully already having, a job). In some ways I will miss school, but a paycheck will be nice.

To tie a nice little ribbon around things, my friend/future roomie B and I signed a lease and put the deposit down on our condo for next year! Very very excited; it's the culmination of the end of a long search. Our place has so many trees, a spot for a little porch and some potted plants. And of course plans for a dog named Ripper (after getting her stuff stolen at the beginning of the semester, B decided that we would need to get a tough dog to protect us, hence the name Ripper was born) and a bird for me!

It's been an interesting 2 semesters and looking back here's what I've learned so far:

1. Grad school is one of the first times that you may have friends studying the same thing as you. Which is weird because sometimes all you do is talk about public health, but it's also nice too.

2. Grad school is awesome because I'm actually learning things that will help me in the real world. I'm so glad I decided to go

3. Undergrad did not prepare me for the job market (I'm sorry, as much as I love and value the liberal arts--the world would be missing something if people didn't study it--I didn't learn that many specialized skills, hence lesson #2.

4. Grad school is also awesome because they give you free booze. At least you know your tuition is going towards something useful.

5. Getting an internship takes persistence; over 65 applications' worth of persistence. But it pays off in the end when you find something you really love.

6. You will work your butt off in grad school, but teachers aren't out to fail you and your GPA will probably be better than it was in undergrad.

7. Public health=group projects, which aren't so bad when you are actually working with people who care (I'm generalizing here, but usually you don't go to grad school unless the field is important to you--and you also don't go to grad school if you're dumb).

8. Small pox, as well as ebola and all kinds of other nasty things, is alive and well right across the way at the CDC (thanks Colin Talley for that daily reminder).

9. The next big epidemic, think mass death on a Spanish Influenza of 1918 sort of scale, is inevitable.

10. Public health is pretty awesome, and I think I've fallen even more in love with it than when I started (although don't get me started on my Curriculum design class...)

Bring on sweet summer time in Hotlanta and the Bahamas!

Bahama Momma

Took all these during my first trip to the Bahamas pre-college. 

Summer is right around the corner; I can practically taste it's sweet freedom! And freedom it is as this semester has been the busiest yet. My summer plans are awesome but are definitely very different from what I had imagined. I'd pictured something more along the lines of a traditional 9-5 internship here in Hot-lanta, but life has a way of bringing awesome opportunities. Instead, I have been lucky enough to receive a research grant to go to the Bahamas!

I will be living on the island of Eleuthera for 6 weeks with 2 other grad students while we conduct a hybrid needs assessment/program evaluation for the cancer society on the island. The organization just recently hired an outreach coordinator, who has a big job to do and isn't get paid a whole lot to do it, so our team is going to assess what are the biggest needs of the community in order to help craft a plan for the outreach coordinator to be able to do the best job possible. Again, coming into grad school I had never imagined that I'd get the opportunity to travel abroad. I hadn't even bothered to go to the research abroad information fair they had held in the fall because I didn't think it was something I really wanted to do, but after hearing that they pay you to go and do research that's actually applicable to what I'm learning, my interest was piqued. And the rest is history. So yes, I'm not getting paid to do this, but how often in life do you get to go on an all expense paid trip to the Bahamas for 6 weeks? That's my reasoning, and I'm so pumped I decided to take this opportunity. 

Post-trip I will be back in the ATL, synthesizing our project into something that will hopefully be publishable. I will also be helping this Emory emergency medicine doctor write up the results for this project he's doing in Ghana, assessing barriers to accessing EMS services (I'll actually be pilot testing this survey in Atlanta in the next couple weeks so be ready to volunteer to sit down with me). I will also hopefully be getting to continue to work at my CDC communications job; I sat my supervisor down and basically told him how much I loved working there and that I'd love to continue, even if it's unpaid (lets face it, I'd do anything for free at the CDC). My library job that I'll also be continuing to do over the summer provides me with some monetary cushioning. Yes, I have my fingers in a lot of different pies, but it's prime-time here for working my ass off to make connections and expose myself to as many opportunities as possible.

Let's go summer!!! 

My first and only encounter with a shark was in the Bahamas while we were kayaking.

I wouldn't mind seeing one again, as along as my leg wasn't in its mouth!