Vietnam - in an epidemiological transition

I'm just back from a 15-day trip to Asia where I wasnt allowed access to blogs so I am playing catch-up with my blog posts...

August 17

I'm now in Vietnam with the same project that I was in India with: EPI-4. Four Swedish universities are collaborating with universities in India, China, Indonesia and Vietnam to promote evidence in policymaking to improve maternal and child health, malaria, TB and HIV/AIDS for disadvantaged (i.e. poor, rural, minorities, etc.). Just a small project! My role is to develop methodologies, work with post-doc students, and keep everybody on course. The best part is working with colleagues in these 4 countries, none of which I've visited before! It's a challenge to keep all of the cultural differences in working practices straight.

Vietnam has a hearty economic growth rate (GDP) of almost 7% (compare to Sweden, 5.5% and the sluggish U.S., 2.8%). So things are happening here. At the same time, they are facing the same problems that all the emerging economies are: wide gaps between urban and rural, ethnic mainstream and ethnic minorities. The "epidiological transition" is another aspect disturbing the Vietnamese government, and the other middle-income countries in the region. This is the state of having both a) major parts of the population exposed to infectious diseases associated with low-income countries, such as tuberculosis and b) rising rates of heart disease, diabetes, and mental illnesses such as suicide, mostly associated with high-income countries. Its an unenviable position for the Ministry of Health to have to deal with both malnutrition and overnutrition (i.e. obesity)!

I feel like a giant here as I am 2 heads taller than most women. For some reason, people like my hair here. Two women have come up and complimented me. I was only in Hanoi for 2 days. I will be back in November and hope to get out the countryside.

Testing

India!

Ahmedabad

Tried to send this from my hotel room in India but wasn't successful. Now trying again from Sweden...

First time to India! I'm in Ahmedabad with a new project I'm working on at Karolinska Institutet. The project is taking place in India, China, Indonesia, and Vietnam so I will be visiting these countries in the next month.

With about 4 million people, Ahmedabad is the largest city in the state of Gujarat and the fastest growing city in India. Its an educational and scientific center.
I was fascinated to see the contrasts on the street. Many houses look like shanties and there are people sleeping on the streets, but most of the cars on the road are new and many young people, especially young women, are riding around on mopeds or shiny vespas. The young women straddle the motorcycles in their jeans or baggy pants, while older women sit sidesaddle behind a male driver. Dress is everything from completely western style, to shalmar kammez, and saris.

I guess I was expecting something else from my first trip to India. There are some things that havent surprised me, like the oxen wandering seemingly aimelessly around the streets (although noone told me about the ubiquitous dogs) and the non-stop beeping of horns I can hear even from my 10th floor hotel room. But both Mumbai and Ahmedabad airports were incredibly well-organized and convenient. Passport control at Mumbai had more desks than any airport I've ever visited, including any of the ports of entry in the U.S. When I got on the plane at the Mumbai domestic airport this morning, after only a few hours of sleep, I realized I had forgotten my laptop computer at the security check. The staff of Jet Airways and the ground staff were incredible. They radioed to security and whisked me off to retrieve it, holding the plane until I got back.

I don't know where India is headed, but it will be exciting to watch them go there!

A Christmas Encounter

After a discussion over Christmas eve dinner about the Swedish "integration" policy, I get a ride home with a Somali taxi driver. Turns out he moved to Sweden 17 years ago so he's lived here 2 years longer than me and his Swedish was better than mine. We chatted about the difference between Californian, Somali and Swedish weather, and how driving in snow is not too different from driving in sand. He asked me about Christmas traditions in the U.S. and I said Santa Claus delivers presents to children's stockings on Christmas eve night. I realized how absurd this must have sounded when he astoundedly asked me who takes care of the costs for this? I realized that he probably thought anything could happen in the "land of opportunity" as he called it. At the same time, he said his sister lives in Ohio and she was jealous about the possiblity for all children in Sweden to get a decent education, even those who dont have money. But he liked the fact that when he is in America nobody asked him "where are you from." I hear that, brother!

Four encounters on my last day in Lesotho

Encounter 1

C-O-M-E-O-U-T!
C-O-M-E-O-U-T!

The chanting was coming from behind double-doors to my left. As young women wearing dress unusual for women in Lesotho streamed out of the room to go to lunch I stopped in my tracks to listen to a participant explain to an employee that it was a workshop on sexual orientation (actually, since they were speaking in Sesotho I heard "blah, blah, blah, sexual orientation.") In Lesotho! Fantastic!

Encounter 2

At breakfast I had heard some people speaking Swedish in a corner of the restaurant. Since they were white, and there were 2 black toddlers with them chattering to each other in a foreign language, I assemed they had adopted these children, especially since there are very few Swedes who have ever heard of Lesotho, let alone been there. I went over to talk to them and it turns out I was right. There were 2 families and they will live 200 km from each other so the children will have the opportunty to meet in the future. The couples said they were on their way home after 2 weeks of "adventures." Seeing as how they had never been to Africa, I can imagine the adventures they had dealing with the administration of adopting a child. Even getting a taxi in Africa for the unitiated can be an adventure!

Encounter 3

After breakfast I walked down to the golf course to play a round of golf. One of my colleagues had kindly arranged for me to borrow a set of ladies clubs for the day. In Africa you always have to have a caddie, whether you want one or not. Mine was a nice kid who knows that I don't like a lot of unsolicited swing lessons while on the course (on the driving range is another story). They call women of a certain age "Meh" (like the "Ma" of Ma Ramotswe of the No. 1 Ladies Detective Agency in Botswana). So he would politely try to encourage me or compliment me based on how well I was doing, ever mindful of his tip I am sure (unlike the unwise ballboy in Bangladesh - there you had to have a ballboy AND a caddie. God forbid the player or the caddie should have to look for a ball - who actually said to me: "Maam, you are very good on the green, but you are very bad on the fairway." He obviously wasn't thinking of his tip. But I digress). Anyway, at one point when I was having a bad streak but trying to look on the bright side, I said to my caddie: "Well, at least I'm not duffing the ball." To which he responded in all seriousness, "Oh Meh it makes me so happy you are not duffing the ball!" So there you go. I made one person happy yesterday!

Encounter 4

After an exhausting 18 holes on the brown, dry course, I stopped by an open-air crafts market. There is a cooperative of women living with AIDS that makes beautiful jewlery out of recycled glass. There was a Peace Corps volunteer there who is helping them with their finances and marketing. He agreed that Lesotho is a pretty cushy place to be stationed. Its certainly very different from my post in Chad over 20 years ago. It's such a beautiful country. It's surprising its not overrun with tourists.

2 miles high

Grand Lake, Colorado
Elevation 8,437 feet (about 3,000 meters)
Temperature: 75 F

The Thomsen Family Reunion 2010 has gathered my siblings, our kids, spouses (spice?) and parents from San Francisco, Las Vegas, Walla Walla, Chicago, Milwaukee and Stockholm. There are 23 of us hanging out in cabins about 2 miles from the entrance to the Rocky Mountain National Forest. We've spent the last few days swimming, horseback riding, hiking, and hanging out with family. This morning I played 18 holes of golf. The air at this altitude is crippling however. It doesn't matter how good shape one is in, walking up 10 steps has you bent over catching your breath.

We took a walk along the Colorado River and saw coyote spoor, bear scratches on a tree, and paw prints from coyote and moose. Unfortunately, half of the trees in the park are dead because of the Pine Beetle. They carry a fungus that destroys mature pines (mostly Ponderosa here) but leave the new saplings alone. So the hope is that when all of the mature trees die, the young ones will grow up in their place. The danger though is all of the millions of acres of deadwood that will pose an immense fire hazard.

We drove over the Continental Divide at about 12,000 feet. Rain that falls on the East side of the Divide eventually flows into the Atlantic and rain that falls on the West side flows into the Pacific. The scenery is incredibly beautiful above the treeline.

Oh, Oregon!

Portland, Oregon
Temperature: 86 F

We have had a fantastic time in Oregon. Here are some memories we will take home with us:

Cannon Beach and Haystack Rock: The sun is shining through the mist as we land on the beach at about noon. We throw off our clothes and run around in our swimsuits. We walk up and down the beach. I notice that I am the only individual over 10 years of age wearing a swimsuit. No, it was not a nudist beach, they all had clothes on! I was told that Oregonians don't wear swimsuits on the beach. That was weird. We had a wonderful time though. My family used to come to this beach on vacations so it brought back memories...

Multnomah Falls: One of the highest freefalling falls in the U.S. We climbed up to the top of Horsetail Falls and bathed in the water. The falls start from a mountain spring and not from melted snow as we thought. The view over the Columbia was awe-inspiring. One of the most beautiful places we have visited.

Portland: Powells Bookstore, the largest bookstore in the world! And tandem biking on the greenway along the Willamette River. Portland is the most bike-friendly city in the world!

Our next stop is Grand Lake, CO for a family reunion.