Global Health Adventures

Wedding Shower

2007-09-17T19:17:00.000-04:00

Engagement

2007-09-17T19:10:00.000-04:00

On August 10, 2007, late on a Friday night, I proposed to Becky under the moonlight at the Jefferson Memorial overlooking the Tidal Basin. She said, "Yes!," and we will be getting married on October 13, 2007 in Jekyll Island, Georgia. I am so blessed to be marrying such a wonderful woman, and can't wait to finally be together in the same city after months of living miles apart!

(The above photos were taken the day after our engagement when we returned to Washington D.C..)

Franklin Institute- King Tutankhamen Exhibit

2007-09-17T19:09:00.001-04:00

Miniature Golf

2007-09-17T18:36:00.001-04:00

A Day in D.C.

2007-06-26T22:26:00.000-04:00

Chris and Becky at the Museum of Natural History

A Giant Lego Map on the National Mall

Our Contribution to the Map (Becky, Chris, Becky's sister Jo)

Chris and Becky at the World War II Memorial
At the World War II Memorial

At the Botanical Gardens

The Washington Monument

Até mais, Fortaleza

2007-05-12T21:28:00.000-04:00

Nine and a half months after I first arrived in Brazil to begin what turned out to be an incredible year working abroad, today marked the end of my Fogarty Fellowship year. The year was different than I expected in many ways, but was an incredible experience in so many ways. Today was bittersweet as I said farewell to some great friends, while packing and preparing to head home to see many friends and family in the States who I have missed durign this year abroad. Much of my day was spent on one of my least favorite tasks... packing. I always seem to wait until the final day to pack, and this trip was no exception. Fortunately, I was able to fit all of my things into the three suitcases that I had available. After a day of packing, I joined two of my friends Andrêssa and Neto for dinner at a rodízio, Boi Preto. There I ate far too much, and followed dinner with a final trip to 50 Sabores, the best ice cream place in Fortaleza. After ice cream, I said farewell to two of my closest friends in Brazil. Currently, I sit in my apartment packing the last few things into my suitcases, with only ten hours before my flight is scheduled to depart from Fortaleza. I know I will leave Brazil tomorrow with some sadness, as Brazil has become home to me during this past year, but I also will depart with great anticipation for catching up with many friends and family in the US. This will likely be my last post from Brazil, and perhaps my last blog post for a while. I started this blog as a way to keep up with friends and family in the US while abroad, and now that I will be back in the US, it would seem to have served its purpose. I may post photos and news from time to time, but this will mark the end of the account of my year in Brazil. Many thanks to all who have read this and stayed in touch this year, and I do look forward to seeing everyone back in the US! Até mais tarde de Fortaleza!

Last Day in the Lab

2007-05-11T20:15:00.000-04:00

Nearing the end... Mais três dias

2007-05-10T16:41:00.000-04:00

The photo above was taken on my first day in Brazil over nine months ago. In some ways, that day seems like years ago, and in others it seems like not so long ago. In any case, it is hard to believe that in less than three days, I should be aboard an airplane bound for the United States. It will be sad to leave behind what has been an incredible year in Brazil, as I have learned much from my research, have made many great friends, and have seen many incredible places. Despite some sadness about leaving, I am incredible excited to be returning to the Estados Unidos (U.S.), and look forward to seeing the many people whom I care so much about and have missed during my year in Brazil. I also look forward to getting back to the School of Medicine, where I will begin my fourth year rotations on May 28, starting with a month of internal medicine (two weeks of consults and two weeks of infectious disease) before beginning rotations in ophthalmology, the field in which I currently plan to apply for residency training.

I'm sure I'll post a few more thoughts later this week on leaving Brazil, but I have been delaying packing my luggage, and that task is only looking more daunting as time passes, so for now I'll close...

Nine months later... three days from leaving...

Campeanato Cearense Final

2007-05-07T12:11:00.000-04:00

Sunday afternoon saw the state soccer championship come to an end as the second leg of the final was played in Fortaleza. Unlike many American sports, where playoffs involve best of five or best of seven series, soccer playoffs typically involve two game series, with the winner determined on aggregate goals. In this year's Ceará state league championship, the finalists were Fortaleza, the best team in our state, hailing from the capital, and Icasa, a team from Juazeiro do Norte, the second largest city in Ceará, 12 hours south of Fortaleza. The first leg of the final, played a week earlier, ended in a 2-2 draw, thus this match would prove decisive.

The match began in front of a larger than capacity crowd at the largest stadium in Fortaleza, Castelão. Nearly 70,000 fans saw Icasa have the better of play for the first 10 minutes, before Fortaleza began to show their superior talent. Fortaleza created a number of great scoring chances over the second ten minutes, but several shots placed just wide of the net left the score tied. Finally, midway through the first half, the Fortaleza attackers combined on a quick series of passes that found a wide open striker at the penalty spot. The striker converted the goal to give the home side the 3-2 advantage on aggregate, and the Fortaleza fans immediately roared to life with chanting, fireworks, and dancing. Fortaleza continued to dominate play for the remainder of the first half, heading to the break with a one goal advantage.

In the second half, Fortaleza again dominated play early, but was unable to capitalize on repeated chances, as striker Rinaldo pushed many a wide open shot just outside the goal posts. Icasa seemed unable to mount a coordinated attack in search of the equalizer until the final moments of the match, during which the Fortaleza goalkeeper made a number critical saves to preserve the win. Fortaleza held on to win 3-2, winning the Campeanato Cearense of 2007, a year after losing the title to crosstown rival Ceará.

The crowd became a bit unruly toward the end of the match with rather uncontrolled use of fireworks, that resulted in a small fire that was quickly extinguished. After being relegated to the second division of the Brazilian championship with a finish near the bottom of the first division last year, Fortaleza will open play in the Campeonato Brasileiro Serie B this Saturday, as will Ceará. Icasa will join Itapipoca, also a team from the interior of Ceará in Serie C, as 2006 Serie C finalist Ferroviário missed out on qualification for the third division with a fifth place finish in the state league.

Meia Maratona de Fortaleza

2007-04-29T14:45:00.000-04:00

Early this morning I took part in the half-marathon of Fortaleza which proved to be 13.1 long miles on a hot, sunny morning. I have ran a few 5k races and ran track in high school, but this is the longest and most challenging race that I have ever run. I entered the race with the primary goal of finishing the race, and set a time goal of 1:40. Despite the hot weather and fighting a losing battle to stay hydrated, I did complete the race successfully. If not for a few tactical mistakes (starting too fast, not drinking enough water, and not realizing that the middle half of the race would be a series of hills), I likely would have met my time goal. Unfortunately, I slid back through the peloton while trying to recover from dehydration and cramps during the second quarter of the race. I was able to make a late surge but that wasn't quite enough to meet my time goal and I finished the race in 1:47. I was happy to have completed the race under some incredibly hot weather conditions which forced a number of runners to drop out midrace, and look forward to improving the next time I try a distance race. I'd still like to complete a full marathon in the next year or so, but that will definitely require some more training, as today's half-marathon proved quite the test.

Vision Study Commences!

2007-04-26T18:47:00.000-04:00

This week, after months of waiting, I finally began my study to investigate the incidence of visual deficits in the community. I've enjoyed working on all of my different projects, but it was especially nice to finally see this project that I designed get started. It has been a long road to get this project designed and through all of the various bureaucratic hurdles, but at last the study has commenced. Following are some photos from the first days of work in the community:

Chris Tests Visual Acuity

Members of the Study Team

Chris and Some of the Children

Chris Tests Visual Acuity

Chris Tests Visual Acuity

Recording Data

Chris Performs the Cover-Uncover Test for Strabismus

Chris Tests Visual Acuity

19 Days

2007-04-24T19:40:00.000-04:00

Last night, Chris Brown began the journey back the the US, although he will be stopping to spend 6 days in Florianópolis on his way back. That leaves just Ben and I in Fortaleza, with Ben departing May 4, and I following on May 13. With so little time left, I thought I'd list a few of the things that I will miss about Fortaleza when I depart in less than three weeks...

1. Running by the Ocean... Almost every night, I have the privilege of going for a run along Avenida Beira Mar, with a view of the ocean and the sound of the waves crashing into the shore in the background. I love running on the hills of Charlottesville, but will miss running along Beira Mar with the ocean breeze and wonderful view when I leave Fortaleza.

2. The hammock... Many of you know that I have a hammock in my house which allows me to lay down in the evenings while reading or working or just relaxing, and look out the window at the ocean, listening to the tide coming in during the evening. I've never lived near the beach before, and the view from my hammock is something I will certainly miss...

3. Children in the community... For two of my projects, I have had the chance to head out to some communities near to our laboratory and spend some time working with the children in these communities, testing physical fitness and vision. Those have been some of my best days at work...

4. Friends... This year there have been so many Brazilian friends who have made the transition to living in another culture so much easier. From Neto who helped us settle in from the start to our other friends like Andressa, Ila, Jamilly, João, and so many others... they all have helped make this an incredible year.

5. Travel... I have had the chance to travel quite a bit this year, seeing some of the most incredible sights I have ever seen... from the grandiose Iguaçu Falls to the majestic Parque Nacional Lençóis Maranhenses to the sheer magnitude of the Amazon River, I have been blessed with great opportunities to see Brazil.

I'll probably post some more thoughts on things that I will miss about Brazil in the next two weeks... but even as I think of things that I will miss about Brazil, there are so many reasons that I am excited to be headed back to the U.S. And indeed, in just 19 days, I will arrive back in the US!

Miscellaneous Photos

2007-04-24T19:29:00.000-04:00

I'm still waiting to get some photos from a few other friends from both my Ilhéus trip and from Chris Brown's farewell party, but found a few pictures from the last few weeks that I haven't yet posted.

Chris, Nate, Margaret, Alex, and Chris in March
Chris in Ilhéus

Chris, Ben, and Chris on Chris' Last Day at Praia do Futuro

Jamilly, Neto, Bruna at Chris Brown's Farewell Party

Chris Brown Decides to Try the Entire Dessert

Mais Um Mes (One More Month)

2007-04-13T17:07:00.000-04:00

April 13th has arrived, meaning that I now have exactly one month remaining in Brazil. It seems weird to be thinking about my time left now in terms of weeks, rather than months, and its hard to believe that my time in Brazil is down to 30 days. Work is rather busy right now, although I've hit yet another snag in trying to start my vision study, one day after scheduling it to begin next Wednesday. Now it looks as though things may be delayed a bit more, and so I'll continue focusing on lab work for the next week.

As I think about leaving Brazil on May 13, I will be happy to get back to the US, but won't necessarily be happy to leave Brazil. While I'm really looking forward to getting back to the US to see family and friends, there are many things that I will miss about Brazil, including the friends who I have made here. I'll probably write a bit about some of the things I'll miss about Brazil later, but for now, I thought the opposite might be more interesting (and timely giving some of the frustrations of the last week). And so without further ado, the top 5 things I won't miss about Brazil...

1. Higher crime... never feeling 100% relaxed given the higher crime in Brazilian cities
2. Long, hot bus rides through narrow, crowded, polluted streets... arriving at work soaked in sweat and exhausted
3. Lack of pedestrian safety... cars speeding up rather than slowing down for pedestrians (or people knocking you into the path of an oncoming car while you're running...)
4. Meetings in Portuguese... feeling exhausted after sitting through a marathon two hour meeting in a foreign language
5. Bureaucracy... The simplest things seem nearly impossible to get done thanks to layer after layer of bureaucracy (see account of my attempts to register with the Federal Police earlier in the blog...)

But despite some frustrations, there will be many things that I will miss greatly about this incredible country that I have called home for the last 9 months. Many great friends, incredible sights, and enjoyable activities will be greatly missed. Living in another culture for a year has been both a challenge and a joy, and I know that I will look back on my time in Brazil fondly in spite of many of the challenges.

There are quite a few people who I'm looking forward to seeing when I get back to the US, and so amidst attending a couple weddings of friends and family, moving back to Charlottesville, and getting started with clinical electives on May 28, I hope to have a chance to catch up with many of the people who I haven't seen in quite a while soon after my return, and there's also a much anticipated soccer game to be played with some friends. Until then, I do hope all of you in the US are doing well, and look forward to seeing many of you in May!

Jericoacoara Photos

2007-04-08T18:48:00.000-04:00

A Large Dune

The Main beach at Jeri

Sunset from the Dune

Looking Westward

The Village of Jericoacoara

One of the Main Streets in Jeri

Headed to the Beach

Fishermen

The Beach

Me at Jeri

Ilhéus Photos

2007-04-08T18:42:00.000-04:00

I'm still waiting for most of the photos from the conference that were taken by the other students with me in Ilhéus, but below are a few photos from my camera, all from our Friday evening in the city of Ilhéus.

Dr. Reinaldo's Wife, Dr. Reinaldo, Jamilly (Brazilian medical student), Dr. Guerrant (Our PI)
The City of Ilhéus at Sunset

Relaxing Before Dinner

More photos to come from the conference...

TMRC Ilhéus

2007-04-03T09:56:00.000-04:00

The weekend before last, I journeyed to Ilhéus, a city in southern Bahia for the 2007 Tropical Medicine Research Center Conference. I learned that I would be presenting at this conference at the very last minute, and so the days leading up to the conference were quite busy in the lab. After a series of flights connecting through Salvador, I arrived in Ilhéus on a Thursday night where we were met at the airport by a shuttle to transport us to the conference. I was traveling with Chris B, Jamilly (a Brazilian medical student), Dr. Guerrant, Dr. Aldo and his life Dr. Noelia, and Dr. Reinaldo and his wife. Since our US PI, Dr. Guerrant, was with us, there was a person waiting at the airport with his name on a sign to meet us and take us to the conference hotel. That's the first time in Brazil that I've arrived at an airport to have someone waiting with transport. It was a relaxing alternative to the usual scramble to find a taxi and to search for a pousada or hotel with a room available.

After a 20 minute drive, we arrived at the "EcoResort" that hosted the conference. We quickly headed to the first conference session which was already underway. The conference was a small conference with about 30-40 attendees which allowed everyone to get to know all of the other participants. We also met up with Tracey, the Salvador Fogarty Fellow who also was attending the conference.

The second day consisted of presentations which focused mostly on Leishmaniasis, as well as a few other miscellaneous presentations including a great talk on study bias and epidemiology. After the presentations concluded in late afternoon, we headed into the town of Ilhéus, and saw a few of the cities most famous sites, including a restaurant where one of Brazil's most famous authors, Jorge Amado, did his writing. Then we headed to a house overlooking the river and ocean from a hill where we were treated to an incredible dinner of shrimp, beef, rice, and many other great foods. Finally we headed back to the conference resort to get some sleep in advance of our presentations.

Saturday morning was the series of talks on diarrheal disease and HIV. I spoke second, following Dr. Guerrant, and I think everyone's talks went pretty well. In the afternoon, after shooting some hoops for the first time in a while, I was invited to play soccer with some Brazilians. I should note that like many pickup soccer games in Brazil, the game was played barefoot. After a couple of hours, I retired to shower with my feet bruised and torn up, but after an incrediblt fun game. Just after my shower, a knock at my door proved to be an invitation to another soccer game, this time wearing shoes with the other conference participants. This proved to be an intense game in which I had a great time, managed to score 3 goals and assist on 3 more to Dr. Reinaldo, although my team ended up losing 10-8. While I've watched a lot of soccer in Brazil, the two games at the conference were the first times that I had stepped on the field to play in quite a while, and while I was tired with some scraped knees and bruised feet, it was quite a fun afternoon.

Sunday, we all headed back to Fortaleza, with a bit of a delay during our connection in Salvador. Chris Brown stayed in the Ilhéus area for a few extra days checking out a nearby surfing location, Itacaré, but now we're all back in Fortaleza sequencing genes, amplifying DNA, and analyzing stool samples... This weekend is another holiday (Easter), and with the lab closed Thursday and Friday, we may finally make our first trip to Jericoacoara Thursday through Saturday. Jericoacoara is known as one of the top 10 beaches in the world, and as the best beach in Ceará. After the weekend, I'll be continuing with sequencing, PCR, and hopefully finally starting my vision study if I receive final approval from the UVA ethical committee this week as expected.

Photos from the TMRC to follow as soon as I get Jamilly and Chris' photos, as I only took a few pictures...

Headed To Ilhéus

2007-03-18T22:55:00.000-04:00

Just when I thought I was done traveling around Brazil for a while, it seems that I'll be flying out of Fortaleza again Thursday... Our PI, Dr. Guerrant, arrived in Fortaleza last Thursday. He will be heading to a Tropical Medicine Conference this Thursday in Ilhéus, a city in Bahia located south of Salvador. I had not submitted an abstract and was not planning to present, as my research projects had been delayed due to ethical committee delays and other issues. In the last week though, I have made quite a bit of progress on one of my lab proejcts and so Dr. Guerrant ahs asked me to present at the conference regarding this project. In the aftermath of this decision, I've spent most of the weekend in the lab feverishly finishing work on the part of this project that I will present and will have to continue this work and put together a presentation over the next three days. Thursday afternoon, I'll join Dr. Guerrant, Dr. Aldo, Chris Brown, and Jamilly (a Brazilian medical student) for the journey south to Ilhéus. The conference should be interesting with presentations on research in leishmaniasis, HIV, and diarrheal disease.

Iguaçu Videos

2007-03-11T11:50:00.000-04:00

While at Iguaçu, I was able to use my digital camera to video the falls as well. Pictures and even video really can't do the falls justice, but I think the video gives a better idea of their size and the incredible sound of water crashing into the gorge below. The videography is certainly not great, but feel free to check out these shots of the falls. Both videos are of Devil's Throat, the last and most impressive fall in the series.

Video from Brazilian Side

Video from Argentine Side

Both are fairly large files, so I'd recommend right clicking on the links and saving the files to your computer, as viewing them from your web browser might be slow.

Apartmento Novo

2007-03-10T21:42:00.000-05:00

Photo Tour of my New Apartment:

The View from my Living Room Window

Kitchen

My Shower (Note the special showerhead - For the first time in Fortaleza, I have hot water!!)

Dining Area

Living Room

Living Room Window

My Bedroom

Florianópolis

2007-03-10T21:21:00.000-05:00

Florianópolis is a city in southern Brazil that straddles the mainland and an island, the Ilha do Santa Catarina. Ilha do Santa Catarina is home to many beautiful beaches that are juxtaposed with mountains and sand dunes. I spend the last weekend of my vacation on the island, primarily at a beach, Praia do Campeche.

I arrived again somewhat exhausted after an early morning flight out of Buenos Aires. After settling into my pousada, I headed out to relax on the beach of Praia do Campeche. It was a rather quiet beach with a view of the nearby mountains without the numerous barracas that litter the beaches of Fortaleza.

On my second day in Santa Catarina, I decided to head out to an island off shore of Praia do Campeche, Ilha do Campeche. This island is home to an archaeological and ecological reserve. I spent the morning hiking through trails observing interesting rock formations, and rock carvings that were created many years ago. Returning to the main island after lunch, I spent the remainder of the afternoon on the beach before retiring to the pousada to spend several hours reading in the evening.

On my final day in Santa Catarina, I headed into the city of Florianópolis, riding a public bus to get a view of parts of the city. Later in the afternoon, I headed to the airport for my return flight to São Paulo, and was able to get on an earlier flight back to Fortaleza, arriving in Fortaleza just after midnight after a fun and relaxing vacation, ready to get back to work in the lab.

Praia do Campeche

Looking Across to Ilha do Campeche

Hiking on Ilha do Campeche

Hiking

Rock Formations

Rock Formations

Rock Carvings

Our Guide Points out More Rock Carvings

More Carvings

Hiking

Rock Formations

Pausing for a Photo

More Rock Carvings

Hiking on Ilha do Campeche

Looking Back at the Main Island, Ilha da Santa Catarina

A Bird
The Boat to Ilha do Campeche

Praia do Campeche

City of Florianópolis

Buenos Aires

2007-03-10T19:30:00.000-05:00

After an incredible weekend at Foz do Iguaçu, my vacation plans next took me a bit further south to Buenos Aires, the capital of Argentina. After arriving on a Monday night and taking a taxi into town to the hostel where I was staying, I was a bit tired, but still ventured out for dinner. I stayed right in the heart of the city near one of the famous landmarks, the Obelisco. One of the major streets in town (about 18 lanes wide) was right near my hostel, and it was quite the contrast to the narrow crowded streets of Fortaleza.

I hoped to see much of the vity of Argentina in a short time, and so I elected for a slightly unconventional method of touring the city. I didn't want to do the whole tourist bus tour of the city, but wanted to see more of the city than I could by walking, and so instead signed up for 2 half day bike tours of the city for Tuesday. The morning tour would be in a large group visiting the southern parts of the city, while the afternoon turned out to be a private tour of the northern parts of the city. Biking proved to be a great way to the city, and I highly recommend this tour group if you ever find yourself in Buenos Aires (www.biketours.com.ar). As the first ever tourist to complete two bike tours in a day, I was even given a free official biketours T-shirt which I now proudly wear :)

The mornign tour began by visiting the memorial to the soldiers who died in the war for the Malvinas Islands. You might better know this war by its other name, the war for the Falklands. Argentines refer to the islands by a different name than the British. We then continued to the old port, Puerto Maduro which now has been converted to fancy restaurants. Then we headed to the ecological park inside the city, which overlooks the Rio de la Plata, and followed this with a trip to La Boca, a very colorful neighborhood and home to one of Argentina's most famous soccer teams, Boca Juniors. After a snack break, we continued on through the Microcentro region passing many plazas, including Plaza de Mayo. Finally, after 4 hours of cycling, we returned to our starting point, where I immediately prepared for another 4 hours of cycling through the northern neighborhoods of the city.

The north included cycling through Palermo, a beautiful neighborhood with many green parks (something else we lack in Fortaleza). After Palermo, we continued through the district where all of the foreign embassies are located, and proceeded to Recoleta. Recoleta is home to Recoleta cemetary, where many of Buenos Aires most wealthy citizens are buried. I found the extravagance and expense of this cemetary to be a bit absurd, as it seemed to be almost a small city. Finally, we rode back through portions of the Centro passing a number of museums, some of which I visited on my last day in Buenos Aires.

On Tuesday, I elected to get back on the bike, this time with a different bike tour group for a 25 km north along the river to a colonial town called Tigre. Near Tigre is a large river delta with many narrow channels and houses located on small islands, with the small rivers serving as the roads of the delta. On the way to Tigre, we passed through many quaint small towns, and were able to look back on the large city of Buenos Aires. Arriving in Tigre in early afternoon, we jumped into kayaks to spend a few hours kayaking in the delta region. After a close encounter with a large ferry in the channel that nearly toppled my kayak in its wake (the channel was shallow, but I would have gotten soaked of course...), we returned to land and returned to Buenos Aires by train. That night, as I did each night in Buenos Aires, I was able to have some of Buenos Aires' famed steak, which is quite cheap and quite good.

On my last full day in Buenos Aires, I saw several museums, and rendezvoused with three of my UVA classmates who were in BA studying Spanish for a month. We had dinner in the Puerto Maduro area late, and I then headed back to the hostel to get an hour of sleep before my very early flight back to São Paulo for a connection to Florianópolis, the final stop in my vacation. Buenos Aires was an incredible city with many great parks, wide streets, and a much safer, laid back feel relative to Fortaleza, and I definitely enjoyed my time there.

Malvinas (Falklands) War Memorial

English Tower

Cycling toward Puerto Maduro

Puerto Maduro

A Unique Bridge in Puerto Maduro

Ecological Park in Buenos Aires

Stopping for a Break in the Park

On the Bike in the Park

Colorful La Boca

Colorful La Boca

La Boca

The Colorful Buildings of La Boca

Stadium of Boca Juniors

Statue

Cycling through Town

Plaza

Unique Art: This metallic flower opens in response to sunlight, and closes at night

Rose Garden

Rose Garden

Statue

Statue of Eva Peron (Evita)

Recoleta Cemetary

Recoleta Cemetary

View of Buenos Aires and the Rio de la Plata Enroute to Tigre

Butterfly in an Ecological Park North of BA

Hiking in the Park North of BA

Towns Enroute to Tigre

The River Delta

Aviation Museum in Tigre

Avenida 10 de Julho (Incredibly wide avenue)

Obelisco

Statue

Iguazú Falls - The Argentine Side

2007-03-10T08:47:00.000-05:00

A day after my visit to the Brazilian side of the falls, I joined a group of four on a journey across the border to visit the Argenine side of Iguaçu Falls. After completing border formalities aand adjusting our watches for the one our time difference between the two countries, we arrived at the Argentine national park in mid-morning. The first activity would be a boat ride on the Iguaçu River below the falls passing under the second largest fall, soaking everyone on board. This proved to be a great way to get a very unique perspective of the falls. After climbing off the boat, we began the hike on the first of three trails in the park, the Passeio Inferior. This gave us a view of the lower portions of some of the earlier falls in the series. The Argentine side allowed for a much closer view of many of the falls, as you can see from the photos below. We then continued to the Passeio Superior, which gives a view from above of many of the earlier falls in the series of cataracts. Finally, after a lunch in the park, we headed out the third and final trail, Garganta do Diablo to view the most impressive final waterfall, known as "Devil's Throat." This required a train ride to reach the catwalk that carried us to the fall, as the catwalk that previously allowed one to continue from the Passeio Superior was washed over the falls in a flood over 10 years ago.

Devil's Throat was equally if not more impressive form the Argentine side. We had an incredible view of the walls of water plummeting into the gorge below creating an incredible tower of steam from the spray. After an hour of observing the falls, we headed back to begin the journey back to Brazil. Photos can't really do justice the magnitude of the falls, as they really need to be experienced in person, but still they do make for some impressive photos.

On the way back to Brazil, we stopped at the Three Frontiers, an overlook of the junction of the Iguaçu and Paraná rivers which meet at the border between Argentina, Brazil, and Paraguay. After this brief stop, I returned to Brazil to get some sleep in advance of my early morning flight back to São Paulo to connect to an evening flight to Buenos Aires, Argentina, the location for the next leg of my trip.

Viewing some of the Smaller Falls from the Boat

The Second Largest Fall - We Went Under this One

On the Boat

Standing by One of the Smaller Falls

Really Close to One of the Smaller Falls

The Same Fall Again

Twin Waterfalls

View from the Passeio Superior

Another Fall

Butterfly

Approaching "Devil's Throat"

Devil's Throat

Falls Adjacent to Devil's Throat

Three Borders (Paraguay to left, Brazil to right, Argentina bottom)

Three Flags

Foz do Iguaçu: The Brazilian Side

2007-03-09T22:40:00.000-05:00

During my February travels, my first stop was Iguaçu Falls, arguably one of the most impressive series of waterfalls in the world, perhaps rivalling only Victoria, which I also have had the privilege of visiting. I arrived in the Brazilian town of Foz do Iguaçu after a long afternoon and evening of flights, which were delayed as often happens in Brazil. Finally arriving at 3 am, I caught a few hours of sleep before heading out to Parque Nacional do Iguaçu to spend my first day viewing the falls from the Brazilian side.

After riding a bus through the national park to a point where the walking trail begins, I stepped off the bus to begin an incredible hike through the national park viewing an incredible series of waterfalls. The series began with a series of smaller falls that were impressive in their width, and gradually built up to one of the most incredible sights I have ever seen. The final fall is know locally as Garganta do Diablo, or "Devil's Throat." This fall occurs where two falls meet at right angles creating an incredible spray of water from the collison of two walls of water plummeting into the gorge below. I was able to walk out on a catwalk to feel the spray of the falls and feel the vibrations of the water crashing to the floor of the gorge, and to hear the incredible thunder of flowing water. Finally, I rode an elevator to an overlook that allowed for a view from above the falls. I found myself returning to the catwalk overlooking this fall several times, before I finally headed back to town late in the day to rest up for my trip across the border to the Argentine side of the falls the following day. Pictures of the Brazilian side follow, and I'll post a separate post with photos an account of my trip to the Argentine side.

Welcome To Foz do Iguaçu

One of the Smaller Falls

More Small Falls

View from the Trail

A Large Fall

Another Fall

The Catwalk

Me at the Last Fall

Me Approaching the Last Fall

Another View of "Devil's Throat"

Another View

Postcard from the Edge

Rainbow

The View from Above

View from Above

The Viewing Platform

Endereço Novo

2007-03-09T17:25:00.001-05:00

Indeed I again have a new address (endereço novo) as last week I moved
for the second time this year, and now live on the 9th floor of an
apartment building with an incredible ocean view. I've been without
internet at home for the first week after the move, hence the delay in
posting photos from my February trip. I'll be posting those photos this
weekend, along with an account of my trip to Iguaçu Falls, Buenos Aires,
and Florianópolis. Work is also busy with one of the larger studies of
community diarrhea getting underway, and my UVA mentor visiting
Fortaleza next week.
Since the move, my address has changed to:

Rua Antonele Bezerra 336 Apto 902
Meireles
Fortaleza/CE 60160-070
Brasil

You'll note the similarity to my old address as I've moved all of 30
feet across the street...

Photos from my trip will follow as soon as I can upload them tonight or
tomorrow...

Back in Fortaleza

2007-02-26T18:06:00.000-05:00

After 10 days of an incredible trip to Foz do Iguaçu, Buenos Aires, and Florianópolis, I arrived back in Fortaleza very early this morning. I took many photos, and will post those along with an account of my trip later this week. Over the next few days, I'll be busy getting my community vision study started, moving to a new apartment, and catching up on some other work. I'll be moving Wednesday, but only across the street to a taller apartment building. Nate Ostheimer will be heading back to the US soon, and Ben will be moving to live with a family so Chris B and I will be moving to a smaller apartment, but gaining an ocean view from our new location on the 6th floor of a building near our current apartment. Photos to follow later this week...

Postcard from Foz do Iguaçu

2007-02-19T07:53:00.000-05:00

Research Update

2007-02-10T13:04:00.000-05:00

Work in the lab is progressing, and it finally looks as though I may be able to begin my community vision study this week. Here's an update on my projects...

1. Evaluation of Physical Fitness in Children with Chronic Early Childhood Diarrhea
We finished data analysis for this project, although the results were a bit underwhelming. We may extend this study to a second community in Fortaleza, but this is not a high priority right now.

2. PCR Diagnosis of Cryptosporidium, Giardia, and Enteroaggregative E Coli
We have two of these three tests functioning, and I should be able to get the final test (for an organism called Giardia) working now that I have finally received a critical positive control sample to validate the assay. Then, I'll just be waiting for the start of rainy season to begin collecting hundreds of stool samples to test for each of these three organisms. Rainy season could arrive any week, as we've begun to receive brief early morning rains a few days a week.

3. Sequencing of various Genes in Cryptosporidium and Enteroaggregative E Coli
This is a new project that I have been assigned in the wake of my certification as a DNA sequencer. We'll try to select genes that might be important determinants for virulence to sequence. This will allow us to determine why some who are infected with Cryptosporidium and EAggEC get ill and have other long-term morbidity, while others have fewer problems and little long-term morbidity. I'll help get this sequencing project going this spring in the form of a pilot study, but this project will continue long after I leave Fortaleza in May.

4. Evaluation of Visual Function in Children
This is a project that I conceived and have pushed through all steps of the ethical approval process. Sicne receiving approval, I have been waiting for two weeks to receive the approved consent form for my study which needed a stamp from the chair of the local ethical committee. Finally with this critical stamp in hand, I will be able to begin scheduling and recruiting for my study this week. I'll begin with vision testing in one of the communities near our lab over the next 3-4 weeks, an later will likely extend the study to an additional community. This will allow us to look at the potential impact of malnutrition on vision in children, and may suggest the need for further nutritional interventions and vision screening in the community.

With these projects, things are actually fairly busy in the lab right now, even as I prepare to head out of town for 10 days while our lab closes for one of Brazil's largest holidays, Carnaval. I'll continue work in the lab this week before departing for Iguassu Falls in Southern Brazil Friday, followed by stops in Buenos Aires (Argentina), possibly Colonia (Uruguay), and finally Florianópolis (Southern Brazil). Then I'll be back in Fortaleza to complete my vision study, and process many samples in the lab before my departure date in mid-May.

Parque Nacional Ubajara

2007-01-30T18:21:00.000-05:00

This past weekend, I made my second journey to a Brazilian National Park, this time to Ubajara in my home state of Ceará. Ubajara is Brazil's smallest national park, and is home to a cave, hiking trails, and waterfalls. The park is a bit inland, directly west of Fortaleza, 5-6 hours by bus.

A day before we headed to the park, we welcomed another American student to Fortaleza. Alex Rogers is a fourth year medical student from Wake Forest who will be in Fortaleza for two months working in our lab. Despite arriving early on Thursday morning, she was willing to join Nate and I for an early Friday morning bus to the park.

After a six hour bus trip west of Fortaleza passing through the town of Itapaje and the apparently "reviled" town of Sobral, and concluding with an ascent of roughly 2500 feet, we arrived in the town of Ubajara. We began walking in the direction of the pousada where we had arranged lodging, unsure of the distance to the pousada. After 45-60 minutes, we arrived at Sitio do Alemão, a pousada run by a German who has lived in Brazil since the early 1980s. We settled in to a nice chalet at the pousada, and joined the owner for a trip to a nearby spring to collect water. We rested for the remainder of the day enjoying the views of the surrounding area from the pousada.

We awoke Saturday and prepared for a hike through a nearby area that had a series of waterfalls. After a somewhat harrowing trip in the very old car driven by the German owner of the pousada, Herbert, we began our hike. We stopped at each waterfall, spending time swimming, or in my case, slipping on wet rocks into deeper pools of water soaking my clothes...

Finally we approached the final waterfall in the series, which apparently was the tallest and most impressive. Viewing this fall though required a bit of effort, in the form of a descent down a 30-40 foot cliff using tree branches and a rope ladder. The water fall proved quite impressive, and allowed us a chance to cool off before beginning the hike back out of the canyon. After an enjoyable afternoon hiking and viewing the waterfalls, we retired to the pousada to rest before our Sunday hike through the national park, descending to the cave.

Sunday morning, we began the 7 km descent to the cave at around 9 am. During the descent, we viewed a few waterfalls which currently were rather dry due to the late start to the rainy season. We also passed a series of donkeys being steered down the same trail to deliver supplies from Ubajara to a town at the bottom of the mountain. After a few hours of hiking, we arrived at the Ubajara cave, and were taken on a guided tour of the cave's outer chambers. The cave likely pales in comparison to some of the famed caves of the US, but still was impressive. After the cave tour, we boarded a cable car for the journey back up the mountain. After an afternoon at the pool of a nearby pousada, we headed into town for dinner before we boarded an overnight bus back to Fortaleza.

The weekend in the mountains was a welcome respite from the heat and traffic of Fortaleza, and I'm already looking forward to my upcoming trip to southern Brazil and Argentina. Lab work is actually progressing quite well also, and I'll probably write an update regarding my research later this week. Photos from Ubajara follow.

Pousada Sitio do Alemão

Overlooking the Sertão of Western Ceará and Eastern Piaui

Lunch at a Local Restaurant: Free-Range Chicken, Claw Included

View of the Sertão and Mountain

Waterfall 1

Another Waterfall

Yet Another Waterfall

Cacti!

Beginning the Final Descent

Cachoeira do Frade: The Final Waterfall

Pondering the Best Approach for the Rope Ladder

After Successfully Completing the Descent

Under the Waterfall
A Rather Dry Waterfall in the National Park

Descending the Mountain
All that Separates one from a 1000 foot+ drop - Only in Brazil...

View of the Cable Car from the Trail

Waiting for the group to catch up

In the Cave

Stalactites and Stalagmites

Nate, Alex, and Chris in the Cave

Preparing for the Ascent

The View from the Cable Car

The View from the Cable Car

A Very Comfortable Bus Ride back to Fortaleza

Ceará vs. Maranguape

2007-01-14T09:21:00.000-05:00

Campeonato Cearense
Estádio Presidente Vargas
13 Jan 2007
1630

Ceará opened defense of their Cearense championship in the first game of the 2007 Campeonato Cearense. A spirited crowd packed Estádio Presidente Vargas to cheer on the reigning champions as they faced Maranguape, a team based in the town Maranguape in the mountains south of Fortaleza.

Ceará had the better of play early in the match, but a misplay by the Ceará keeper left a rebound free 5 yards out. A Maranguape striker buried the close range shot to give the visitors a surprising 1-0 lead 10 minutes in. Ten minutes later, Ceará answered back after the Maranguape keeper yielded a long rebound off of a Ceará break. The right sided Ceará striker made no mistake in tying the score off the rebound. The teams traded chances for the remainder of the first half with Maranguape's speedy strikers gaining chances and Ceará's midfield possession controlling play. The teams reached the break tied at one.

The second half began with a few quick chances for Maranguape before Ceará again began to control play. Gaining a corner kick 20 minutes in, Ceará played a beautiful arching kick right to the head of a Ceará attacker at the far post who struck a header into the back of the net to give Ceará the 2-1 lead. Ceará would not relinquish this lead, and the remainder of the game was remarkable only for two yellow cards to Ceará for reckless tackles, and a pushing and shouting match between two Ceará defenders after a miscommunication lead to a Maranguape chance. Ceará did not look entirely in control in this first match of the 2007 season, but will look to continue to shake off the early season rust as they return to action on the road against Itapipoca Wednesday night.

Certificação, Campeonato Cearense, Carnaval

2007-01-13T10:12:00.000-05:00

After two weeks in the US, I returned to Brazil last Saturday, after what fortunately was a fairly uneventful day of flights. With the large number of flight delays in Brazil lately, I worried that I would miss a connection or have significant delays, but was fortunate to arrive back in Fortaleza more or less on time.

Back in the lab on Tuesday, I was drafted to be one of our lab's representatives to participate in DNA sequencing training. In the US, DNA sequencing is generally done for researchers by "core facilities," which have individuals trained in the operation and maintainenance of DNA sequence analyzers (machines that cost $70,000 - several hundred thousand dollars) who do all DNA sequencing for researchers in a large University. Here in Brazil at the Universidade Federal do Ceará, we have no such facility, but our lab was recently given funding to purchase a sequencer which arrived a few months ago. This past week, five individuals were to participate in training on the sequencer, which would consist of about 40 hours of instruction over four days on the use and maintenance of the machine. Three other labs each were sending one representative, and our lab was given two spots. Now one would think that since the instruction and examination were entirely in Portuguese, our lab would send some Brazilian doctors, grad students, and professors, but alas, Chris Brown and I somehow made the cut for the training. And so, over the last four days, I've spent about 10 hours a day in lecture and practical training with the sequence analyzer. Yesterday, we concluded our training with a 10 question short-answer examination in Portuguese, which the two Americans both passed with flying colors. Therefore, now both Chris Brown and I can proudly say that we are Applied Biosystems Certified DNA Sequence Analyzer Engineers. Indeed certificates are on the way in the mail from São Paulo which will occupy prominent locations on our refrigerator.

With the accomplishment of sequence training in Portuguese complete, I somehow seem to have inherited a number of additional projects related to sequencing which I had no idea I would be involved in a week ago. And so this week, I'll be doing more work with sequencing, while also doing some other laboratory work to prepare for the PCR testing that we'll be doing a lot of as rainy season begins shortly. Additionally, I'll begin analyzing data from our physical fitness study from the fall, and may be able to present some of these results at a research conference in Ilheus, Bahia (South of Salvador) in March. My study of visual function in children should receive final approval in the next 1-2 weeks, which means that I'll also be able to begin this work which is quite exciting.

Outside of work, the Campeonato Cearense begins today with the top 10 football teams in the state of Ceará playing for the next two months to determine the state champion. Among the teams are four teams from Fortaleza: Fortaleza, Ceará, Ferroviário, and Uniclinica. The other six teams hail from elsewhere in the state. Fortaleza and Ceará will also compete in Serie B of the Campeonato Brasileiro which begins in April, and the next two highest placed teams in the Campeonato Cearense will qualify for Serie C of the Campeonato Brasileiro. My favorite team remains Ferroviário, but I'll probably catch quite a few games involving all four of the Fortaleza based sides, beginning with the opening match of the championship today as Ceará hosts Maranguape.

Otherwise, I'll be quite busy at work over the next five weeks, before the lab closes for several days for Carnaval. During Carnaval, I've decided to travel to Foz do Iguaçu, Buenos Aires, and Florianópolis. Foz do Iguaçu are incredible waterfalls in Southern Brazil that some describe as more magnificent than Victoria Falls, which I had the privilege of visiting in Zambia in July 2003. Buenos Aires of course is the capital of Argentina, where I'll spend 4.5 days, also possibly crossing the Rio de la Plata to visit Montevideo, Uruguay if I have time. Finally, I'll conlude my February journey by spending 3 days in Florianópolis, a city that is located on the Ilha da Santa Catarina in Southern Brazil. Then I'll return to Fortaleza to continue work on all of my research projects before returning to the US on May 18. It should be a busy final 4.5 months here in Brazil, and I look forward to getting a lot of work done, and also continuing to enjoy South America.

Estados Unidos

2006-12-23T14:25:00.000-05:00

Despite the best efforts of Brazilian Air Traffic Control, I arrived back in the US yesterday. My adventure began as I went to the airport for my flight out of Fortaleza to Sao Paulo, only to learn that it ws delayed by over 4 hours due to the continued air traffic control slowdown in the country. This delay would mean that I would likely miss my connecting flight in Sao Paulo to Washington D.C.

Fortunately, after I learned of the delay, I was able to talk to a representative from the airline that I was scheduled to fly from Fortaleza, TAM Brazilian Airlines, who agreed that the airline would pay to put me on an earlier direct flight to Sao Paulo with another of the Brazilian airlines, Gol.

Thanks to this change, I was able to arrive in Sao Paulo with ample time to collect my baggage and check in for my connecting flight with United. This United flight was delayed 12 hours on the previous night due to an aircraft problem, but I was told that the flight would depart on time on this night. Indeed, after clearing customs, we boarded the flight 15 minutes before the scheduled departure time, and seemed on course for an ontime departure as the doors were closed and we prepared to push back from the gate. Alas, Air Traffic Control struck again, this time as Brasilia Air Traffic Control handed down a 2 hour takeoff hold, delaying our takeoff. In the aftermath of the Gol crash, underpaid and overworked controllers have been refusing to handle the usual number of flights leading to widespread delays, particulary in Sao Paulo and Brasilia. In this case, our flight would fly through Brasilia airspace, thus the reason for the delay. Finally, after two hours of watching a movie on the inflight entertainment system, we took off bound for D.C. After a 9 hour flight, with little sleep, but many hours of listening to the collection of Christmas music playing on the plane's audio entertainment system (the same 20-25 songs over and over again), I arrived in a chilly and rainy Washington. Indeed the 40 degree weather was quite a shock as I arrived in shorts and sandals. dressed more appropriately for the 90 degree and humid weather of Fortaleza than the early winter weather of our nation's capital.

I'll spend the next two weeks in the US spending time with family and friends and heading to Charlottesville for a few days to set up things for my fourth year and to pick up supplies for Brazil before I return for the last 5 months of my fellowship.

Feliz Natal!

Feliz Natal!

2006-12-20T18:17:00.000-05:00

Feliz Natal (Merry Christmas) to all!

It seems odd to be uttering the phrase as I sit here in 88 degree weather (with lows around 77), but as our lab Christmas party today reminded me, it is indeed nearly Christmas. I wanted to wish all of my friends and family back in the US a Merry Christmas in this season of remembering Christ's birth.

This week has been quite busy as I finished up some lab work on Monday and Tuesday, also celebrating my 25th birthday on Tuesday with dinner at a Mexican restaurant with friends. Tonight I'll be packing because tomorrow afternoon (Thursday) I will fly out of Fortaleza on a flight to São Paulo, where I'll board a flight at some time around midnight bound for Washington D.C. I'll be spending the next two weeks in the US while our lab is closed for Christmas, spending time with family and also spending some time back in Charlottesville planning for my fourth year of medical school and getting some supplies together for my research projects in the second half of the year.

Again, I wish everyone a wonderful Christmas, and hope to see some of you all while I am visiting the US!

On the Proper Use of Mosquito Nets

2006-12-20T17:44:00.000-05:00

I have previously slept under a mosquito net during some of my travels in Africa, where malaria is a serious risk, but didn't really consider using a net during my first few months in Brazil. Fortaleza, unlike the Amazon region, is not an area where malaria is endemic. We do ahve a significant presence of dengue, a different mosquito-borne illness, but it is transmitted by a different type of mosquito that is more active during the day. Since mosquito nets did not appear necessary from the standpoint of disease prevention, I never really gave the idea a thought until the past few weeks.

Since I live so close to the water, we have quite a concentration of mosquitoes around each night. Despite my best efforts at repelling the annoying insects, I found myself waking up with multiple mosquito bites each night. Finally, Nate and I went to Mercado Central in search of mosquito nets to cure this problem. We quickly obtained the necessary nets, and returned home only to realize that we would need some form of string or rope to suspend the nets over our beds. Undaunted, I headed off to the oceanfront market in search of an enterprising salesman willing to sell me some of their string or rope for what would likely be a ridiculous price. Indeed, after much searching, I found just such an entrepreneur who sold me enough of a plastic string/rope that would function to suspend my mosquito net.

I returned home and quickly set up the net, draping it around my bed, nearly touching the floor on all sides as shown below. This seemed to work well for a few nights, as I only received a few bites each night, which I assumed occurred prior to when I went to bed. Unfortunately, my confidence in my initial implementation of the net proved unfounded when put to the test by one of the worst nights for mosquitoes in recent history. On the third night after I set up my net, I awoke at 3 am covered in mosquito bites with approximately 50 mosquitoes flying around inside my net. Apparently they flew under my bed and found their way inside the net, at which point they were trapped by the very device that was designed to prevent their attacks.

This lead to a sleepless, itchy night that was followed by a day of reevaluation of the net design. I quickly realized that it was apparently quite important to ensure that all sides of the net were tucked tightly under the mattress to prevent the entry of fierce Brazilian mosquitoes (which I assure you are more aggressive than their American counterparts). After this bit of reengineering, I have had a week and a half of mosquito-free nights. Photos follow of the incorrect and correct approaches to mosquito net suspension, especially useful if you need to construct a mosquito net yourself...

Not the Way to Prevent Mosquito Bites

The Appropriate Method...

Amazon Days 5-8

2006-12-18T19:38:00.000-05:00

Finally, the remainder of the report on my trip to the Amazon...

On our fifth day, we awoke in the jungle and began the journey back to our base camp. This trip was relatively uneventful, but our voyage later that morning would prove slightly more interesting. We set out for a rubber plantation on two boats, and en route, the motor failed on one of the boats. We were able to tow the other boat the remainder of the way and continued with our trip.

Rubber was a huge industry in the late 19th century in the Amazon, but after the seeds for the trees were exported to Southeast Asia, the rubber industry in Brazil all but disappeared. Still, a few rubber plantations remain as tourist attractions in the region. We were able to visit one and view various creations such as gloves and rubber boots. We were also able to observe a demonstration of how latex is collected and used to make rubber objects. After this brief trip, we returned to our base camp for lunch, and returned to Manaus shortly after lunch.

In Manaus, we relaxed a bit before joining the Irish and Australian girls for dinner. We then headed to bed to rest for a very early flight to Santarém the following morning.

Day 6: Santarém
We arose at around 2 am to prepare for a 4:40 am flight to Santarém. Santarém is a smaller city than Manaus, but also lies at the junction of two large rivers, in this case the Rio Tapajos and the Rio Amazonas. After a long bus ride into town, we arrived in the downtown area and began searching for a hotel at which we could recover from the early morning flight. Our first two options proved to have no vacancies, but on our third attempt we found a hotel. After resting for a while, we went out in search of something to do for the day. After being offered some expensive afternoon boat tours, we instead decided to head to Alter do Chão, a highly recommended river beach. We rode a bus to the beach (about 1 hour) and arrived to find an incredible beach on the Rio Tapajo and Lago Verde. After sitting on the beach for a few hours, playing hearts, I noticed that there were many people kayaking, and then spotted a kayak rental place. I assumed that this would be an expensive activity, only to learn that the kayak rental cost only $2.50 an hour. Chris B and I immediately jumped on this opportunity, and spent the last hour before sunset kayaking across Lago Verde. This proved to be one of the highlights of the Amazon trip, and I only wish that we had discovered the kayak rental a few hours earlier. After watching an incredible sunset over the river, we headed back to Santarém to rest before another early morning flight to Belém.

Days 7-8: Belém
We spent our final two days in Belém, a city located near the mouth of the Amazon. nate had wanted to journey to an island near Belém famous for its parrots, but alas the parrots migrate before November, thus there were no parrots that weekend. Instead, we spent Friday resting as it rained in Belém, and played quite a bit of hearts. We visited the port that evening and dined at a converted warehouse that has been modified to house great restaurants.

On Saturday, we were able to go on a boat tour to an island near Belém. During the trip, we played more hearts, listened to live music, and watched Chris B attempt to dance forró. After having lunch on the island, we returned to Belém for dinner, and after dinner journeyed to the airport to wait for a very early return flight to Fortaleza (our third early morning in four days...). After a few hours of sleep in the airport, we returned to Fortaleza to resume our research, after an enjoyable week in the Amazon.

Returning to Base Camp after a Night in the Jungle

A Rubber Tree

Rubber Boots
Returning from the Rubber Plantation

Arrival: Santarém International Airport

Sunrise at the Airport

Downtown Santarém

Alter do Chão

Alter do Chão

Sunset at Alter do Chão

Sunset at Alter do Chão

Sunset at Alter do Chão

Sunset at Alter do Chão

Sunset at Alter do Chão

Chris and Chris at Alter do Chão

Sunset at Alter do Chão

Belém

Our Island Tour

Chris Aboard the Boat

Sunset in Belém

The Boat

Work Update

2006-12-01T22:34:00.000-05:00

I do plan to finish the chronicle of my Amazon vacation from last month, but wanted to post a brief update on my research. We are preparing to begin the data analysis for the physical fitness study that I focused much of my time on for the first 3 months in Fortaleza. As soon as the database is created with our data, we'll begin the process of analyzing the data looking for correlations between historical data and our new data.

On another front, I have encountered some challenges in getting my study of visual function started. I continue to await approval from the ethics committee. Since my study involves a US principal investigator, I will have to resubmit the protocol to a review board in Brasilia, rather than simply the local review board. I also continue to work on the protocol for this study in English for the UVA review board. I hope to resolve these issues and begin work on this study in January.

Finally, things are picking up with my work in the laboratory. Along with Ila and Andressa, the Brasilian Fogarty Fellows, I have the task of getting PCR (Polymerase Chain Reaction) tests for three organisms (Cryptosporidium, Giardia, and Enteroaggregative Escherichia Coli) up and running for a large ongoing study. After months of waiting for necessary supplies, we now have most (but still not all) of the supplies we need, and I believe that we now have the Cryptosporidium assay up and running, and hope that the other two will be functioning after another week of work.

And so despite some frustrations, I'm optimistic that research is moving along well. Over the next few weeks before the Christmas break, I'll be working on all three of the above studies, and hopefully improving my Portuguese further, and continuing to enjoy Fortaleza.

Amazon Day 4: Night in the Jungle

2006-11-29T19:11:00.000-05:00

Tuesday, November 14

After postponing our night in the jungle secondary to rain on Monday night, we awoke Tuesday hoping to have good weather for a night in the jungle Tuesday night. Indeed the rain ended and we had enough sun during the day to dry our wet shoes and clothes that were soaked during the previous day's journey.

Before heading to the jungle for our night of camping in the forest, we set out for a manioc plantation during the morning. In addition to growing manioc, this farm also grew pineapple, as shown below in the photos. We also encountered a plant that could be used to paint one's face (also see the photos below...). After a morning at the plantation we returned to the lodge to eat lunch and prepare to leave for our night in the jungle.

We set out for our night in the jungle at about 3 pm, and noted a few threatening clouds in the sky en route. Fortuantely, we were nearing the camp when a few rain drops began to fall. The rain ended up amounting to little, and we actually had a dry night in the rain forest, quite a contrast to the previous night. Our first task was to erect our hammocks and mosquito nets, which required us to procure some vines and sticks from the jungle to support our mosquito nets. Our guide set up the nets and hamocks for the ladies in our group, but left the three of us to figure things out for ourselves. Just as it was beginning to become too dark to see, we were able to complete the setup of our hammocks. We had a great dinner of chicken around the fire, and headed to bed only after Nate and half of our group went off on an unsuccessful search for more caimans. While not finding any caimans, our guide vaught a bullfrog, and Nate found a wasp (or rather was found by a wasp which subsequently stung him). We retired to our hammocks to enjoy a night in the forest, falling asleep to the sounds of frogs, insects, and all of the noises of the jungle.

Face Paint

Herman Prepares the Pineapple

Eating Pineapple (Abacaxi)

Our Shelter for the Night

Erecting the Mosquito Nets

Around the Fire

Ferroviário vs. Ipatinga

2006-11-28T18:42:00.000-05:00

Estádio Presidente Vargas
26 Novembro 2006
1600

Ferroviário faced Ipatinga in a crucial encounter in the penultimate round of Serie C games. Ferroviário entered the game in fifth place, one point behind Barueri for the final promotion spot. Ferroviário needed to win to maintain pace with Barueri in advance of the final match of the season which would pit the two teams competing for the final transfer position in a match of great importance in São Paulo. Before worrying about Barueri, Ferroviário needed to focus their attention on a strong Ipatinga side which already had clinched promotion to Serie B for next year.

Ferroviário began the match strongly, making several great runs into the penalty area early. These early attempts skipped wide of the net, but ten minutes into the match, a Ferroviário striker was taken down in the area from behind, earning a penalty kick. The kick was deftly converted after a lengthy protest from the Ipatinga keeper, giving Ferrão the 1-0 lead. Ferroviário continued to control the follow of play, but Ipatinga continued to intermittently create chances. Roughyl five minutes after the Ferrão goal, two Ferroviário defenders slipped in the box, misplaying the ball leaving the Ferrão keeper to face a Ipatinga striker all alone. The striker danced past the keeper and touched the ball across the line to tie the score at one all. The match remained tied at the half, despite continued pressure from Ferrão.

Ferroviário returned to the field in the second half with continued pressure and attacks. Early in the half, Ferrão hit the crossbar and goal post with shots in rapid succession. Midway through the half, Ferroviário received a free kick 25 yards from the goal. The free kick was rifled past the Ipatinga wall, also beating the keeper for a goal, giving Ferrão the 2-1 lead. The score remained at 2-1 until 5 minutes remained in the match. A Ferrão striker entered the penalty area on a near breakaway, and the ball was tackled away by the last defender. The defender followed through with a hard tackle to the legs of the attacker, and the referee again pointed to the penalty spot to award a penalty kick to Ferroviário. This penalty was met with an even greater protest from Ipatinga, with one defender shoving the referee, leading the referee to issue a red card, leaving Ipatinga to play 10 vs. 11. Ferroviário converted the ensuing penalty to leave the score at 3-1. The match ended in favor of Ferroviário by this score. Barueri also won, leaving Ferroviário in 5th place, one point behind the São Paulo side. Ferroviário needs a win on the road against Barueri in their final game to advance to Serie B.

Amazon Day 3: Birds, Worms, Ants, Rain!!!

2006-11-21T18:13:00.000-05:00

Monday November 13

We awoke early after a night sleeping in hammocks under mosquito nets for an early morning boat trip to watch birds. The 5:30 am start was a bit harsh, but the bird-watching was quite enjoyable as we headed up river on a small boat observing the birds of Amazonas, also searching unsuccessfully for sloths. The plans for the day called for bird-watching followed by breakfast, with a morning hike in the jungle, and plans to sleep in the jungle that night. The weather would later change those plans, but the morning began well with the bird-watching and breakfast.

After breakfast, we again boarded the boat to head to another part of the jungle for our jungle hike. We reached the jungle as a light rain began falling. Fortunately, in the jungle we were largely sheltered by the canopy of trees above us. We headed through the jungle enjoying the sounds of insects, birds, and the rain falling on the trees. We were shown how to use palm trees to create fans, hats, or even the roof of a shelter. After trekking a bit further, we were shown a fruit/nut that harbored edible worms inside. Chris B and I immediately tried one worm each. Chris B. wasn't a huge fan of the taste after the worm popped in his mouth. I was game to try two more, and didn't find the taste bad at all. No one else in the group cared to try the worms, despite my enthusiastic recommendations...

We continued through the jungle as the rain picked up a bit, and eventually came upon an ant's nest attached to the trunk of a tree. Our guide told us that the ants could be used as a natural mosquito repellant by allowing them to crawl on your hands/arms, then wiping them off, leaving behind an insect repellant. Our guide also insisted that the ants did not bite. I again was game to try somethign new, and allowed the ants to crawl on my arms twice in an attempt to photograph the experience. Unfortunately, as I waited for a photograph while standing on a crowd of ants as well, the ants crawled up my arms and legs, at which point I learned that they do in fact bite... Nate also tried the ants, and also learned of their biting ability.

Shortly after the encounter with the ants, we headed back out of the jungle and began to boat back to camp. As we did, the rain began to pick up. This would not have been a hge problem had I had a rain coat, but despite my usual preparedness, I had forgotten to bring a rain coat on this trip to the rain forest (of all places...). As a result, I was quite soaked by the time we reached the lodge, and most of the remainder of the group with rain coats also were quite wet. The rain continued into the afternoon, and this lead us to decide to delay our trip to sleep in the jungle to the next night. The rain continued well into the night, proving this to be a wise decision.

With the original plans for the evening delayed by one day, we instead spent the evening playing card games at the lodge as the rain continued. We played a Colombian card game that our guide taught us, and then began playing endless games of Hearts, a series that would continue for the remainder of our Amazon trip. We retired to our hammocks for the evening, anticipating the activities of the next day which were slated to include a trip to a local village as well as the night in the jungle.

Our Guide, Herman, Poses with the Machete

Our Guide teaching us to Use the Local Flora
In the Jungle

Weaving a Fan

Yes, I Ate Three of these Worms

Ants' Nest

I Coat my Hand in Ants (Natural Mosquito Repellant)

Napping during a Rainy Afternoon

Amazon Day 2: Meeting of the Waters, Piranhas, Caimans

2006-11-20T19:12:00.000-05:00

Sunday, November 13

Our second day in the Amazon involved the beginning of our journey on the river. Our group included two Irish young women, an Australian, and a German couple, as well as our guide Herman. We were fortunate to have a great group that allowed us to really enjoy our time in the Amazon, as well as an excellent guide.

We began the day by heading by van to the port on the Rio Negro, one of the two rivers that meet near Manaus. The other river is the Rio Solimões, also known as the Rio Amazonas. After meeting just east of Manaus, they are referred to as the Rio Amazonas. We boarded a boat that headed across the Rio Negro to a location called "The Meeting of the Waters." This is not just a typical river junction, and was quite the impressive site. The Rio Negro is a very dark river, black in color. The Rio Negro travels at about 3 km/h, while the Rio Solimões travels at about 10 km/h. The Rio Negro though is warmer than the Rio Solimões. As a result of these differential temperatures and velocities, the rivers travel in contact with each other for 5-10 km without mixing, creating quite the impressive sight.

After viewing the meeting of the waters, we continued across the Rio Solimões to a port on the opposite side of the river. We boarded another van that carried us to another dock where we boarded a boat that carried us down a tributary of the Rio Solimões to our lodge. We made one stop en route during the 2 hour boat trip to view a very large tree adjacent to the river, and get our first look at the jungle. We arrived at our lodge just in time for lunch. Our lodge included a floatign house which served as the dining hall, and a few other buildings for lodging on the hill. We slept outside on hammocks each night, under the cover of mosquito nets.

During our first afternoon, after an incredible lunch of fish, rice, and potatoes, we headed out to fish for piranha. We used sticks with some fishing line attached to a hook, initially using chicken for bait. After running out of chicken, we began to use piranha as bait to catch more piranhas, which also worked rather well. I caught the first piranha within seconds of dropping my line in the water, and caught a second later in the afternoon. We also observed dolphins swimming in the water, including the beautiful pink dolphins. Unfortunately, these dolphins are not easily photographed, as they rise out of the water briefly for air, and submerge before one is able to photograph them. As a result, I have many photos of the water moments after a dolphin submerged...

We returned to the lodge, and after an equally incredible dinner of more fish, chicken, rice, and vegetables, we headed out after dark on the boat to search for caiman, which are reptiles similar to alligators or crocodiles. We were able to catch a small caiman, and spot some larger caiman. After caiman spotting, we retired to our hammocks for the night in advance of an early morning of bird watching the following morning to be followed by a jungle hike.

Meeting of the Waters (Rio Solimões brown and to the left, Rio Negro to the right)

A Large Tree
Preparing our Hammocks
Heading out to Fish for Piranha

My First Catch

Caiman Spotting

Amazon Day 1: Arrival in Manaus

2006-11-20T18:54:00.000-05:00

Saturday November 12

We departed Fortaleza on a flight bound for Manaus via stops in São Luís and Belém on a small airline called TAF. On landing in Manaus, we made our way through the airport, and were able to set up our tour of the Amazon at the airport. We were then shuttled to our hotel, where we dropped off our backpacks before setting out to explore the city of Manaus. We had lunch at a restaurant not far from our hotel and then walked around the central market for a while, picking up a set of playing cards that would fuel numerous games of Hearts during the next week of travel. We then walked past the Teatro Amazonas, a theater built during the Amazon rubber production boom many years ago. We learned that a Brazilian film festival would be held outside the theater that night, and after learning that the price of the festival fit perfectly into our budget (free), we had our evening planned. After walking around town a bit more, we rested at the hotel (we had awoken early for our flight to Manaus) before heading to dinner and then to the film festival to see part of the evening's film. We then returned to the hotel to rest in advance of our 4 day/3 night journey in Amazonas. Photos from day 1 follow.

Teatro Amazonas

Chris and Chris Outside the Theater

Teatro Amazonas at Night

Amazon Adventures

2006-11-19T19:38:00.000-05:00

I returned early this morning to Fortaleza after 8 days in the Amazon region. The vastness of the Amazon river was incredibly impressive, and I greatly enjoyed the chance to see parts of the Amazon near the cities of Manaus, Santarém, and Belém. In some ways parts of the trip were a bit rushed, as I have awoken for early flights between 3 and 6 am on three of the last four days. I plan to post brief blogs about each day of the trip, along with photos from each day over the next few days. A few highlights from the trip included eating worms in the jungle, sleeping in the jungle, fishing for piranhas, spotting dolphins in the Amazon, kayaking on a lake adjoining a major branch of the Amazon, and simply experiencing the awesomeness of a unique part of the world that I never dreamed that I would visit even a year ago. Photos and stories of all the above and more will follow as I can upload them in the evenings this week.

I'll be back at work this week trying to finish the remainder of the paperwork in advance of the vision study that I hope to begin in January, while continuing to finish up data collection and analysis for the physical fitness study.

Mães, Mais, Pães, Pais: Lessons in Brazilian Portuguese

2006-11-10T17:24:00.000-05:00

Today, I gave my second ever presentation in Brazilian Portuguese. I was determined to ad-lib more this time and spent some time yesterday rehearsing pronunciations for some words I knew I'd be using. In my study, we collected data from the mothers (mães) and fathers (pais) of children in our study. Yesterday, I was having trouble saying the word for mothers, as I pronounced it more like mais (pronounced like the English word mice, more or less), which means more rather than mothers. Mães is pronounced like saying "mice" with your nose plugged to produce a nasal sound. Having seemingly mastered these words, I hoped to avoid this mistake in my presentation.

Instead, I was able to make a different, even more humorous mistake. Instead of writing pais on my slides to describe how I would need to collect data from the children in my study's fathers, I wrote "pães," which is the plural noun for bread. And so today there were certainly a few chuckles in the room as I described my future work on this study by stating confidently that we needed to collect data on the height, weight, and blood pressure of the bread of the children in my study (rather than the fathers of the children). I definitely need to work on my Portuguese more, but little mispronunciations like this will continue to happen I'm sure, and I'll be sure to share them when they do (unless they're particularly embarassing in which case I'm sure Nate will write about them...).

In other Portuguese news, I learned a new colloquial expression today. While in the US, people say, "That's just not my cup of tea," in Brazil, they say, "Esse não é meu praia," which translates as, "That's not my beach." A great example of what is important in Brazil...

São Luís: The Full Story

2006-11-10T16:54:00.000-05:00

Last weekend, we journeyed west of Ceará to the state of Maranhão, home to São Luís and Parque Nacional Lençois Maranhenses. We departed Fortaleza on a Gol flight scheduled for mid-morning Thursday. Last Thursday, Brazil was in the middle of an air traffic control slowdown however, in which controllers were refusing to handle the usual number of flights in protest for better working conditions. This lead to significant flight delays and cancellations at some of Brazil's largest airports, including Pinto Martins International in Fortaleza, but fortunately our flight was only delayed by an hour and a half. We arrived in São Luís in early afternoon, and boarded a bus bound for the center of town. After disembarking in the center of town, we set off in search of the Pousada Colonial, accomodations recommended to us by a Fortaleza friend, Neto. Armed only with the map in Lonely Planet Brazil, we managed to navigate rather rapidly to the Pousada Colonial and settled in to rooms equipped with two things that our home in Fortaleza lacks: air-conditioning and hot water. We then began calling tour operators to arrange a tour of the local national park. After a high-speed harrowing trip across town in a tour operator's car, we were able to arrange a two day trip to the park beginning the following day. For the remainder of Thursday, we checked out the historic center of São Luís, which was rather deserted due to the holiday.

Very early Friday, we set out for Parque Nacional Lençois Maranhenses, roughly a 3.5 hour bus ride from São Luís. Unfortunately we were left with the seats in the back of the minibus. These seats not only were out of the airflow of the conditioning, leading to a warm trip, but also seemed to magnify the effects of taking every speed bump along the road at full speed. After a long journey however, we arrived in Barreinhas a town that serves as a jumping-off point for the park. We were offered the chance to take a four wheel drive tour of the park in the mornign or afternoon. We selected the afternoon option, hoping to the sun set over the sand dunes and lakes of the park. After a morning of rest, we headed out in the back of the four wheel drive vehicle, beginning by crossing a river on a ferry. I somehow have missed out on experiencing these sorts of ferries in Africa in my previous travels, so this was my first ferry trip. After crossing the river, we rapidly drove through sandy paths to reach the national park. My photos say more than I can with words, but even the photos do not do justice the majesty of the park. The view seems like somethign from another world, with sand dunes as far as the eye can see, interspersed with freshwater lakes created by rainfall during the rainy season. We had the opportunity to hike in the dunes and swim in the lakes for the afternoon. We saw the beginning of the sunset, but some in our party feared that if we waited to see the full sunset, our return trip could be dangerous, so we headed back, slightly disappointed, before the sun set. Still, the day was an incredible day of magnificent views and images that are among the most incredible I have ever scene (perhaps only ranking below Victoria Falls in my mind).

On Saturday, we arranged to have a boat tour of the national park. The journey down the river through narrow channels, and with stops at sand dunes and beaches was incredible. We had the chance to hike in the sand dunes a bit more, and also swim in the river, and spend some time at the Atlantic coast. We enjoyed the view from atop a lighthouse near the ocean, overlooking the national park and surrounding area. After eating lunch, we headed back to Barreinhas by boat. That evening, we returned to São Luís, hoping for an uneventful journey by bus, but alas sufferred a flat tire less than an hour into the journey. Quickly, the bus driver realized that he lacked an essential wrench to change the flat. A random gentleman passed on a bicycle, and our driver asked him if he could obtain the necessary wrench. I held out little hope, but not too much later, he cycled back to the bus with the required tool in hand. After an hour, the tire was changed, and we continued on the journey back to São Luís. We arrived back tired, and after dinner, I headed to bed for some much needed rest.

Sunday, we walked around São Luís for a while, and were rather unimpressed by the city itself. The city is crossed by a river and neighbors a bay, but both were more like large mudpits during the current dry season. After another afternoon in the historic center, we headed to the airport, not suspecting what adventures awaited us there.

Chris B. checked in at the airport for our return flight without incident first, but as Nate and I tried to check in, the airline employee looked suspiciously at our reservation. She told us that our flight was scheduled not for November 5, but December 5. Indeed, the Gol employee who booked us had entered our reservation incorrectly. She had read the reservation back to me correctly when I purchased the ticket weeks early, and so I had failed to notice the typo. Unfortunately, this would prove to be a costly error. We headed to the Gol office in the airport to try to change our reservation, and were told that the fare we had booked was no longer available (a $50 fare) and so we would each need to pay an additional $100 (more than the original fare) to get on the flight. Not having that much money, I then began to scurry from ATM to ATM in the airport to obtain the necessary funds. Unfortunately, the first 3 ATMs I tried either were broken or not set up for US debit cards. At last, as time was running out, we were able to complete the transaction and get added to the flight. After the drama in the airport, the remainder of our trip was relatively uneventful. Definitely a lesson was learned here, and thankfully it occurred with a relatively cheap flight rather than a more expensive long-distance flight that would have been harder to change.

Saturday morning, November 11, we fly to Manaus to begin our 9 day Amazon trip, before we return to Fortaleza for 4+ more weeks of work before the Christmas break.

Ferroviário vs. Brasil

2006-11-08T20:17:00.000-05:00

Ferroviário vs. Brasil
Estádio Presidente Vargas
8 Novembro 2006
1930

Ferroviário battled Brasil in Brasilian Serie C action tonight. Brasil entered the game in eighth and last place in the final round of Serie C, while Ferroviário entered the game in sixth position. Ferroviário was looking for the win which could potentially elevate them into one of the top four positions in Serie C, the promotion positions, with several games remaining in the season.

Ferroviário started slowly as usual, and Brasil found themselves with a striker all alone in the penalty area. The Ferrão keeper however made back to back incredible saves to keep the game scoreless. For the remainder of the first half, play was dominated by Ferroviário, with striker #11 continually dancing past defenders to create incredible scoring chances. Chance after chance ended up sailing wide of the goalposts, and despite many opportunities, the game remained scoreless. Still, the Brasil defenders grew frustrated with being embarassed by the moves of the Ferrão strikers, and repeatedly committed tactical fouls after beign beaten. The referee did well to caution the majority of these offenses, each time showing the yellow card.

After a scoreless first half, the teams returned to action with Ferroviário domianting the first fifteen minutes, but still repeatedly missing the net. Finally, twenty minutes in, a beautiful series of passes found the Ferrão striker wide open 10 yards out, and the player made no mistake innettign the game's first goal. The yellow cards continued to fly out of the referee's pocket, all shown to Brasil, and finally a few moments after the first goal, a Brasil defender received the game's first red card for a second caution, after committing a foul that lead to a Ferroviário penalty kick. The kick was converted to give Ferrão a 2-0 lead. Not long after this red card, a straight red card was given to a Brasil midfielder for a vicious elbow to a Ferroviário attacker who had beaten the defense and gained a breakaway. With a two man advantage, Ferroviário soon capitalized on a free kick from 25 yards out to take the 3-0 lead. A third red card was issued late in the game to another Brasil defender, leaving the teams to play 11 vs. 8 for the final 10 minutes of the match. Ferroviário took the victory, 3-0, while Brasil ended the game with 3 red cards and innumerable yellow cards (11 by my best estimate). Ferroviário exemplified brilliant attacking soccer with the win, while Brasil only seemed capable of dirty play and repeated tactical fouls.

Ceará vs. Guarani

2006-11-08T15:00:00.000-05:00

Ceará vs. Guarani
Estádio Castelão
7 Novembro 2006
1930

Ceará faced Guarani of São Paulo in a match Tuesday night at Castelão in Fortaleza. The Cearense were not able to atract quite the large crowd as at their home game versus São Raimundo, but the crowd still was quite enthusiastic as the match began. Early, the teams raded chances. Ceará seemed to lack the teamwork and fluid midfield play that has characterized their play of late, instead relying on individual runs through the defense, which produced few chances and no goals in the first half of play. Guarani had a number of close chances in the first half, a few denied by great goalkeeping, and a few sailing wide of the mark. The teams headed to the locker room with the score knotted at zero, after a first half marred by numerous yellow cards for late tackles and other misconduct.

The teams returned from the break, and Ceará quickly created a great scoring chance on a cross into the box that was pushed just wide of the net. Ceará soon brought on a substitute who made an immediate impact by crossing the ball into the penalty area right to the head of a Cearense attacker. Unfortunately, the attacker headed the ball directly to the Guarani keeper again failing to capitalize. Later in the half, Guarani had a series of chances to win the game, but pushed the ball high or wide multiple times, and were stymied by excellent goalkeeping as well. As the 90th minute of the match arrived, the referee signalled that there would be two minutes of stoppage time added. The match seemed headed for a 0-0 draw and fans began to file out of the stadium, when with less than 30 seconds left, the referee signalled for a penalty kick after a Guarani attacker fell to the ground in the penalty area. This seemed to place the victory on the foot of Guarani, but an incredible stop by the Ceará keeper kept the match scoreless. The referee blew the final whistle a few seconds later, and Ceará escaped with a draw, remaining in 14th position in Serie B, three points out of the zone of relegation.

First Half Action

Ceará on the Attack
The Referee Books a Ceará Defender

Second Half Action

Fortaleza VS. Corinthians

2006-11-08T14:38:00.000-05:00

Fortaleza vs. Corinthians
Estádio Castelão
1 Novembro 2006
2145

Fortaleza hosted Corinthians last Wednesday night, realistically needing a tie or win to avoid falling deeper into the zone of relegation. Corinthians is a strong side, having won the Brazilian Championship last year. This year, they have struggled a bit in Serie A, making a mid-season coaching change, languishing in the middle of the league table.

Early in the match, Fortaleza seemed to have the better of possession, but seemed unable to create great scoring chances. Midfielders seemed intent on making individual runs through the defense, giving the ball up to their opponents rather than distributing the ball to the strong Fortaleza strikers. Corinthians proved to be opportunists as they created an excellent scorign chance with a clever sequence of passes followed by a beautiful run into the area. The Corinthians striker made no mistake in burying his first chance into the back of the net for a 1-0 lead for the São Paulo side. Fortaleza had a few more minutes of dominant possession, but again little teamwork and poor distribution by the midfield, before a Corinthians striker capitalized on a defensive error by Fortaleza to create a breakaway. The striker missed the net high, missing a golden opportunity to increase the Corinthians lead. The score at halftime stood at 1-0, with Fortaleza in need of better tactical play in the second half.

Fortaleza opened the half witha few moments of possession, but still highly individual play with a total lack of vision or creativity by the midfield. Corinthians proved opportunistic yet again, breaking through for two more goals in rapid succession early in the second half, each near carbon-copies of the games first goal. Fortaleza seemed in even greater disarray from that point forward, allowing one final goal to drop the crucial game to Corinthians by the score of 4-0. Fortaleza remained deep in the zone of relegation, and seemed almost certainly bound for Serie B in 2007.

Incrível: Parque Nacional Lençois Maranhenses

2006-11-05T22:12:00.000-05:00

Words cannot adequately describe some of the incredible (incrível) sights that I saw this weekend. This weekend, we flew to São Luís, a city in the state of Maranhão. From São Luis we journeyed by bus to Parque Nacional Lençois Maranhenses. Below are some photos from the national park. I plan to post an account of our trip tomorrow night, including an account of some of our travel difficulties, but the pictures will certainly do a better job of conveying some of the incredible views from the weekend.

Arrival in Barreinha, a town near the National Park

On the Ferry

Magnificent Sand Dunes

More Magnificent Sand Dunes

Lakes between the Dunes

More Magnificence

Chris Enjoying the National Park

Nearing Sunset

Nearing Sunset

Traveling in the Park by Boat

Journeyring through a Narrow Channel

Birds!

Chris and Chris give every Brazilian's favorite gesture

Swimming in the river

Atop a Lighthouse

Heading Back Downriver

Flat Tire - and no Chris B. was not actually involved in changing the tire...

Upcoming Work and Travels

2006-10-27T19:15:00.000-04:00

Today, we completed field work for the physical fitness study that I have been working on. Over the next few weeks, we'll be analyzing data from this project in addition to moving forward with more lab work for some of the other projects that are ongoing. I also was able to submit my proposal for a study of the effects of chronic early childhood diarrhea this week to the Brazilian institutional review board (IRB), and hopefully will be able to get started with that in early January. Over the next few weeks, I'll be traveling a bit courtesy of two national holidays, and in late December I'll be back in the US for two weeks. My itinerary for the next few weeks follows:

November 2 - November 5 São Luis, Maranhão and Parque Nacional Lençois Maranhenses
November 11 - November 19 Amazon Trip
November 11 Fly to Manaus
November 11 - 15 See Manaus and Take 3-4 day jungle trip
November 16 Fly to Santarém and spend 1 day there
November 17 Fly to Belém (the mouth of the Amazon)
November 17-18 See Belém and surrounding area
November 19 Fly back to Fortaleza

Ferroviário vs. Criciúma

2006-10-27T19:12:00.000-04:00

Ferroviário vs. Criciúma
Estádio Presidente Vargas
25 Out 2006
2030

Ferroviário squared off with Criciúma in another important Serie C matchup Wednesday night. Ferroviário entered the game in fifth position in Serie C, one position out of the last promotion spot. Ferrão needs to continue to win at home to move back into the promotion zone.

Criciúma dominated play early with the home side seeming a step slow. Some big saves by the Ferrão keeper kept the team in the game early. The most notable save came on a near breakaway by Crici~uma in which the Ferrão keeper was able to charge the shooter and parry the shot away, keeping the score at 0-0. A few moments alter Ferroviário finally penetrated deep into the penalty area and blasted a shot past the outstretched arms of the Criciúma keeper to give Ferrão the 1-0 advantage. The score remained unchanged at halftime.

After the break, Criciúma returned with a flurry of attacks. Early in the half, a Criciúma appeared to receive the ball in an offside position before being fouled in the area. The assistant referee, who of course had the best vantage point to judge the offside ruled that the player was onside, and the referee awarded a penalty kick for the foul. The kick was converted squaring the score at one all. A few moments later, a Ferroviário striker fell to the ground in the penalty area, appealing for a penalty, but to no avail. With 20 minutes remaining, a Criciúma attacker sped past the defense and was met with a harsh tackle from the Ferroviário keeper inside the penalty area, completely missing the ball. This led to the game´s second penalty kick, again converted by Criciúma, giving the visitors a 2-1 lead. Ferroviário managed little in the way of attacks or chacnes late, and the visiting side left Fortaleza with the win, leaving Ferroviário in need of much improved play as they take to the road for their next match.

Fortaleza vs. Atlético

2006-10-23T21:30:00.000-04:00

Fortaleza vs. Atlético (Paraná)
Estádio Presidente Vargas
22 Out 2006
1600

Atlético of Paraná journeyed to Fortaleza for what seemed to be a must-win game for the home side. Fortaleza entered the game deep in the relegation zone of Serie A, and needed to win a number of games in the last 2 months of the season to have any realistic chance of remaining in Serie A for the 2007 campaign. The crowd was quite boisterous as they welcomed the tricolors to the field with chants of "Fica leão na primeira divisão," which translates as "Stay lions (Fortaleza's mascot) in the first division." Fortaleza came out with a spark, and earned a number of early corners. Those attempts were parried by the strong Atlético keeper. Fortaleza created another chance 15 minutes in, and their striker buried a chance from 12 yards out, giving the Atlético keeper no chance. Unfortunately, the typically porous Fortaleza defense then gave up two quick goals to Atlético giving the Paranaense side a 2-1 advantage.

Midway through the second half, the Fortaleza attack awakened and replied with two goals in short order, each thanks to a series of precisio passes that found a striker wide open 12-15 yards from the net. Fortaleza held a 3-2 lead with their fans holding renewed hopes of remaining in the first division. In the 75th minute, Fortaleza had a great chacne to make it 4-2 when a striker exploded past the defense and faced the keeper all alone, but shot wide of the net. A great effort by Fortaleza for 80 minutes seemed to have the side poised to capture three points in the standings with a win. Unfortunately, some errors in the midfield, and further poor defensive play, and forgettable goalkeeping yielded two goals to Atlético in the final ten minutes, giving the visitors a 4-3 advantage. A Fortaleza striker flopped in the penalty area late, appealing for a penalty that could have tied the game, but the referee would not fall for the dive, wagging his finger at the attacker. Fortaleza remains in the relegation zone with the loss, and appears headed for Serie B in 2007. They next play at home on national television against Corinthians in Estádio Castelão next Wednesday.

Football Photos: Fortaleza vs. Atlético

2006-10-23T21:17:00.000-04:00

Fortaleza Enters the Field with Children Dressed in Fortaleza Jerseys
Pregame Festivities

Fortaleza has an Early Chance on a Corner Kick

Unveiling the Fortaleza Flag

Injury: Bring on the Unimed Cart

Referee issues Game's First Caution (I do miss refereeing...)

It's in the Net: Fortaleza Makes it 1-0

Fortaleza Celebrates a Goal

Halftime: Protection for the Referees

Corner Kick

Fortaleza Fans Celebrate Fortaleza's Third Goal: Fireworks

Late Game Action

Fights, Football, Fire: Ceará vs. São Raimundo

2006-10-23T21:15:00.000-04:00

I went to a Ceará game Saturday out at Castelão. Originally this game had been scheduled for the smaller stadium, Presidente Vargas, but the game was moved to the larger Castelão as of last week. Until I arrived at the game I was curious as to why the game was moved, but any question was resolved after I arrived at the stadium. I arrived to see the stadium surrounded by approximately 30,000 fans seeking to get in to join 20,000 already inside the stadium. Seeing the crowds which undoubtedly would pack the upper deck beyond capacity, I thought that this might be a good time to go ahead and pay the extra $5 to sit in the much less crowded lower deck. The entrance and ticket office for the lower deck is on the opposite side of the stadium from the upper deck ticket office and entrance, and so I began to walk around the stadium. I quickly encountered a woman running with her child, who grabbed me and said, "Briga!". As I walked a little further I quickly realized that briga apparently can be translated either as large fight or small riot, depending on your perspective. I immediately turned away from the growing fight and crowd of military police and rejoined the long queue for seats in the upper deck.
I entered the stadium to see the largest crowd I have seen at a game here in Fortaleza.The upper deck was filled to capacity with people seated on the stair wells and in every available position in the aisles. The lower deck was only about half full, but the experience was incredible in the crowded upper deck. The game proceeded with a very boisterous Cearense crowd screaming at the referee frequently and cheering on their team with great enthusiasm. As the team entered the field, the fans had thrown toilet paper onto the field, covering the area around the field between the two moats (Yes the stadium has two moats). Late in the game, an errantly launched firework hit some of this toilet paper resulting in a fire adjacent to the field during the last ten minutes of the match. It was quickly brought under control by security. The game report follows below, but the game certainly could not compare to the excitement outside and inside the stadium…

Ceará vs. São Raimundo
Estádio Castelão
21 Out 2006
1800

Ceará looked to continue their winning ways against São Raimundo in a Serie B match Saturday. Ceará has climbed from 20th (last place) in Serie B to 15th in the last few weeks, and with a win today would climb to 12th position.

The match got under way with a few quick chances for the visitors, easily parried away by the Ceará keeper. In the 10th minute of the match a Ceará striker received the ball just inside the penalty area, and blasted a shot inside the left post to give Ceará a 1-0 lead. The teams traded chances over the next 20 minutes. During this time a São Raimundo midfielder was cautioned for a reckless challenge to the legs of a Ceará attacker. In the 30th minute, the player repeated the infraction and was sent off for a second caution. This left Ceará with a man advantage for the remainder of the game. Ceará controlled the flow of play with the man advantage, with the best São Rainmundo chance deflecting off the woodwork late in the game. The game was marred by a pregame riot outside the stadium, and a fire in the stadium late in the game. The fire which consumed some of the toilet paper thrown onto the field during the pregame celebrations, appeared to result from an errantly deployed sparkler or other pyrotechnical device which made its way onto the field adjacent to the playing service, igniting the aforementioned toilet paper. The fire was quickly extinguished as Ceará held on to win the match 1-0, advancing in the standings to 12th position.

Miscellaneous Photos

2006-10-20T08:44:00.000-04:00

A few more photos from the last few months follow. Included are photos from our not so successful attempt at hosting a barbecue. As our guests arrived, we realized that we had foul-smelling spoiled chicken, the wrong kind of barbecue sauce, the wrong kind of salt, the wrong kind of lighter fluid, and not enough charcoal. Fortunately, one of our Brazilian friends rescued our barbecue with his more extensive culinary experience.

Avenida Beira Mar (I live less than 2 blocks from Beira Mar)

Realizing that our barbecue was in Serious Trouble

Fabrizio Rescues our Barbecue

Friends at our Barbecue

Canoa Quebrada

2006-10-19T19:53:00.000-04:00

As may be obvious from the contents of this blog thus far, the only thing Brazilians seem to like more than soccer is holidays. We seem to have a federal holiday at least once a month forcing us to take tough four day weekends in locations such as Canoa Quebrada...

Enjoying the Beach

A Look Along the Coast of Canoa Quebrada

Relaxing on the Porch at our Accomodations for the Weekend

The Atlantic Ocean

Checking Out the Town - Canoa Quebrada

Brazil Fogarty Reunion

Life is Tough Here in Brazil

Working - Physical Fitness Testing

2006-10-19T19:46:00.000-04:00

Indeed amidst all the traveling and moving, I have actually been working on the physical fitness study. Finally, some photo evidence of our progress...

Eller at Work Checking a Blood Pressure

Preparing for Physical Fitness Testing

Chris Performs the Harvard Step Test

Moving

2006-10-19T19:37:00.000-04:00

Here are the photos from our move to an apartment 2 blocks from the Atlantic. You may recall that this move involved misadventures such as pushing a stalled car through a busy intersection and dropping chairs from the rooftop of our apartment...

The Rooftop Verranda

Election Advertising Near Our Apartment (Complete with Fireworks)

Chris is Asked to Tend the Keymakers Shop While He Goes in Search of More Keys

What Happens When Four Medical Students Try to Get Furniture to the Rooftop Verranda

Success!

Our Wall

Nate in Our New Living Room

The Only Way to Decide Room Assignments
(The Most Intense Game of Rock/Paper/Scissors Ever)

Our Rooftop Verranda

Salvador Photos

2006-10-19T19:24:00.000-04:00

Finally, the long promised photos from our September journey to Salvador, Bahia, a city further down the coast of Brazil, and also home to the other Brazilian Fogarty Fellow, Tracey.

Nate, Chris, Tracey View a Sunset Over the Bay

Chris at an Isolated Beach North of Salvador

The View from Tracey's Apartment

Near the Pelourinho in Salvador

Nate, Tracey and Chris at Dinner by the Bay

Ben Tries the Drums

Pelourinho

Mass Transit, Salvador Style: Elevator Lacerda

Corte de Cabelo

2006-10-19T15:12:00.000-04:00

Antes:

Antes:

Depois:

Reflections at the 25% Point

2006-10-18T09:50:00.000-04:00

The last week in Fortaleza has been reasonably eventful. Aside from the soccer games which I have already written about, I have continued with my work and enjoyed a holiday weekend at a beach town further down the east coast of Ceará.

We are now approximately halfway done with the physical fitness testing, and should conclude the testing late next week. Then, we'll have a large amount of data to enter and analyze, and also will have some saliva samples to analyze in the laboratory before we conclude this study. In addition, things are progressing well with the paperwork for the study of vision deficits that I hope to start later in the year.

Thursday of last week was another national holiday, which of course could only mean one thing – another four day weekend. On this occasion, rather than flying to a different part of Brazil, we chose to visit Canoa Quebrada, a beach town reachable in 3-4 hours by bus from Fortaleza. Tracy, the Salvador Fogarty Fellow, flew to Fortaleza to join us for this holiday weekend.

Canoa Quebrada was a beautiful place. The sand dunes and rock formations were slightly less impressive than those of Morro Branco, but the town was a little larger and more fun. Events of the weekend included spending time on the beach, listening to the loquacious owner of the guesthouse/pousada where we stayed, and time walking through the town of Canoa Quebrada. As you would have noticed had I actually posted any photos in the last several weeks (I do plan to catch up on that before this weekend), my hair was getting a bit long for my liking. I usually have it cut every 3-4 weeks in the US, but had not had it cut since mid July. And so, for the cost of five reais ($2.50), I had my first Brazilian haircut while in Canoa Quebrada. Photos will follow, but I was quite pleased with the outcome. I returned to Fortaleza Friday night feeling a little ill thanks to whatever organisms (amoebas, worms, bacteria or viruses) that seem to have found a home in my intestines. After a day of rest though, I was back to my usual self, ready for physical fitness testing in the community on Monday.

Thus far this week, in addition to physical fitness testing and other work, I have continued to enjoy running on Avenida Beira Mar right along the Atlantic Ocean. Tuesday night, I enjoyed about a 15 mile run, which is the longest run I've been on in a while. I hope to be able to run a marathon (26.2 miles) either here in Brazil or after I return to the US, and think that I'll return to the US in better shape than I have been in for a while.

The next month includes two more national holidays, and so I'll be traveling a bit more in between continuing my research. November 2-5, I'll be in São Luis, a city in the state of Maranhão, just west of Ceará. Near the city is one of the most beautiful national parks in Brazil, with sand dunes and lakes and picturesque views. We're also working on planning our Amazon expedition which likely will take place November 10-19 surrounding another federal holiday.

It's hard to believe that I have been in Brazil for two and a half months now, meaning that my fellowship is 25% complete. Fortaleza definitely feels like home now, and the surgery rotation that I ended my third year with seems quite remote now. Thinking back on the last four years, I admit that I could not have imagined that I would be here in Brazil for a year now. A little over four years ago, I had never been on an airplane, nor had I ever been further than 8 hours from my home in Maryland. Since that time, I have had the great privilege of traveling to serve in Guinea-Bissau and Senegal in West Africa on three occasions, and in Zambia in Southern Africa for a month as well, all as a volunteer missionary with the SBC. Now of course, I am spending ten months in Brazil doing global health research, and I am reasonably confident that this will not be my last journey outside the borders of the US. I probably would have laughed had someone told me five years ago that I would have the well-worn, heavily-stamped passport that now lies in my desk, along with the many images, memories, and people that will forever be etched in my mind as a result of the last few years travels. I have greatly enjoyed the challenges and joys of working abroad, and look forward to the remainder of this year and future experiences abroad.

Later this week, I hope to post some photo updates with photos from Salvador, Canoa Quebrada, and our new home in Fortaleza, as well as some photos of me at work on the physical fitness project. Until then, I'll be doing physical fitness testing and continuing to write research protocols and consent forms in Brazilian Portuguese.

Ferroviário vs. Vitória

2006-10-16T17:42:00.000-04:00

Ferroviário vs. Vitória
Estádio Presidente Vargas
15 Out 2006
1600

Ferroviário returned home after a midweek loss to face Serie C leaders Vitória of Bahia. Ferroviário entered the game tied for third on points, tied for fourth based on the first tie breaker of goal differential. Facing one of the favorites in Serie C, Ferroviário needed at least a tie, and had to be looking for a win on their home pitch.

Things got underway on an especially hot afternoon. Ferroviário looked a step slow for the first fifteen minutes, with Vitória winning all of the headers and 50-50 balls. A few moments later however, the Ferroviário strikers combined on some rapid one touch passes to penetrate deep into the penalty area, where a Vitória defender brought down an attacker with a trip. The referee pointed to the spot, awarding a penalty kick. Ferroviário converted the chance, scoring the only goal of the first half. The remainder of the first half included a few near misses for both sides, but no further scoring.

The second half resumed with Ferroviário attacking constantly. An early chance skipped just wide of the goal post, denying Ferrão a two goal lead. Approximately ten minutes in, another nice sequence of passes found a Ferroviãrio striker wide open ten yards out. The striker buried a shot into the back of the net, leaving the Vitória keeper little chance to react. The score stood at 2-0 in favor of the home side. Ferroviário moments later had the chance to make it three goals, but a nice save by the keeper kept the margin at two. A breakdown in the Ferroviário defense 25 minutes in allowed Vitória an unmarked shot on goal, narrowing the gap to 2-1.

Thirty minutes into the second half, a blatant elbow to the face of a Ferroviário midfielder lead the referee to show the red card to a Vitória player, giving Ferroviário a man advantage for the remainder of the game. Ferroviário quickly set up another beautiful series of passes culminating in their third goal, making the score 3-1. A late chance by Vitória rattled off the cross bar, hitting the goal line, but never fully crossing the line, leaving the score at 3-1. No further goals were scored, and Ferroviário ended the game quite satisfied with a 3-1 victory against a strong Vitória side.

Work: Diarrhea, DNA, Documents

2006-10-10T22:25:00.000-04:00

Indeed, amidst all of the traveling, beaches, and football games, I am actually working. I admittedly have not spent much time discussing my work in this forum, and so I endeavor to share at least an overview of my work. I'm currently involved in a number of research projects and also have some opportunities to see clinical medicine practiced here in Fortaleza.

Research Projects:
1. Effect of Chronic Early Childhood Diarrhea on Physical Fitness
In this study, we are looking at children who now are roughly ages 8-16, whom were surveilled for diarrhea during their first 2 years of life. Our lab previously showed that children with high diarrheal burdens early in life had decreased physical fitness at ages 5-10, and now we will investigate whether these adverse effects on physical fitness persist. Currently, I spend 4-6 half days a week in the community administering physical fitness tests, and checking blood pressure, height, weight, and other anthropometrics. Administering the physical fitness test involves supervising a balloon game in which children wear watches with motion detectors, and admnistering a test called the Harvard Step Test. This has turned into a physical fitness challenge for me as well, as I perform each harvard Step Test along with the children to help them maintain the appropriate pace. This involves five minute stair climbing sessions that complement my evening runs well as I try to improve/maintain my own physical fitness. This study is very enjoyable as it allows me to spend time each day in a favela near our lab working with the children in the community.

2. Effect of Chronic Early Childhood Diarrhea on Vision
This is a study for which I am currently writing protocols for submission to the Institutional Review Board. This study is a study that I will hopefully be coordinating from start to finish, beginning with developing the hypotheses and writing protocols, continuing with data collection and analysis, and ultimately with reporting the results in the form of a paper. Currently, my time on this project mostly involves writing protocols and preparing documents, but by January or February should be in the community conducting vision tests with a similar time commitment as the physical fitness study, which will have concluded by that point.

3. PCR Studies
I'm also involved in multiple other studies that utilize PCR (Polymerase Chain reaction). PCR is a mechanism for amplifying DNA. It is used for multiple diagnostic tests for various infections. Effectively, I start with a stool sample which contains human DNA, and the DNA of many normally present bacteria, as well as any pathogenic bacteria or parasites. I then extract DNA using a series of chemicals that allow me to progress from a stool sample to a solution that looks more like water, which contains the DNA. I then need to isolate the DNA for the bacteria or parasite for which I am testing. For this we use special sequences of DNA called primers, which allow us to use PCR to amplify only a specif region of DNA corresponding to the organism of interest. We then can assess samples for the presence or absence of this sequence of amplified DNA using a process known as gel electrophoresis. In summary, these projects will involve me conducting laboratory tests to determine whether patients have one of two parasitic causes of diarrhea (Cryptosporidium or Giardia) or a bacterial cause of diarrhea (Enteroaggregative Escherichia Coli). There are also other PCR tests for many other bacterial and parasitic causes of diarrhea, but I will focus on the three mentioned above. I'll be using these tests in three different populations to assess the causes of diarrhea in those populations. Currently, I spend a few days a week working on these assays, trying to get them up and running before I begin receiving stool samples to analyze en masse.

Aside from this research, I also have opportunities to observe the practice of medicine at the local hospitals. I was able to round at the ID hospital and hear many diagnoses discussed that rarely are mentioned in the US. I hope to take advantage of these clinical opportunities more often as the research begins to flow more smoothly.

And so, indeed I am working in addition to enjoying the football, food, and praias (beaches) of Brazil. I should also qualify this description of my work by mentioning that this Thursday is yet another Federal holiday, which means another four day weekend. On this occasion, our fellow Fogarty fellow from Salvador, Brazil will be visiting Fortaleza. We plan to visit Morro Branco and another beach 3 hours east of Fortaleza called Canoa Quebrada, in addition to seeing a bit of Fortaleza. We'll return to Fortaleza some time Saturday, and head back to work on Monday. November brings with it two holidays, and plans for those are still in the works. The latter holiday may present a good time for a 7-10 day trip to the Amazon. I had planned to try to visit there during the second half of the year, but have learned that during that time (the rainy season), the weather may not be as optimal. For that reason, we may consider undertaking this journey in mid-November. For now, its off to bed to rest in advance of another expedition to the Policia Federal to attempt to register as a foreign citizen in Brazil. I received my passport via DHL today (although a bit wet as they apparently lost it briefly en route) and it now has all of the appropriate notations, thus I expect that this will be less of a pain than my last few trips to their office.

Ferroviário vs. Barueri

2006-10-08T20:01:00.000-04:00

Ferroviário vs. Barueri
8 Out 2006
1600
Estádio Presidente Vargas

Ferroviário opened the fourth and final stage of Brasilian Serie C play against Barueri. Barueri had won their phase 3 group, with Ferroviário finishing second to Bahia in their phase 3 group. As the home team, Ferroviário had to be looking for a win and the associated three points in the standings to open their campaign to advance to Serie B. There are eight teams in phase four of Serie C, with the top four advancing after each team plays 14 games, home and away against each other remaining team.

Ferroviário started quickly tonight, gaining three corners in the first five minutes. Unable to convert these chances, the game remained scoreless. Ten minutes in, Ferroviário played a beautiful diagonal through ball between the last two Barueri defenders. One defender slipped, leaving the Ferroviário striker on a breakaway with the goalkeeper. The striker beat the keepr, but was unable to beat the crossbar, and the game remained scoreless. The sides traded chances for the remainder of the first half, but the score remained nil-nil at the half.

In the second half, Ferroviário continued to attack, slotting a few shots just wide of the post. Throughout the first half, multiple yellow cards were issued for tactical fouls and reckless play. Fifteen minutes into the second half, a Ferroviário midfielder committed a reckless tackle from the side for what seemd to be the fourth time. This lead to the player´s second yellow, and thus a sending off. With the score knotted at zero, and now a man down, Ferroviário could easily have went into a defensive strategy. Instead, Ferroviário continued to attack and scored after penetrating into the penalty area and ahving a shot deflect off a defender past a bewildered Barueri keeper. The score stood now at 1-0, favoring Ferroviário. The partisan crowd came back to life with chants in support of the home side.

With the man advantage, Barueri continued to attack, just missing wide of the post on multiple occasions. With fifteen minutes remaining, a Barueri midfielder was sent off after a vicious tackle from behind aimed at the back of a Ferroviário players knee, leaving the sides to play 10 vs. 10. Five minutes later, a second reckless challenge from a Barueri player playing with a caution lead to a second red card, this one for a second caution. Ferroviário played with a 10 vs. 9 advantage for the final ten minutes narrowly missing a second goal, and withstanding the final attacks of Barueri. There were no ties in Serie C action today, so Ferroviário is tied for first on points, and sits tied for second in Serie C on goal differential, after an excellent start to phase four action in Serie C.

Fortaleza vs. Figueirense

2006-10-08T12:48:00.000-04:00

Fortaleza 1 Figueirense 1
4 Out 2006
1930
Estadio Presidente Vargas

Fortaleza, currently mired in the relegation zone of Brasilian Serie A squared off with Figueirense Wednesday night at Estadio Presidente Vargas. The tricolors need to finish the season with a run of victories if they are to avoid relegation to Serie B for 2007.

Figueirense controlled play in the first half, scoring first after a nice cross found a striker wide open in front of the Fortaleza keeper. Fortaleza figured to need some help in the second half if they were to get back into the game. This help came in the form of misconduct by a Figueirense midfielder. Early in the second half, the player challenged a Fortaleza attacker hard, with the foul deemed worthy of a caution. In the aftermath of the foul, the Figuiriense midfielder shoved the Fortaleza attacker, earning a simultaneous second caution, mandating a send off. This left Fortaleza with an 11 vs. 10 man advantage for the remainder of the game. They quickly had an excellent chance and the ball appeared headed into the goal when it was touched by an offisde Fortaleza attacker, negating a potential goal. A few moments later, Fortaleza again entered the penalty area with numbers, and converted placing a shot into the upper corner of the net. Figueirense settled into a more defensive posture for the remainder of the game, and the game ended in a 1-1 draw. The draw left Fortaleza in 19th postion of 20 teams in Serie A, needing multiple victories to avoid relegation.

In other soccer news, Ceará of Serie B has been on a winning streak, positioning itself to potentially avoid relegation to Serie C. Ferroviário commences play today on Sunday 8 Out 2006 in the final group of eight in serie C. The top four teams from this group of 8 will play after each team plays a series of 14 games, playing each other tram home and away. A distinct possibility exists that Serie B could have a decidedly Cearense flavor next season as Fortaleza will likely be relegated, and Ferroviário could be promoted to join Fortaleza and Ceará in the

Casas, Cars, Churrascos

2006-10-08T12:47:00.000-04:00

Last weekend was quite the busy weekend in Fortaleza. We arose at 8:45 am on Saturday, after a late dinner at a friend's house the previous night. We headed to meet the landlord for the apartment that we planned to begin renting on Saturday. We arrived at the apartment, reviewed the rental documents in Portuguese and prepared for a day of moving. The first task we faced was making copies of the keys to the gate, two ouside doors, and doors to our first floor porch, and roof top patio. Noticing a key maker adjacent to our apartment, I quickly came to the conclusion that perhaps for the first time a task could be accomplished easily in Brazil. Little did I realize that the key maker did not have enough keys for the sets that we needed. Thus, he did what any shop owner would do, he asked me to sit and watch his shop while he set off on his bicycle to acquire more keys. I assumed that he would just be headed around the corner, but instead he arrived back nearly an hour later, keys finally in hand. The first task of the day now complete, we qte a quick lunch, and set off in search of a rental car to move our things and make a trip to the local Hiper Bompreço (Walmart Brasil) for supplies for our new home.

After a few unsuccessful attempts, we finally were able to obtain a small rental car for $30 for a day. We were told that the car had no gas, and so we quickly headed to a gas station. We were not told however that this car had a habit of quitting when stopped, AND had some problem with the battery that prevented it from restarting. And so as we journeyed to our old home in Rodolfo Teofilo to pick up our things, the car quit just as we rounded the final turn. Fortunately, the car had a manual transmission, and we were able to have three of us push the car, while the third person steered and popped the clutch to restart the car. We then began to move our things, planning to pack the car as full as possible along with 2 people (one person to drive and one to push should the car stall). Chris Brown and I made the first trip, and indeed the car stalled out on a busy street at an intersection. Fortunately, I was up to the task of pushing the fully loaded car through the intersection, eventually achieving a high enough velocity to allow Chris B. to pop the clutch and get the engine restarted. After a second trip, we headed to Walmart Brasil to purchase items for our new home.

I am not a fan of shopping at large department stores in the US, and this trip to Hiper Bompreço reminded me exactly why. After scurrying around the store for a long two and a half hours, we finally felt that we had all that we needed for our new home. Ben and I took a car full of things back while Chris and Nate took a taxi back to our new house. We then began to unload our things, which included some furniture for our rooftop patio. We quickly realized that this furniture would not fit up our narrow staircase, and devised a cable (actually an old piece of coaxial cable connected to an exercise band) to raise the tables and chairs to the roof. This process went reasonably smoothly, with the exception of one chair crashing to the ground from near the roof as it slipped from our poorly tied harness. Exhausted, we finally were able to catch up on our sleep. We planned to have friends over for a barbecue the next evening, an event that would teach us amny more lessons about life in Brazil.

Regarding our barbecue, we purchased some chicken from the store from the refrigerted section. First mistake: In Brazil, apparently one should always purchase frozen chicken unless they want inedible foul smelling poultry. I had also purchased some charcoal and lighter fluid. Second mistake: Purchasing not enough charcoal, and the wrong type of lighter fluid. We had planned to barbecue the chicken American-style, and had purchased some barbecue sauce and salt. Third mistake: I purchased regular salt, not realizing that to barbecue, one needed to purchase churrasco sal, salt designed just for barbecuing. Also, apparently to properly barbecue chicken Brazilian style, one needs to use pepper and other spices, rather than barbecue sauce. And so as our guests arrived, we were informed that we had spoiled chicken, not enough charcoal, the wrong kind of salt, and a complete absence of suitable spices or Brazilian side dishes. Fortuantely, our friends Fabrizio, Germana, and Fabiana were able to resuce our barbecue by bringing more meat, and suggesting appropriate spices to use. And so the barbecue ended up going well, just with a bit of a delayed dinner secondary to all of our "mistakes."

Novo Endereço

2006-10-04T22:51:00.000-04:00

I indeed now have a new address as the title of this post might suggest.
After spending two months in Rodolfo Teófilo, far from the ocean, I now live
in an apartment less than 2 blocks from the Atlantic, in a much nicer part
of the city. Some humorous stories will follow regarding the move, but for
now, my new address:

Chris Eller
Rua Antonele Bezerra 303 Apto 3
Meireles
Fortaleza-CE
CEP 60160-070

It has been an eventful week for me as I have moved, and commenced physical
fitness testing in the community for our Physical Fitness study, designed to
assess the effect of early childhood diarrhea on long-term physical fitness.

In addition, it has been an eventful week for the people of the Brasil, with
the first round of elections Sunday leaving incumbent Lula just shy of a
majority. Lula gained a plurality of 49% to top challenger Alckmin's 42%,
forcing a runoff election in late October. This election occurred in the
wake of allegations of corruption among staff members of Lula's campaign and
government. It remains to be seen if these allegations will further cut
into Lula's lead into the polls as the day of the runoff election
approaches. Last week also ended with sad news, as the worst aviation
accident in Brasilian history occurred with a Gol plane traveling from
Manaus to Brasilia plunged to the ground after a collision with an American
piloted smaller plane. The American plane was able to land safely, however
the Gol jet fell to the earth with no survivors among the passengers and
crew. Investigations into the accident continue, dominating the news in
Brasil along with the election news.

Updates on the move will come shortly, and with the installation of internet
at our new apartment, I should be able to post the long promised photos of
my Salvador trip, along with photos of my new apartment.

Football aside...

2006-09-28T09:02:00.000-04:00

Aside from catching football matches in the evenings, I am actually getting work done in the laboratory in Fortaleza. A few of my projects will involve molecular testing using PCR to detect certain organisms that cause diarrhea (Cryptosporidium, Giardia, Enteroaggregative E Coli) and I have spent some time during the last week trying to get one of these tests functioning properly. I still need to work out some problems with the protocol, but work is progressing well in that area. In addition, I have been working to translate background, protocols, and IRB (Institutional Review Board) documents for the vision study that I would like to pilot later in the year. Finally, it seems that our study of physical fitness in children in the community may actually commence next week.

In other news, we were able to check out some apartments in nicer parts of the city (read: closer to the ocean) and may soon be moving to another location. This Sunday will be election day across Brazil with Presidential elections and other state and local elections. Interestingly, in Brazil all adults are required to vote in the election. In two weeks, our fellow Fogarty Fellow Tracey (Fogarty Fellow - Salvador, Brasil) will be visiting Fortaleza, and we hope to travel to some of the beaches of Ceará that we have not yet visited. That weekend will be yet another holiday weekend, with two more holidays to follow in November.

Regarding my schedule for the remainder of the year, I will be returning to the US briefly in late December and early January for Christmas and to obtain necessary supplies for my vision study, as well as to begin to set up my schedule and plans for the fourth year of medical school. I´ll then return to Brasil for the last 5 months of my fellowship, beginning my vision study and continuing other projects. At some point in that five months, I plan to spend a week of my vacation in the Amazon. I'll ultimately leave Fortaleza sometime in mid-late May. What I'll do from there is still up in the air, as I plan to either begin fourth year of medical school on May 28, June 11 or June 25. I plan to do a little traveling in South America on the way home. I'd like to at least spend a few days in Argentina, and a week in Peru, and if I elect to start fourth year in June, I'd also like to add in stops in Chile, Bolivia, and/or Ecuador. Starting fourth year in May would technically be a month early, but that would allow me time to do one extra rotation early, and so I may consider doing so to allow me more time to experience ophthalmology prior to making a final decision regarding the field to which I will apply for residency. I'll figure out those elements of my schedule over the next few months.

Football, Ferroviário, Fireworks

2006-09-28T08:38:00.000-04:00

Last night I took in a match involving the third football team in Fortaleza, Ferroviário. Ferroviário is currently in competition in Brazilian Serie C. Serie C is a competition with multiple stages in which teams are divided into groups of 4, with teams playing each other team in their group home and away, with the top 2 teams in each group then advancing to the next stage. Ferroviário is now in the second to last stage, and sits in second place in their group. The top 4 teams from the final group of 8 will be promoted to Serie B for next season. If Ferroviário were able to manage a draw against Bahia last night, and a a win or draw on the road this Saturday, they stood an excellent chance of advancing to the final group of eight.

Last night, Ferroviário took on first placed Bahia, from the city of Salvador. The game was held in Estádio Presidente Vargas, rather than the larger Castelão that I have previously seen games in. Vargas has a nice atmosphere, as it is a smaller stadium with concrete bleachers and an enthusiastic group of fans. The Ferroviário fan club sets up behind the opposing goalkeeper and creates a considerable amount of noise in the form of drums, fireworks, and songs. At halftime, they march to drumbeats to the opposite end of the stadium to continue the harassment of the opposing keeper in the second half. Last night, I saw fireworks set off in one corner of the stadium three times, and many more times outside the stadium.

Ferroviário vs. Bahia
Estádio Presidente Vargas
27 Set 2006
2030

Ferroviário took on Bahia in a critical Serie C match last night at Estádio Presidente Vargas. Throughout the first half, Ferroviário created numerous chances with a clear advantage in team speed that allowed their outside midfielders to penetrate deep into the corners to produce crosses into the penalty area. The Ferroviário strikers placed heads or feet on a few of these crosses, but were unable to find the back of the net. Bahia had a few chances on counterattacks after defensive mistakes by Ferroviário. At the half, the score was knotted at 0-0.

Returning from halftime, Bahia took the opening kickoff and came out with a bit more enthusiasm, immediately creating high quality chances. The Ferroviário parried a few well taken corners and free kicks away before a 2 on 1 break by Bahia resulted in the first goal of the game, putting Ferroviário down 1-0 on their home turf. Ten minutes later, Ferroviário would penetrate deep into the penalty area, only to be tackled from the side by a Bahia defender. The referee blew the whistle immediately, pointing to the spot to award the game's only penalty kick. After a bit of dissent from Bahia, the kick was taken, with Ferroviário placing the ball past the outstretched arms of the Bahia keeper. The game resumed with the score now tied at one, and Bahia again mounted attacks that required brilliant goalkeeping to keep the score level. With five minutes remaining, Ferroviário had their best chance of the match with the recently substituted left striker penetrating deep into the area only to push a shot just left of the goal post. The game ended a few moments later in a tie, with each team gaining a hard earned point in the standings.

Ceará VS. Náutico

2006-09-20T07:57:00.000-04:00

As I posted Monday, there are three professional soccer teams in Fortaleza. Fortaleza EC plays in the top division (Serie A), Ceará SC plays in the second division (Serie B), and Ferroviária plays in the third division (Serie C). Fortaleza and Ceará are currently find themselves at or near the bottom of their respective divisions, but Ferroviária is currently tied for second place in their Stage 3 group in Serie C, and can advance to Stage 4 with some good play in their next 3 games. More on Ferroviária another time, but last night I was able to get my first look at Ceará SC as they took on Serie B leaders Náutico. The great thing about professional sports in Brazil is that is actually affordable to go to a game, unlike in the US. I paid the equivalent of $4 for a ticket, $1 for popcorn, $0.80 for a bus ride to the game, and $7 for a taxi ride home (because it was late). Even with the taxi ride, the entire night only cost $13, probably what you would pay just to park at some US stadiums.

Ceará 1 Náutico 1
Estádio Casteláo
19 Sep 2006
2030

In Campeonato Brasil Serie B action last night, Ceará SC and Náutico of Recife, Pernambuco played to a 1-1 draw. Ceará started fast from the opening whistle, finding themselves attacking with numbers 3 minutes into the match. A nice cross from the right sided striker found his cohort on the left side streaking past the sweeper unmarked. The left sided striker finished off the chance with a beautiful one touch shot into the left upper corner of the net. This early goal seemed to provide a source of enthusiasm for the crowd as the singing of the team song grew louder, and the drum beats of the Ceara fan club reverberated throughout Castelão.

Five minutes after the goal, Ceará would leave one of the Nãutico midfielders unmarked, and the player made no mistake in beating the goalkeeper with a perfect shot into the upper 90, squaring the match.

Ceará continued to have the better of the chances and possession, but they never constructed another significant scoring threat until 5 minutes remained in the half. The right sided striker again found some space streaking down the side line and was able to cross the ball into the penalty area where a teammate skillfully attempted to head the ball into the ground passing the charging Náutico keeper. This attempt beat the goalkeeper, but was unable to beat the goalpost, as the shot skipped harmlessly off the outside of the goalpost. Ceará had one more chance late with another ball crossed into the box which the right striker pushed just wide of the post.

The teams returned from the break with Ceará again having the better of possession and chances. A Ceará midfielder created a chacne by weaving his way into the penalty area, advancing to the corner of the goal area before dropping the ball back to a wide open striker 10 yards out. The striker again pushed the ball wide of the net, wasting a golden opportunity. Náutico would next threaten to break the draw when one of their strikers found himself on a breakaway all alone in front of the Ceará keeper. The keeper made a brilliant reflex save, and was able to collect himself to quickly gather in a second shot off a rebound. Ceará had a final flurry of chances late with five minutes remaining, all parried by some equally excellent goalkeeping from the Náutico keeper. In the end, the match ended in a draw. The story of the match was outstanding speed and attacks by Ceará, hurt only by a frustrating inability to finish chances, coupled with great goalkeeping from both sides. The match was a great effort by last placed Ceará against first placed Náutico, but the Cearense have to be disappointed that they were unable to earn three points in the standings for their efforts. With the draw, Náutico drops to second palce in Serie B, trailing Sport, also of Pernambuco. Ceará remains in last place, and must improve their play over the last three months to avoid relegation to Serie C.

Flamengo 4 Fortaleza 3

2006-09-18T07:56:00.000-04:00

Yesterday, I would have ran the 10k race that I thought I had registered for, but instead learned Saturday that my registration had been cancelled, apparently because I lacked a CPF number (Brazilian social security number). That was a little disappointing, but I still was able to enjoy a football (soccer) match last night.

Journeying to the match was quite interesting as we first boarded a bus for Terminal lagoa. After arriving there, we transferred to the bus that would carry us to the stadium. Like most city buses, this bus was designed to carry about 50 seated passengers and 20 more standing passengers. Last night though, the bus had approximately twice that number of passengers crammed into every possible place. At one point in the trip, we rounded a corner and due to the weight distribution, the bus briefly was riding on 2 wheels. After a 20 minute ride though, we arrived at the stadium, resolving to take a taxi home...

The game was unlike any sporting event I have observed in the US. I never have been to a game where fans set fireworks off before and during the game. It was also quite interesting to hear all of the fans shouting in words that I had no chance of understanding. They were definitely very passionate about their team. Fortaleza has three major professional football teams, the best of which is Fortaleza EC of Brasilian Serie A. They also have Ceará FC, a Serie B squad, and a third team in Serie C. Fortaleza is in Serie A this year, but is currently near the bottom of the league table, meaning that they will msot likely be relegated to Serie B at season's end. For those of you unaware of how football works in most countries outside of the US, each year the bottom few teams of each division are demoted to the next lower division, with the top teams then being pormoted to the next higher division. The top teams of the top division (Serie A) are rewarded by being invited to participate in continent-wide champions leagues in addition to continued participation in Serie A. My report of last nights match follows, and I do still plan to post some Salvador photos at some point this week...

Flamengo 4 Fortaleza 3

Estádio Castelão
Fortaleza, Brazil
17 Sept 2006
18:10

A high scoring match saw Flamengo of Rio de Janeiro knock off Fortaleza EC in Serie A of the Brazilian league. Some highly questionable goalkeeping by Fortaleza allowed Flamengo to jump to a quick 2-0 lead, despite a few early chances by Fortaleza. The Fortaleza keeper displayed an inability to hold onto the ball, frequently giving up large rebounds leading to Flamengo scoring chances. Fortaleza was able to get one back shortly before the break with a nice set piece, but Flamengo responded quickly, scoring for the third time on what was also a nice set piece off a free kick from the far corner. The score stood at 3-1 at the half, with Fortaleza needing to return with more inspired midfield play and tighter goalkeeping if they were to have any chance at achieving any points from the match. Indeed Fortaleza returned from the break with a bit more speed and creativity from their midfield, and were able to get within 3-2 on a beautiful goal early in the second half. From the ensuing kickoff, Fortaleza quickly regained possession and had an incredible scoring chance within the Flamengo 6 yard box, but failed to capitalize. A few moments later, the combination of fast Flamengo strikers, slow Fortaleza defenders, and questionable goalkeeping led to a fourth goal for Flamengo. Fortaleza was able to get a third goal late, and had a few more scoring chances before full time. Fortaleza and their fans appealed for a penalty with about 2 minutes remaining after an attacker went down inside the six yard area. The attacker appeared to simply slip, and the referee saw it this way as well, ignoring the pleas of the Fortaleza captain for a penalty. Flamengo withstood a final corner kick for Fortaleza before the referee blew the whistle for full time, signalling the end of a high scoring affair in the Brasilian Serie A.

Reunion, Reunião (Meeting), Racing

2006-09-13T07:48:00.000-04:00

This past weekend was a holiday weekend, with Brazilian Independence Day falling on a Thursday, making for a nice four day weekend. This allowed Ben, Nate, and I to travel to Salvador, Bahia, Brazil for four days, which also allowed us to meet up with Tracey Newlove, the Fogarty Fellow in Salvador, Brazil.

Salavador is a beautiful city (photos to follow later this week), located more than 1000 km down the coast from Fortaleza. Salvador has many hills, and more variable weather than Fortaleza. Salvador also is on a peninsual such that the Atlantic Ocean is to the east, and a bay is to the west, allowing one to view a beautiful sunset over the bay. I greatly enjoyed this change of scenery for a few days. It sounds great to have the weather forecast be sunny with a high of 87 and low of 76 everyday, but it is actually nice to have a little variety at times. Indeed in Salvador, we experienced cooler weather, and rain during 3 of the four days that we were there. Despite the rain, we still were able to explore parts of the city of Salvador and a few beaches north of Salvador.

The first two days were spent exploring parts of the historic downtown, Pelourinho, and the area near the bay. We ate at some good restaurants, walked through Pelourinho, and met some other students traveling in Salvador, some from the United Kingdom, others from Norway and others from the US. We were able to get a room cheaply at a hostel in the Pelourinho area. Saturday was the day that we planned to travel to a beach north of Salvador, Praia do Forte. We read in our travel guide that this beach had turtles and a castle, and we hoped to see both. We also hoped for sun. Unfortunately, we saw no turtles (they're actually raised in captivity for release into the wild, and they charge admission to see them), and were unable to find the famed castle of Praia do Forte despite driving northa nd south of the beach in search of the castle. It also rained for part of the day putting a damper on our day at the beach. Despite these facts, while searching for the castle after the rain had stopped, we discovered a beach 10 km north of Praia do Forte that was more isolated, much less touristy, and quite beautiful. Reachign this beach required a hike through a small town across a stream, around a lagoon to reach the ocean. I definitely preferred this small quiet beach to the touristy Praia do Forte. We returned to the city Saturday night and dined with Tracey in the Rio Vermelho area of Salvador. Here we had one of the few bad experiences in Salvador in which a man came up to us while we were eating at an outdoor restaurant, and after trying to sell some product or upcoming event, said something to the effect of "Gringos go home." This put a little bit of a damper on the evening, but we still enjoyed the chance to see a little more of Salvador and talk.

Sunday afternoon involved further exploration of the Pelourinho and Barro regions of Salvador. Our flight was scheduled to leave Salvador Sunday evening at 10:35 pm, and arrive in Fortaleza at 1:30 am after a stop in Recife. We reconfirmed our flight prior to heading to the airport in Salvador, taxied to the airport and checked in for our flight. We were then told that the plane was delayed leaving Sao Paulo, and the flight would be an hour or so late. In fact, the plane arrived about 2 hours late, and we departed 2.5 hours late, arriving in Fortaleza at 4:00 am, arriving back at our house at 4:30. This wouldn't be much of a problem, except for the fact that our PI, Dr. Guerrant was giving a presentation the next morning at a hotel near Praia do Futoro for an HIV conference, and we were expected to attend. This required us to wake up at 7 to taxi across town for the presentation, going on 2+ hours of sleep. This was followed by a day with a very long meeting about our projects, also on 2+ hours of sleep. The meeting refocused our projects, and now I have about 4 projects that I am in some way working on or planning. We're still continuing with final preparations for a physical fitness study, I continue to plan a vision study, and now have a project involving PCR testing for cryptosporidium and enteroaggregative E Coli that I am currently working on. Later in the year, we all hope to collaborate on a project that will bring together some of the diagnostic tests that we are working on for a small study in HIV patients.

The remainder of this week will be focused on my PCR project, and continuing to plan my vision study. Friday, Chris Brown, the final member of the Fortaleza crew will arrive. Chris is another medical student from my class at UVA who will be here for part of the year this year. This weekend I will be participating in a 10 kilometer race here in Fortaleza. It is part of a series of races across Brazil that apparently attract some of the elite runners in the country. I have been running quite a bit here in Brazil, and look forward to seeing how I can do in a timed test with other runners. The setting for the race is perfect as there will be two circuits of a course along Beira Mar, bordering the Atlantic Ocean near Praias Iracema, Meireles, Nautico, and Mucuripe.

Salvador photos should be up later this week, and I hope to post a few thoughts on life in Brazil early next week.

Independence Day, Salvador, Round 3: Federal Police

2006-09-05T14:33:00.000-04:00

Thursday will be our second national holiday in Brazil as the lab will be
closed for Brazilian Independence Day. Currently, we're in somewhat of a
holding pattern with respect to our projects, as the physical fitness
project should hopefully start in about 1-2 weeks after we receive final
approval from the Institutional Review Board. I'm also working on writing
up a proposal for a project that would involve some vision assessments.
That interests me for a number of reasons, as visual impairment is a huge
problem globally, and I am still considering ophthalmology as a potential
field of medicine (I'm also considering internal
medicine/pediatrics-infectious disease).

The last national holiday occurred on a Tuesday immediately after our
arrival, and so we weren't able to take advantage of the potential four day
weekend to travel elsewhere in Brazil. Given the current delays in our
projects, we have decided to take advantage of this four day weekend to
travel. Early Thursday morning, we'll fly to Salvador, Bahia, Brazil, to
return late Sunday night. Salvador is about a 25 hour bus trip, or in our
case a 3 hour flight down the coast of Eastern Brazil. Salvador is also
home to the other Fogarty Fellows in Brazil, so we should get to spend some
time with Tracey and Ricardo while there. In addition, Salvador is a
beautiful city with a significant African influence. I look forward to four
days to explore the city, and will certainly post some photos on our return.

Finally, today's events included round 3 with the Federal Police. Ben and
Nate successfully registered as foreign students on a temporary visa,
however I will still have to send my passport either to Brasilia or
Washington D.C. for a notation to be added. I hope to complete that process
after returning from Salvador to finally end my struggles with the Brazilian
Bureaucracy...

Rodizio

2006-09-03T16:21:00.000-04:00

This weekend has been rather eventful. Saturday, I remained in Fortaleza to do some work, and spent the afternoon on the coast on Avenida Beira Mar. Ben and Nate journeyed a half hour inland to some mountains near Fortaleza along with a Brazilian friend. Unfortunately, they were met by an armed robber who apparently may have recently escaped from the local jail. They lost their bags, digital cameras, cell phones, wallets, and a small amount of money, but thankfully they escaped unharmed.

Sunday afternoon, we joined Ila (One of the Brazilian Fogarty Fellows) and her husband for lunch at a Rodizio. It's a place where all sorts of meat, seafood, and vegetables are served buffet style, and in addition, circulating waiters bring different cuts of meat right to your table. We ate quite a bit, as the photos below illustrate...

Nate, Ila, Chris in Line at the Buffet

Meat Delivered to our Table

A Great Dessert

Chris Enjoys the Great Dessert

Chris, Ben, and Nate outside the Beach Park near Fortaleza

A Closer Walk TONIGHT

2006-08-31T09:27:00.000-04:00

Tonight, PBS will be showing the documentary, "A Closer Walk," which
chronicles the HIV/AIDS crisis. I encourage you to check your local
listings for PBS (your local public broadcasting station), and to not miss
this film. I believe the broadcast will be at 9 pm in most areas.

Speakers for R$22,90

2006-08-30T16:50:00.000-04:00

We occasionally will watch a movie in the evening on the weekends on one of our laptops. Unfortunately, the speakers built in to most laptops these days simply will not broadcast a loud enough sound to watch a movie. Thus, we have been left to surround the computer in a group of three sharing 2 sets of headphones.

For that reason, tonight while at Hiper Bompreço (Walmart Brasil, actually owned by Walmart), I purchased a set of computer speakers for R$ 22,90, the equivalent of $11.00 in the U.S. Arriving back home, of course I hurriedly plugged in my computer to test out the new devices. I didn't expect much for $10, but the speakers amplified the sound reasonably well, with only some loss of quality. Or at least that is what happened for the first 5 minutes of their use…

After about 5 minutes, there was a resounding pop, followed by the smell of burning plastic. Apparently, that is what one gets for R$22,90: speakers that function for only 5 minutes. It goes without saying that I will soon be returning to Hiper Bompreço in an attempt to recover my R$22,90, and I can only hope that that adventure proceeds more smoothly than my ongoing adventures with the Brazilian Embassy and Federal Police.

Photo Update: Centro and a Look at Rodolfo Teófilo

2006-08-29T08:08:00.000-04:00

This week's photo update includes photos from shopping in the Centro neighborhood, as well as some photos from the neighborhood where I currently live, Rodolfo Teófilo. For those of my friends who have suggested that I have posted too many beautiful beach photos, this week's update includes no such photos...

Shopping at an Open Market in Centro

Puppies in Centro

Rodolfo Teófilo Correios (Post Office)

Banco de Leite Humano (Leite=milk,Banco=bank,Humano=human,de=of)
Yes, this is exactly what it sounds like...

Rua Professor Costa Mendes, a main road in Rodolfo Teófilo

Chris Studying Portuguese

As always, I welcome comments, questions, or advice on dealing with the Brazilian embassy and Federal Polce of Brazil, who continue to ignore me.

Portuguese, Presentations, Police

2006-08-25T14:28:00.000-04:00

This week, we've been working on translating the protocols for our study into Portuguese. Translating scientific protocols is definitely a way to improve your Portuguese. Next Friday, I'll have to give a presentation on the physical fitness project in Portuguese along with Ben, the other Fogarty fellow.

Tonight, at 11 pm, we'll journey to the airport to meet Nate Ostheimer, one of my classmates at UVA Med who will be here in Fortaleza for the next 6 months. He also has created a blog to which I'll add a link later today on my blog site. It will be good to welcome Nate tonight. In another week and a half, we'll welcome our UVA mentor, Dr. Guerrant, who will be back in Fortaleza for a week. A week or so later, Chris Brown, another of my UVA classmates will join us here in Fortaleza. Chris will also be here for several months as part of a different research project.

Meanwhile, I continue to struggle to register with the Federal Police. I have been hung up on by the Brazilian Embassy in Washington, and Brazilian Consular Service in Washington many times this week, in addition to a series of 6 unanswered emails that I've sent to the consular service and ambassador. I hopefully will eventually be able to get in contact with someonewho can actually help me resolve the issues with my visa, but things haven't went so well thus far...

Aside from that matter, I'm enjoying the time in Fortaleza, and continue to work on Portuguese and getting the physical fitness study up and running, my two primary tasks right now. The weather remains perfect: I'm not sure that the job of weather forecaster even exists here, as aside from rainy season, one could simply forecast a high of 85, a low of 75, and sunny, and be correct 99% of the time. I hope that everyone reading this is well, and feel free to post your comments, questions, or advice on navigating the Brazilian bureaucracy.

Adventures in Brazilian Bureaucracy

2006-08-18T07:53:00.000-04:00

DISCLAIMER: The following story is meant to serve as a cautionary tale to anyone planning a long-term stay in Brazil. In no way does the author intend to imply any negative opinion of any Brazilian agency or official. In fact, the author considers the Federal Police, SUDENE, and the Brazilian Embassy to be highly efficient agencies that accomplish their purposes with great proficiency.

The line above aptly titles this account of my attempts over the last two weeks to register as a foreign citizen with the Federal Police. First, a little background: As a student here on a 1-year temporary visa, I am required to register with the Federal police of Brazil within 30 days of my arrival. This certainly sounds easy enough, take a bus to the federal police station, bring a few passport photos, a copy of my visa application, and my passport and I should be all set. In practice, a bit more difficult:

After reading on the internet that to register, one needed to bring a notarized copy of their passport, an original copy of their visa application, 2 passport photos, and their passport to the Federal Police, Ben and I did just that. After spending a morning finding a Brazilian notary, we arrived at the Federal police office only to learn that in Brazil, passport photos were a different size, and ours would certainly not be acceptable. By this time, it was growing late, and so we headed back into town to obtain new passport photos of the correct size. By the time this task was complete, the Federal Police office was closed, and so registration would have to wait until the next day (or perhaps longer…)

The next day, after spending a few moments looking at the map, we immediately realized that the Federal police station appeared to be a simple ten minute bus ride on a road called Avenida Borges de Melo. And so we walked to a bus stop on one of the main roads, Avenida José Bastos, and boarded the bus Borges de Melo 2. Little did we know how important that number 2 was. After 2 hours of circling the city in the opposite direction that we had hoped, we realized that a deeper knowledge of the Fortaleza bus system might be worthwhile after all. (Side note: There are about a 100 or more bus routes in Fortaleza. I am told that no map exists of these routes. I was also told that there was NO source available to figure out the routes, but a little google searching revealed: http://www.ettusa.ce.gov.br/ If you ever find yourself in need of taking a bus in Fortaleza, please save yourself a 2 hour bus ride in the wrong direction and read this site first. )

After our unplanned tour of some of the not-so scenic portions of Fortaleza, we did finally arrive at the Federal police. At this point, things should be simple, or so I thought. Wait in line for a few minutes, turn in my forms, go to the Bank of Brazil to pay my registration fee, and I should be registered for the year. I chuckle now at my ignorance…

After waiting in line for some time, Ben and I reached the head of the line. Now you may recall that I mentioned that one of the requirements for registering was an original copy of one’s visa application. I’ll spare you our luggage story, but suffice it to say that one of my suitcases is still sitting in Brazilian customs in Fortaleza, and one of Ben’s suitcases is sitting in customs in Manaus (Why Manaus? Another long story…) Unfortunately, Ben’s visa application also is sitting in Manaus in the aforementioned suitcase. And so, Ben’s attempt to register was immediately denied by the Federal Police, in spite of the fact that he had a letter from the local US embassy which was supposed to replace the lost document. Still, I remained hopeful that I could complete registration. I presented each of the required documents, was fingerprinted, filled out some forms in Portuguese, and sat waiting for the process to complete. Suddenly, I noticed the Federal Police official looking more closely at my passport. He then stood up, and began showing my passport to other federal police officials. In case you haven’t guessed, that never bodes well. He then returned to let me know that because my passport did not have the words: “Universidade Federal do Ceará” written adjacent to the visa along with the letters RN and a four digit code to indicate the sponsoring organization for my visa., I could not register. Now, I quickly pointed out that in fact this very notation was written on my visa application by the Brazilian Embassy in Washington D.C., but as the Federal police quickly pointed out, the information was not written in my passport.

Obviously, I thought, there has to be a simple solution to this dilemma, but then I quickly realized that I probably had already missed the right time to try crying, and that I also probably lacked the appropriate number of official stamps and titles to easily accomplish anything else within the bureaucracy. Instead, I was told that I would need to send my passport back to Washington D.C. for the appropriate notation to be made. And so now, one week after I began attempting to register, I sit here still emailing the Brazilian Embassy in Washington and various other agencies in Brazil in an attempt to sort this out. Appropriately enough, my latest contact, as directed by the embassy in Washington, has been with an agency in Brazil called SUDENE. I read their website to try to figure out their role in this mess, and although my Portuguese is not great, I think I was able to decipher that their principal role is to handle communication between other agencies in Brazilian government. In a sense, SUDENE, or at least my contact at SUDENE’s sole purpose is to navigate the bureaucracy of the Brazilian government. It has been three days since I contacted them, and I have not yet heard back, so I suspect that they are quite the busy agency…

Reading, Holidays, Pizza Hut

2006-08-16T08:06:00.000-04:00

Yesterday was a Brazilian National holiday, Assumption Day, which lead to us having the day off from the lab. This allowed me to read a bit, work on Portuguese, and have dinner with a Brasilian medical student and her friends. I have enjoyed the opportunity here to read for pleasure, something that I've done little of in the last few years of medical school. I just completed Mountains Beyond Mountains by Tracy Kidder, a chronicle of Paul Farmer's work in the area of global health. I am now nearly halfway through the Fellowship of the Ring, the first part of the Lord of the Rings trilogy. I have delayed seeing the films of this series for some time, as I had planned to first read the books. Unfortunately, with the demands of the 3rd year of med school, I am only now getting started reading the series.
Thus far though, it has been a great read, and I'm glad I delayed seeing the
movie.

Last night, Ben and I joined Germana, a medical student here at UFC, and some of her friends for pizza at Pizza Hut. Now, I assure you that the restaurant choice was their's not ours as we plan to avoid American
restaurants (especially McDonalds) while here in favor of experiencing the many great local restaurants. In any case though, it was good to meet some other Brazilians, and spend an evening hearing Portuguese spoken (albeit little of it from my mouth), as that definitely will aid my language acquisition.

Today, I have some meetings in reference to the physical fitness study in the morning, and then hopefully will be able to really get started on my
project with the remainder of the week. The weather remains perfect, I continue to adjust to life in Brazil, and I continue to strive to communicate in Portuguese. In the future I plan to continue to try to post a text update at least weekly, in addition to a weekly photo update. I have also taken many more photos not posted on this blog, which are freely available on a Kodak Ofoto site. Email me if you'd like to check any of those out. I've tried to select a few of the best each week for the blog, as I realize that most of you do not want to sort through the 50-100
pictures that we've been taking weekly.

A Closer Walk on PBS

2006-08-14T20:59:00.000-04:00

I just wanted to plug PBS' (your local public broadcasting station) upcoming showing of the documentary "A Closer Walk," which will air on the evening of August 31. I've seen this film four times, most recently at Fogarty orientation, and I highly recommend it. It is a documentary illustrating the impact of the HIV/AIDS crisis around the world, with many personal accounts of the impact of the disease. The time of the showing of the film varies by time zone, but check your listings as this film should not be missed. I warn you that the film can and should disturb you, and hope that it will make many more aware of the magnitude of the impact of HIV/AIDS worldwide.

www.acloserwalk.org

2006-08-14T08:58:00.000-04:00

Below i've posted some photos from the last week, mostly from the weekend that I spent at Morro Branco. Morro Branco is a beach located about 57 miles down the coast from Fortaleza, about a two hour bus ride from the bus station (rodoviaria) in Fortaleza. We also visited Praia das Fontes, another beach an hour walk from Morro Branco. I'll post some more about the trip later this week, but for now, check out the photos.

Chris in Fortaleza at the Gira Sol Restaurant (where I'm staying this month)

View of Morro Branco from Above

Chris at Morro Branco

Chris Traversing Morro Branco

Arriving at Morro Branco

Atlantic Coast at Morro Branco

Sunset at Morro Branco

Sunset at Morro Branco

Photos Week 1

2006-08-08T13:26:00.000-04:00

Rodolfo Teofilo, My Current Neighborhood

Chris in the Atlantic Ocean at Praia do Futuro

Chris and Rita (guesthouse owner) with Fortaleza Skyline

Chris in Rodolfo Teofilo

View of Downtown Fortaleza

Neto, Ben and Chris at 50 Sabores Sorveteria

Adjusting to Fortaleza

2006-08-08T13:21:00.000-04:00

Blog Entry 8/5/06

Today, I finally feel as though I’m getting over the initial culture/language shock of arriving in Brazil. Ben and I were talking last night about the difference in going abroad for 1-2 months versus an entire year. When one travels to another country for a few weeks to a few months, as I have in the past, there is a clear endpoint in sight at all times. However with this trip, for the first time, I feel that there isn’t necessarily a clear endpoint in sight right now, which I’ll confess was initially overwhelming as I began my year in Brazil. While this is one challenge of a year abroad, I also feel that it is one of the greatest parts of the Fogarty program, in that one must adapt to life in another culture without that clear endpoint in sight.

Regarding language, my Portuguese is beginning to improve, as I’ve spent several hours a day using the Rosetta Stone language software for Portuguese. After some practice, I now feel that I can follow at least some of the conversations that I hear. Portuguese will remain my primary task for the beginning of the next week, but I will begin with the research later next week, while continuing to study Portuguese.

My project again seems to have changed, with a new initial focus that I am very excited about. I will ultimately work with some of my Brazilian colleagues on some molecular diagnostic tests for diarrhea in children in the laboratory, but my initial project will be to take charge of a community study related to physical fitness in children as related to some genetic and environmental determinants. It should be an interesting and fun project that will take me frequently into the local community.

My culinary experiences thus far in Fortaleza have also been enjoyable, as I’ve had some excellent seafood (fish, shrimp, and lobster) and incredible fruit (pineapple, guava, mango, and melon).

And so after 3 days in Fortaleza, I am settling in and beginning to enjoy life here. Boa noite!

Arrival

2006-08-03T12:18:00.001-04:00

This morning, after some 18 hours of flights and connections that carried us from Philadelphia to Miami to Manaus, Brazil to Belem, Brazil to Fortaleza, we finally arrived at our destination. We were minus two bags that we had initially carried on, but were then forced to gate check in Miami. I then lost another bag of lab supplies temporarily to Customs, with that bag hopefully being liberated from the Fortaleza airport customs office by next week. My lost abg has been found, and Ben's should be en route tomorrow, hopefully resolving our baggage issues.

The bigger issue that I face currently is the language barrier, as I realize how big a task learning Portuguese will be. There's also a little bit of the initial culture shock that is inevitable. Fortaleza in many ways resembles to me a larger more modern version of Guinea-Bissau with similar Portuguese style architecture and sharp juxtopositions of poverty and wealth. The city though is 10 times larger than Bissau, so it will prove quite a chore to learn to navigate, while also learning Portuguese.

Today, we stopped in at the lab, settled into our temporary housing, and may do some further exploring of the city later. Tomorrow we'll meet with Dr. Lima, our site mentor, and then should continue settling into Fortaleza. I'll hopefully be able to post some photos soon, as soon as the remainder of my luggage arrives with the cable to transfer photos from my camera. I can leave with you a taste of the cliamte though, as it is currently feels like the temperature is in the mid to upper 80s, with some humidity. The weather is refreshing relative to the heat wave that we left in the Eastern US.

Boa tarde from Fortaleza!

Miniature Golf

2006-07-26T23:38:00.000-04:00

Tonight, the Brazilian Fogarty Fellows, two other Brazilian medical students, and I went miniature golfing at the local putt-putt course. In the photo are Andressa, me, Ila, Jamilly, and Joao. Andressa and Ila are the Brazilian Fogarty fellows who Ben and I will work with for the next year. Jamilly and Joao are medical students from the Federal University of Ceara in Fortaleza who are spending six months at UVA. For most of the crowd, it was their first miniature golf outing, and I think everyone had great fun trying their hand at the game.

Last Week of Fogarty Orientation/Return to Charlottesville

2006-07-22T21:31:00.000-04:00

The last week of orientation flew by in Bethesda, with more presentations, a group project, and great times hanging out with the other fellows. Our sampling of international cuisine at local Bethesda restaurants continued with visits to Mexican and Afghan restaurants. The orientation concluded with group presentations in which each group had to present a potential research project. My group presented on a potential clinical trial to investigate interventions to prevent dengue fever. The project was a bit annoying in the fact that it required us to spend some evening time preparing for the presentation, but it turned out well in the end. The last week of orientation included a number of football (soccer) matches among the fellows including an epic North America VS. South America match that was lead by our North American side until the teams were redistributed as others arrived. The last night of orientation involved having dinner with many of the other fellows one final time before we all departed for sites around the world. Indeed, while we heard many interesting presentations at the orientation, the best part of the orientation was interacting with all of the other fellows from around the US and around the world. Although orientation was two short weeks in Bethesda, it seems odd now being back in Charlottesville without the rest of the fellows with whom I had spent the last few week. I look forward to our reunion at the interview conference for the 2008-2009 class of fellows, and hope to see at least some of the fellows before then, perhaps during our vacation time.

I’ll be here in Charlottesville for further orientation specific to my project and my research site for one more week. I’m spending time in the lab of our PI, Dr. Guerrant, along with Ben (the other US Fellow going to Fortaleza), Nate (another UVA student going to Fortaleza on a Pfizer grant), and Ila and Andressa (the two Brazilian Fogarty Fellows). I’ll return to Maryland on July 30, and Ben and I will depart Philadelphia for Fortaleza on August 2. Ila and Andressa will return to Brazil 10 days later, and Nate will join us in Fortaleza later in August. In September, the Fortaleza crew will be complete with the arrival of another UVA medical student, also named Chris, another Pfizer grant recipient.

It seems odd that I now only have a week left in Charlottesville and ten days left in the United States before my departure. I still have much to do in the way of preparation and packing, but things seem to be on course for my departure.

Weekend at Fogarty-Ellison Orientation

2006-07-09T23:14:00.000-04:00

The weekend at Fogarty-Ellison orientation has been a great time to get to know some of the other fellows and see the Bethesda and Washington D.C. areas. My activities this weekend included a visit to the Smithsonian, a trip to a Washington Nationals game, and watching the World Cup final Sunday.

Saturday, I traveled into Washington D.C. with several of the U.S. and foreign site fellows. We arrived on the metro, and set off in two groups bound for various sites in our nation’s capital. A group of the foreign site fellows accompanied by one of the U.S. fellows headed to the White House and other monuments, while I headed to the Smithsonian along with two of the fellows from Yale. Paul (U.S. Fogarty: Lima, Peru), Libby (U.S. Fogarty: Chennai, India) and I headed first for the National Gallery (of Art), a museum I had not previously visited. After lunch at the folk festival on the National Mall, we all headed to the Museum of Natural History, meeting up with the group who had traveled to the White House. Finally, Paul and I checked out the Air and Space Museum, while the other fellows returned to Bethesda. Unfortunately by this point, most of the foreign site fellows were tired from walking around D.C., and so we were unable to get a large group for the Nationals game. Undeterred, Paul and I took the Metro out to the game, and were able to get great tickets behind third base for a game that we later learned was also attended by President Bush and Secretary of State Condoleeza Rice. The Nationals lost 5-2 to the San Diego Padres, but this game, which was the first National League game that I have attended, was still quite fun.

Sunday afternoon began with brunch at our program director’s home in Silver Spring, and ended with watching the World Cup final, won by Italy on penalty kicks. Penalties are definitely a tough way to lose a cup final… With my favorite teams USA, England, and Cote d’Ivoire long since out of the competition, I was hoping to see Zidane of France conclude his international career with a second cup victory, but instead saw his career end with a reckless head butt that resulted in his ejection during extra time. An unfortunate end to a stellar international football career.

Sunday evening involved Japanese food for dinner, at the local Benihana restaurant. At this restaurant, we watched as our food was prepared and cooked on the table right before our eyes, which was quite the experience. It proved to be a great dinner with twenty of the other Fogarty fellows, and a nice end to the weekend. Tomorrow, we’ll return to orientation with epidemiology in the morning, and country presentations in small regional groups in the afternoon.

Week 1: Fogarty-Ellison Orientation

2006-07-07T23:36:00.000-04:00

I’m writing now from the Fogarty-Ellison orientation in Bethesda, Maryland. It has been a great three days thus far, as the 23 U.S. and 24 foreign site fellows have gathered together at the NIH in Bethesda for 2 weeks of orientation. It has been great meeting fellows from such places as Brazil, Zambia, Peru, Bangladesh, India, Thailand, and Botswana. It has also been great to again see many of the US students whom I met at the program selection conference in March. The Fogarty fellows are an incredible group of people, with diverse backgrounds, experiences, and interests. It has been a great pleasure to meet all of the other fellows, and I look forward to the remainder of our time in Bethesda.

Thus far, we have had introductory sessions, sessions on the roles of the World Bank and World Health Organization (WHO), and sessions on the history of clinical research and the process of grant writing. Also, we have had a few sessions focusing on the state of the science with respect to specific diseases. Thus far, we have heard presentations on maternal and child health, malaria, and tuberculosis.

In our free time in the evenings, we all have tended to gather for dinner in large groups of US and foreign-site fellows at various restaurants in Bethesda. I had Thai food on Wednesday, and tonight a group of 21 of us ate at an Indian restaurant. You might imagine how hard it was for us to find a restaurant in Bethesda on a Friday night with a table for 21…

I thought I’d leave you with a few concepts discussed in some of the presentations thus far. These are facts and concepts with which I and many of the other fellows are quite familiar, but I realize that some of those reading this may not be as familiar with the status of health around the world.

Economics: Greater than 1 billion people in the world live on less than $1 per day. Approximately half of the world’s population lives on less than $2 per day.

Poverty and Health: Poverty is the result of poor health. We often assume that health is poor in developing countries due to poverty, but in many respects, it is the disability resulting from poor health that leaves many countries in poverty. In reality, both sides of this statement are likely true, but we often fail to consider the economic impacts of poor health.

I hope to revisit some of these issues in later posts. Orientation has been great thus far, and tomorrow (Saturday) will be a day off. We plan to visit some of the museums and monuments in Washington D.C. with some of the foreign site fellows. Despite living so close to D.C., it actually has been several years since I’ve visited the Smithsonian or monuments of D.C., so I’m looking forward to the day tomorrow. I may also catch a Washington Nationals game tomorrow night with some of the other fellows.

Advance Look at Fortaleza and Ceara

2006-06-19T12:17:00.000-04:00

As I've tried to get an idea of what life in Fortaleza will be like, I've found a number of photos on the web that give me at least some idea of what the city and surrounding area will be like. Fortaleza is a city of just over 2 million, with a large downtown area with many surrounding favelas, which some define as "shantytowns." Fortaleza is located on the Atlantic Coast, in the state of Ceara. In this post, I've included a few photos which I found listed as public domain images. I'll try to post a few more iamges of the city and surrounding areas in the coming weeks, and certainly will post photos of my own after I arrive in Brazil.

Pinto Martins International Airport, Fortaleza

Cityscape and Beaches of Fortaleza

Sand Dunes of Jericoacoara

(Up the Coast from Fortaleza)

Flight Arrangements at Last!

2006-06-12T16:09:00.000-04:00

Today, after what seems like weeks of attempts, I finally have confirmed flights for my journey to Fortaleza. Over the last three weeks or more, making these arrangements have seemingly lead to problem after problem. Initially, our departure date kept changing, ranging from July 31 to August 15. Last week, August 2 finally emerged as our target date. Then, it seemed that I would find reasonable itineraries only to see them disappear before I could get them booked through the program. Finally, late last week, I found a suitable itinerary, but had more problems getting the flights booked due to issues related to how the flights were being paid for by a third-party, which required additional verification to be submitted. Today, at last, all of the issues seem to have resolved, and I can finally state with reasonable confidence that I will be leaving the U.S. for Brazil on August 2, 2006.

My journey will be a bit circuitous, departing Philadelphia along with my fellow Fogarty fellow, Ben, at roughly 12:30 pm, bound for Miami, Florida. After a five hour layover there, we will board the plane which will carry us on the remainder of our journey to Fortaleza. We'll leave Miami at around 8:30 pm, and will ultimately reach Fortaleza at 8 am on August 3rd. En route to Fortaleza, our flight will have brief stopovers in Manaus, Brazil and Belem, Brazil in the Amazon region, but these stopovers will each be an hour or less, in the middle of the night, and without a change of plane.

Its good to finally have a reasonably concrete itinerary, now I will set out to finalize visa arrangements, while also studying for a surgery oral exam and surgery written exam which will occur next week.

My updated schedule for the next weeks:
Today - June 20 Neurosurgery Rotation
June 21 Surgery Oral Exam
June 22 Surgery Written Exam
June 23 - July 2 Study for USMLE Step 2
July 3 USMLE Step 2 in Lynchburg
July 5-19 Orientation for Fogarty-Ellison Program at NIH in Bethesda, MD
July 20 - 28 Lab orientation at UVA
July 31 Move out of Charlottesville, travel to Conowingo, MD
August 2 Departure

Upcoming Events

2006-05-02T21:42:00.000-04:00

I anticipate that these next 3 months leading up to my departure for Brazil will fly by, so here's a quick look at what I'll be doing for the next few months.

Today - May 12 Finishing up my 6 week General Surgery Rotation
May 15 - June 2 Cardiac Surgery Rotation
June 5 - June 20 Neurosurgery Rotation
June 21 Surgery Oral Examination
June 22 Surgery Written Examination
June 23 - July 2 Studying for Step 2 of US Medical Licensing Exam
July 3 Taking Step 2 USMLE Clinical Knowledge Portion (Lynchburg, VA)
July 4 Preparing for Orientation
July 5 - July 19 Fogarty-Ellison Program Orientation - NIH (Bethesda, MD)
July 20 - July 21 Fortaleza Site Orientation (Charlottesville, VA)
July 22 - ? Moving/Preparing to Go
circa July 28 - August 2 Departure for Brazil

The updates may be limited until I finish surgery, but look for more frequent updates as I head to orientation in July, and on to Brazil in August.

Childhood Diarrhea

2006-04-02T19:48:00.000-04:00

Diarrhea in children. Something that certainly is common in the United States, as evidenced by the number of cases of rotavirus gastroenteritis that I saw during my inpatient pediatrics rotation. In the United States, however, many children will experience brief episodes of viral or bacterial gastroenteritis during their childhood. These children are often treated as outpatients with oral rehydration and other supportive care, and even the fraction that require inpatient hospitalization, due to an inability to maintain adequate oral hydration, ultimately do quite well, generally recovering quickly over a few days.

The story is quite different in other parts of the world. I think of Guinea-Bissau, a country close to my heart as a result of parts of three summers spent there as a volunteer missionary. In Guinea-Bissau last year, a cholera epidemic resulted in 25,111 cases of severe watery diarrhea, with at least 399 deaths in less than 6 months [1]. While epidemics such as this recent cholera outbreak often are the only episodes of diarrheal illness that will even make the news (and even then often only international news websites, rather than major US news outlets), the topic which I'll be studying over the next year has an even greater impact on morbidity and mortality in developing countries than these intermittent epidemics. I'll be involved in research that investigates the long-term effects of chronic diarrhea in children. Mortality due to diarrheal illnesses has dropped significantly over the past few decades due to the impact of oral rehydration therapy, but the morbidity of chronic childhood diarrhea continues to rise. Mortality still remains in the neighborhood of 2 million deaths worldwide due to diarrheal illness in children. Children who experience chronic diarrhea in early childhood perform worse in school years down the road, secondary to impaired cognitive development in their early years. These children also experience growth shortfalls, and impaired physical fitness and cognitive function [2].

Over the next year, I will be working in an NIH funded laboratory in Fortaleza, Brazil with the research group of Dr. Richard Guerrant, also of the University of Virginia. In addition, I will also spend time in the University Hospital, seeing illnesses that are uncommon in the United States and observing differences in how medicine is practiced in less developed countries, something that will hopefully prepare me well for future medical work abroad. I will not be the only medical student in Fortaleza over the next year, as I will be joined by another Fogarty fellow, and likely by 1 or 2 UVA School of Medicine classmates who are hoping to spend a year in Fortaleza on Pfizer grants through the School of Medicine. We'll each be working on different aspects of the research on chronic diarrhea in children, with projects ranging from cognitive function testing to pedigree analysis to integration of PCR diagnostic tests for common pathogens. In future posts, I'll talk a bit more about the research that we'll be involved in, and the clinical opportunities that we'll have, as well as a bit more about Fortaleza.

References:
1. http://www.irinnews.org/report.asp?ReportID=50859&SelectRegion=West_Africa&SelectCountry=GUINEA-BISSAU
2. Guerrant, RL, Kosek, M, Moore, S., Lorntz, B., Brantley, R., and Lima, AAM. (2002) Magnitude and Impact of Diarrheal Diseases. Arch. Med. Res. 33:351-355.

Welcome to my Blog

2006-03-20T23:41:00.000-05:00

Welcome to my blog! If you're reading this, you probably know that I'm currently a third year medical student at the University of Virginia. I hope to use this blog to communicate my experiences as I spend the next year (beginning in July/August) as one of the 2006 Fogarty-Ellison Fellows in Global Health and Clinical Research. What exactly is a Fogarty Fellow you might ask? I'll soon be posting more about what I'll be doing for the next year, but for now, check out the Fogarty program webpage. Where am I going to spend the next year as a Fogarty Fellow? I have the privilege of spending the next year in Fortaleza, Brazil, a city in northeastern Brazil. See the map below:

For the remainder of the week, I'll have to quickly get over the excitement of my selection as a Fogarty fellow, as I will be taking my final exam in pediatrics on Friday. After that, I'll be on spring break for a week, during which time I hope to post more about what I'll be doing for the next year.