On Puddle Jumping

I have flown over the pond for the first time in ten years and find myself on an entirely new continent! Given my three year absence, this blog officially earns the title of my “international travel” blog. I haven't left the United States since I returned from the Dominican Republic in 2012 and subsequently graduated from Emory’s MPH program the following spring. And with that, blog posts have fallen by the wayside.

I think for many people, international travel and blogging go hand-in-hand. It’s an efficient way to reflect on new experiences and share those reflections with a wider audience of loved ones. As I find myself in an unfamiliar place on my next big adventure, here I am blogging again, digesting new experiences for you all to see.

I arrived in northern Senegal this afternoon. I will be here for a relatively short time (less than two weeks) this time around, but this trip marks the beginning of semi-regular trips to pursue research here. I’m switching hemispheres and disease systems to pursue an interdisciplinary PhD at Stanford University.

Schistosomiasis is a parasitic disease that’s a big problem in northern Senegal. Its prevalence here is associated with the ecological disturbance due to water resources management (such as dams). Dams arguably provide essential economic opportunity through irrigation to the region’s predominately agricultural society, but have had the unfortunate consequence of causing one of the most explosive epidemics of schistosomiasis ever.

In this scenario, economic opportunity comes at the cost chronic exposure to parasites. People often talk about how infectious diseases like schistosomiasis keep poor people in poverty - what is often called a poverty trap. Less often are people actually able to quantify that relationship. In a place where economic activity and disease risk are so obviously linked, I'd like to explore ways to measure that connection in concrete ways. Can schistosomiasis in Senegal legitimately be called a poverty trap?

The difficulty of quantifying this relationship is exacerbated by the way health and disease is measured. These metrics can capture many facets of health and disease: mortality, disability, quality of life, cognitive development, but they inevitably pit certain diseases against others in a competition for attention and resources. Is it worse to get malaria or tuberculosis? Would you rather die of a deadly disease at a young age or be chronically ailed by a less severe disease over the course of a lifetime? Some argue that the burden of schistosomiasis is consistently underestimated precisely because it involves chronic infection over time and doesn't necessarily kill those it infects. For this reason, schistosomiasis long been considered a neglected tropical disease. Whether its more important than other diseases or not, its a problem here and our choice of health metrics should reflect that. 

All that said, I'm looking forward to digging into discussions with research partners tomorrow and getting to see the study area for myself. I've arrived just as Senegal's rainy season has taken hold. We had a decent rainfall this afternoon, which resulted in the complete flooding in the street outside the building where I stay (due to a clog in one of the drainage pipes, I'm told). In my experience, rain often drives people indoors, but today, the kids in the neighborhood had a hay day running down the street knee deep in rainwater, chasing cars as they waded slowly through the slosh. It was a fun soundtrack for a jetlagged nap but made for an interesting quest to eat dinner. Managed to do two kinds of puddle jumping today for the first time in a long while!