Adventures in Malaria: Indonesia

After a grueling 10 hour flight from Monrovia and a 15-hour flight from Amsterdam, I arrived in Jakarta last Friday. Thankfully the flight from Amsterdam was nearly empty so I had a whole row to myself and actually slept for about 7 hours! I arrived in Jakarta at 5pm on Friday, just in time for rush hour traffic. I didn’t realize how bad this would be. It took 2 ½ hours to get to the hotel! After a 15-hour flight I was ready to cry! The traffic in this city of 23 million (23 million!! That’s almost as many people as in all of Canada!) is appalling…we crawled along as thousands of motorbikes and scooters buzzed by us. I told Eric I felt like I was in Blade Runner…the city at night has a weird post-apocalyptic feel to it, with neon lights flashing through the smog and ultra-modern architecture interspersed with shanties and ramshackle buildings. I was so relieved to get to the hotel and crawl into bed. Unfortunately I woke up 3 hours later, my body clock so screwed up that I ended up watching a couple of episodes of Desperate Housewives (my new most favorite show ever!!) and eating Instant Noodles – the ubiquitous food of Asia – from the minibar at the hotel.

The next day I repeated the same journey in reverse but with much less traffic – only took 45 minutes this time. Got to see a bit more in daylight, but not much…the air is choking smog that limits visibility substantially. Like Beijing’s. Ick. And it’s very hot and humid to boot. An asthmatic’s nightmare.

Thankfully the air in Banda Aceh is better. Got here on Saturday afternoon. My first impression was that you would never know that a tsunami completely destroyed large swaths of the city 4 years ago. And that it is completely and utterly different from Africa. It is a fairly modern city of about 400,000 people. The roads are paved, there are traffic lights and things function as you would expect in a major city.

I am living in a fairly nice (way too big, cavernous actually for 2 people to be rattling around in) house with my colleague Geraldine, a lovely girl who has worked at HQ and in Chad. She is French. She looks after the finance and administration here, which is great as I don't have to deal with it (my least favorite part of the job). We have a housekeeper who does all of the washing and cleaning and shopping for us. Food is incredibly cheap (a big relief after Liberia). You can buy fruits and vegetables for a week for under $10. And the variety is huge, every fruit and vegetable you could imagine is available (including the notorious durian fruit, or stinkfruit, which is supposed to be tasty but reeks so bad that some hotels ban people from bringing them in). So I've been eating really well!

Every street is packed with little kiosks selling cooked food - mostly the ubiquitous nasi goreng (fried rice). Literally every street corner has a couple of little "restaurants", which are little boxes often attached to a motorcycle. You sometimes see them driving slowly down the street, with the driver/chef dinging a spoon on a bowl....like the ice cream man. THere is fresh fish and seafood galore, but obviously no pork as this is a muslim area. I stopped one night and bought about 2 pounds of satay - pieces of meat marinaded in spicy sauce, threaded on skewers and grilled then coated in a spicy peanut sauce - for like $2. There is KFC, pizza hut and A&W here as well. The only thing missing is a Starbucks.

I got a membership at the gym at the posh hotel in town so am able to run and swim laps and do weights at the pool (can't run outside because I'd have to wear long pants and shirt and I would die in the heat). On the weekends I work out and then sit at the pool and read or surf the internet. Not a bad life for the moment, but a bit boring, which I shouldn't complain about after the 24/7 work schedule in Kenya. Geraldine has a boyfriend who is in town on the weekends so I spend them by myself, which I absolutely do not mind! We have loads of DVDs (they have every tv series and movie ever created for sale for less than $1 each) so between TV and internet I can amuse myself for hours. Since our housekeeper doesn't speak english and Geraldine says that she isn't a very good cook i've actually been cooking for myself, but of course nothing fancy (as everyone knows my culinary skills are nonexistent) but i can stir fry vegetables and make rice and that's dinner!

This programme has been running since 10 days after the tsunami in 2004. We've trained over 4000 health care workers in malaria and dengue case management, provided drugs and diagnostic tools to all of the health facilities in the province and done spraying in a large number of communities. Immediately after the tsunami we distributed insecticide-treated plastic sheeting, which is used to create shelters and is very effective at keeping mosquitoes away.
Indonesia has a double-whammy of malaria and dengue. Malaria isn't such a huge problem but dengue is quite bad. And there is not a lot you can do about dengue, as it is transmitted by Aedes mosquitoes that bite during the day. There is no treatment as it is a viral disease and no vaccine. In most people it is a mild illness but in some cases it turns into its deadly form, dengue hemorrhagic fever, which is very serious and can be fatal.

It is hot as blazes and very humid. A bit like North Carolina in August except hotter. I break into a sweat as soon as I step outside the air conditioning. Unfortunately for me, this is a muslim province under Sharia law, so I have to wear long sleeves and long pants everywhere! At least I don’t have to cover my head like the women here do. They all wear hijabi (I think this is how it is spelled) and I don’t know how they stand it.

So the fact that the city is muslim influences all aspects of daily life. It starts with the 5am call to prayer, which is repeated five times a day. On Fridays, the men go to the mosque for two hours at mid day so we extend the working day. The Sharia police roam the streets on Fridays looking for men as they are supposed to be at the mosque. Women who get caught without hijabi get hauled to the police station where their parents or husband have to come and bail them out. Forget about alcohol. It can be found but you have to know where to get it and you have to ask the shopkeeper in some secret code and they bring you your “package” already wrapped up. There are a couple of restaurants where you can get beer, one of which is a German-run place that has “super beer” on the menu and they bring it to you with a cut-up coke can wrapped around the beer can.

Ramadan is about to start next week and it causes a drastic slowdown everywhere. Everyone fasts from sunup to sundown, no water, food, cigarettes, or anything. As you can imagine by the end of the day everyone is dragging. At sundown some sort of signal goes off and everyone eats, drinks and smokes like crazy (I have not met a single man who does not smoke here, everywhere you go there is a cloud of stinky cigarette smoke, which is disgusting). Everyone takes time off to go visit their families the last part of September/beginning of October so that slows down work as well.

I’m having a bit of culture shock, actually, especially coming from Africa. I might as well have landed on another planet. Its going to take some time to get used to it! The people are nice, but more reserved than Africans. There is also a big language barrier as not everyone in the office speaks english and those who do don't speak it fluently or understand everything so communication is a bit frustrating. Geraldine also isn't totally fluent in english so conversations are slow and I have to be very patient. None of the drivers speak more than a few words of english. I find it exhausting. I'm trying to learn a few words of Indonesian so i can at least give directions.

I had to go to Singapore last week to renew my visa (yes, after being here only a week, a long story involving the massive and complicated government beauracracy here). It is a beautiful city. Incredibly clean, landscaped with lush tropical plants everywhere, totally modern and one big shopping mall!! I've never been anywhere that seemed so obsessed with shopping! Every subway station is a shopping mall. Not that I could afford to buy anything...it was all Gucci Prada Cartier super high end shops. I bought some starbucks coffee (the stuff here is too strong for me! burns a hole in my stomach!) and some books, and got my hair done.

After Singapore I flew to Jakarta for meetings with our donors. We sat in a taxi for 4 hours to get to 2 meetings. The traffic is totally insane. Did a bit more shopping, I found the running shoes that I pay over $100 in the US for less than $70 here. Bought my colleague Geraldine an 80G Ipod for $200. Stuff is cheap here, i guess cause they make it in Asia.

So back to work this week after a week out of town, it will be nice to get back into the routine of work, gym, etc.

Here are some pictures: