Michaela, Senhor do Bonfim, and research update

By far the most exciting news of the last week is that my cousin Michaela has arrived in Salvador! She’s spending a month here volunteering with orphans before returning to Indiana to start her 3rd year in optometry school! She’s living in a place ~15 min walk from my apartment! It was such a strange coincidence that we had both separately made plans to be in Salvador this summer and it’s been great to have her here!

Last weekend I ventured to the Igreja do Nosso Senhor do Bonfim, an 18th century Catholic church. Catholic churches are a dime a dozen in Salvador (apparently there are ~365 churches in Bahia…one for every day of the year), but Senhor do Bonfim has become one of the most famous and unique churches in Salvador due to its ties to Candomblé, an African-Brazilian religion. Candomblé was the religion practiced by the African slaves in Bahia and since it was forbidden to practice any religion but Catholicism, the slaves got creative and worshiped their gods, the Orixás, under the guise of their respective Catholic saints. Today the Orixás and their corresponding Saints have become quite blended. Senhor do Bonfim refers to both Jesus and Oxalá (the most important Orixá).
Igreja do Nosso Senhor do Bonhim
Inside of Nosso Senhor do Bonfim

The most famous tradition from Senhor do Bonfim are the fitas or fitinhas. They are bright colored ribbons that say “Lembrança do Nosso Senhor do Bonfim da Bahia,” which translates to “Remember our Lord of Good End of Bahia.” The ribbons are all over Bahia, very commonly hanging from rearview mirrors for good luck and also tied all over the gates and doors to the church.

Fitas are worn on people’s wrists and known as miracle ribbons. The wearer gets to make (and supposedly have granted) three wishes! The wishing protocol is pretty simple:

1. you must be given a fita as a present
2. You cannot tie the fita to your own wrist, someone else has to do that for you
3. They must tie 3 knots. Make a wish when each knot is tied.

The tricky part is that in order for the wishes to come true, the fita must be worn until it falls off on its own (which apparently can take over a year!). Supposedly each Orixa/saint has a color but I have no idea which color corresponds to which orixa/saint. I got two fitas when I visited Senhor do Bonfim, although I couldn’t think of many wishes so I made the same three wishes for each bracelet. I also bought a whole bunch of fitas to bring back to the States in case anyone would like to make some wishes!
Fitas tied to the door and gate of Nosso Senhor do Bonfim
My fitas! Note the other colorful fitas in the background...ready for gifting when I get back



The Igreja do Senhor de Bonfim has a room of miracles that is both creepy and fascinating. The room is covered in pictures, notes, and personal items from people who are requesting a miracle of Senhor do Bonfim and from people whose miracles have been granted. There are a decent number of diplomas from people who had wished to graduate school, lots of pictures of babies and also graphic pictures of wounds, scans of tumors, etc. The weirdest part of the room were the wax body parts hanging from the ceiling. I guess if you have an ailment in a particular body part (the most common being feet, hands and heads) you could bring in a wax replica and hang it from the ceiling. I’ve posted some pictures of the room for your perusal.







Research:
Today is the absolute last day we can submit documents for the NIH grant! YAY! I’ve spent the last few weeks working on administrative aspects to the grant: writing up a budget, writing everyone’s biographical sketches, letters of support, anything that from Brazilian collaborators that needed to be written in English, etc. While rather boring, I can now say I have experience writing grants… I also used a TB database to determine the incidence of TB in Salvador from 2001-2008, compared those rates to the incidence of TB in Rio de Janeiro, Sao Paulo and the whole country of Brazil. I’ve also been gathering data to try and create an epidemiologic profile of TB in Salvador since 2001. While this was originally for the grant, I’ll be presenting my findings in the end of the month and hopefully write this up into a paper. I found a published paper with a similar methodology to mine that looked at TB in Salvador in the 1990’s, so I’m hoping I can manage to put something publishable together! The trick will be writing it up in Portuguese…hopefully I’ll be able to convince someone here to help translate.

I’m hoping to finally go to the TB hospital and start research with Almerio soon. Fingers crossed for next week! Hope everyone's summers are going well! Beijos!

My nerdiness is showing...

I can't help myself...I'm a big nerd at heart. Last Thursday I inadvertently found some very exciting items. I realize most people probably don't find my purchases/findings as awesome as I do, but I KNOW that there are a few people who will. So here you go:

I decided to pop into a bookstore while running errands and I happened upon a Microbiology coloring book! The cover (pictured below) depicts Koch's postulates and the book covers everything from fungi life cycles to ELISA's! It will definitely be making an appearance at ID study groups this fall...

After my exciting find at the book store, I went grocery shopping. Later that night I noticed something strange on a grocery bag that I had left on my table. The bag had pictures of boobs on it! I was a little disconcerted until I realized that my grocery bag had a step by step guide to do a self breast exam! I guess it's a logical place to put a public health message, seeing as how women typically buy food for their households. I give big creativity points for whoever thought of that one.

I'll post about something more relevant (ie a research update) later this week! Beijos!

I really need to update this more frequently...

I haven’t been very good about updating this blog so this will be a long entry, don’t worry there are pictures…

Natal
I didn’t have to work most of this week thanks to the festival of São João. Actually, I thought I had the whole week off until I got a text at 7:30 Thursday morning from Sergio saying he was at my apt to pick me up for work! Anywyas, the fun São João parties apparently happen in the interior of Bahia but none of my friends had plans to go! I couldn’t waste a perfectly good (partial) week off so I booked a flight to go visit Pooja in Natal for a long weekend. Pooja and I have been friends since freshman year at Northwestern. She just finished her first year of med school at Iowa and is spending her summer doing research or visceral leishmaniasis in Natal.

I got in on Friday night, went straight to a Forro (a traditional northeastern dance), drank a few too many caipirinhas and stayed up most of the night catching up on life with Pooja. It was an excellent evening!

Along with three other med students, we spent Saturday and Sunday in a cute vacation town called Pipa, about an hour and a half outside of Natal. There were fun shops, fantastic restaurants and beautiful beaches… it was a wonderful change of pace from the very urban Salvador! I took a surfing lesson on Sunday and despite my sore muscles and a few bruises, I’m hooked! I was able to stand on the board and ride into the shore twice! The waves in Salvador are great so I’m hoping I can continue to learn how to surf here!

A view of the beach we learned to surf at
Our boards
The walk to the beach
Our hostel

I spent Monday and Tuesday working with the team of med students on their visceral leishmaniasis project. We drove out to rural towns outside of Natal, gave questionnaires and physical exams to former VL cases and their family members. Pooja and her roommate Alex taught me how to take a patient’s blood pressure and explained all of the parts of their physical exam to me. I got to help administer their questionnaire, which was great experience since my own project has a questionnaire component! I made myself useful by teaching them Epi Info (a data entry/analysis program) and by rambling on about biostats and epi…I was in nerd heaven ☺

Aside from fieldwork, we managed to stuff ourselves nightly with delicious seafood, walk around the boardwalk and explore Natal. I somehow managed to forget to take pictures of people in Natal (thankfully Pooja has some which means they’ll be on facebook by 2012), but I’ve put some pictures of the beaches in Natal below. It’s a really lovely, low-key city. I really liked it, although I was happy to return to the very urban Salvador (I am a city girl at heart).

The beach in Natal
The boardwalk in Natal

Research:
I still have no antigen. Long story short, there’s some Brazilian import law that states that you can’t bring anything into Brazil that is kept cold for any reason (I think I have that right…), even if it’s for research! What a ridiculous law! Apparently the head of all of Fiocruz from Rio is meeting with the head of ANVISA (the people who enforce health surveillance) and there’s some talk of trying to get the law changed.

The antigen is also being tested back in the US at SF General. They ran the mce1A test and the existing quantiferon (QFT) test on four cases of active TB. There was no cytokine response in any of the four patients, which indicates that something was wrong with the peptides themselves, the buffer, the blood sample, etc. Dr. Riley’s people in the US are troubleshooting and hopefully we’ll have new and improved peptide by the end of July (when Dr. Riley comes to Salvador with more antigen).

Since I won’t actually be starting the mce1A project until late July, I’ll be working on a couple other TB projects in the mean time. I’m pretty sure I’ll be running QFT’s of people who stopped latent TB treatment and working on follow-up study looking for people who enrolled but didn’t finish a latent TB treatment study. I’m pretty excited about both projects! I’ve spent the last couple weeks (when we didn’t have holidays) working on an NIH grant to help fund the mce1A project. While not the most exciting of jobs, it’s been a good experience to learn about some of the components that go into grant writing.

Life in Salvador:

I really need to update this blog more often…I’m starting to forget things I’ve done! Salvador is starting to feel more like home and less like I’m on a long vacation where I also happen to be doing work. I finally figured out how to turn on my oven (without blowing up my apartment)!
A week or so ago I spent the day exploring Pelourinho, a historic neighborhood with lots of churches and brightly colored houses. Pelourinho was nice but very touristy! I got a tour guide to tell me all about the churches and buildings and ate some delicious Baihan food. My next goal is to find a place to rent surfboards and perhaps get another lesson...and my cousin Michaela arrives tomorrow for a volunteer program in Salvador! Yay!!!
The view from of Modelo Mercado from Pelourinho
Painted houses in Pelourinho
Sao Francisco Church

Getting Settled

Research
I couldn’t start my project this past week because my antigen is STILL being held hostage by customs. Despite having people from the lab calling pretty much daily, the antigen won’t be released until the people at customs call the capital, Brasilia, to see if our visa got approved. Apparently that’s not a huge priority for customs since they haven’t called yet. I’m moving on from just crossing my fingers to crossing both my fingers and toes…I’d really like to start doing work!

So I’ve been asked the question “what is this antigen and why is it so important?” a few times last week and I realized I’ve never really explained the role of this antigen in my project (or what it is for that matter). The goal of this project is to determine if a new diagnostic test for TB is able to a)diagnose TB and, more importantly, b)differentiate latent and active TB. The test works the same way as an existing TB test called QuantiFERON (QFT). Blood from a patient is incubated in an antigen from TB, the plasma is harvested and we run an ELISA to determine the amount of the cytokine gamma interferon produced. The amount of gamma interferon produced tells us if the person has TB and, hopefully whether they have latent or active infection. The new test uses different antigen than QFT. The antigen is a peptide (in this case 2 peptides) that are thought to be differentially expressed by Mycobacterium tuberculosis, depending on whether or not a person is latently infected or if they have active disease. The patient’s blood must be incubated in the antigen within ~1 hour after being drawn, so clearly I can’t start recruiting patients until customs frees the antigen!

Since I have no antigen and the rest of the prep work is done for this project, I’ve had a pretty boring work week. I passed a biosecurity class (consisting of LOTS of online quizzes in Portuguese) and spent the rest of the week trying to get people to take me up on the offer to help them with their work…no one took me up on that offer…Good new though, thanks to the biosecurity class I now know all about how to dispose of nuclear waste and genetically modified organisms properly…it was quite the comprehensive class! The first couple weeks are going to be an awkward transition and I’m really looking forward to starting research!

Life
I’m still working on getting adjusted to life in Salvador. My Portuguese is getting noticeably better (I think) and I’m slowly learning more about my neighborhood, Barra, and the rest of the city.

The food in Salvador is EXCELLENT! I usually have no idea what I’m eating, all I know is that I like it! There are a bunch of pay-by-the-kilo buffet places…these are going to get me in trouble…I always put too much food on the plate, eat it all, and then feel a little sick afterwards from eating so much. My only bad food experience was at a concert on Friday night. Federico was eating something that was blue/purple-ish and offered me a piece. It was really salty and pretty gross. I later found out it was cow spleen! I’m glad I have my own, but I don’t think I’ll be eating other animals’ spleens again. On a better food related note, I’ve become obsessed with açaí na tigela. This delicious smoothie-esque concoction is açaí berry blended with some sugar (I think…and maybe some orange juice?) and topped with bananas and granola. It’s a little cup of purple heaven.

I went to a concert Friday night with Federico and some of his friends. We saw Caetano Veloso a singer who, according to Wikipedia, is the “Bob Dylan of Brazil.” I really liked him! Everyone was really great, although I think learning some Brazilian pop culture will help me fit in. There’s a novela (soap opera) about India and it was ALL that some people were talking about. I need to watch this show!

On Saturday I found a crafty, slightly touristy market this weekend! I haggled the price for a lovely yellow hammock! I love it but can’t find a place to put it up in my apartment. No worries, I fully intend on taking naps in it this fall! I’ll post a picture later.

Aside from my continuing problems with customs, life in Salvador is going well. It’s been a huge adjustment living in a country where I don’t know anyone and am still learning the language. That being said, I’m slowly making some friends and I’m sure in another couple weeks I’ll feel right at home.

When I’m at my apartment I’m usually on skype and would love to talk! My skype name is megalt512.

Hope everyone’s summers are going well! Tchau!

First weekend in Salvador!

It's been quite the eventful first weekend! Here are the highlights:

Friday (Sexta-feira):
Sergio was out of the office so I spent the day hanging out with the Leptospirosis group at Fiocruz. It was someone's birthday so I got free cake! Free cake=new friends! I finally met Federico, Brooke's friend who found me my apartment. He was really nice, offered to help if I needed anything, etc.

After work I got my internet installed! I'm happy to report I have working, reliable internet! YAY! The installation process, however, was a little iffy.... The installation guys strung the ethernet cable through my bathroom window, drilled a hole through the wall between the bathroom and the hallway (pictured below) and then used a hot glue gun to secure the ethernet cable along the wall! Hopefully this is standard practice and the landlord doesn't get annoyed when I move out!
The hole in the wall and some of the hot glued ethernet cable

Saturday (sabado):
I decided to spend Saturday exploring some of Barra (my neighborhood). I walked along the ocean, bought a coconut and took some pictures. I would have gone to the beach, swam in the ocean, etc but I don't have any sunscreen and my pale skin would have burnt to a crisp! I did, however, find a mall called Shopping Barra! I bought a new doormat (strange purchase, I know) that says "welcome" in Portuguese and has some shamrocks! My Irish side loved it AND it was on sale. It will definitely be coming back to the US with me.
My doormat!

A view of Salvador from the Farol da Barra (the lighthouse of Barra)
My coconut!
Self portrait (it was very windy!)

Saturday night I went bowling and out for some Chinese food with two girls from the lab, Iukary and Bete, and some of their friends. Bowling in Salvador is EXACTLY the same as it is in the US! The lanes even said "Brunswick" and I wore some lovely bowling shoes! I was quite proud of my Portuguese speaking skills. I was able to carry conversations and didn't need too many words defined for me! Everyone was really patient, which helped a lot. I have a long way to go, but I think I'm getting better!

Sunday (domingo)
I spent more time exploring today. I invested in some SFP 50 sunscreen and am planning on spending some quality time in the ocean next weekend! In not so fun news, I was robbed by a kid who looked younger than the hs freshman I used to teach! It was 2pm and I was walking along the very crowded sidewalk next to the beach when all of the sudden this kid runs up from behind me and rips my silver necklace off my neck! Admittedly I had been told not to wear jewelry but I thought wearing a little silver necklace during the day would be okay...bad call. Being the genius that I am decided to chase the kid to get my necklace back. Amazingly after about 20 feet of chasing he stopped and gave me my necklace back! He ran away and about 10 seconds later a few cops came over and started arresting the kid's friend. I told them that I didn't want to press charges (at least I think that's what I said) since I had my necklace back and made sure they knew the kid they had wasn't the one who robbed me. Lesson learned: don't wear jewelry. Also, how sad is it that kids spend their Sundays robbing people instead of playing on the beach and being kids?

Other than the necklace incident, it's been a lovely weekend! I'm very excited to get started on my project this coming week!

Antigen update: on Thursday the customs people agreed to put the antigen in the refrigerator (phew!). All of the visa paperwork has been submitted and now we're waiting for approval. I am so grateful for all of the work Sergio has done to get my antigen back! Hopefully I'll have some good news this week!

Ate logo!

First days in Salvador

It´s been an interesting day and a half so far in Salvador. Here are the highlights:

My Arrival

My flight got into Salvador at 6am. I slept on the plane, my bags arrived safely and I thought things were going great until I got to customs... I had packed lab supplies that are essential to my project in two separate bags. A box of heparin tubes was well hidden in my suitcase but the other container was a cooler with antigen that apparently wasn't well hidden in a duffel bag. Customs found the cooler with the antigen! I thought I´d be fine since I had a letter from Dr. Riley explaining that they were a donation for a lab in Brazil. Turns out the antigen needs its own visa! This was tricky to understand since no one spoke English and all of the customs agents were wearing masks because of H1N1... Fortunately Sergio, the doctor who runs that lab I´ll be working in, came to pick me up from the airport and found me in the Ministry of Health office try to get my antigen. Even though I had an official person from Fiocruz with me, customs still wouldn't hand over the antigen...I did, however, get a lovely flier on H1N1. Sergio has been trying to get the antigen from customs ever since...he´s at the airport right now, hopefully with a box of ice-cold antigen. Fingers crossed.

Here's a picture of the H1N1 flier I got when arriving in Salvador (also pictured is my TB giant microbe courtesy of Rachel)

My Apartment

Since I don´t know anyone else in Brazil, I´m renting a one bedroom apt for the summer. A friend of a friend in Brazil was nice enough to find me the apartment and set things up with the landlord! I´ll post pictures soon (when I get internet in my apt), but here are some fun facts: I´m on the 8th floor of a big high rise, less than a block from the beach. The apartment is great but the kitchen is very small and has a big tank of propane attached to the stove...I haven't tried to use it because I'm scared I'll blow up the building...

My living room
The little kitchen (propane tank not pictured)
My bedroom
The view from my living room window
My ocean views! (Seen when I stick my head out the window and look right)

People

I was pretty sure before I left for Brazil that I'd struggle understanding spoken Portuguese...turns out I was right! I've said the phrases "what?" "I don´t know" and "I´m learning" about a million times so far. Not too many people speak English... In the long run this will be a good thing but it'll be an interesting first couple of weeks. Everyone has been really nice and patient. I went out to lunch today with two girls from the lab. They've invited me to go out bowling with them this weekend. It took a while for me to realize they were talking about bowling. Someone had to describe it to me first before I had any idea what they were asking me to do on Saturday! Iukary (one of the girls from the lab) said she´d call to pick me up...2 problems, one I am a mess when I try to talk on the phone in Portuguese and two she needs directions to my building and I only know the name of my street...I´ll have to work on both of those things!

Sergio is the head of the lab I'll be working with at Fiocruz. He's been ridiculously great! He's done everything from work on freeing my anitgen to drive me to and from Fiocruz to taking me to get a SIM card for my phone!

Aside from my antigen/customs problems, life in Salvador is going great! Hope life in the US is treating everyone well! Tchau!

My first blog EVER!

Welcome to my blog! I´m not going to lie, I never thought I´d be a blogger yet here I am. There are lots of people I´d like to keep in touch with and since I´m notoriously bad at staying in touch, I figured this would be the easiest way! For anyone who doesn´t know, I´m spending my summer in Salvador, Brazil doing TB research. I plan on using this blog as a way to send out mass updates on my adventures in Brazil (hence the blog name Meghan´s adventures in Brazil) and the inevitable random situations I find myself in. Happy reading! Tchau!