18 November 2015

Parasites examined by UCPH student in Africa

Masters student Iman Mohamud Mohamed explored traditions, landscapes, and medical science in Kenya and Tanzania. Iman is doing her Masters work at the Department of Veterinary Disease Biology at the University of Copenhagen. Here is her report.

As part of my master thesis in biology, I was fortunate enough to get the opportunity to do 14 weeks of field work in Kenya and Tanzania.

My project is part of a large epidemiological study across Africa, focusing on shores of different lakes, where people get infected with schistosoma parasites through water contact in their daily lives. Schistosomiasis is a neglected tropical disease caused by a parasitic flatworm, which uses snails as intermediate hosts. The disease is a large poverty-associated public health problem.

My studies were aimed at investigating disease in school-aged children combined with socioeconomic status. I used genetic analysis to find out whether the parasites causing schistosomiasis in Kenya and Tanzania were the same strain.

Questionnaires and samples

As I came out of Kisumu Airport, the boiling weather hit me straightaway; it felt like it was 40 degrees. This was in the beginning of January and leaving Danish winter, you can just imagine how unbearable it was.

In a class-room, the children got called up one by one, while they curiously looked at us with big smiles - probably because of the sweets they would receive after completing a range of simple tests.

They were cooperative and well behaved. Besides collecting questionnaires (filled out by their parents) for the socioeconomic statuses, my aim was also to collect miracidia (the parasitic stage that infects the snails) for my genetic analysis from the children’s stool samples.

Cooler box on a bus

I had two schools left and several miracidia to collect. I was in a rush, but determined.

It took us 3 hours to get to the first school. I then had to rush to the next school. I knew if I stayed and waited for the team to finish, I would lose a day of laboratory work. I spoke to our driver and got dropped off at the nearest bus station to make my way to the laboratory.

The 'mutato' in Kenya and Tanzania is a bus, but it is not like your everyday bus, like those here in Denmark, but they drive fast, so I knew I would get there in no time. I got on the bus with the cooler box with my samples and people on the bus looked at me very strangely, even though people had chickens on their laps. A few people on the bus started conversations with me about my cooler box and what was in it. As I got off, everyone waved goodbye and wished me all the best of luck. The best bus ride ever.

The following day, as I was rushing back and forth between the laboratories, I twisted my foot, and it swell up within a short time. Everyone got worried, but I refused to go to the hospital as I had to finish, because I was leaving the next day. I finally managed to finish my work.

The dirt road had holes full of water and at one point; we got to a big pit. The only way forward was to drive through it ...

So, the last week of my stay in Kenya ended with a completely swollen foot spiced with a slight suspicion of infection. I had so far only learned 'Sasa' (how are things?), 'Habari' (what's new?) and 'Asante' (thanks) in Swahili, but I did gain enormous experience from my first field work, and I was ready for Tanzania, where I would implement the same approaches in an improved version.

Stuck in the mud

As I arrived in Mwanza Airport, Tanzania, the next long rainy season was approaching. I had only heard about it, but soon I would experience the wetness first-hand.

It was a rainy afternoon, as I was driving to one of the schools, on a bumpy road. The dirt road had holes full of water and at one point; we got to a big pit. The only way forward was to drive through it and hope to get across. The pit just so happened to be deeper than our driver anticipated and we of course got royally stuck.

He looked at me and my co-worker, both in our beautiful summer dresses and sandals, and he knew he was alone in trying to get the car out of our sticky situation. I am usually not afraid to get dirty, so I looked outside to evaluate the situation, to see whether I could manage to help our poor driver.

But I estimated the water was at least knee high, and not knowing exactly how long I would be in the water, jumping in was a scary thought for a biology student who had studied countless water-borne diseases. I therefore decided to take the role of being the moral supporter.

Maybe one day I can finally jump in that lake and have the longest swim.

After a struggle, he finally managed to scrape enough mud of both front wheels and use enough force to drive us up. Superhero.

One day, the lake

So what did I take home with me?

It is so easy to implement something theoretically, however in practice it often does not go as planned. I learned skills such as time management, team work, lateral thinking and patience.

I am pleased to say, I managed to get enough data to draw insightful discussions. The study has brought home my understanding that socioeconomic status does not necessarily always link with the disease burden. What does link with disease is the behavioural changes within the communities. The saying, 'old habits die hard', certainly fits well to this study’s conclusion.

The bonus of being in a tropical place is that you will always have something beautiful to look at. Wherever I went, Lake Victoria was in sight. It was a constant reminder for me not to give up. It made me more determined than ever to continue such work, which brings us just a little bit closer to eradicating the parasite.

Maybe one day I can finally jump in that lake and have the longest swim.