Wednesday, September 29, 2010

remembering (great) Grammy Roy

It seems that there has been no end to the events that we have missed (or that others missed) by being abroad this year: Eleanor turned one, my dear friend Meghan was married, Tim's dear friend Jeremy will be married, my dear friend Mekhala had her first baby ...

Perhaps the most difficult of these events we learned about just this afternoon; Tim's grandmother, Yvette (Grammy) Roy, passed away (this morning on the East Coast). We hear that it was a peaceful passing surrounded by her loved ones. The news weighs heavily on our hearts, but she lived a long, full life and she will be remembered with love. In life, she was a successful business woman, an honest friend, a devoted wife, a caring mother, and a warm and loving grandmother. We are so glad that she had a chance to meet Eleanor, and that Eleanor could meet her. We will continue to share stories of her teaching Tim to drive, making crepes for her grandchildren at camp, and reminding us of the importance of making wise financial decisions. She was a powerful force in Tim's life, and I'm sure the lives of all her family, and she will be greatly missed.

Here's to a life long and well lived. Rest in peace, (great) Grammy Roy.
-kjd, tdb, elb
Grammy Roy.

Great Grammy Roy.

Tuesday, September 28, 2010

a rose by any other name

I long ago posted about Eleanor's butter habit. Perhaps this photo will jog your memory:

Well, it seems I've found another way to indulge her desire: I pair the butter with sugar, flour and olives (yes, olives) and cut it into cute little shapes. So she's not eating it right off the block, but really does that make it any more acceptable? For the time being, the answer for me is "Yes. Absolutely."



 little fingers.

Monday, September 27, 2010

An outside

For almost 10 months now I have been faithfully putting insightful, poignant, imaginative, humorous posts on this blog. By turns they have made you cry with laughter and weep in sadness; you have savored our adventure stories, and marveled at Eleanor's growth. Surely this is not hyperbole (wink, wink).

A friend, also living in Arusha, recently revived her long dormant blog as part of an online writing workshop. For a couple of weeks now, she too has been putting insightful and witty posts on her blog. This afternoon I received the following text from her: "Omg! Someone from a reality show in the US commented on my blog!"

My internal monologue went a little something like this: "I'm sorry...what was that?! Someone that is (a) not related to you or (b) not a really, really good friend commented on your blog? You've only been doing this for like 2 weeks! Wait...WHAT? A reality show?"

In all seriousness, kudos for writing something that someone "out there" wants to read. Her blog is pretty awesome; you should check it out. Especially this post; the "friend" she's going to visit...yeah, that's me.

Sunday, September 26, 2010

save the date

With this post I'm making it official; Eleanor and I are coming home a little early.

After long debates and late night discussions, Tim and I decided that it makes the most sense for Eleanor and I not to return to Tanzania after attending my dear friends' wedding at the end of October. There are many reasons for this decision, a few of which include:
  1. Making two 24+ hour plane trips alone with an 18 month old in the span of two weeks (and the jet lag that would come with those trips) only to turn around and make them again three weeks later seemed crazy. 
  2. Tim will have time to focus on wrapping up his research without feeling guilty about being away from home, he'll be able to leave his wet towels on the floor whenever and wherever he wants, and he'll be able to eat Frosties (aka. Frosted Flakes) three meals a day if he so desires. 
  3. Staying home means that Eleanor will be able to have some real QT with her grandparents (both sets) who, I'm certain, are ready to make up for lost time.

Of course the best reason not to stay in the states: leaving dad in Tanzania while we enjoy live-in daycare (we'll be staying at my parents' house until after Christmas) and having reliable...well...everything. In the end, neither decision seemed to be the obvious one, so we chose the most logical. Mark your calendars. We're coming home.

Saturday, September 25, 2010

beans, beans, the magical fruit

I have at least once written about the plethora of dried beans and legumes available in and around Arusha. Given the ease of acquiring them, the fact that Tim and I are eating a lot less meat, the fact that they are "little fingers" friendly, and the fact that they are relatively inexpensive, I try to incorporate them into our meals as often as possible.

Two of my favorite go-to lunch-time recipes have become versions adapted from this pan-toasted chick pea salad and this 3-bean salad (which I've officially turned into 4-bean salad). They are equally delicious, nutritious, and easy to prepare-- and my family loves them. Although, preparing them does leave me humming a song from my childhood; Molly, I bet you know the one...

Pre-mixing: pan toasted chick peas and leeks, chopped cilantro and red onion, and a curried-yogurt dressing.

 From Top: green, cannellini, and red kidney beans, and chick peas. All are topped with a honey-balsamic dressing and toasted almonds.

Friday, September 24, 2010

A visit with friends

Nearly two weeks ago now, our dear friends Kelley and David flew all the way from Carrboro, North Carolina to visit us. We were honored and thrilled to have them visit- and to be able to share our Tanzania life with them. We had a great time at Tim's field site, visiting Tarangire National Park (with our favorite driver/guide Jonas), and experiencing the thrills of downtown Arusha. We were sad to see them go, and look forward to our reunion in NC. Here are a few images from our safari with them. Kelley and David- thank you!

(Warning: Given the number of animal photos already posted on this blog, I tried to limit images to those that are a little out of the ordinary. Hopefully they work.)

 Eleanor, from above.

Cars stopped for leopard viewing.

Kelley, master photographer.


Spotting giraffe and lion.

more giraffe.

Watching people watching animals.

Elephant and plams.

Kelley and elephant.

David, master videographer.


Eleanor...oh la la.


Palm tree.


 Mom and Eleanor.

Duty calls.


Giraffe, again.

Ox peckers.

(I'd like to blame the wind, but my hair was actually that stiff and dirty.)

"Bye mom."

"Ha, ha."

 "Oh, wait..."

The famous view from Tarangire Safari Lodge; Tarangire River.

Wednesday, September 22, 2010

dads and daughters

Sometimes they are going to be on the same page; their experiences aligned. Sometimes, they are not. But of one thing I am certain- they will always love each other. After all, dad's are awesome.

Case in point:

Tuesday, September 21, 2010

family dinners

Eleanor likes communal eating. Well, perhaps a more realistic statement is that Eleanor likes eating what you're eating- not what mom has spent 30 minutes preparing for her to eat. The staff cook, Yuda, has even taken to preparing a little extra food for her, so that she and Asina can sit and eat lunch with them. This weekend we returned from shopping to find a little to-go container of rice and beans at the bottom of the stairs; for Eleanor, from Yuda.

In an effort to save time, because Tim and I ended up eating so late in the evenings (it wasn't until I had put Eleanor to sleep that I was able to start on dinner, which generally meant we ended up eating sometime between 8 and 9 pm), and because Eleanor seems to prefer dining with friends, I decided it was time to institute family dinners.

Although I haven't managed to pull it together every night of the week (surely that's going to take some practice, right?), the times that I have managed to put a hot meal on the table that's both delicious (for us parents anyway) and kid-friendly have been a relative success- which is to say that even if she doesn't devour the food, Eleanor sits happily at the table long enough for us all to enjoy the dining experience.

On the menu last night: roasted cherry tomato,bell pepper, and leek quiche.

Oh, the anticipation.

First bites.

Saturday, September 18, 2010

It might not be pretty

It's dry here. Very dry. There are parts of one's body that are especially susceptible to such dryness, and mine have not escaped this fate. The weather has been especially unkind to my feet, which have become particularly thirsty. Several weeks ago Tim and I had another movie night -- Ocean's Eleven. In the film Bernie Mac's character comments that the way to really soften your hands is to slather them in lotion and then wear gloves to bed. This got me thinking...

It might not be pretty, but my feet are thanking me.

Wednesday, September 15, 2010

[intentionally left blank]

I have been debating about this post for several days now, but I need to process something so I'm going to write about it. It involves sensitive information, but since you, our "readers", are all stateside I trust that you will help us maintain the privacy that this issue demands.

After returning from a night at the Tarangire Safari Lodge with some good friends from NC, I opened my email to learn (from an Arusha friend) that our nanny was suspected by her former employer (also an expat) of being HIV positive. In an email to me, this employer said that "Asina came to work one day with what looked like the chicken pox so we sent her to our friend", who was a doctor. Following her visit, that doctor called the employer and "alluded very strongly to the fact that she [Asina] was HIV positive". The employer, not wanting to confront Asina directly, gave her "ample opportunity to disclose this information to me, and since that day I have been operating under the assumption that she was [HIV positive]."

We were flabbergasted that this information had been concealed from us, but also a little understanding given the incredible culture of fear that surrounds HIV here. So, after soliciting (oh SO helpful) advice from doctors in Arusha and the states as well as HIV researchers from UNC and Duke, we decided that the risk of transmission to Eleanor was so "vanishingly small", and that the risk that someone else (i.e. a new nanny- a new nanny that Eleanor did not know and love and trust) would also have the disease was so high, that we would continue to employ Asina.

With that decision made, next came the decision about how we were going to confront her. Tim is a HUGE proponent of honesty (does that surprise anyone to learn?!), so we decided that no matter how awkward we were going to be completely forthcoming. We played through every possible scenario of what we could say, and how she might react. We felt prepared for an long discussion, an awkward hour.

The one thing we never stopped to consider is that she had no idea about whether she was HIV positive or not. So when I asked her to come upstairs and I told her what we knew (suspected by your previous employer of being HIV positive based on your visit to the doctor that one time) she was shocked. Blindsided. She had no idea. Not only had she never, to her memory, consented to an HIV test, no one- not a doctor not her employer- had told her that she was in fact tested or that the test result showed that she was HIV positive.

"Well," we thought, " if you've never been tested then the doctor CAN'T know for certain that you are positive. This is a good thing." She told us, though, that the doctor did take blood, but then just gave her medicine and sent her home. An American doctor working in Arusha, a friend of ours, has since confirmed that tests (HIV tests in particular) are performed here without consent all the time. It is horrifyingly commonplace.

The next 6 hours were spent getting her tested (the test was positive) and then trying to find someone that she could talk to- a doctor, a nurse, a councilor- someone. Anyone. Most of the time she just stared blankly. Empty. When she wasn't doing that she was crying. Weeping. When Tim asked her if there was anyone she could talk to- a friend, a family member- she just shook her head. "They will separate themselves from me, Tim," she said. "There is no one. I know them. It is best for me to just die. That is best."

We were SO HORRIBLY unprepared. I felt desperate. Tim seemed to hold it together pretty well, but we both knew that we could not leave her alone. Under no circumstances was that an option. We finally found someone to talk to, and by days end she has spoken with the leader of a support group for HIV positive people in Arusha, had liver function test results which showed that she was a candidate for ARVs, and learned that treatment was free (finally...good news?!). That night she sent a text message (which I will never forget) saying that when she first heard the news she was "thinking that it was just best to be killing by[sic] myself" but that with our help she was feeling better.

Tim and I still trying to come to terms with the experience, but are (1) amazed at the strength that Asina showed by getting tested, and (2) infuriated at a country that (a) understands so little about the disease that someone newly diagnosed can't share the news with most people because he/she will be completely ostracized and (b) allows for the testing of people without their consent and then DOES NOTHING with the information. What kind of doctor does that?

That night was I giving Eleanor a bath, laughing with her, and I suddenly felt immensely guilty. Here I was, in my fancy apartment, all the opportunity and freedom in the world, happily going about my (healthy) life and this woman, who has spent so much time with us, who cares for our daughter, is sitting in her one room house knowing that she is, and always will be, HIV positive. She will wake up the next day and have to face the reality that it was not a dream. It is real. What makes matters worse for me is, even knowing what I know about the real risks of transmission I still couldn't help feeling a little bit unsure- feeling a little like the chance (for infection of Eleanor) that we were taking by keeping Asina, no matter how small, was still too big.

Even now, though, reason still wins and Asina is still our nanny. We (Tim, Eleanor and I) are going to be as constant a support for her as we can. At least that is our hope.

Finally, I thought it prudent to share some of the information that was given to us regarding HIV transmission. It's one small, small thing that I can do to hep reduce the fear of this disease.

Useful information
- The most risky practices for transmission include unprotected sexual contact, IV drug use, and direct blood-to-blood contact. The risks for transmission are very low even for sexual contact - on the order of <1/100 for male-to-female sexual exposures, and MUCH lower than that female-to-male. Generally, HIV is surprisingly NON-infectious.

- Household transmission risks are extremely small. There are a couple documented anecdotes of household transmission out there (e.g., two sisters shared a razor), but it's really really rare. So rare that it's not really studied - we don't have much more than anecdotes. (Search Pubmed for "'household transmission' HIV" and you get 9 hits; "'casual transmission' HIV" gets 17 - only one since 2006.) People do AIDS hospice without getting HIV; for example, of 206 contacts of 90 AIDS patients had NO infections in median 23 months:

- Tears, saliva, and so on all have very small amounts of HIV in them, but even if someone skinned their knee and an infected person licked it clean (not that this would happen), the chances of actually passing HIV from that contact is really very very very small. The virus itself is quite fragile, and will die quickly when exposed to air.

- Taking ARVs lowers the risk of transmission even more.

- (CAVEAT: This is for someone in Eleanor's situation specifically, where the pretest risk is so low. See the comment below this post). When testing for HIV, a positive result is MUCH more likely to be a false positive than a true positive - so much more likely to be a false positive, that THREE consecutive positive ELISA tests in a row are as informative as flipping a coin. What does this mean? It seems that HIV is a screening problem with a VERY low pretest probability. If we call the pretest probability 1 in a million, and we say that ELISA antibody testing has a sensitivity of 100%, and a specificity of 99%, then the positive predictive THREE positive tests would give you a positive predictive value of 0.50. The FOURTH positive test in a row would give a PPV of 0.99. Bottom line: if you test positive, test again. It's better to give someone a false positive than a false negative. This is unfortunate, I suppose, but understandable.

- More information can be obtained here, or here for Tanzania specifically.

Saturday, September 11, 2010

are you STILL in Africa?

A recent email from a friend with this same title has prompted me to provide an answer.

Yes. We are very much still here.

And despite having just had someone truly wonderful time with friends (two different sets of friends at that) from North Carolina we are all feeling quite ready to NOT be in Africa anymore.