Settling In

Things have been relatively quiet here while we've been settling into our new routine.  On Monday, Laura and I were supposed to meet with our collaborators at the University of Zambia (UNZA) to lay out a game plan for our stay.  We never quite managed to get in touch with them, so instead we decided to walk around a bit and explore.  About 10 miles (17 kilometers?) and two sunburns later, we ended up back home with the following observations:

• Everything is covered in dust.  Unless we wear sunglasses while walking, this includes our eyeballs.
• Drivers are crazy, and there's not really anything resembling speed limits, traffic control, crosswalks, or sidewalks.  Initially we couldn't decide whether we felt safer as passengers or pedestrians, but this walk made it very clear that we'd rather be inside the vehicles.  Walking along the side of the road works relatively well in most cases, but drivers don't pay much attention to pedestrians, and crossing the road is incredibly difficult because there are traffic circles rather than traffic lights or stop signs, so the flow of incoming traffic literally never lets up.

We finally started work on Tuesday, and our first lesson was that nothing ever starts on time.  So far, no matter the time that we've been told to be available (8, 8.30, 9...), things have started at 10.30.  It'll be a great source of amusement to see how long this phenomenon can continue.

Everyone at UNZA has been incredibly nice and wonderful to work with.  We're getting ready to pilot a costing study that aims to "provide quality evidence for improving the equity and cost-effectiveness of health systems."  I'm really excited to be able to see the survey development and implementation side of things rather than just the data analysis side.  So far, this has consisted of our spending two days looking through the 172-page survey questionnaire and compiling a list of clarifications and changes that should be made.  172 pages!  This is going to be one hell of a survey to take (we're currently estimating that it will take most health facilities multiple days to complete), but it should capture a lot of incredibly useful and relevant information that hasn't been collected before.

Time for bed, but first: more random observations!

• It's much colder than we expected.  Most days this week, the maximum temperature was around 72 degrees (22 C?).  This would be perfectly pleasant if we were outside in the sun, but we've been spending most days indoors at UNZA, where the windows are open and the breeze makes it quite chilly with a long sleeve shirt and a fleece.  At night the temperature tends to drop into the mid-40s, and there's not much in the way of insulation in our guest house (not to mention the fact that most windows don't close very effectively).  Needless to say, I've been wearing lots of layers to bed, and Laura and I immediately curl up in blankets when we get home in the evenings.
• The shower is ... interesting.  It's essentially just a tub with a shower head attachment.  No shower curtain, no hook on which to hang the shower head.  It's taking some getting used to, especially since I'm usually freezing by the time I get around to taking a shower at night.
• I have yet to see a mosquito.  Laura claims to have seen one in her room the first night, but I have a sneaking suspicion that all the mosquitoes in the house are being eaten by the giant spiders that like to hang out on the walls and ceilings.  I'm trying not to think about it. In the meantime I'm continuing to take my antimalarials and sleep under a bednet.
• Speaking of bednets, I feel like I'm camping every night when I crawl into bed.  We don't have bedside lamps, and even if we did it would require climbing out of the net to turn it off, so I've taken to wearing a headlamp to bed so I can read for awhile before sleeping.  I'm sure I look absolutely ridiculous with my sweatshirt hood pulled up and a flashlight on my forehead.  We'll see how long it takes for the batteries to run out...