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Diarrheal Diseases. What they do. What we do. And why it matters (part 2). August 1, 2012

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Even after making rounds for 3 months, the first few moments in the wards are always surreal. Just walking through the hospital is an eye-opening and humbling experience; perhaps the most striking thing (besides the smell) is the poverty and malnutrition. Its one thing to see starving children on CNN, quite another to see them in real life. Bangladesh has one of the highest rates of child malnutrition in the world and many of the children admitted to ICDDR,B are about half the size and weight of their counterparts in the developed world.


I have always had an interest in combating malnutrition. My work with the World Food Programme in Egypt last summer and my classes at Auburn University provided me a strong background and understanding of hunger and its manifestations. This is by far the most hands on experience I have ever had with malnutrition and its deadly effects. The doctor I was shadowing yesterday explained how babies were assessed according to WHO guidelines. Upon admission, children are measured and weighed, and their nutrition status is determined by the Z-score of their weight for age (WA) and weight for length (WL). A Z-score of 0 indicates a healthy baby, while a z-score between 0 and -3, indicates the presence of some malnutrition. A z-score of more than -3 means that a child is severely malnourished. Most of children we see here at ICDDR,B have z-scores as low as -9.8.

Furthermore, because their bodies lack basic nutrients, they cannot metabolize the medication to counter diarrhea. These children show signs of severe stunting and physical wasting as well as delayed mental and cognitive development. Illnesses as common as colds frequently become life-threatening.


As heart wrenching as many of the cases are, they are also inspiring; the hospital staff go to great lengths to touch as many lives as possible. Severely underweight and malnourished babies are transferred to the Nutrition Rehabilitation Unit rather than discharged. There they are fed a wholesome diet including “milk sugee” a milk and glucose mix, Kichuri, a light rice and lentil mix, and diluted chicken broth. Most children stay for at least 2 weeks or until their Z-scores are less than -3. The NRU has been heralded as one of the best ways to combat malnutrition in the developing world. In addition to providing free nutritious food for children, the healthcare workers in the ward teach the mothers how to cook safe and nutritious meals and play games with the children to provide mental stimulation and prevent cognitive damage.


One of the most fascinating aspects of working with the patients at ICDDR,B is seeing the impact that a lack of education can have on basic healthcare. Many of the patients (or their parents) are illiterate and deeply rooted in superstitious beliefs. Almost every child in the pediatric ward is clad in trinkets or ornaments to ward off evil spirits. At the emergency, where most of the patients are admitted, its common to see a mother crying that her child’s illness was caused by a curse or demonic possession rather than unhygienic living conditions or dirty water.

Less than 72 hours left in Dhaka…more soon!

Diarrheal Diseases. What they do. What we do. And Why it matters (part 1) July 21, 2012

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Its 10:30 AM and Dr. Tariq and I are beginning our rounds. We have one hour to check as many children as possible in the Short Stay Ward – we have to report to the Emergency before noon.

 

Everyone has some form of diarrhea; all the patients lie on “cholera beds” – plastic-lined steel gurneys with holes in the middle allowing them to relieve themselves without moving. It sounds gross, but its highly practical. Collection buckets are located under the center hole of each bed, allowing doctors and nurses to quickly view and assess the stool of hundreds of patients.

 

The ward stinks. Even after 2 months here, I still haven’t gotten used to the smell. And it’s crowded. Very crowded. There is barely enough room to stand between stretchers and the main aisle is just wide enough for a nurse’s cart to squeeze through.

 

Rounds are fast; we spend less than 2 minutes per patient – “Its military medicine” jokes a nearby nurse. Dr. Tariq and I work quickly through the hundreds of patients, beginning with the youngest – newborns and children under 6 months. We listen to their breaths, examine their stool in the buckets below their beds, and ask the mother a few questions about sleep patterns, urine output, and general mood.

 

Most of the children respond well to the first line of drugs administered (ciproflaxen or azithromycin) but complications are also quite frequent. Malnutrition is rampant, almost all the patients, especially children under 5, are moderately to severely malnourished.  Thus, the drugs are not as effective, and even when they are, children with already weakened immune systems are prone infections, pneumonia and sepsis (with a morality rate as high as 60%).

 

Dr. Tariq shows me how check for dehydration with a simple skin pinch test. If the baby’s skin takes more than 2 seconds to return to normal after a firm pinch, the baby is severely dehydrated and needs IV fluids. Between 1 and 2 seconds, there is some dehydration – the doctor will either order an IV line put in or tell the mother to begin Oral Rehydration Therapy (ORS) – a salty electrolyte mixture known as Pedialyte in America. Under a second, and baby is not dehydrated.

 

We then examine the stool collected in buckets under each bed. It’s disgusting, and smelly, but it’s a great way to see what the problem is. At ICDDRB, the 3 most common diarrheal diseases are Cholera, Rotavirus and Shigella.

 

Cholera

Found in history books and novels in America, cholera remains a major killer in the developing world. Though waterborne, it is highly contagious and spreads quickly. Once a water supply is contaminated, usually by human waste, cholera spreads quickly and with devastating results. In Bangladesh, a country still struggling to develop basic sewage and clean water systems, cholera is leading killer.

 

The stool of a Cholrea patient has a rice watery look and smalls vaguely like fish. Amongst all the diarrheal diseases here, Cholera is the most deadly. A person who contracts it can begin loosing up to 3 liters of fluid per hour. At that rate, most people are dead within a few hours. Rapid intervention is necessary and highly effective, as the local cholera stains are not drug resistant (not yet, more on that from the lab later).

 

Rotavirus

Vomiting, watery yellow diarrhea and mild fever – Rota virus accounts for over 50% of hospitalizations in the developing world, causing over 450,000 deaths and another 2.7 million severe illness. Luckily, rotavirus can easily be cured with basic antibiotics and good fluid intake. In fact, a healthy human can normally withstand the gut-wrenching experience without antibiotics if they just keep hydrated. It’s still miserable though. I speak from personal experience…

Shigella

 

Meet Salmonella’s twin sister. Causing over 90 million cases of severe dysentery per year, and another 100,000 deaths, Shigella, like Cholera and Rotavirus is a menace to public health and frequently found at ICDDRB. It causes severe abdominal pain, bloody stool and can last for weeks. In the past few years, more and more strains have become antibiotic resistant, making the disease even more deadly and difficult to treat. Fortunately, it can generally be avoided by practicing basic hygiene.

 

Now go wash your hands! Before you end up at IDCCRB with diarrhea…

 

More tomorrow!

 

 

 

Paperless healthcare in the 3rd World…check it out America! July 10, 2012

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Welcome to Matlab, the world’s oldest demographic research unit, and ICDDRB’s internationally renowned field hospital system.


Getting here was a pain. Our driver took the wrong road (not that there was much of a road to begin with) and 2 hour journey stretched to over 7 hours of bouncing through potholes. But then again, everything in Bangladesh takes way longer than it should – even when things are done right.

The Matlab field site is unique for a number of reasons. Like the main ICDDRB hospital in the capital, Matlab has a strong focus on Diarrheal diseases like Cholera, Shigella and Rotavirus. But it also has a maternity ward and a ward for babies born prematurely, in addition to serving as the command center for dozens sub-clinics and home based sites. The hospital sees several births per day and has only lost 2 patients last year. Finally, and perhaps most famously, through its Matlab site, ICDDRB has been painstakingly collecting demographic and socioeconomic data on the region’s 200,000 inhabitants for over 60 years. Think of is like the US Government Census, but 6 times a year, every year, for 60 years…and counting

The Matlab Hospital:
The Kangaroo Ward


Most of Bangladesh’s rural hospitals are minimally equipped to handle even the slightest complications, let alone a premature baby.
But at Matlab, the doctors and staff have pioneered a new way to save babies even in the most resource poor environments. Unlike its Western counterparts, Matlab’s Kangaroo Neonatal Ward doesn’t have sealed incubators or any fancy machinery. Instead, the mother acts as the incubator with the baby held close to her body and the whole room kept warm. This is known as the Kangaroo method and the ward has extremely low mortality rates for children who might not have otherwise survived. The nurses talked excitedly about the hundreds of babies whose lives have been saved.

Health and Demographic Surveillance System

HDSS

Built in-house over 60 year ago by icddrb doctors, Matlab’s ever-evolving data-collection system is the oldest and largest ongoing demographic research project in the world.
Every 2 months, teams of ICDDRB trained local staff (primarily women) set off the collect data has part of the Health and Demographic Surveillance System. The trends and information they have obtained over the years have proven priceless to not only researchers, but also public health experts and doctors from around the world.
The data is obtained almost exclusively by women, from women. The 9 -page questionnaire asks each family to document births and deaths, marriages and divorces, migrations, internal movement, socioeconomic conditions and attitudes towards rural healthcare and child immunizations.


Until 2010, the data was collected on paper and painstakingly reentered into a computer database. For the past 2 years, however, the surveyors have been equipped with PDA’s (handheld computers), allowing them to collect and store the information on an SD memory card (like those used in cameras). While the technology is old – the Palm Pilots and HP Touch devices were discontinued years ago in America – the system works remarkably well. Every 2 weeks, the surveyors travel to the main hospital to turn in their information laden memory cards and report on any new developments.


We visited a village where one of the data collectors lived. We could barely fit in her home, the nicest in her village; a 10 by 12 foot rectangular structure of wood and corrugated steel, with one power strip and a single hanging light bulb. But after 15 years of data collection, she knew the ins and outs of her village. Clutching her PDA, she insisted that the project should be expanded across the country, if not the world. “Its cheap, fast and makes sense,” she pointed out, “…and it saves lives!”


Home-based Healthcare


Like their demographic research work, icddrb is also leading the way in child immunizations. Rather than requiring local mothers to make the difficult journey to the hospital by foot or ricksaw with their newborns, icddrb operates dozens of home based clinics where trained healthcare workers provide all immunizations including polio and smallpox. They also provide tetanus boosters for at-risk mothers, and assist with family planning advice and materials, in addition to reminding mothers of the importance of basic hygienic practices such as filtering water.

All the mothers carry a card with a unique identification number for each their children, which can then be traced back to the HDSS records. This allows the hospital and its sub-clinics to track illnesses and immunizations in addition to serving as a huge test bed for multiyear public health research projects. Other than the card, the entire system is paper-less and backed up “in the cloud” on the hospital’s servers – healthcare efficiency still unheard of in America.

 

Sub-Clinics

We also visited 2 of Matlab’s sub clinics that provide basic care for anyone suffering from diahorrea (which, if left untreated, can quickly turn fatal) as well as basic services for pregnant women including ultrasounds, medical advice and a very basic delivery room with a doctor or trained midwife for uncomplicated deliveries.
Severe cases, particularly pregnant women with expected delivery complications, are referred from the sub-clinics to the Matlab hospital or the larger Chandpur Hospital in the regional capital an hour away.


As you can see from the photos, the facilities are extremely limited. Nonetheless, these clinics have infant mortality rates lower than US hospitals.

Attached are some other photos from the trip. After all, a picture is worth a thousand words. And I’m tired of typing.

The first one I shot from our van travelling at about 50 MPH as we crossed a bridge. Gotta brag a bit :)


And here we go! (again) June 10, 2012

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Greetings from the Intensive Care Unit at the International Center for Diarrheal Disease Research in Dhaka, Bangladesh (icddrb). Its been a crazy week here – the emergency room has been admitting several hundred patients per day – forcing the hospital to open a tent ward (pictured above).  Almost all of the patients are malnourished, dehydrated and dirt poor.

My first week here has been an eye-opening experience. Every day I make rounds with the doctors who point out diseases almost forgotten in America - cholera, typhus, malaria, dengue, polio and tuberculosis. A nurse asked me when the last Cholera outbreak was in America. It was in 1910. More than a century ago…

It is here at ICRRDB that one sees the true devastation of hunger, poverty, and disease. This morning I saw a little boy with an IV line in his forehead. He was so malnourished and dehydrated that the veins in his arms were collapsing with a needle was inserted. He was 4 years old and weighed only 19 pounds (8.7 kg). The doctor assured us that he was on a fast track to recovery, but quietly added that there are many others who won’t be so lucky.

Here’s another lucky chap who just couldn’t stop staring at the doctors making their rounds. At just 12 lbs, he’s about half the weight of most one year-olds in the developed world.

On the bright side, the hospital and dozens of partner NGOs are doing their best to provide for the millions of Bangladeshis who live off less than a dollar a day. ICDDRB is a sprawling complex, home to the J.P. Grant School of Public Health and 12 different research units including Nutrition, Infectious Diseases, Reproductive Health, and of course, my unit, Child and Adolescent Health.

The hospital provides free health services to all and is the recipient of many international humanitarian and research awards including the first Gates Award of the Bill and Melinda Gates Foundation. Despite the crowded conditions, hospital staff work tirelessly to keep the facility clean. And with one the lowest infection rates of any medical facility in the country, they seem to be successful.

Before I go any further, I’d like to give a very special thank you to all my friends and mentors, particularly Ms. Lucinda Cannon and the members of the W. James Samford Foundation without whom this trip would not have been possible. A very special thank you also goes to my uncle, Dr. Shamim Qazi at the World Health Organization, as well as Doug and Lynne Coutts from the World Food Program for putting me in touch with the right people and supporting my application as one of the few undergrads at ICDDRB.

A special shout out to the folks in Congressman Mike Rogers office in Washington DC (and Allie in Montgomery) for getting stuff moving at the visa department of Bangladeshi Embassy.

I would also like to thank Dean Anne -Katrin Gramberg, Dr. James Wright, Dr. Paul Harris, Dr. Harriet Giles, Dr. Jim McKelly, Dr. Susan Hubbard, Jayne Kucera and the folks at the Auburn University International Hunger Institute, Clark Solomon, my little brother Aleem, my parents and so many other people without whom I would never have been where I am today. Thank you all!

I’m blogging from the 2nd LEAST livable city in the world (read more about that here: http://www.bangladeshchronicle.net/2011/08/dhaka-is-the-least-livable-city-in-the-world/). Apparently, the only place worse than Dhaka, Bangladesh, would be Harare, Zimbabwe. Frankly, I can believe it. Sewage flows openly in the streets of even the nicest neighborhoods, daytime temperatures hover in the 90’s with near 100% humidity, and there are cockroaches EVERYWHERE. And I HATE cockroaches!

But maybe I’m just homesick – its been a long 3 weeks.

Over the next 2 months I hope to use this blog to share my experiences as an intern at one of Dhaka’s busiest hospitals and the one of the few diarrheal and tropical disease research facilities in the world. In addition to clinical work, I’ll also be helping out on a multiyear project to promote better access to healthcare through sepsis. I know that sounds crazy. More soon.

The older posts on this blog are from my adventure in Egypt with the World Food Program last summer. Feel free to poke around and let me know if something really catches your eye ;)

The power is about to get cut off here, so I’ve got to go! Talk soon!

Make sure you wash your hands – or you might get diarrhea…

Peace!

p.s. thoughts and prayers to the victims of the shooting back in Auburn.

WHY? October 3, 2011

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“Why on Earth would you ever want to go Egypt?” people always ask, “You’re crazy”

I admit, on the surface, heading to Egypt right after their revolution may not seem like the smartest idea for a 19 year old American college student. And what I did (and the way I did it) probably isn’t for most people.

I landed in Egypt on Friday, May 13th and didn’t even know where I’d be living for the next 3 months, my Arabic was worse than I had expected, and a massive protest in downtown had blocked off access to many parts of the city. Unlike most students who study or work aboard, I was pretty much on my own – my last email from the UN WFP offices where I was to be interning simply said “We’ll see you on Monday morning at 8:00 AM, be safe!”

For the next 12 weeks I got to see the world like few people ever do.  We all grow up hearing about fighting hunger and poverty, of revolutions and military takeovers, of people pouring into the streets demanding their rights, yet hardly any of us see it firsthand.

Contrary to popular belief, Egypt is not a war zone or a third world country; it is a nation much like our own – continuously working to improve itself under pressure from both inside (political corruption) and out (global credit crisis and rising energy costs). The revolution that swept the county on January 25th was the one of the largest and most peaceful in the modern history of the Middle East. The protests that I covered, the people I interviewed and storied I heard were the aftermath (or “aftershocks”) of that movement. My goal was to have a “street-view” of a democracy in the making…time will tell if I succeeded.

Today more than ever, we have an obligation to see the world – it’s a responsibility to our country, to our schools and most importantly, to ourselves… What was a summer break for me is reality for millions of people around the world.  We owe it to ourselves to understand why.

Is it easy? No. But then again, life isn’t supposed to be easy. Sure, the two car wrecks weren’t fun, and tear gas is no joke, diarrhea is the devil and 70 hour work weeks are exhausting, but then again, if it doesn’t kill me, it’ll make me stronger, right?

Take my advice, leave your ideas and expectations at home, grab a backpack (and a camera) and go see the world for what it is, uncensored and raw – the way it was meant to be…

Ramadan in Cairo August 15, 2011

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Last night marked the fourteenth day of the Muslim holy month of Ramadan. For the next 14 or 15 days (depending on the moon) most of Egypt’s 72 million Muslims – about 90% of the population – will be fasting from sunrise to sunset. This means no food and NO WATER for a little over 16 hours. While many consider it a time for spiritual revival and remembering God, its also a time to beat the heat as hundreds work places (including UN WFP) close a early. By mid afternoon, with temperatures topping 100 degrees, the normally packed streets are quiet, stores shuttered and most people asleep at home (or at their desks) trying ignore the heat and the hunger.

Cairo’s soul rises from its daily slumber just as the clock strikes 7 PM and the evening call to prayer echoes through the city while families eat their Iftar (the meal to break fast).For the next 8 hours, thousands of micro-buses, cars, donkey carts, motorcycles and pedestrians battle for space in the city’s ancient, narrow streets. Restaurants overflow, loudspeakers blast Qu’ranic verses, just about every person in Cairo heads to out to smoke, shop, and of course, eat!

Perhaps no where else is the festive spirit more visible than the  ancient district of Islamic Cairo, home to the famous Khan el Khalily market and Al-Azher University. Hope you enjoy the pictures and I’m sorry the post is short –  a little busy packing  :(

Dahab means Gold… August 10, 2011

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Just wanted to share some pictures from a recent trip to the backpacker resort of Dahab on the Red Sea coast near Israel. Dahab literally means “gold” in Arabic, and believe me, the city lives up to its name. Tourism has taken a huge hit since the revolution and the normally bustling main street and sea side cafes were almost empty. Of course, that worked well for me because prices were super low – scuba diving: $30, quad biking in the desert for 3 hours: $18, hotel with AC: $20 ($40 at the 5 Star Hilton), a full dinner: $10.

Among the many awesome things in Dahab:

The Blue Hole, at over 300 feet, its the world’s deepest (and deadliest) dive spot…

The Red Sea (though it was pretty blue if you ask me)…

and, of course, Mt. Sinai – where Moses received the 10 Commandments.

After hearing the tale from dozens of other backpackers, I decided that the 5 hour climb to the top to watch the sun rise would be an awesome experience. Getting to the mountain itself was a two hour drive in the middle of the night, followed by a tiring moonlit hike to over 7,000 feet. Being in an Arab country, we arrived at the valley extremely late (1 AM instead of 11 PM). Ignoring our Bedouin guide’s pleas to wait and dire warnings of getting hurt, a fellow Australian backpacker and I broke from our group and rushed ahead. We hoped to make it to the summit before the flocks of other tourists – we ended up getting lost for 2 hours and barely catching the sunrise on the crowded mountaintop. They say Moses got lost here for 40 years, and frankly I can’t blame him.

On the way back we stopped at the Monastery of St. Catherine, home to what many consider the famous Burning Bush through which God spoke to Moses. There’s been a great deal of discussion among historians so I’m not sure if this is actually the bush many claim it is…but I took a picture anyways (the one on the right). Just in case… :)

Protesters are out, Mubarak is back…sort of August 6, 2011

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Its been a historic week for the Arab world – Egypt in particular. On Sunday hundreds of soldiers and police riot gutted Tahrir Square of its remaining protesters, many of whom had been there for over 3 weeks. Within hours, the makeshift barricades  had been replaced by armored personnel carriers, streets had been reopened for traffic, the remnants of hundreds of tents lay strewn across the ground, and garbage burned on the sidewalks.

Riot gear clad police officers stood guard every few feet, while dozens of curious Egyptians (and a few journalists) timidly scampered through the debris making cell-phone movies.

Here’s a clip a clip of people praying in the square the night before the crackdown:

One day later, however, downtown Cairo was looking very different. Since the military is now in control of the Square, photography is strictly prohibited – luckily, that rule (like many others in Egypt) wan’t being enforced everywhere.

The crackdown came on the eve of Ramandan, the Muslim Holy month, and as the faithful finished prayers that evening, passions flared:

The main news however, came two days later on August 3rd.

Arriving by helicopter at a massive police academy once named after him, Egypt’s disposed President Hosni Mubarak, along with his sons Gamal and Alaa’, Interior Minister (once head of Egypt’s notorious secret police), and several high rank police officers,were put on trial.

Across the country, Egyptians were glued to their TV’s as the trial was aired live. At the UN WFP office, phones went unanswered and emails unread as we all crammed in the conference room or huddled around our laptops to watch the events unfold. While the trial was conducted in Arabic, it wasn’t hard to follow…

An entire nation seemed to be holding its breath as the doors to the dock were opened.  In Egypt, all defendants are tried while held with a steel cage, and the former president was treated no differently. Mubarak was rolled in on stretcher behind his sons Gamal and Alaa (on trial for corruption).

As the hours ticked by, it was amusing to watch the army of defense lawyers haggle for the microphone – the Judge was increasingly  irritated and more than once ordered people out of the room.

Equally disorganized were the 30 plus lawyers allowed into the Courtroom (hundreds more waited outside) representing the families of protesters killed during the revolution. One of them  demanded compensation from Mubarak because he believed that Cairo was holy city and that God had ordained it to be a safe haven. Judge Ahmed Rifaat finally got fed up and said, “Leave the mic and go sit, all of you.”

Over the next few hours, the trial took a number of unique turns: When called to the dock, Mubarak told the judge, “I am here, your honor,” and “I completely deny all these charges.” The recorded quote has now become a popular Egyptian ringtone.  Moments later, another lawyer claimed that Mubarak wasn’t even in the courtroom – that the man lying in the hospital bed which was wheeled into the dock  was merely a lookalike f Egypt’s hated despot. The real Mubarak, the lawyer claimed, died in 2004, and the court appearance was part of a conspiracy by the U.S. and Israel. The attorney requested DNA tests to confirm identities.

Then, Mubarak’s main lawyer claimed the former president had secretly given up his power before the violence broke out and then-defense minister Hussein Tantawi, now the country’s de facto ruler, ordered the shootings. The lawyer then presented a list of 1,631 witness for the Judge to call to court to prove Mubarak’s innocence.

A visibly enraged Judge Ahmed Rifaat soon dismissed the Court – the trail will continue on August 15.

It was somewhat eerie to watch the man who once rule this country of 80 million for nearly 3 decades, lie helplessly on a stretcher in a steel cage as people jeered. As a foreigner observing the trial, it seemed to lack a certain degree of dignity. Most Egyptians happily agreed…

Shopping and Protesting August 1, 2011

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Shopping in the souqs (markets) of Cairo can be a mind-blowing and somewhat intimidating experience. Prices are rarely fixed and haggling is commonplace. Yesterday I set out to buy a shirt in the famous Khan el-Khalili market and was determined to not be ripped off. The first shop wanted 55 pounds (about $11) for a 100% cotton shirt, but I thought that was too high. The next shop wanted 50 and then offered me a “special discount of 35 pounds”. Still too high, I kept walking. At the forth shop I mustered the confidence to haggle – the man asked 50 and I said 25. He agreed and again I walked off – price still seemed to high. Finally, I found the shirt I wanted…the owner demanded 40 and said 10. She dropped to 35, I held at 10. 15 minutes later, her price was 18 and mine was still 10.  I started to walk away, but she called me back – half an hour later, we settled at 12.5, roughly $2.

There is nothing that can not be found in the open air souqs of Cairo. After hours of wondering through miles of markets, I’ve discovered treasures like original maps of the city from nearly 200 years ago, brand new leather seats from a Mercedes SLS AMG, silver shops for custom handmade jewelry, book binders,

Cairo is also home to Sour El Azbakia, otherwise known as the “University of the Poor.” Sprawling  around the Attaba Metro station with no particular order, the market is a massive collection a closet-sized shops stuffed with hundreds of rare, used, and out of print books. A number of original publishing and banned books can be found here – if you have the patience to look for them. As with all the other markets, no prices are fixed and with a little bit of haggling, you can easily walk away with an amazing deal…

Shame you can’t do that at WalMart….

In other news: A small demonstration was staged at the Syrian Embassy just down the street from where I live in response to the violence in Hama, Syria. The protesters were calling for overthrow of President Bashar al-Assad’s government and a quick end to the violence. You can watch a clip of the protest here:

Now, if you’ll excuse me, I’m off to eat some falafel…

Back in the news…. July 30, 2011

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Let’s start with politics,

It’s been more than 3 weeks since major protests restarted and Tahrir Square is still closed. Another massive protest was held yesterday, drawing in thousands of conservatives from the Muslim Brotherhood and the increasingly fundamental Salafi movement. The Liberal 6th of April youth group and other secular organizations accused the religious community of hijacking the protest and trying to shine the spotlight on controversial issues such developing an Islamic based constitution rather than a secular one. Additionally, many conservatives arrived early in the square, and according to the liberal parties, tore down and replaced signs advocating a secular government.

There were several noticeable differences between yesterday’s protest and those from days before. 1st of all, it was much larger and the rhetoric was far more heated. The guitar-strumming revolutionaries were replaced with shouting old men. Security around the square was relatively lax as many of the young men and women who checked ID’s and bags at the entrances (Metro stations and blocked roads) seemed to be drained from weeks of protests and were overwhelmed by the influx of zealous religious parties who had previously kept a low profile. The protest remained peaceful but there was a noticeable degree of tension. Perhaps the most poignant difference was the presence of women, or the lack thereof. While the crowd numbered in the tens of thousands, the number of women was no more than a few hundred.

I had the opportunity to talk to a number of people from the Muslim Brotherhood who were in the Square. They were extremely welcoming and very curious about the American public’s perception of Egypt’s Revolution. Many of them worried that the US would end support of Egypt if the new Parliament (to be elected in a few weeks) had a majority from the Muslim Brotherhood. A number of them also expressed concern that the US only supports the idea of democracy when it supports national interests. One man joked about the impending Debt crisis, saying that America isn’t as great as it once was and that Americans strayed from the values they preached to the rest of the world – sadly, I couldn’t help but to agree.

At one point, apparently upon seeing my camera and tripod, a man asked where I was from. When I said America, he became visibly disturbed and began shouting the foreigners were not allowed. He was quickly surrounded by other protesters, primarily from the Brotherhood and told that his views were extreme and unnecessary and that he would have to leave. The man eventually calmed down. Smiling sheepishly he gave me a thumbs up and said, “America good, Micheal Jackson good!”

At the end of the day, I guess we all have something in common… :)

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