“You’re going where?”
“Uzbekistan”, I repeat.
“No, not Pakistan, Uzbekistan.”
“Where is that, and why mumblemumbleStan- what are you going to do? Do you have to go there?”
For the few weeks I had in Dublin to get ready for my mission in Uzbekistan, this was the recurring conversation. Having worked for the past 7 years between London and Africa (and fitting in a PhD part time), I had decided I needed some time off. I planned to take a year off, go travelling, relax, spend time with my friends and family, figure out my next life/career move. To stay in Academia? To resist my desire for Africa? To move home to Dublin/ settle down (unlikely)? So, I set off on a cycle trip along the West coast of Ireland in search of answers. Instead I found beauty, adventure, and a reinvigorated Maeve ready for more.
I admit it, I knew almost nothing about Uzbekistan- but after seeing my ideal job advertised in Uzbekistan (MSF, MDR-TB, epidemiology and not in Africa), I set out to find out more…. Bordered by Kazakhstan, Turkmenistan, Tajikistan, Kyrgyzstan and Afghanistan I would be heading for the middle of the Stans- Central Asia.
Now that, I’ve been here a couple of months it’s hard to remember what it was like not to know Karakalpakstan- the autonomous region of Uzbekistan- the centre of my world for now. Forgotten Central Asia? Not even mentioned in the weather forecast on “world” news channels!
Talk about TB: HIV and Africa is at the foremost of most people’s minds. While, many new drugs have come onto the market for HIV recently, TB remains out of focus- there is a desperate need for new drugs to combat TB. I had thought of MSF as a medical charity that provides emergency aid in conflict zones. But what MSF does is respond to medical emergencies in at risk populations. This project is a bit different from many of MSFs programmes- there’s no conflict here and it’s a much longer running program than most. But MSF is here because there is an emergency: an MDR epidemic and at present the government of Uzbekistan is not able to cope alone with one of the highest rates of MDR-TB in the world.
So while most focus elsewhere, I will focus on Karakalpakstan.
It’s not easy to focus though. I’ve been here two months now, at first a very steep learning curve. As the epidemiologist in charge of the project’s data, I had to try to get a general understanding of all aspects of the project: the disease, the treatment, the lab, the psychosocial support, the epi data collection system, and the management and reporting of the data. I came here knowing what my focus should be- analysis and dissemination of the projects wealth of data-our data should help us learn what works and what doesn’t and it may help us to bring more attention to this part of the world about the MDR epidemic.
Last week, I lost focus- something changed. I suddenly knew enough to see the 101 things that could be improved. For a few hours, I felt overwhelmed, unsure what to do.
Karakalpakstan is back in focus. I can see clearly again. It’s a challenge- but that’s why we are here!