Sunday, May 31, 2009
Friday, May 29, 2009
After two days of travel and over 16 hours of flight time, I am now safe and sound in American Samoa. It feels a bit surreal, but I am extremely glad to be done traveling for the time being.
Yesterday’s flights went much smoother than the first day’s (see below). After a 5:15am hotel wakeup call, I arrived back at LAX to catch my flight to Honolulu, Hawaii. The Hawaiian Airlines flight was on time and surprisingly pleasant. Five hours later, I was in Honolulu with over five hours to spare before my next flight.
I meandered around the Honolulu airport in search of something to pass the time, finally asking the advice of a lady at an information booth. She suggested I take the bus over to the Arizona memorial at Pearl Harbor, a mere 3 miles away. With my luggage conveniently checked through to Samoa, I left the airport and discovered that Honolulu has a surprisingly efficient bus system. Within a half hour, I made it to the Pearl Harbor memorial area. While I was unable to stay around for the next available tour of the Arizona, I did do a self-guided audio tour of the USS Bowfin. After passing through the submarine (and gazing for a while at the massive torpedoes), I reemerged to find that it had begun to rain. I took this as a sign that it was time to return to the airport, so I cut my adventure short and headed back to the bus stop.
Back inside the terminal, I met up with Susanna, one of the other students who will be working on the project with me. We chatted over late lunch and a beer before heading to the gate to board the Pago Pago flight. At the gate we met Pratima, an MPH student who will be living with us in Samoa and running Professor McGarvey’s major diabetes project. Again, the flight took off without a hitch. I spent the ride conversing with my neighbor , a nurse-in-training from Seattle, who was returning to Samoa to visit her family and attend her younger brother’s college graduation.
Five hours later, I caught my first glimpse of American Samoa out the airplane window – a beautiful array of lights and a few mountain tops peaking out through low-hanging clouds. Unfortunately, I could not truly take in the entirety of the island in the darkness of 10pm, but I was satisfied with the short look I was able to get.
Exiting the airplane out into the night air, I was hit by a wave of heat and humidity. The air had a thickness to it, and the evening breeze felt nice after so long cramped in a confined space. I was not expecting the initial health form/inspection that followed, apparently the American Samoan government’s response to the swine flu scare. I passed quickly through immigration, retrieved my bags in a matter of minutes, and glided through customs. Exiting the airport, Susanna and I were met with dozens and dozens of Samoans, mostly children, eagerly awaiting the arrival of a friend or relative. Professor McGarvey quickly spotted us and we pushed through the crowd to get to him.
We got a ride to our house in Ile’Ile (a five minute ride from the airport) from the outgoing field director whom Pratima is here to replace. She pointed out some of the stores and attractions as we drove along, but I will need to orient myself tomorrow during daylight hours.
Our house, located in the village of Ile'Ile is a three-bedroom, one-story flat with an abundance of windows and a comfortable living room, dining room, and kitchen. In a few weeks, there will be seven of us living here, so we will no doubt be cozy (especially due to the limiting single bathroom). You can see the picture here that I took from the outside last night.
In addition to the muggy heat, the most defining feature of the island seemed to be its abundance of sounds. From the clicking and whining of geckos that, as professor McGarvey puts it, “are everywhere and are very friendly because they eat bugs,” to the growling and barking of the stray and very territorial dogs that cover the island (Adam Lewin would certainly not do well here). While we sat around our living room and drilled Professor McGarvey with questions about the island and its people, a pack of dogs noisily fought on the road just outside.
I awoke this morning just before 6:00am from a combination of jet lag, barking dogs, and an incessant rooster nearby who cock-a-doodle-doo-ed his little heart out approximately every 10 seconds. I am sure my early wake-up will make for a very long day, but professor McGarvey is excited to show us around the island and I am excited to start adjusting.
I have a lot more I could say, but I’ll pause for now to grab some coffee and a shower.
Wednesday, May 27, 2009
Friday, May 22, 2009
The project studies energy expenditure and physical activity in American Samoan children, with the eventual goal of understanding if differences in children's activity levels have an impact on obesity trends in adulthood. This summer, we will conduct an abbreviated version of the study on a small sample of 30-40 children to ensure that we can effectively measure their energy expenditure and activity levels. We aren't concerned so much with random sampling or the actual analysis of the data so much as how well the data collection goes. For each participant, we will measure some basic anthropometric traits (height, weight, blood pressure, etc), carry out a doubly labeled water test, administer an activity monitor, and collect information on dietary intake. The activity monitor and doubly labeled water methods will be the two under the closest scrutiny.
The doubly labeled water (DLW) method involves giving the children a sample of water with two heavy isotopes (O18 and H2) and taking six urine samples over the course of 7 days. We will submit the samples to a mass spectrometry lab, which will give us the total energy expenditure for each participant. Using height and weight, we will estimate resting energy expenditure (the amount of energy your body uses just to stay alive) and subtract it from the total energy expenditure to get energy expenditure due to physical activity. This method is fairly commonly used now, but we must verify that it will work specifically among American Samoan children. Click Here for a more detailed description of DLW.
During the same 7 days we carry out the DLW method on each child, we will give him or her an electronic activity monitor to be worn night and day around the waist. The device works similar to a standad pedometer, but it records much more detailed records of the child's activity and allows us to view trends in physical activity. Combining this data with the DLW data should give us a good overall indication of each child's activity level and energy expenditure. The image to the right shows one of the activity monitors we will be using.
The project will certainly keep me busy for the summer. Even with five of us working, we will be following nearly 40 children for 7 days each - no easy task. However, working directly with the children should be both fun and educational, a great combination for a summer research project. Even though everything sounds very systematic, the realities of recruiting kids and getting them to go along with our crazy research endeavors will likely prove much more chaotic. I guess I'll know soon enough.
Tuesday, May 19, 2009
"Samoans accept the scientific theory that most Polynesians migrated to the Pacific islands from Southeast Asia. They believe this applies to Maoris, Hawai'ians, Tongangs, Rarotongans, Easter Islanders and Tahitians...but not to themselves. Their land is the 'cradle of Polynesia'. Samoa, they say, was created by the god Tagaloa, and their story is remarkably similar to the account given by the Book of Genesis."The Manu'a Islands are at the center of this creation story, possibly accounting for their currently pristine nature. I am looking forward to taking the quick plane ride over to Osu and Olosega for a weekend of hiking and exploring. I also hope to make a separate weekend trip to Western Samoa, which is supposed to be less Americanized and more rich in culture.