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Vital Signs

Trip to Tanzania was "disheartening" but "just the beginning"

Nothing went as planned," says Shahrzad Ehdaivand, M.P.H., a first-year medical student at DMS. She's referring to a recent project she undertook in Vikuge, Tanzania, a farming community 13 miles from the East African country's capital, Dar es Salaam. She traveled there hoping to collect health information on the citizens of Vikuge, which for the past 15 or so years has been the storage site for unwanted pesticides donated to Tanzania by Greece.

Goal: But Ehdaivand never realized her goal—despite careful planning and frequent contact with researchers at the University of Dar es Salaam (UDSM) whom she'd met on an earlier trip to Tanzania. In 2002, as a biochemistry major at Hood College in Maryland, Ehdaivand went to Tanzania through a federal program called Minorities in Research Training (MIRT).

On that trip, she worked with UDSM chemistry professors in Vikuge, taking samples of pesticide- contaminated soil. Ehdaivand, who had always been interested in medicine and public health, began to wonder what effect the pesticides might be having on residents' health.

So she stayed in touch with her UDSM contacts, and, after earning a master's of


Ehdaivand and a passel of pesticides.

public health at Dartmouth's Center for the Evaluative Clinical Sciences (CECS) in June, she returned to Vikuge on another MIRT grant.

"I wanted to start a registry to collect [health] data the way I wanted the data to be collected," says Ehdaivand. "We had just learned in CECS how important data collection is."

Hurdles: Finding more hurdles than she had envisioned, she turned to the regional hospital for help. She asked for all the data they had on people who had come in with abnormal growths. But the chief medical officer, even though he spoke English, "wouldn't really talk to me. He would talk to the person I was with from the university, who's a man," she says. "I think part of it was because I'm 'just a

girl.' I'm not married." So Ehdaivand had to explain what she wanted to the professor, who relayed the message to the medical officer.

"I finally got something close to what I wanted, but they only gave me the data on women," she says, laughing ruefully. "And they only gave me information about ovarian cysts and other woman problems." By then, Ehdaivand had to make the best of "horrible" data. She hasn't found any correlations yet between tumor incidence and subjects' residency in Vikuge, but she hasn't given up on the project. Nor has the experience deterred her ambition to work in international health—in fact, she's more resolute than ever. "It's not over yet," she says. Indeed, she hopes to return to Vikuge. "I'll definitely stay involved. . . . The only people that are working on it now are chemistry people, just constantly taking samples to see how high the levels of pesticides are. I'm the only health person involved in the project.

"It's very disheartening to go and hope that you're going to be able to make some huge change and you don't," she continues. "But it's the small victories, I think, that matter." There's still "a lot of work to be done . . . in Vikuge. I think it's just the beginning of the research."

—Jennifer Durgin

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