Shining Evolutionary Light on Global Health Challenges
Continued
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and quantifying musculoskeletal health and stressors on
lower limb function. We found that like westerners, the
Malagasy villagers also get very little sleep - an average of
6.5 hours per night - and that many people (31%) present
with surprisingly high blood pressures, despite few
obvious risk factors. Additionally, we found that tooth
decay and loss are associated with sugary diets, and that
people in this community exert unusual forces when
walking -- patterns only previously seen in paraplegics and
amputees. It is our hope that continued data analysis and
return trips to Mandena will further explore these
patterns and provide realistic options for improving
community health.
Despite months of planning, this summer was filled
with unexpected twists, and the days often ended with
more questions than answers. In the absence of
electricity and reliable storage conditions, would our
samples survive temperature fluctuations in the field and
during the long trip back to the US? How would we find hundreds of participants for repeat data collections when we
often had no more information than their first name? And why was my tent constantly filled with hundreds of ants,
despite obsessive cleanings?
This takes me back to the importance of cooperation and adaptation during our stay in Mandena. These projects
would not have happened without team collaboration and unwavering dedication from our Malagasy research
assistants. Such is the beauty of field work that much of our preparation in the US was futile. The most crucial
decisions were made in the moment, by candlelight, over Malagasy beer, and with no internet or external resources.
Being able to adapt to realities on the ground is a hallmark of fieldwork and generates fantastic ideas, innovative
strategies, and wonderful memories.
No project can be successful without buy-in from the participants. Often, people are compensated for their
participation in these types of studies. In our study, participants were given fresh, local coconuts. Participants not
only found this comical, but the gesture
seemed to motivate them to return for
subsequent data collection days. The
coconuts quickly became a symbol-- it
let friends and family know that you
had put up with the foreigners
swabbing your armpit, connecting
nodes to your skull to measure brain
activity while you slept, and digging
holes around town to bury a massive
metal plate used to analyze your
walking strides. But it also became a
symbol of cooperation. It represented
an endeavor to connect across different cultures, languages, and backgrounds over the shared goal of better
understanding and treating health ailments.
Despite my natural tendency to let logic and order dictate my experiences, much of this fieldwork season was
driven by surprising circumstances, reactionary decisions, and allowing the natural rhythms of the field dictate our
progress. Every field experience is an opportunity to challenge current views, strengthen research skills, and learn
patience and appreciation for the process. For these opportunities, I am indebted to the creativity of our research
team, the support of our assistants in the village and from SAVA Conservation, and the open-minded and engaging
nature of the people of Mandena. Thank you all, and we can’t wait to return!
Locomotion testing.
Duke in Madagascar 2015! DLC-SAVA Conservation + Duke Global Health Initiative +
Duke Engage
