17 05 2010

Welcome to my blog! My name is Kristen, and I’ll be spending my summer in Dar es Salaam, Tanzania working on a malaria-related project. To start, I’d like to give a bit of background on who I am, what I’m doing, and why.

The top of Mt Kilimanjaro


I graduated from Boston College a year ago, with a degree in Biology and Environmental Studies. In the summer before my senior year, I spent a month working for a non-profit orphanage and social outreach organization in the Kilimanjaro region, named “Light in Africa” (www.lightinafrica.org). Aside from absolutely loving the culture, I was struck by connection between people’s health and the state of the environment in which they lived. The people I met depended on the land, needed stability and predictability to their environment in order to survive. Yet that same environment was the source of many diseases, deaths, and hardships. What struck me even more was how many international tourists came in and out of Tanzania. They come to watch wildlife roam across the vast plains of the Serengeti, to conquer the tall peak of Mount Kilimanjaro,or to stare across the endless water at Africa’s largest lake, Lake Victoria. People taking in the natural wonders of exotic Africa, and looking right past the people struggling to live off the resources these wonders provide.

When I arrived at Duke’s Nicholas School for the Environment in September (a first year Masters student in Environmental Management, with a focus on Environmental Health), I interviewed with a couple different professors for my research assistantship. I was assigned to my top choice: a project under Professor Randall Kramer, called “Malaria Decision Analysis Support Tool: Evaluating Health, Social, and Environmental Impacts and Policy Tradeoffs”— MDAST for short. I was so excited about the position, I still have the official assignment letter saved in a box of “important things” 🙂

The MDAST project is creating a decision analysis tool to help stakeholders apply knowledge on the effectiveness of and costs associated with different malaria interventions to the parameters of their community (current malaria prevalence,  climate variables, amount of money available to contribute to intervention, etc), in order to predict outcomes based on different intervention combinations. These predictions would guide decision makers towards the best choices for disease management in their community, and the program would allow a community leader or policy maker to play out their options and see what type of benefits and consequences would ensue.

The part where I come in: finding sets of “parameters”– published studies showing that implementing use of a certain type of insecticide treated net over a X percent of a community for Y number of months reduces malaria prevalence by Z percent…and so on. Over the course of the year, I’ve read over a hundred articles on malaria and insecticides. malaria, malaria, malaria. Insecticides, bednets, insecticides, money money money …and more malaria. Well in the course of all this reading, I decided that there’s an important missing part to our knowledge base. People know that high exposure to insecticides can have some serious health consequences–that’s one of the reasons we regulate agricultural chemicals and create all sorts of worker safety laws. And people also know that spraying insecticides in the homes of malarial regions (a technique called “Indoor Residual Spraying”, or IRS) can reduce the burden of disease. What we don’t know is how these low-dose applications, resulting in low exposures, effect the health of a population–especially when they are used continuously over years and decades. One very recent study that caught my eye this fall suggested that the effects are potentially very serious (Bornman, 2009: DDT and Urogenital Malformations in Newborn Boys. Published in BJU International). So…long story shortened: I’ll be spending my summer in Dar es Salaam exploring this issue, through Expert Elicitations (a mix of a survey and an interview, more explanation to come) with, well, experts in the field of malaria. What do people know? What do they think is happening? Are insecticides the answer to malaria? Or are insecticides a temporary fix with some long-term consequences? Are they aware of these potential consequences on human health and ecological integrity, do they believe the researchers who say those consequences are there, and how do they feel these consequences balance against the benefits of decreased malaria burden? There’s no strong data to support that IRS is bad, or that IRS is the magic bullet cure for malaria, so no answer from these experts is wrong. There are a lot of open questions, and any answers, any opinions, will be beneficial towards guiding malaria interventions in the right direction.  

Asante sana kwa kusoma! (Thanks for reading!)

– Kristen Pfau

Ps. Google translate is great. So much faster than my paper Swahili-english dictionary 🙂




3 responses

18 05 2010

Hello Kristen,
Thanks for your blog, I have read your background, it sounds that you have determined to help people there in Tanzania.
I am a Tanzanian, born in Kilimanja, lived in Dar, now studying in Japan. I am currently doing a research pertaining to architecture (Swahili type in Dar-Magomeni). I need your help. I want to get some information but unfortunately unless I have another person doing research in Dar, it is very difficult to get feedback from the people while you are out of that place.
I need to know the the following related to Magomeni mapipa-juntion of Morogoro Rd and Kawawa Rd.
.Population of Magomeni area
.How dense is that place
If you can, please.
My background is architecture, then environment, and now urban design.
I will be coming there in July for Data collection, however, i need this information at the moment.

21 05 2010

Hi Swai,

I’m glad to see you stumbled across this blog but unfortunately, I am still in the US. I won’t be in Dar until June 15. I will see if I can find any of this information when I get there, but this will probably be too late.

Good luck,


18 05 2010

Your research sounds amazing, I can’t wait to hear more about it, in the coming weeks! My students can’t wait to hear about it too! (June 8th)
I am so proud of you,

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