Below is the latest installment of our summer blog series authored by Cornell student Seth Hoffman! Read on for his experience landing in remote areas of Indonesia, and feelings on the striking contrast of his previous research environment to his current “laboratory.” 
by: Seth Hoffman
Hello there!
Since I last checked in, I suffered terrible travel delays, talked to over 30 Continental/United personnel, arrived in Bangkok, arrived in Bali, and FINALLY arrived in Flores, Indonesia. I met up with one of my best friends, Michael Billingsley, in Bali to fly to Flores, and we landed in one of the most rural airports I have ever been to in my entire life – there were people and goats crossing the runway as we were landing and when we got off the plane about 20 taxi drivers began screaming at the only two “bule” – or Americans, aka me and Michael on the flight. Shortly after landing, we eventually met up with Eddie who is an M.D. working at the Nangapanda study site. We made a quick pit stop at a market, had some delicious beef rendang for lunch, and were off on our hour long drive to Nangapanda.
The drive was beautiful. Hugging the coast, black sand, with open ocean to the left, and luscious forest to the right. We finally arrive to a retro-fitted colonial hospital in the middle of a small village…located in the middle of nowhere. It was quite a shock at first, but after the first week or two, I really began to fall in love with the place. Since starting my stay at Nangapanda, I have learned to make thick and thin blood smears, how to do a proper finger-prick method rapid malaria test, how to convince local populations to give blood and stool samples, and how to process/analyze those blood and…stool samples. Furthermore, this whole week we have, and will be, waking up at 5am to conduct a local population study in which I help take the blood pressure, height, and weight of the study participants.
This past Sunday we woke at 4am to travel 3.5 hours away to the village of Anaranda. This particular village was chosen for study because the population has experienced very little exogamy and western influence, and as such can demonstrate how the truly local population is affected by endemic malaria and helminth infections. Anaranda was probably, for lack of a better word, one of the most “undeveloped” places I have ever had the chance of visiting in my entire life. Observing the interaction between traditional culture and modern medicine was extremely fascinating. The people of Anaranda live literally amongst their pigs, and 90% of the children run barefoot or incompletely clothed. While talking with one of the heads of the village, I watched as a child went up to his older brother to display a moderately sized wound on his calf. The brother scolded him, spit into the wound, and sent him on his way. It is not like the villagers have not been exposed to modern medicine; in fact the village used to experience a high incidence of lymphatic filariasis, but the whole village was treated for it, and the rate of infection has dropped to almost nil.
A similar situation occurs in Nangapanda. While conducting the population study this past week in Nangapanda, I have found that a lot of people seem confused about the procedures of the medical exams they are volunteering for. However, these same volunteers have been experiencing the same medical exams for the past three years! For example, several women had problems when Michael and I as we tried to measure their weight. One lady thought she had to step on the scale backward and another thought she had to step on the physical dial.
The clash between established culture and “Western” medicine is seen especially in terms of scientific cleanliness. It is fascinating to appreciate the ultra-pristine research environment of the labs I have worked in back in Maryland as compared to that of a tropical research station in which safety measures, which I have come to understand as necessary precautions, cannot always be met or are not always perceived as essential. All in all, the experience, on the scientific side, has been groundbreaking for me and has personally reaffirmed why I love interacting/helping people and why I want to get into medicine. Further, it has sparked important global health questions that incorporate my anthropological background in regard to the local understandings of health and disease and how these intersect (or not) with Western or biomedical ones. Also, in terms of to what extent health care delivery is encumbered by culturally specific understandings (e.g., biomedicine, indigenous healing systems, etc.) that facilitate or inhibit understanding and rapport between research scientists/practitioners and study volunteers/patients.
On a slightly different note, Michael and I have been writing a lot of music for our band, Nigeria, with a focus on broadening the influences of our music, and using the local musical tastes as a guide. My younger brother Benjamin just arrived in Ende today, and has brought with him a drum machine which we hope to use extensively to create a sound that appeals to the sub-concious and underlying tribal nature of human beings.
Until the next lucky occasion in which I get internet access, I hope you all are having an equally interesting and mind blowing summer as I am!
Seth Hoffman is a pre-med student at Cornell University, majoring in Anthropology and minoring in Global Health. He has worked for a number of years on identifying olfactory genes of Anopheles mosquitoes involved in mate and host seeking, and has published on his work in the scientific literature. He is a singer and guitarist for the band Nigeria.
