Our First Sample Collection Experience

Today marks our three week anniversary of landing in Sibu, and Iooking back, I am in awe of all we have accomplished and experienced. This past week, members of the Swine Study (Laura, Kerry and I) started collection of bioaersol samples after facing some unexpected hurdles. 

For those of you who don’t know what I’m doing this summer, I’ll give you a bit of a cliffnotes. Laura, Kerry and I will be working closely to find out if a host of viruses are present in the air. Kerry and I will be focusing on the collection of bioaerosol samples using a pump in a backpack, and Laura will be focussing on the collection of nasal washes as well as bioaersol samples using a pump on a tripod. 

(Photo of chickens in newspapers being sold. Photo, Kerry Mallinson.) 

(Photo of the Swine Study Members at Sibu Jaya. Photo, Greg Gray.)

So, this Wednesday, our small team visited Sibu Central Market, one our collection sites. This open air market is often boasted as the largest in Malaysia; however, I’m sure most of the Sibu Six would rather attach the superlative “best bagels” to the market instead. In fact, our very own native New Yorker, Kerry Mallinson, seems to be more excited about this find than the Rainbow Bagel trend that has been making its way onto every Instagram feed. This infatuation has set Mallinson on a wild goose chase in search of cream cheese as a pair to her newfound love.

(Photo of Sibu Central. Photo, Rick Tsao.)

(Back to business…) To use the samplers that we had brought to the field, it is necessary to calibrate pump and do some other setup work at the site. This meant that we had to pull out our pump, adorned with a huge timer display and some flashing green and red lights, to mess around for a few minutes. Surely, you readers know how this would look. Well, so did we. Thankfully, we were able to discretely run through the set up with no conflicts, and we’re still allowed back to the place with the nice bagels. 

(Photo of me at Sibu Jaya. Photo, Kerry Mallinson.)

In the market, we had a set amount of time that we intended to walk around and collect air. And while the suspicious looking pump with the lights was discreetly placed in a sound muffling briefcase and then stuffed into a normal-looking backpack, there was still a plastic tube that popped out of the bag and connected to a metal device on one of the shoulder straps. In other words, I still looked incredibly suspicious (see below). However, we were only approached once, and that situation resolved itself pretty fast when we explained that we were conducting research. We did notice that some were some side-eyed glances, but it was, overall, a successful trip.

We had arrived at the market around 11:30, in the middle of the day. Nearly every stand was open, and the market was simply bustling. The market serves the local population, selling seafood, produce and other household essentials everyday of the week. In addition, butchers come every Thursday through Sunday. During the sampling, we got the opportunity to browse the oddities offered by the market. We saw everything from sharks to snake-skinned fruits, called Salak. Exotic fruits such as waxed apples and guavas are also sold here. This is certainly a must for any travelers passing by and wishing to sample Sarawakian culture. 

First Trip to Kapit

On Thursday morning at 5:45, our little group gathered at the Sibu ferry. Five of the Sibu-Six and two of our Malaysian colleagues had met together that morning to travel to Kapit, a little town about three-hours boat ride from Sibu City. Our mission was two-fold. First, we wanted to meet Dr. Hii and the medical officers working under her guidance at Kapit hospital, and train them on how to enroll patients and collect samples for the pneumonia-based portion of our study. Secondly, we wanted to visit local wet-market to see what kinds of meat are sold there, and begin drafting plans for how to collect samples during future trips.

To our pleasant surprise, we discovered that the boat to Kapit was comfortable and fast. In fact, the air conditioner in our cabin area was so powerful that it created artic-like conditions which forced the team to don jackets and long sleeves...in 100% humidity! It seems we hardly noticed, as we were all soon fast asleep, and shortly there after had safely arrived at the wharf in Kapit.

(The boat we took from Sibu to Kapit. Photo, Hudson Berkhouse.)

(Walking up to landing in Kapit. Photo, Hudson Berkhouse.)

After disembarking, Mr. Chong, one of our Malaysian colleagues from the Sibu divisional health office, quickly guided us to a small café for our choice of iced tea or coffee with condensed milk and batter-fried plantains. As we enjoyed our breakfast we looked around and familiarized ourselves with Kapit. This was made easier by the fact that Kapit constitutes one main road leading to the town-square and wet-market, intersected by only a few smaller streets. Across from our café we could see our hotel. Ironically named Greenland Inn, the hotel we stayed at sits squarely atop Sugar Bun, one of only two fast-food restaurants in town. I can personally confirm that their fried chicken is "finger-lickin good", but cannot as of yet attest to the local quality of their internationally famous competitors just down the road. I can only say that it was a little surreal to see The Colonial grinning down at me with the Sarawak jungle as a backdrop.

(Breakfast right after we arrived. Photo, Hudson Berkhouse.)

(The Sugar Bun below our hotel. Photo, Hudson Berkhouse.)

After breakfast, Mr. Chong arranged a truck to drive us to Kapit hospital, only five-minutes walk away from our hotel. The staff had readied a conference room, complete with bottled water and assorted buns and Korean-style-rolls, for which Kapit is famous. Dr. Hii along with the medical officers and lab technicians in attendance listened attentively to our presentations and asked insightful questions. We were so encouraged to see how invested they all were in collaborating on our projects.

After the initial presentations, the pneumonia group stayed behind to go through an enrollment with the medical officers while the bio-aerosol group went with Mr. Chong to see the local-wet market. One medical officer took the lead during the enrollment process and demonstrated for her co-workers how to take a nasal swab. The only difficulty we encountered was that the formal-style Malay language used in our enrollment forms is not widely used in Kapit. However, the medical officers again showed their professionalism by adapting our questions into the locally spoken language.

(Antoinette, a lab technicians at Kapit hospital, working with us to process a blood sample. Photo, Hudson Berkhouse.)

That afternoon, we explored Kapit with our other Malaysian colleague, Kamila from Sibu hospital. She introduced us to some local snacks, including ABC, a smoothie like drink, and half-moon cake, a thick, fluffy pastry with peanut butter in the middle. Exhausted from an early morning and full of local snacks, we returned to the hotel for some well-needed rest.

In Kapit, almost everything closes when the sun sets around 5:00 or 6:00pm. However, just across from town square there is an elevated alley of sorts on which are two rows of food vendors, with tables and chairs arranged under tarps. The sunset is just the start of the relaxed night-life in this area. To us it seemed like the entire town closed shop and walked to this area to enjoy a leisurely dinner with their families and friends. There we were able to sample food from different vendors, pointing out to them where we were seated. We chatted there for quite a while, between bites of roti-chani and sips of milk tea.

(The evening food court in Kapit. Photo, Hudson Berkhouse.)

The next morning was rushed as half of us went back to the market while the other half returned to Kapit hospital to work with the lab technicians to process a blood sample collected in the early hours. We met back for an early lunch with Dr. Cheesan Lee who had just arrived from Sibu with two of his colleagues. He treated us to a delicious meal of wild boar and local-style noodles before we had to had to leave for the ferry.

(Lunch with Dr. Lee, middle right. Photo, Waitress at the restaurant.)

On the boat ride home we all remarked how much we enjoyed the relaxed pace of live in Kapit. Our experience there was wonderful, and we all very much look forward to the next time our schedules give us occasion to return. To all our new friends there, we look forward to seeing y'all again soon.

(The Sibu Six, minus Sara and plus Kamila, on the boat back to Sibu. Photo, Hudson Berkhouse.)

First 100 Hours: A Sibu Welcome

Its been a whirlwind first few days here in Sibu, the rest of the team arrived late Monday night and I landed early Tuesday morning. Since then, we have been shown where we'll be working this summer and introduced to the people with whom we'll be working.

I left from the airport Tuesday in a cab arranged by our on-site collaborator, Dr. Toh, and was taken to the hospital to start our long orientation day. We were briefed on the hospital guidelines for being in the wards and working here and introduced to various hospital officials. Importantly, we were shown the temporary lab spaces at the hospital we can use while the Clinical Research Center's (CRC's) more permanent space is finished. On Wednesday and Thursday we met with collaborators to discuss the logistics of executing our various summer projects. Needless to say, we are all very excited about getting started on sample collection and analysis!

Among the many impressions that I've had since arriving, the one that stands out to me most is the absolute hospitality we've been shown by everyone here. Our direct supervisor, Dr. Lim, has been incredibly helpful with introducing us to local foods at the hospital canteen. Our favorite was a dish called Laksa which is a spicy soup with rice noodles and protein. He's also taught us the Malay words for common foods. Most importantly, I've already learned how to order black iced coffee in Malay (those of you that know me understand how necessary this is). Dr. Lim has also answered any and all of our questions about local customs and ways we should interact with people in the hospital.

Tea drink (Tae ci beng) served at the hospital canteen, photo credit: Hudson Berkhouse

Tuesday night, Dr. Toh graciously invited us to his home for dinner where we were treated to delicious food and a dish found only in Sarawak: Midin. Midin is stir-fried ferns and is absolutely delicious. Thursday night, we were introduced to local Chinese cuisine and the night market in Sibu by our Airbnb hosts and their family. They have also offered to show us around Sibu and to answer any of our questions about local culture and things to do. Hudson also got the chance to practice his Chinese with their two young daughters!

Dinner on Tuesday, June 6 at Dr. Teck-Hock Toh's home; left to right: Hudson, Laura, Jane, Kerry, Rick, Dr. Lim, Sarah, Dr. Toh; photo credit: Hudson Berkhouse

It is apparent to me that everyone here wants us to feel at home, and it is definitely working. Everyone has been so kind and helpful. Words cannot express how thankful we all are to be in a place with people who are so gracious and welcoming. It seems that the people we have interacted with are just as excited as we are for us to spend our summer in Sibu. I can't wait to get to know them all better and work with them on our projects. 

Sibu Six: The Journey Begins

It’s been a long time coming with our preparation for fieldwork in Sibu.  You could say we’ve generally been getting ready since August, and more directly since December.  From then, our questions and concerns have steadily shifted from research to travel and back.  First it was a general question: What are we going to study?  We’ve all identified some interesting One Health oriented viral surveillance projects, and spent months creating study documents, seeking ethical approval, verifying laboratory assays, creating supply lists, and much much more, with lots of help from the Duke Global Health Institute and Duke One Health teams (thanks guys!).  

As we’ve crossed those items off of the list, we bought our plane tickets and started getting ready for travel.  So many questions and discussions have happened in that time.  Where will we stay?  How will we get around?  What clothing should we wear?  What vaccinations do we need?

With 2 weeks to go, all six of us (Hudson, Jane, Kerry, Laura, Rick, and Sarah) met in person for the first time; we've even dubbed ourselves the Sibu Six (t-shirts pending 😉).  Just to briefly introduce the team:

• Hudson is from Midland, TX.  He's a MScGH candidate at Duke Kunshan University.  He did his undergraduate at Texas A&M, and studied wildlife and fishery sciences (as he calls it, WiFiSci... it'll catch on eventually).
• Jane is from Washington D.C.  She's a MScGH candidate at Duke.  Prior to to her time at Duke she studied cultural anthropology and French at Hamilton College, and was a Peace Corps volunteer in Benin.
• Kerry is from Pelham, NY.  She's joining us through Bass Connections.  She's a rising junior at Duke studying biology and global health. 
• Laura is from Truman, MN.  She's a MScGH candidate at Duke.  She studied biology and anthropology at the University of Minnesota, Morris.
• Rick is from Milpitas, CA.  He's also joining us through Bass Connections.  He's a rising sophomore at Duke studying chemistry and global health (provided we can convince him to join the ranks).
• Sarah is from Northville, MI.  She's also a MScGH candidate at Duke.  She studied biology with a minor in theology at Notre Dame.

Photo Credit: Ben Anderson (aka the team dad)

Sibu Six, left-to-right: Rick, Kerry, Sarah, Hudson, Laura, and Jane

As you can see, we’ve packed up 5 HUGE duffel bags full of laboratory supplies (along with our own personal effects), and today we're setting off for Sibu!

We're all very excited to have made it through baggage check and security.  Soon we'll reach our first stop: London!  We've got a long layover during the day, so we're anxious to explore the city for a bit before we get back on that flying Pringle's can to Malaysia.

That's all for now.  Stay tuned for an abundance of adventures to come!