Tuesday, February 23, 2010

I'm off!

‘ello! Fantabulous news- I am off to Zambia for a 4 day safari. My staying in Malawi for more than 3 month necessitates a special visa that requires me to leave the country for a few days.  As such, the project is sending me on a safari.  I will be going with Courtney who is sadly leaving Malawi for good once we return.  We’re going to leave after work tomorrow and take the bus to Lilongwe (a 5hr experience which I’m sure will be an adventure in and of itself). Back on Sunday night in time for work on Monday.

And to console you in my absence...here is another installment of that beloved photo series: "Children Hate Me."

To refresh your memory, this series features photos of wee Malawians who are scared out of their mind by the pigment deficient weirdo with the camera. I would like to add a disclaimer, however, for those who don't know me/potential babysitting clients/pediatric residency program directors/the small children who frequent my blog: I have no reason to believe that children do, in fact, hate me. In fact, there is at least limited evidence to the contrary. The title and content of this series is meant purely in a lighthearted and intended to provoke a chuckle (whether reality matches intent is up to you, dear readers). Anywho, here goes:

 
He is not loving life at all. Sorry little man.  Again, mom is endlessly amused.

Screen vacation

Usual house activities: data entry, reading, being awesome.

Entertainment.  Africa has helped me take a break from many of my vices. In particular, my “screen time” has been cut pretty drastically. The internet is terrible here, and we only have 2 logins for 7 people so I don’t get unfettered access to nyt.com, style.com, facebook, google searches for “funny blogs” or “cute puppies” or any of my other usual cyber haunts.

Harder to deal with, perhaps, is the fact that Africa has made me break up with my boyfriend. And if you know me, you’ll know that by “boyfriend,” I’m referring to my blackberry. A recent acquisition, my bberry had become a crackberry as quickly as everyone predicted. I told myself that the med school application process justified knowing the status of my inbox 24/7 but the truth is that I’m 22 and I have no business important enough to necessitate constant communication. I tell myself that this is a break, not a breakup, but I think it’s in everyone’s best interest

I’m also very happily devoid of television here. This is not particularly hard for me at all (except when I hear about Christine’s toddlers and tiaras Halloween costume). The one time I have watched television is at the father’s house (where the monkey is). He inexplicably has satellite TV which everyone watches after dinner. Out of like 200 channels he had us watching a cartoon. Of talking shoes.  There was a girly shoe and a pirate shoe. What were the cartoon shoes talking about? I don't know. Because it was in Chinese. So yes, the 15 minutes I got of TV time in Malawi featured Chinese talking shoes.

But after 9pm Lacey and I were the only ones up. Free from the tyranny of Chinese talking shoes we grew delighted with the possibilities.  It was Thursday night and Lacey had seen NBC on the channel list…30 Rock anyone? Turns out NBC= Namibian Broadcasting Company. So my screen vacation lives on.

Saturday, February 20, 2010

Malawi-wowie

So Sara told me that she had no idea that Malawi was so beautiful after I posted a few pictures. Thus I felt that it was incumbent on me to show a few snapshots of what Malawi looks like:


 
  
  
  
 

Lookin' good

The other day I was hit on pretty hardcore….by a crazy elderly woman. Who followed me around saying “azungu okongola” (pretty white person) and cackling to herself. I’m not sure if she was trying to ask me out or planned to eat me for dinner.

I know, I know- I still got it.

And now....random and prototypical picture for your viewing pleasure:

Kazinga and Carbs

 
You know that philosophical question that asks about the existence of a falling tree devoid of an audience? In Malawi I find myself pondering deep questions like that one except it’s more like “if there is a food and it’s not fried in a gallon of oil, does it exist?”

Food in Malawi is, as predicted, not exactly haute cuisine. Most of the population eats a diet that consists almost exclusively of corn and soy with a few vegetables or fruits thrown in. The national dish is ncima (pronounced en-ceema) which is like a gluey, pasty porridge thing (sometimes shaped into patties) made from corn flour that tastes (and I say this  without a hint of exaggeration), like nothing. Well, maybe like packing material. The Malawians eat huge helpings of it with anything else (beans, fish, veggies etc) designated as “relish.”

The amount of relish you eat is proportional to your socioeconomic status. Most people only eat ncmina or a little bit of Likuni Palla (soy based porride) and have a tiny helping of beans or dried fish on special occasions. [Incidentally, this non-varied, nutrient poor diet is thought to be at least partially responsible for the development of kwashiorkor- the  deadly edematous swelling that we treat in children.]

Here at Kabula Hill where we live, we are lucky enough to have two wonderful women: Sheena and Eliza who cook for us and do our laundry while we work in the field. We buy the ingredients and they make us food.

And by food I mean oil. Literally everything that they prepare is slathered in generous quantities of Kazinga, the oil we get here. Beans? Yep, covered in so much oil that we sometimes strain them before eating. Veggies? Why not? Fry ‘em up in a pot with a munificent helping of Kazinga and stir them in a pot with peanut flour. Literally nothing escapes this bath of Kazinga and, try as we might, no amount of pleading seems to discourage them.

When not eating almost straight Kazinga, we eat almost exclusively carbohydrates. If you have a little bit of money in Malawi, you will probably spend it on white bread (those with less money eat sweet potatoes or ncmina with their tea)- which you buy freshly sliced for around 100 kwacha (less than a dollar). Fun fact about white bread here? They always advertise is as STD WHITE BREAD. Hee hee hee.

So a typical meal schedule for me is the following:

Breakfast (5am)- mango and white bread with peanut butter
Lunch (1-2pm because we don’t like to eat in front of the mothers)- toast with jam, fruit, leftover cake, other assorted carbs.
Dinner- oil with a side of beans and rice, or beans and potatoes, or beans and pumpkin leaves/other greens fried and put in a bath of ground nut (peanut flour)
Dessert- Cake or cookies. (Dessert is where Sheena shines because no one can object to the use of copious amount of oil).

So, to you, my dear friends, I raise a cup of Kazinga- chin chin!

Thursday, February 18, 2010

Ridin' dirty

 

We frequently end our days by taking a mother to the hospital on the way home.  We take them if they need prodding to get staging for ARVs (for HIV), medical concerns that we can't deal with or if the child won't eat Chiponde and need a feeding tube. The hospitals in Malawi are so depressing, however, that we try to avoid sending anyone to the hospital if at all possible. But I digress. The best thing is that we ride in the trunk and let the mom sit in the cab of the car. We call this, of course, riding dirty. Depending on what car you're in, what driver is driving and what road you are on, riding dirty leaves you with varying degrees of butt bruising.

This never fails to horrify the nurses, mothers, HSAs etc. "You are sitting in the back?! Why? No!" They say this everytime. And every time we sit in the back.

I also love the looks we get when driving down the dirt road whilst in the trunk. Triple takes. Crowds of children chasing us. Bicycles veering off of the road. And this is the internal monologue I imagine for most everyone we see:

"Look Yamikani! Did you see that?! An azungu! In the trunk! Perhaps they are holding them hostage. Best to smile and wave."

Fun with critters

 
On my Zomba hike we saw this incredible trail of ants snaking across the path and up into the hills. These little critters were busy and there was a mix of small ants and larger ants with huge pincers. I leaned down to document these Formicidae and then "@$#&#" one of those big f-ers pinced me with his evil jaw. Ever a lady I screamed an obscenity and proceeded to throw my belongings onto the ground. My companions loved that.

The next day at Mitondo I was measuring a kid when a huge fly/bee/demon from hell stung/bit/mauled me. I screamed, swatted it off of me and did the "bug dance." Needless to say, the mothers around me thought that was hysterical- and my hysteria launched then into a frenzy of delighted Chichewa, the gist of which probably was something like "Look! That bug just but her white skin! And now she is freaking out! Silly white people."

Wednesday, February 17, 2010

Moments of tragedy

Sometimes I feel like I could sum up my Malawian experience as "general hilarity and punctuated by moments of extreme tragedy."

Working with children is inspiring, annoying, hilarious, exhausting, unpredictable, uplifting, messy and wonderful all at once. Despite the fact that we treat seriously ill children, I find myself laughing through most of clinic. The babies are always doing something to make me smile and despite the fact the some of the kids are in pretty bad shape- most of them are doing OK and will probably be just fine after treatment. That is why I find clinic enjoyable and end the day satisfied and content.

Sometimes, however, I see things that make my stomach turn. I mentioned HIV positive kids and I'll say again that this never ceases to be tragic even though its sadly very common.

Older children also especially tug at my heart because they are fully cognizant of their issues. We had two kids today that stuck with me. The first was a child who was seven years old and myrasmic. I sat down with her and her mother and, with the aid of an HSA (for translation), I tried to figure out what was going on. Severe malnutrition is most common between 6 months and 5 years so older children (who can find food for themselves and are physiologically stronger) generally have other issues (TB, HIV, cancer, congenital problems) that lead to malnutrition. Turns out that the mother is HIV-positive and the little girl had yet to be tested. My guess is that the test won't bring good news. Sitting there with her and knowing that she is probably positive was particularly painful for some reason. She just looked so dissociated. 

The second child was a 9 year old with severe myrasmic kwash (meaning they were very skinny/wasted and also had extreme swelling) who couldn't even walk. In order to put him on the height board I had to get him out of his mothers arms and lay him down. He clung to me like a baby monkey. He was very cooperative and just lay there with a blank expression as we measured him and squeezed his feet to assess swelling. Then I leaned down and he reached up and put his arms around my neck and I returned him to his mother. Something about his somber forbearance and total reliance on me in that moment when I picked him up nearly broke my heart.

We also witnessed a horrific event yesterday that may have been coloring my perceptions. When we arrived at the health center, our nurses told us that something was amiss. I'm not sure how they knew because it looked like a normal crowd of people but it turned out that a 4 or 5 year old child has passed away the previous night. Apparently the mother had brought the child to the health center at 3 in the morning but the clinical officer was asleep and could not be roused (the details of this are sort of unclear). The child died during the night and the community was outraged.

In the middle of clinic I felt a silence descend and looked up to see the tiny shrouded body being wheeled away from the health center on a cart. Following the body was the child's father, moaning and crying and, a few steps behind him, the child's mother, also crying. This is apparently typical: grief is expressed intensely and publicly and then largely put aside as life goes on.

We lapsed into respectful silence as the body was wheeled past us. Clinic went on as usual and my life went on as usual but I am sure that the image of that funeral procession will stay with me forever. And I sincerely hope that no amount of exposure to tragedy, poverty and sickness will make the death of a child any easier for me to stomach.

Happy Update: I saw the mother who had the premature baby (we took both mother and baby to the hospital- see earlier post) and the baby is alive and mom is doing very well and managed to bring her other child to clinic while dad stayed with the baby at home. 

Monday, February 15, 2010

Dear interwebs

Dear interwebs,

Enough is enough. I know I'm in Malawi but please, I get the point and I think we can move past that. OK OK, you're right. How should I expect the internet to work when I don't even have running water at the moment? Good point, well presented. I'll make you a deal. I won't use up any of your precious bandwidth with People.com if you'll let me upload pictures faster than 1 per century. And I'll even throw in a ban on streaming video. Please?

Love,
Hayley


And because the interwebs (in their benevolence) only took 1 hour to upload these, here are two pictures from my Valentine's Day hike at Zomba Plateau:

 
  
And yes, I wore that shirt because it was Valentine's Day. Cheeseball. 

Sunday, February 14, 2010

Valentine's Day

 I was slightly surprised to discover that Malawi is not immune to this saccharine holiday. All the restaurants in town have V-day specials and the streets are positively littered with young couples. This is not bad news, however because despite my cynical nature, I happen to love Valentine's Day.

I celebrated in my own way by making silly valentine's for my coworkers. I wrote poems like this one:

"Chiponde babies get fat
As graduation they waddle toward
There is no one with whom I'd rather
Torture kids on the height board."


Then Courtney and I made egg sandwiches with fresh tomato and avacado, had tea and listened to Simon and Garfunkel. Following that I decided that I needed to move the 'bod a little so four of us set out for Zomba Plateau. We had a glorious hike and then came home for some pizza at the Malawi Sun.

We call this establishment by its affectionate and more descriptive moniker: The Dirty Sun. Eating at the Dirty Sun is thus labeled "doin' it dirty." And therefore a+b=c and we were doin' it dirty on Valentine's Day. And who said I'd have no fun on VD here in Malawi?!

[And now the interwebs have decided not to cooperate so I can't post one of my beautious pictorals. So sad, I know, but try to find the stength to enjoy your Valentine's Day despite this minor tragedy.]

Happy Valentine's Day mes amis! I miss you all very much. 

Friday, February 12, 2010

Latenight- Malawi style

 

Some of you have expressed curiosity about my day-to-day routine. While I try to dazzle you with pictures of monkeys and decadent Malawian sunsets, the truth is that I have a pretty set schedule:

Mon-Fri:
-4:45 wakeup, leave by 5:30
-5:30-7:00: pick up nurses, drive to the site
-7-2ish (on average): screen and treat babies
-2-3: drive home
-3-4: data entry, repack boxes for the next day
-4-6:30: shower, read, try to get on the internet
-6:30 dinner
-6:30-9: more reading etc
-9: bedtime

Saturday+Sunday:
-"Sleep in" until 7:30
-Maybe some errands (grocery store, open-air market, hardware store etc)
-Nothing
-More nothing
-8pm: Go out to one of the 4 restaurants that our teams loves
-More nothing


I think I'll pretty much stick to that rigorous schedule for this weekend because although its not super exciting: the week can really take it out of you. Last weekend, though, I broke with tradition and went out on the town with Mrs. K -our program coordinator. Mrs. K is a wealthy Malawian woman who is in her late thirties but seems about 25. She always wear high heels, changes her hair all the time and loves all things American. She is a devout Catholic but she loves her some Akon and we bonded over our mutual adoration of terrible music. From the time she picked me up from the airport she had promised to take me out because, in her words, "everyone is too serious!!!" While I find my coworkers less than serious, I still wanted to see the Malawian nightlife scene.

On the way we decided to call Horris- one of our drivers who is 27 and very quiet. I think that's partly because his English is not stellar: if you ask him almost any question he will reply "ah yes of course." Endless comedic possibilities but makes communication difficult. What he lacks in linguistic facility, however, he makes up for in serious muscle so he acted as our amiable bodyguard for the evening.

We went to two clubs: Blue Elephant and Mustang Sallys. Blue Elephant was packed with young Malawian 20-somethings with money to burn and a few sketchily old white men who I think were there to pick up prostitutes.

We had a few drinks and then hit the dance floor.  As the only white girl I certainly attracted a lot of attention but it wasn't uncomfortable and I had Horris to deflect any unwanted attentions. I actually think that the Malawian boys were more respectful than boys at, say, Fishco. A simple "no thanks" seemed to suffice just fine and we were able to enjoy ourselves.

As for the dancing: people in Malawi have great rhythm. I think, I hope at least, that I didn't embarrass myself. In fact, I think Molly Jo would be proud: I went all out and had a great time. My thought was that no matter what I do people are going to stare because I wore my white skin so I might as well have fun. I especially had fun at the second club even though it was quite empty. One perk of that, however, is that we basically could request every song so we turned the night into my iPod (a scary place for most people except those who frequent clubs like this). So Akon and Beyonce ruled the night and I was able to flashback to Saturday nights with my favorite ladies of 444 (don't worry: I requested our "call to arms" and even clapped like our favorite little friend).

It was also funny to see what a Malawian celebrity Mrs. K is. Everywhere we went she knew people through church or the internet cafe she owns or through the general social network. Horris and I were just along for the ride.

All in all, it was a truly awesome night especially because it also included a late night ice cream.  Quite a depature from my normal routine and well worth it.


Note on the picture: This is not a picture of the club, nor was it even taken last weekend. It's the moon rising from Chez Macky's: one of our favorite hangouts. Those bags of water are hung all around the porch and supposedly keep flies away (mechanism unclear). But its the only picture I have that was taken at night so, in the interest of marginal relevance: enjoy the mediocre image. 

Thursday, February 11, 2010

Where can I get some chamba?

During the ride home yesterday we were talking about Malawian foods with our two nurses and the driver.

"Mmmmmm," I said, "I really want to try chamba. Where can I get some chamba?"

Long silence.

Chamba means marijuana. I meant chambo- a popular fish. Yeah.

A good couple of days

So it has been a good couple of days. Nothing of note in particular but I feel like I have a smile on my face which is a great feeling.
 
Some shots of Ntonya


-Yesterday Lacey and I were at Ntonya a site at a "health clinic outpost" (which means a building with a roof and nothing else) at a school. I really like Ntonya: the kids there are curious but not obnoxious and we get a roof over our heads which goes a long way in the dirty-hot heat of Malawi. Today Gus and I went to a brand new site: Namasalima. We didn't know whether to expect 2 kids or 2,000 so we packed a lot. When we rolled up, though, there were about 4 moms. Luckily, they just kept rolling in and we got some highly respectable numbers.

Highlights from the past two days:

Nesta+Kwinje=Best car ride ever

-The dynamic between our driver, who we call the 'kwinje (his last name is Makwinja) and Nesta, one of our oldest and our most hysterical nurse. They tease each other like siblings and they get everyone in the car laughing so hard that we are almost crying. Half of it is in Chichewa and sometimes a little bit of English but it's always hilarious. Nesta calls him "Mr. So and So" and was teasing him that he had a "hyenia" (a Malawian word for mistress). I'm well aware that you "had to be there" to think any of this is remotely funny but hey, I was there and if you weren't then maybe you should have taken me up on my offer to host you? Katie? Mike D? All of 444? Reebs? Everyone else in the world? In sum: if you don't find me hilarious- it's your fault.

-The 'kwidje lent me some CDs with music that he thought I'd like. The first 2 were Lucky Dube- a South African reggae artist and the last was a mix with Chris Brown, Akon, TPain etc. How I love the 'kwinje. After I took his picture I let him take a picture and showed him some pictures stored on my camera which delighted him. I let him take a picture and he remarked "the pictures are so small!" referring, I think, to my LCD screen. Loveeeeeee him.

-At Ntonya school (like every government school in Malawi I think) they serve Likuni Pala to the kids for lunch. It's like a thin porridge. The kids are always clowning around with us and offering us exaggerated spoonfuls (or handfuls for those who don't have spoons) so Lacey and I took one kid up on his offer and tried some. It mostly tasted burnt but it wasn't half bad. I'm really giving my intestines a workout, huh? Also, what circle of Hades is reserved for those who eat some food from a chronically undernourished child? He didn't seem to mind though and judging from the delighted reactions of his classmates- he was the coolest kid in school for a good 15 seconds. And I think we all know that despite what Adam Sandler says, giving porridge to white people is way cooler than enuresis.

-It was Eleanor's (another of our nurses) birthday and she brought us some leftover cake. Nothing to brighten my day like a serious hit to my glycemic index.


-Beautiful cloud last night illuminated by the setting sun. We lost power again for awhile but its not that big a deal here because we don't use electricity that much. Just another excuse to watch the sun set and finish my 5th book.

-Had to move rooms because we have a new person: Jackie, a marketing executive from San Fran, who likes to take time off to work for non profits. She seems really cool thus far even if I had to give up my "single" for her. Plus she has an awesome name.

-We had ladies night last night. Imagine for a second three ladies in fashionable dresses sipping cocktails at a swank bar. Now erase that image- this is Malawi, people! Instead imagine three girls crowded around a laptop watching Sex and the City. Surrounded by Simba chips, Chock-kits and Cadbury. Much better. Pretty much the happiest night of my life. Again- glycemic index might be a good way to track elation.

Wednesday, February 10, 2010

Once a crack baby...

I don’t have that many nicknames. Lila, Lee and Hayls pretty much cover it I think.

Skylar, however, recently added to that short list by calling me her “little crack baby.” This affectionate (I think) moniker, is not a reference to any predilection for illegal substances nor is it a dig meant to suggest the presence of any developmental delays. Rather, “crack baby” refers to the annoying  tendency that my pants have of slipping down.

It is with equal parts humiliation and delight that I report that Malawi has caught up with Skyface. She will be overjoyed to know that I was called out on this unfortunate, er, trait. We stopped at a bustling market to pick up some mangos (I’m officially an addict) and Jackson, our driver told me that some guy who was walking behind me appreciatively called me “kukwefura” which apparently refers to the way that some guys like to wear their pants really low to imitiate rappers and the like. I’m sure the rest of what he said was lewd and not repeatable but the salient point was that he called me out.

Let me just take a moment, however, to defend my honor. Keep in mind that I was dressed like fundamentalist Mormon child bride: t shirt, braid and long skirt. I just needed a unibrow to complete the picture.

Still, however, it’s nice to know that this is a cross-cultural phenomeon that merits its own word in Malawi. Maybe there’s even a support group. Sigh. I'm going to have a mango to...er...drown? my sorrows. Here's looking at you, Sky.

Monday, February 8, 2010

My name is Hayley. H-A-Y-L....

So I was at our usual lunchtime hangout, Chez Mackys, the other day and Macky walked over. "Macky!" I said (feeling pretty suave for knowing and chatting up the owner of this popular spot), "How did the big move go? Are you all settled?" 

He looked at me for a second and, in lieu of responding to my query, said "have you been eating curry?" Turns out my mouth was stained yellow from the mango I'd been eating earlier. Not suave at all.

I am legit so infatuated with mangoes that I eat somewhere between 2 and 3466 every day. And I've developed addictive behaviors: worrying when there are no mangoes in the house, stockpiling them to prevent the aforementioned anxiety, lusting after my next mango fix. As evidenced from my anecdote above, mangoes have also been interfering with my social life. What will I do when mango season ends? When I'm fiending for my next hit and have to turn to desperate measures (like *gasp* buying one from a grocery store instead of the cheap juicy ones from the roadside)?!?!

I think that Nick and Miles and Katie (but not Igor) would agree that I need an intervention. This is cry for help!

In other fruit news: I tried a passion fruit. It was super tart but it did kind of taste like the passion fruit Fanta (which is my favorite):

Saturday, February 6, 2010

More picture from Namandage



Sorry to be jumbled about this (post about the lake in between two posts about my Thursday night stay in Namandage) but I wanted to show more pictures from Namandage besides my and Figo's lovely faces.

Here are some pictures from our walk. It was cool to see a village in a non-work context. But it was hard to be unobtrusive: people were literally dumbfounded by our presence and walking down the dirt road felt like leading a parade:




Here's a picture of the kitchen at the priest's house. Part of the fun of staying here is that you get chicken for dinner (!) and eggs in the morning. Right before breakfast, Figo snuck in through a door (which I'd mistakenly left ajar), leaped across the table, broke a cup and snatched a banana before being banished again.


And for good measure here are some more pictures of that rascally rascal:
Just chillin'
 
Playing with some kids

Investigating the camera
 
Trying to relax (the paparazzi is ruthless in Malawi)

To schisto or not to schisto

So a quick(ish) recap of our trip to the lake last weekend:

The lake is about 4 hours away so we took an extra car and left right from one of the sites. The drive itself was amazing because we weren't cramped in the back of an old truck as per usual. Instead we were luxuriating in a large SUV with a working CD player.


We stayed at Gaia house: a pretty typical Malawian hostel-type place. It cost about $27 to stay for two nights and the rooms had electricity (at least until the power outage). Pretty swank by Malawi standards.

Although I was pretty much the driving force behind the trip I did not, in fact, want to actually swim in the lake. If you are familiar with my Walden Pond obsession (on par with my monkey obsession), this may puzzle you. If you are familiar with my germ/parasite phobia, this would not puzzle you- Lake Malawi is chock full of schistosomiasis. If you are familiar with both obsessions, you may have wanted to take a ringside seat and watch the battle royale between my desire to swim in the amazingly gorgeous freshwater and my desire to avoid offering my body as a breeding ground for parasites.

 
No amount of soap and scrubbing will get rid of the dreaded shistoooooooooo

If you haven't surmised my decision by the language that I just used, I decided against a swim. I did, however, walk along the beach- possibly giving myself "ankle schisto" and I kayaked- which, by virtue of the puddle of water I was sitting in, might give me a case of the dreaded "butt schisto."


In order to make myself feel better about this decision, allow me to quote from the infinitely scholarly font of information that is Wikipedia: "The parasite secretes enzymes that break down the skin's protein to enable penetration of the cercarial head through the skin. As the cercaria penetrates the skin it transforms into a migrating schistosomulum stage....The nearly-mature worms pair, with the longer female worm residing in the gynaecophoric channel of the shorter male. Adult worms are about 10 mm long....Parasites reach maturity in six to eight weeks, at which time they begin to produce eggs. Adult S. mansoni pairs residing in the mesenteric vessels may produce up to 300 eggs per day during their reproductive lives. S. japonicum may produce up to 3000 eggs per day. Many of the eggs pass through the walls of the blood vessels, and through the intestinal wall, to be passed out of the body in feces....Up to half the eggs released by the worm pairs become trapped in the mesenteric veins, or will be washed back into the liver, where they will become lodged. Worm pairs can live in the body for an average of four and a half years, but may persist up to 20 years."


My decision resulted ridicule from most of my travelling companions who simply take medication three months after exposure that supposedly kills the adult worms. To them I say: gross- you have schisto. Nuff said.

In lieu of swimming for hours and hours as I would have wanted- I simply relaxed, enjoyed the view and the company of my coworkers.

Some highlights (with pictures!) from the trip:

-A performance by one of the many "children's bands." I use the term band loosely and use it to include throngs of small children who beat homemade drums and have songs where the lyrics consist soley of "Muli Bwanj? Ndiri Bwino. Muji Bwanj? Ndiri bwino!" (which means: "How are you? I am fine. How are you? I am fine!"
-The highly questionable food. The omelets were rockin' but we had some downright disgusting "pesto" pasta that was certainly not made with basil and had an aftertaste of soap. Also, the ketchup was curdled (see picture). This just drove home the lesson that I should have down pat by now: if it's not fried in Malawi- it's definitely not very good and might be dangerous.

-An amazing long walk along the beach with Lacey. By the end of the walk we were literally trailed by close to thirty children, all of whom were clamoring to hold our hands. One girl kept trying to put her mouth on my arm and I'm still not sure if she was trying to kiss or bite me (what do azungus taste like anyway?). 99% sure it was a kiss but best to leave that a mystery.
-Ample time to relax: I finished my book in the first day we were there.

-Hysterical room name: the first night we all stayed in a "family" room with four beds named Black Madonna. The key had a wooden keychain that said B.M. So (again my maturity level is solidified as "very low." I, like Margaret, sometimes feel more at home with school children) I decided that we should refer to ourselves as the B.M. family. It's funny to me.

On that note, I need to do some errands so I must bid ye adieu until I get the energy to post again.

Friday, February 5, 2010

Namandage

Last week I got the good news that I was going on the bi-weekly overnight trip to Namandage. Why was I so excited? The chance to see a different part of Malawi? Time to hang out with our nurses and drivers in a non-work setting? The dinner which always includes chicken (protein is almost non existent in my diet right now)? Sleeping in an extra 15 minutes? No, no and no. I was excited because I would get to hang out with a monkey.
Namandage is the base of operations for Father Samoso- an Italian priest who helps run a rural hospital. The reason we stay there is because we serve a site on Friday that is 3 1/2 hours from Blantyre so we'd need to get up at 3:30 am to get there on time. So, on Thursdays, we stay at Namandage which is between Chamba (the site we serve on Thursday) and Chipolonga and Chikweo (the sites we serve on Friday). But enough explanation- back to the monkey.

Much like every other sentient being in the 1990s, I had a serious thing for Aladdin. Putting aside blantantly racist imagery, Aladdin is one of Disney's masterpieces. Specifically, I loved Abu: Aladdin's plucky and sometimes pesky simian sidekick. My obession with Abu, combined with seeing a documentary  about Jane Goodall, left me with a hankering for a monkey friend.

Well, my friends, I finally got to play with a monkey. Father Samaso has a pet monkey named Figo who lives and plays at Namandage and I couldn't wait to to meet him. Yes, I know its unethical to keep monkeys at pets. Yes, I know monkeys probably have plently of nasty diseases. But c'mon- I got to play with a monkey!

Figo was quite the little rascal- he lives outside but kept sneaking inside to steal bananas and break cups.

Namandage was great in other ways: I got to take a long walk through two villages where we were followed by the usual gaggle of awestruck children, stupified stares, shouts of "azungu," butchered English and double-takes. But any chance to walk through Malawi is worth capitalizing on because it is such a beautiful country.
 
Mr. Figo

Me and Figo

Tuesday, February 2, 2010

Crazy weather at Lake Malawi

 
Storm rolling in

 

My three travel buddies watching the storm come in

 
Rain hits Lake Malawi (cleared up about an hour later).



And the walls came tumbling down...

So Malawi is finally getting going with the rainy season. This is great news for the whole country because the majority of residents are subsistence farmers, so no rain means serious problems. The fact that the rains started late is quite problematic in and of itself so we'll see what the future holds for the chimanga (corn) crop.

But despite the slow start, mother nature has been making up for lost time. It's been raining all day in Blantyre. As today was the cook's birthday, I offered to drive her home so she didn't have to walk. It took me a second to find the keys to an automatic car (driving lessons haven't been going as well as I'd like) but as we were ready to go...BOOM....we heard a big bang!

We thought that the down house had been struck by lightening- but it turns out that the the wall diving our house and the neighbor's property had totally collapsed. Luckily no one was hurt (especially lucky it was raining because normally all of the kids play in the driveway.) And we realized that if I had found the keys a minute earlier we might have been hit with the wall.
Here is a picture of the wreckage.


We survey the damage.

Monday, February 1, 2010

Vella



 
Vella- one of the little girls who lives in our compound. I love her shy smile and her tiny little braids. I promised everyone a Malawian baby and I don't think I could do much better than this lil critter. 

On a lighter note:

So it feels kind of weird following a more serious post with a silly anecdote. The truth is, however, that this sort of juxtaposition has become commonplace. Even after a serious day, we always end up laughing and cracking jokes. It works quite well as a coping mechanism even if it seems kind of callous.

Tonight, for example, Courtney happily informed me that she had a name to add to my list of African baby names: Faggles. Yes- Faggles. Not even Faggle. Faggles.

Nothing like a lil bit of parental ingenuity to end my day with a smile.

Quite a Monday

So I'm going to post about the lake but first I wanted to post about my draining but satisfying day:

You know your week (and month for that matter) is going to be interesting when it starts with a toilet that doesn't flush, spilled placebo (juice) and a skinned knee. Luckily, after these minor issues (the last being the biggest blow...to my pride), Gus came to my rescue. After falling, I got up, tried to play it off like it was no big thing, fell again and finally staggered to the car. When I opened the door, however, Gus was playing Leona Lewis at full blast even though I already told him that BBC Africa was OK by me. Ah, the restorative power of bad pop music.

Mondays we always visit sites in the Shire (pronounced she-ray Valley which is, in the words of our team: dirty hot. And Mitondo, the site we went to this week, is also a dirty long drive. As Gus had kindly indulged my prediliction for horrible music, however, I could have sat in the car for another couple hours. When you roll up to a site listening to Akon's "So Paid," you know that your week/month is irrelevant because you are so freaking happy at the moment.

But I digress. Our clinic went fairly smoothly although Mitondo is kind of annoying because the moms were showing up late and sort of trickling in which makes it very difficult to get things done in an efficient manner. We'd measure 10 kids, go help weigh some, measure a few more, make some antibiotics, weigh some more kids, wander around, measure some more etc etc ad nauseum.

When we finally finished at clinic we determined that our day was not quite over. We would have to make a home visit. When a mother fails to show up to clinic, we create a "send the message" card and give it to the HSA that is responsible for that family's village. The HSA delivers the card to their house and lets them know when the next appointment is. In order to find these missing children, we always ask directions to the home on the original study form. Now when I say "directions," I don't mean the kind that MapQuest gives. A typical "directions" section reads like this: "from Namphungo Health Center, go down road until Nhware village. Once there, go to second bore hole and ask about family at Mr. Nrwutu's home behind maize mill." Amazingly, the HSAs seem to find these families with no issue. They generally are able to get the mother to come to the next village or bring back news that the child has passed away.

Today, however, this mother had failed to respond to two separate send the message cards and the village HSA was working with us at clinic and informed us that the child was still alive. On our way home, therefore, we stopped on the road and, with the HSA, ventured into the village to find the mother. When we got to the hut we found the child and the father. The mother was inside and, they informed us, had just given birth the night before. This sent the HSAs into a tizzy becuase giving birth at home is illegal- mothers must go to the local Health Center or they must give a goat to the village chief as a punishment. This is policy is apparently meant to discourage home birth because of the increased risk of complications (although having seen the Health Centers which are little more than Tylenol dispensaries with a row of dingy old beds I think that the increased benefit is minimal).

I told the HSAs that they could deal with the unauthorized birth later and asked the mother to bring her older child to the road so that we could measure her. We determined that this child (the older one who was in the study) was fine and asked the mother why she had missed clinic. She told us that she had run away from the child's father and was gone for several months. They apparently reconciled because she was back in the village living with him. In the course of the conversation, however, the HSA informed us that the mother said that her new baby was 2 months premature, hadn't cried and wouldn't nurse. As this was clearly a serious situation, we told the mother to go get the baby and we would bring the baby to the nearest Health Center where they could get an ambulance to the district hospital. As the mother turned around to go back and get the infant, however, she basically collapsed. We picked her up, put her in our car, went and got the baby ourselves and headed to the Health Center. During the ride to the health center I had this tiny baby in my lap. It was so cold and so puny. It's hard to describe how I felt: it almost didn't seem real but at the same time I felt protective and scared.

When we got to the health center, however, there was no clinical officer and no ambulance.  So we piled back into the car and drove an hour to the hospital. During the ride, I was trying my damndest to keep that little tiny thing warm. It was barely moving and it was taking labored breaths. As soon as we stepped out of the car at the hospital, however, the baby had begun to sort of mew in a high pitched voice. We left the baby and mother at the maternity ward and finally headed home.

While I feel good about the fact that we took the baby to the hospital (it almost certainly would have died at home because it was too small and lethargic to nurse), it doesn't feel like a clear victory. The hospital, while better than the health center, is abysmal. The mothers lie on garbage bags instead of sheets, the water is most likely infected with cholera and the resources are severely limited. Add to that the fact that this woman's husband is probably a dead beat and you begin to realize that you may have helped the baby but you did not save the him or his family by any means. I comfort myself, however, with the knowledge that we truly did the best we could.

As we were leaving the hospital, Rose, one of our nurses, turned to me and said: "that baby was so very warm as if he had been with his mother. You did an amazing job of taking care of the baby." And that is what I am going to take away from this hectic Monday.