Thursday, January 28, 2010

I woke up on the wrong side of the bed

I had such a cranky day today. I didn't want to get up, I was not at all charmed by the kids chasing the truck and shouting "azungu" and everything was making me angry.

Lacey was also feeling cranky and I was quite glad to have her: together we turned our crankiness into snarky humor which alleviated much of the feeling behind the rancor. The HSAs were certainly not helping our mood: they were filling out cards wrong, sitting doing nothing, seemingly making up weights and then staring at us blankly when we tried to correct their errors. During a height board lull, Lacey stands up and goes "I'm going to go rain some fire down on the HSAs." Needless to say I'm happy it was a relatively short day.

A quick mango fix, trip to the Malawi Sun (a food court type place at a local hotel) and sharing some funny stories from the day with the team has taken care of my crankiness and I'm feeling much better.

We're off to Lake Malawi this weekend! We're leaving directly from one of our sites tomorrow so likely I won't be doing any blogging unless I'm feeling ambitious later tonight. Hope everyone is having a good end to their week.

Tuesday, January 26, 2010

Children hate me

Inspired by the rousing success (read: Sara liked it) of my post on children reactions to me, I would like to start a new series on the fine piece of journalistic brilliance that I call my blog. The new series will be entitled "children hate me" and will feature 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:


 

This little girl was so perturbed and disgusted that she gets two pictures. I also particularly enjoy how her mother seems to be delighting in her terror. This is actually quite common: mothers think it's hysterical when their brethren are fear-stricken by the sight of an azungu and generally try to force their offspring even closer to me. This, of course, makes the child even more terrified which in turn makes the mother laugh harder. Perhaps Malawian mothers are the intended audience for this series?

Water, water everywhere?



One of the things I was most surprised by in Malawi was the water system. Every time I’ve traveled to a developing country I’ve taken great pains (with mixed success- right Tanya and Mike?) to avoid
drinking the water or eating anything even washed with water. Here I can fill up my water bottle without worrying that I’ll deplete the stock of Pedialite that I brought. It feels incredibly luxurious to not be constantly worrying about what I drink. Apparently Carlsberg beer, which has quite a few factories here, helps to chlorinate and cleanse the water system in Blantyre and Lilongwe. This is even more impressive given that in the villages the water is fully tainted with Giardia, Chlorea and other fun stuff.

The downside to all of this is that when there is not enough clean water, they just simply don’t pump anything. That means that we might get back from a particularly sticky day at the field and have no water. Usually it will start flowing within 24 hours but until then you have to suffer in your filth or splash scalding water on yourself from the hot water tank. Today is one of those days. Thus, I write to you in a state of less-than-cleanliness. Let's just say that I would not be welcome in most respectable eating establishments at the moment. Luckily I have Purell and a mound of mangoes to keep me company.

Monday, January 25, 2010

Custard Apples

Tried a new fruit today. It's called a custard apple and you kind of eat little hunk and spit out the seeds. It has an almost coconut-y type creamy taste. All in all it's kind of a lot of work for a little pay off but I was kind of into it. Here's a picture I shamelessly stole from google image:



Felt kind of like I was cheating on mangoes but I'd already had 5 mangoes (this is not hyperbole) so I think it's OK.

In my infinite maturity...




That picture of a child's rear end was intended to visually signify that the following post is scatological in nature:

So, in dealing with terrified children you need to expect a bit of messiness of the urine variety. As urine is quite sterile this hardly bothers me at all. Normally I say "clean up on aisle four," pick up the offending child, hand the dripping lil critter to his mother and get the cleaning fluid- all with a smile on my face. Today, however, a mother handed me the study cards for her two children and there was a legit hunk of feces/diarrhea on it. Not a smear, not a smudge, but a thwonk of pure human fecal matter. I must confess that I was pretty grossed out. Many kids here have diarrhea (you would too if you drank the cholera infested water, ate goat intestines and weren't able to refrigerate anything) and on more than one occasion I have seen a kid with diarrhea running down his or her leg. But there was something about being handed this particular chunk that spoke passionately to my gag reflex. For some reason, however, my response was to start giggling uncontrollably and grinning to myself. But I'm sure that's no surprise to anyone who knows my level of humor. Nothing like a set of loose bowels to really make my day.

Some random pictures

And now for some random pictures:



 This little girl looks like she's praying to the study card (or is about to make out with it). Now there's some dedication to clinical research.


This is Chiponde in action. The child must demonstrate that he/she will eat the food before we send them home with a two week supply. If they can't eat it (too sick), we take them to the hospital. However, outpatient therapy has been shown to be significantly more effective than inpatient therapy for malnutrition- even severe malnutrition- so even if a child is quite sick, if they can eat the Chiponde they are sent home. 

Sunday, January 24, 2010

Anyone for some Chiponde?



On one of my first days here I had a Chiponde/supplementary food tasting. Let me tell you- I don't hate it. Chiponde is my favorite and it kind of tastes like a really sugary Cliff Bar.

One of the problems that we have is that sometimes a mother will share the Chiponde with other people in the family. While it's understandable, it also means that the child who really needs the nutrients will not recover fully. Another big no-no is feeding the child other foods along with the Chiponde. Chiponde is so energy dense that if you give a child other food, they won't be able to eat all of their therapy food.

It's very important to educate the mothers about these issues so our nurses teach a mini lesson at every site. Part of teaching is always singing. We sing songs that the village women already know and add parts about Chiponde. One of the songs we sing, for example, says "Chiponde ndi mankwala" which means Chiponde is therapy. I tried to post a video but blogger didn't like whatever format my camera recorded it in. Probably for the better as my skills as a videographer are more closely alinged with the creators of the Blair Witch Project then Ken Burns. You would most likely be upchucking your Chiponde if you watched it so a picture will have to do.

Saturday, January 23, 2010

Our house, in the middle of our street


So I thought I'd take this lazy Saturday to show some picture of where we hang our collective hat. Our house is not actually just one house- we live in three houses in a gated compound belonging to an Indian man who owns a paint company. His name is Tochi but we call him the Toche and we rarely see him although he and his family (son, daughter in law and grandson) live in one of the houses. The compound is located on Kabula Hill which is about a fifteen minute walk from downtown Blantyre.

Here is Vela, one of the kids who lives in the compound. There are about 5 from three different families ranging in ages from 3-12.  Their parents work for the Toche and all three families live in a tiny house on the compound. The kids play together all day in the driveway. They love to say "hello" (the only English word they know) and also relish any attention you give them. If you are walking back and forth between the houses you will get greeted approximately 3,000 times (hello apparently suffices for hi, how are you, bye, and play with me). When we return form the field they rush to the gate and start chanting our names and waving.


  Needless to say it's impossible to whip out a jump-rope and iPod and exercise when there are kids around. And these kids don't seem to have any toys, they just play with the big banana leaves and climb on the old forklift that's in the driveway. So instead of exercising I just end up letting them use it to play:




Here is the driveway and you can see the corner of the "down house" where Indi lives. We store some Chiponde and some of our supplies (syringes, data cards, antibiotics, office supplies etc) in the down house so that's where we pack our boxes everyday after the field. We also do most of our data entry down here. You can also see the edge of an old forklift (left side) where the kids always play:




Here is a view of the front of the "up house" where I live. The biggest kitchen is up here so that's where all the cooking happens and we also eat dinner up here:





So there's a small glimpse into my domestic day-to-day.

I still need to get a picture of Precious- one of the little kids- because he's my favorite. He's about 4 and looks like a pudgy little demon. He isn't as enthusiastic as the others about the azungus and I imagine he's way too cool to get all excited over some dumb white people. He does, however, love to open and shut the door to the car for some reason. When we pull in the driveway he gets a grim, determined look on his face and will run toward the car without any regard for his own safety. He also dresses in some crazy outfits. Yesterday he was wearing a Cleavland Indians hat, jorts and a pink Supergirl vest with nothing underneath as well as what looked like a pair of miniature ladies dress mules. What can I say, my man knows how to dress.

Friday, January 22, 2010

A daily dose of pictures (while the internet is cooperating)

A snapshot of clinic:



Some twins:

Happy Friday

"Rasorz: a barbershop that caters to the primal tastes of men"

That is not a joke. That is exactly what the sign said. I would go investigate but I'm afraid I'd be co-opted into...er....catering to the primal tastes of men.

Thursday, January 21, 2010

Pictures


Here is Vegas (one of our drivers) with the baby scale. Vegas is great at getting terrified children to sit still long enough to get a weight. Sometimes they are so beside themselves that they attempt suicidal leaps off the table. Vegas usually grabs them, turns them upside down for a second and replaces them. Much like pheasants, they are so disoriented by this that they usually sit there, stunned.









A child or two.

6 degrees of separation? Maybe 7?

We work with Health Service Aides at each site we go to. These men and women are Malawians who live and work in the rural communities and provide basic health screenings (for malnutrition and diseases like malaria) and dispense some medications. They help us by bringing sick children to our clinic and also help us run our clinic.

Their English ranges from decent to unintelligible and talking with them usually yields at least one conversational gem.

Today I was speaking with a woman and the conversation went like this:

Her: How are you doing?
Me: I am very well, thank you. How are you?
Her: Good, good...how are you?
Me: errrrrrrr
Her: I would like to know you
Me: Ah yes, my name is Hayley
Her: I am happy to know you Heedlay. Where is your homeland?
Me: I am from the United States.
Her: Ah, yes. Very good. I had a teacher from the US. She was called, Taylor, Tyler...Talbot. Her name was Talbot (looks at me expectantly....
Me: (pretending to think)  I do not think I know her.

Classic.

An update for Sara

So today we had a pretty ideal day in the field: enrolled quite a few children, not to many fat babies to waste our time, mixed antibiotics with no issue, pretty short drive (around an hour or so) etc.

We did, however, see the sickest kid I've seen thus far. He was an eight year old with full blown marasmic kwashiorkor (deathly skinny with huge, puffy feet and skin breakdown). Kwash past the age of 4ish is pretty rare and this child had already been treated for malnutrition at the hospital (and he was HIV negative) so it looked like something else was going on: an incredibly bad tapeworm, leukemia- something. He was incredibly listless and his eyes were pretty much blank as his mother carried him to the table.

We took him to the hospital again and recommended other tests but in truth I'm not sure how well this guy will do. My coworker said she saw him two weeks ago and he was already pretty bad. They tried to give him the therapy food but he was apathetic and refused to eat. His older brother was trying to help and kept waving money in his face trying to entice him to eat but the kid just stared into space. It's pretty heartbreaking.

We do see children that simply don't recover despite weeks of therapeutic foods and trips to the hospital. Many of these children are HIV positive and others have congenital issues that will never be fixed in a country like Malawi. Last week there was a child who had been through more than twelve weeks of RUTF therapy but was still wasted (severely skinny) because he had a heart condition. We simply had to stop feeding him knowing that he will most likely not survive. It's hard to be the one to circle "finisher" (code for child who fails therapy and does not graduate to a healthy weight) but it's important to remember that RUTF will not save these kids. Still, it's not easy and it makes it hard to joke and laugh on the car ride home when you have a mental picture of a child who you can't save.

While these children are heartbreaking, however,  they are not the norm. Most children do excellently on a regime of RUTF and gain weight quite rapidly. It's very gratifying to groan under the weight of a child only to look at their card and realize that they started out severely malnourished and now are luxuriating under rolls of adorable chub.

Monday, January 18, 2010

African baby name(s) of the day

Today I present two sets of twins:

1) William (boy) and Milliam (girl)
2) Chifuso Angasi I (boy) and Chiafuso Angasi II (boy) - if you got a good thing going, why switch it up?

War paint

While mixing antibiotics on the hood of the car I was joined (as is custom) by a throng of school aged children. I looked up at one point and they were sticking their fingers in the exhaust pipe and smearing the soot all over their faces. It was adorable- they looked like tiny African warriors.

Sunday, January 17, 2010

Work it Malawi!

If you’ve ever been to a developing country (particularly in Africa) you are well aware of the liberties that are taken with fashion. Malawi is no exception. For women in rural areas (the cities are all fairly Westernized), skirts are a must and all skirts are covered by a large piece of fabric called a chitenje. Women also use chitenjes to hold money, carry fruit, carry babies and wipe up spills.

Beyond that, anything goes. Reuse is the name of the game. Most people don’t have shoes but for those who do, croc-type sandals or even mismatching footgear is the norm. Some people wear clothes in such inventive ways that it borders on avant garde. I saw a woman yesterday wearing a deflated soccer ball as a hat. Used clothing from America is sold at every market so you see a lot of familiar T-shirts. I saw a girl the other day wearing a hooded vest that said “Boston” on the back (who even knew such a delightful product existed?).  Also very popular for some reason are tees that say K-Y on them. Over-representation of Dane’s homeland or product placement?

The other curious thing about Malawian fashion is the gender-bender way that they dress their children. Sometimes grown men will wear a western shirt that was clearly meant for a woman but that’s not as striking as the little boys. It’s not uncommon to plunk a kid on the height board and her little dress will fly up revealing- well- the fact that the pronoun that I just used is incorrect. This, coupled with the fact that a buzz cut is standard for boys/girls/men/women, makes for some anatomical surprises and awkward social faux pas.

I am in desperate need of a haircut but given the national trend for gender ambiguity I think I'll ride it out until I get home. Although I could rock a buzz cut I think?

side note: I was just informed that one of my coworkers routinely sees women wearing children's underwear on their heads. Is that more or less hysterical than a deflated soccer ball? Perhaps the infinitely fashionable ladies at wapatoko could weigh in?

Saturday, January 16, 2010

Finally- A Malawian baby or two


This little guy is getting his diaper changed for the stool study. They don't normally wear these diapers- but we provide them for the study.


Fruits of my Saturday

Here is a picture of some fabric I bought at the market today. I am going to make some of it into a Chitenje (wrap that goes over a skirt that all women wear) to wear in the villages and have the rest made into a dress.


here is my room! (and a creepy half of my face)


Friday, January 15, 2010

love, Hayley

Dear huge lizard that lives in my room,


I have no issue cohabitating with you. In fact, I appreciate the work you do in eating bugs that dare cross my threshold. I also appreciate the fact that you do not have a disgusting chitinous exterior nor are you capable of biting/stinging me.

All of that being said, I find you unnattractive and the thought that you might slither/crawl across any part of my body deeply repulses me. I don't ever want to actually see your ugly mug. I will allow you to live without interference but I don't want to open the door and have a heart palpitation because I see something dart down the wall and think that it may be a tarantula. When I enter the room, I expect you to the crawl back to whatever godforsaken corner of my room you normally occupy.

Many thanks in advance,
Hayley

Mosquito infiltration

There are few things more annoying than mosquitoes. That insufferable whine, the theft of bodily fluids and the resultant angry welt. I also particularly hate the way you swipe at one and (if you don’t succeed in annihilating it) it simply disappears.

Mosquitoes in Malawi don’t just bring histamine, however. Malaria is a real problem here and many of the children we treat are infected. To ward it off I take Cloroquin every night and sleep covered by a mosquito net.

The other night, however, the latter part of my anti-Malaria defense failed miserably. I tucked my net in all around my bed and snuggled down, ready to sleep in anticipation of my 5am alarm. Then: catastrophe. I heard that unbearable whine- one of those little devils was inside my net! I switched on my headlamp and, joy of joys, got a visual on the little bugger. I swiped at it so hard, however, that I smashed it onto my sheets leaving a smear of blood. I tried to go back to sleep (while avoiding the bloody patch of my linens) but my net had been fully infiltrated. Throughout the night I kept hearing them whining right near my ear so I would slap myself in the face to try and end the torment. I continued beating myself at every sound up to and including the Muslim call to prayer in the middle of the night (which caused me to almost give myself a black eye because, in my sleep induced delirium, I thought it was the sound of a monster mosquito). When the sunrise finally signaled an end to my sleepless torment I went to the bathroom and noted that I’d succeeded in killing one of those little devils. How could I tell? There was a smear of blood and a dead mosquito crusted into the corner of my eye. Yummy, huh?

Thursday, January 14, 2010

I don't wanna brag

As most of you know, I adore children. And because this is my blog and you are all my imaginary captive audience (until you find the strength to click back to facebook), I will indulge in a bit of old fashioned bragging. I think I’m pretty damn good with kids. Since I was young, people have always remarked on this fact and encouraged my passion to work with children. And work with children I have. Babysitting all through college, working at two different pediatric hospitals, teaching health, nannying this fall for three families and working with Child Life Services at the hospital. What can I say? I love the little buggers.

Needless to say, working with malnourished infants in Africa is like a dream come true. I get to see babies from sunup to sundown. Granted, I have to wrestle them on a height board or examine them for edema but it’s still great fun. I can usually manage a smile out of even the most terrified child.

Some kids, however, will have none of the terrifying white girl. Many babies will take one look at me and simply start to cry. Nothing I can do will calm them. I am a big, scary azungu and they want me gone:

I had a kid yesterday who was about 3 years old. I started to lay him down on the height board and he was literally screaming like a banshee. I had to pull some WWF takedown style moves simply to get him to lay there while I recorded his height. “Osalira! (don’t cry)” I kept saying but he only got worse. “He’s saying WHHHHHHYYYY MMEEEEEEE?!!?!” explained a nurse. Great. Now I’ve become a torturer of small children.

Another time I saw a set of irresistibly chubby toddlers who were just learning to walk. I crouched down next to one of them and started making funny faces- a move that usually kills with the under 2 set. His response? He leaned down, grabbed a rock and chucked it directly at my head. With surprising accuracy for a lil’ feller who can’t even talk yet.

I think Gus put it best. When a mom handed me their child to measure, it took a gander at my pale skin and light blue eyes and pissed itself. “Well,” Gus remarked, “that’s what happens when you see a
ghost.”

Tuesday, January 12, 2010

This is how we do (Kite may want to skim this blurb)

So I realize that some of you might be unclear on what exactly I do 5 days a week. The purpose of the project is twofold: treatment of malnourished children and research about how best to accomplish that goal. During the week, we visit different sites around rural Malawi. Some sites are visited weekly, others biweekly.

At each site we work with Malawian HSAs (Health Services Aides I think) who are hired by the government to run vaccination clinic and screen for basic ailments such as malaria (diagnosed by a fever) or pneumonia (diagnosed by labored breathing). We pay these HSAs an additional stipend: partly to help us run our clinic (fill out forms with the mothers, hold heads on the height board etc) but mostly to “sensitize” (recruit) mothers and encourage them to bring their malnourished children to our clinic.  As these HSAs live in or near the villages we visit, they are better able to communicate with the villagers.

Once we arrive at our site we screen all of the mothers that the HSAs have brought. Screening is accomplished using internationally accepted standards for weight for height. Any child more than 2 standard deviations from the internationally accepted mean are considered moderately malnourished, children more than 3 SDs are severely malnourished. We also check each child for edema (a swelling due to malnutrition). Any child who has edema is diagnosed as kwashiorkor, and is automatically severely malnourished.

We are conducting three separate studies. One deals with the type of supplementary food best suited to treating moderate malnutrition and one deals with the type of antibiotic most effective at treating severe malnourishment. The third study is conducted independently and deals with the bacterial composition of stool for twins (malnourished and healthy).

Every child, once categorized as severe or moderately malnourished, is enrolled in the appropriate study. Those who don’t qualify (if they are over 5, developmentally delayed, handicapped etc) are still given the appropriate food. We are testing three different types of therapeautic foods (but none are the RUTF- Chiponde which is described below).

I am working on the study that examines severe malnutrition. All children who are severly malnourished are given a RUTF (Ready-to-Use Therapeutic Food) called Chiponde.

Chiponde is comprised of peanut butter, oil, powdered milk, sugar and a vitamin supplement. It’s a more effective alternative to milk-based therapies that are administered in an inpatient setting (the hospital). It is a very conducive to outpatient therapy because it has no water and thus resists bacterial contamination for months without refrigeration.

In addition to the Chiponde, we are trying to determine which antibiotic (if any) helps alleviate severe malnutrition.

That is a basic overview of the three studies. I’ll make another post later about the actual grunt work and what happens when we get to the site.

Creepy crawlers

As expected, I have already been introduced to some of Africa’s most unsavory characters belonging to the class “insecta”. While I don’t consider myself a rugged outdoorswoman, I also don’t consider myself a priss.  I think I nurse a secret self- image that pays tribute to my obsession with Laura Ingalls Wilder. My inner prairie girl, however, is nowhere to be found when I am confronted with a slug or a big hairy spider.

Last night I went into my bathroom only to realize that it was already occupied... by a centipede (millipede? billionapede?) that was literally 6 inches long and half an inch thick. It looked like a long, slimy grub with thousands of legs. I was literally paralyzed. I slowly shut the door and called Gus who mercifully removed the offending intruder from my bathing quarters.

But I shall not relax my vigilance. Before I arrived no less than two tarantulas had been spotted on the premises. Thus I approach every room with some degree of trepidation and drift off to sleep with visions of arachnids dancing in my head. I comfort myself that even Laura would permit herself some degree of vigilance.

Monday, January 11, 2010

Ground control to Major Tom

The huddled, unwashed masses are complaining that the peanut buttery toasts that I've used to decorate my bleak prose are getting in the way. I dismissed this nonsense until I was debased and forced to use a non-leopard Mac and (horror of horrors) a PC. It does seem to be overlapping with the text. Are people still having this issue?

Margaret, great goddess of the interwebs: is there a way to fix this?

Shire Valley

Mondays are out hottest days because we go down into the Shire Valley (pronounced Shee-ray). It was a very busy day as well: we enrolled like 15 severe and 15 moderate kids at our site. While mixing antibiotics on the hood of a car, however, I almost fell into the mud where there was a mother pig and her piglets.

African name of the day: Symon Simon

Business names of the day:

1) This one's for you, Hannah: Body Huggers: stockists of ladies attire
2) 10 points for honesty: Decent Fast Food

Things that are better in Malawi

Fruit. Specifically mangos and pineapples. Out in the remote villages you can buy about 25 delicious, juicy mangos for around 70 cents. Perfection. As well as my new afternoon snack.

Sunday, January 10, 2010

Things that make me miss the good ol’ US of A #1

Cable Internet.

Have you seen that Louis CK standup sketch about wifi on planes?

http://blogs.wsj.com/middleseat/2008/12/15/comedian-louis-ck-on-in-flight-wi-fi-griping-travelers/

 Mea culpa. He may have been speaking to me and me alone. He’s spot on: I’ve been thoroughly spoiled by modern technology. I of course still remember the days of leafing through the newspaper while the modem connected. Truth be told, however, those days already seem like a quaint memory along the lines of horse drawn carriages or Bravo without the Real Housewives. These days I’m used to a fast connection- how better to appreciate Margaret’s prolific photoshop career or keep up with the welcome deluge of 444 group emails?

Lets just say that Malawi has yet to catch up with my penchant for gmail and nyt.com. In the words of Louis CK- this is bullshit. I’m in the middle of Africa and I want my DSL. Without it I cannot, for example, pepper this blog with pictures of small African children or give you a visual on the people I work with. Nor can I operate my beloved gchat and thus keep Sara entertained at work. I have to (gasp) use HTML mode. Alas, my friends, I will have to torture you with my pictures only upon my return. Until then, enjoy your Hulu, your iPhoto exporter and your websites that require Flash. I’ll be sitting here in one of the most beautiful places on earth just waiting for the page to load. Bullshit.

Thursday, January 7, 2010

Islamic derrières

Most people in Blantyre speak at least a few words of English. Outside of the cities, however-most people speak only Chichewa. For some reason, however, most of the signs and business names are English and have very strange names. As a rule they are misinterpretations or weird usages of idioms. For example: Y2K Shoprite , No Black Out Barbershop (?), God Can Do Anything Tire Shop. My favorite thus far was a large sign proclaiming “Muslim Ass” (Association). Yes. Incredible.

Crazy people and large goats

Slow day in clinic. Quite a lot of moms but not that many sick babies. Lots of fatty fat fat babies though. Two of which peed on my hands. Also, while the moms were listening to the nurses, one kids who was standing starting peeing ON his mom who didn’t notice for a few seconds.

I’m starting to take charge of the antibiotics and today was my first day on my own. I was nervous I’d forget something. It went well, though. Granted: there were so few kids today but that was a blessing in disguise so I could get comfortable with the meds.

There was also a crazy woman who was hanging around the health center and would just come and stare. She kept talking to me in Chichewa and I would tell her “Paipani, sini mah tah Chechewa, sini kumva!” (I’m sorry, I don’t speak Chichewa, I don’t understand) but she kept chattering away and picked an ant out of my hair. Then she told the driver that she would take me home and teach me Chichewa but told a nurse that she didn’t have a home. She was actually quite sweet if a bit annoying. So often you see very angry crazy people but she was very calm and personable. But then the nurse told me that the community doesn’t really care for the mentally ill and they are frequently raped and abandoned to wander the streets and beg. So very sad. I wish I could have done something for her but I need to remind myself not to take on the problems of the whole world.

On the brighter side, the driver heard me speak a few words of Chichewa to her and told one of the nurses that he didn’t believe that it was my first time in Malawi because I’d already learned so much Chichewa! Largely a joke but it felt good. I’m trying to learn at least a word of Chichewa every day. Today I learned chimbuzzi- which means bathroom or large goat. Clearly a very important word to have in my repertoire.

Sunday, January 3, 2010

Getting into gear in Malawi

I had my first crack at a Malawian stick shift yesterday. Indi, Amanda and I were on our way back from Mujete: a wildlife refuge when Indi offered to let me have a turn at the wheel. I’m going to have to drive here sooner or later so I bit the bullet and switched seats with him.

Just to give this some context: I may be one of the most, if not the most, anxious people behind the wheel. Even in an automatic, I dislike driving places I’ve never been, dislike traffic and hate parking. So hopping behind the wheel of a car where the driver sits on the right, when I need to shift with my left hand and drive on the wrong side of the road was quite a feat for me. Add to the mix your garden variety developing country madness: a constant stream of people walking on the side of the road, mango vendors, minibus vans with 30 people crammed in, goats, cows and bikes. Suffice it to say that I was quite jumpy. By some miracle I was able to get ‘er started without stalling and off we went. I rode the clutch like a cowboy but managed to avoid stalling the entire time. We stuck to the highway (loose term in Malawi) but having most of the car on my left was pretty disconcerting and I almost offed quite a few roadside walkers. I stopped before we got to the next police checkpoint (I didn’t have my license on me) but I was pretty happy that we all survived the experience.

Side note: I tried driving again today and stalled about 300 times. In my stress induced panic I forgot basic tenants of driving such as how to maneuver the car in reverse and thoroughly embarrassed myself. Lacey and Gus were really nice about it and Lacey said its like having braces: at first you think you’ll never adjust but eventually you forget you have them. Oh well, two steps forward and one step back?

First Weekend in Malawi: Elephant standoff

Mujete: so its my first weekend in Malawi and I have some time on my hands. Indi and his girlfriend were going to check out Mujete wildlife reserve so I tagged along (I’m here with two couples right now so all I ever am is the third wheel). The park is relatively unknown- the log at the guard gate said we were around the 4th car that whole week. It was quite fun: the wildlife is nowhere near as impressive as it was in Tanzania but we still got our fair share of impala, water buffalo, monkeys wild boar and elephants.

The highlight was seeing a huge elephant on the trail. Instead of backing off, however, the elephant started walking toward us which was terrifying because we were unarmed and a charging elephant would turn our car over and kill us pretty damn quickly. So we backed up quickly and he went back to eating. We couldn’t backtrack out of where we were though so, for better or for worse, we needed to pass this guy or wait him out. Indi decided that we should turn around because if the elephant was going to charge, he could easily outrun us in reverse but we had a chance going forward. So after a few false starts we backed past the elephant (with the idea that we could gun it back to where we were originally if need be) and he finally backed off the path. At one point our car scraped a branch and we all jumped about a foot in the air until we realized that we were making that sound and not him. We felt pretty triumphant when we eventually won the standoff even though he was probably never aggressive in the first place, just curious. But the important thing was that we felt victorious and could drive off to our next destination (a tree house with a view of a watering hole where we could watch a monkey show us his junk). Excellent day.

Friday, January 1, 2010

I'm here!

Well I’ve officially arrived in Malawi. The trip from England went well but it was a bit stressful. I got to the airport and discovered that despite my online confirmation of South African Airways baggage policy, I can only check one bag weighing and not two as I’d been led to believe from the website (something about how I stayed longer than 48 hrs in the UK). Anyway, I was then told that my hiking backpack was too large to carry on leaving me with Sophie’s Choice: abandon my duffel with everything I own or leave my new, very expensive hiking backpack that I’ll need to travel around after my PPB work. Obviously this dichotomous choice of horrors was not going to turn out well either way so I did what I do best: I looked panic-stricken and I cried. The woman took pity on me and let my duffle slide even though it was half a kilo overweight and told me that if I got through security with my backpack then that was good enough for her. Fun fact: they take that carry-on size/weight restriction very seriously in the UK. I somehow wiggled through the cracks but I noticed that no one had an obnoxiously large rolling bag and the overhead compartments were barren compared to domestic flights in the US. After I smuggled my huge backpack onto the plane I was able to breathe a sigh of relief. Things got even better when I snagged an exit row. My joy was somewhat tempered when I realized that I’d have to prop up my TV with my foot but hey, I was going to Malawi and so was all of my luggage so I wasn’t complaining.

Now I’m here in Blantyre, Malawi’s financial center. The project rents three little house/apartments in a guarded compound. It’s quite comfortable: I have a bed with sheets and there’s hot water and a woman who cooks and does laundry. I am most excited about the people I’m going to be living and working with: Indi is a doc with fellowships in Peds, ID and EM, Lacey is a med student and Gus is her husband. They have each been incredibly welcoming and fun. I think we’re going to get along very well. I’ve also had my first day in the field and we’re going out for New Years but I’ve got to cede the computer so I’ll report more later. Suffice it to say I think I’ll get my baby fix here.

Hullo from England

Hey everyone. First of all, I have to say I am so flattered that the famous Sasha (aka Sasha Fierce) is reading my blog. Second of all, I must say that my first post reads like a lengthy justification explaining why my blog is going to be horrible. Writing and subsequently justifying a horrible blog is not my intention. I simply want to focus on my experience rather than crafting the perfect blog post. Thus I anticipate entries that lack the linguistic panache of "Harlanguage" or the style of "Wapatoko." Nevertheless I can't wait for the chance to update any and all interested parties.

Moving on.

I know that this blog is Malawi themed but I feel compelled to report on an experience that is not at all African. It is, however, nutty and thus I feel fully justified in its inclusion. I am talking, of course, about family Christmas in England. For those of you who don't know, the whole G-bach nuclear clan packed off for a jolly 10 days in the British countryside to stay chez Aunt B and Uncle R. When I say that we had a good time I mean I don't think I wiped the smile off my face for the entire 10 days. Those of you who have spent any appreciable amount of time with me know that my family is my #1 priority. While I'm lucky enough to live 5 minutes away from most of my mom's family, I don't get to see my dad's family quite as much. Which is really a shame because they are, in a word, hysterical.

I feel so lucky to have spent my pre-Malawi week surrounded by people that I love. As I am a procrastinator by nature I know that left to my own devices, I would have left everything to the last second. This trip forced me to pack and then forget about it and simply enjoy myself. I got to swim, eat, ride, walk, watch movies and then eat some more. I really don't think that I've eaten that much since Brown ("you should get CBR, it's your favorite") and it was so fun to break into the tea and apple crisp/pie/cake after watching a movie surrounded by my entire extended family.

Anyway, thanks to the Gbach extended family for an incredible time and I miss everyone already.