Farewell, Blogosphere

I remember when I created this blog; t’was one late, insomia-filled night up in The Chronicle’s office with my friends Sarah and Saidi. It was on a whim, designed to reduce the number of e-mails I would have to write to family and friends detailing my summer whereabouts and activities. It’s come a long way since that night. I’ve avoided making the blog a travel diary, as so many blogs these days are. Instead, I’ve tried to take a step back from my experiences, think about them, and dive back into them with a renewed understanding and write, offering more in-depth, thoughtful pieces (I hope), rather than simple summaries of my daily schedule.

I’ve received feedback from friends about the blog that warms me to the core. Most are grateful for relaying back important information about a sometimes invisible-to-us pandemic and poverty trap. Comments have come from friends, family and way more people than you might think from random corners of my past. A handful of you have pledged to go abroad and get involved in similar work next summer, citing the blog as inspiration. This, to me, is the measure of the blog’s success, and the reason why I am glad I spent so much time maintaining it. I never planned on it having that kind of impact.

But now, as I sit in my corner office with less than two hours before my last day of work ends, I am retiring from the blog. It’s be fun; I’ve learned more about myself and experience as a result of forcing myself to sit down and rassle with this stuff, to construct thoughts and arguments about my time here, and I am the better for it. But when I leave Sunday, I will no longer be in the same mindset that I am here, now. I will be, like it or not, influenced by my culture and surroundings in the U.S.

Perspectives of global health change. When I’m sitting comfortably with two of my best friends discussing Chronicle politics, final exams and facebook profiles, my point of view is inherently different from when I am walking through a rural village in Dowa or spending my birthday holding orphaned and abandoned babies in Lilongwe. There’s just no comparison.

So I hope this blog can serve as a snapshot of my perspective while I was here in Malawi, right in the thick of things. Let it remind me, and you, of what responsibilities we all share in fighting this fight, in winning it.



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I hope the partnership between FHI and the Hubert-Yeargan Center continues. If it does, and you’re a Dukie (grad student or undergrad), I encourage you to apply for next year’s fellowship. If this program isn’t for you, I’ve got lots of connections in Malawi, Zambia, Kenya and Uganda that I can give to you. I’m more than happy to help.

Thanks, guys. It’s been a wild ride.

Dan
dbe@duke.edu
602.320.5629

Mr. Jing Has Gone

Antambo, one of the men that works the reception at the The Golden Peacock (GP), talks a lot, but doesn’t speak that much English. He tries his darndest to have conversations with us, but they usually end with our staring confused back at him and his wondering why we don’t understand, both parties then surrendering to the language barrier, smiling and moving on.

One of his favorite things to tell me is that Jing has left the GP. His accent combined with his unique almost-lifetime-smoker-ish voice quality combine in a fantastic: Meestah Jeeng is li-eeeveeng. It doesn’t matter whether or not Jing has actually left to go to town or if he is still in the room sleeping. Mr. Jing has left, or so I am told about 3-4 times a day.

It’s become my favorite inside joke that Jing and I share. It never ceases to make me laugh when we have impersonation sessions in our room. It’s absolutely hysterical.
But Antambo, whether he knew what he was saying or not, was right yesterday when I returned from the airport to his (unexplainably) enthusiastic “Meestah Jeeng is gone FOR FLYYY!!”

Yep, that’s right ladies and gentleman, Mr. Jing left yesterday to head back to Durham and then Chicago to start medical school at the University of Illinois at Chicago. I’ll leave to head back to Phoenix next Sunday. Until then, it’ll be just me, Antambo and Raki holding down the fort as the permanent residents of the GP.

Update on the Former President

From the AP:

BLANTYRE, MALAWI — Theft and corruption charges against the former president of this southern African nation have been dropped after the current president suspended the chief investigator in the case, Malawi's top prosecutor said Monday.

Bakili Muluzi had been due in court Tuesday to answer 42 counts of theft, corruption and breach of trust after millions of dollars in donor funds were allegedly diverted to his personal account during his time in office.

Director of Public Prosecutions Ishmael Wadi said, however, that he had no choice but to drop the charges after President Bingu wa Mutharika suspended the chief investigator in the case, Gustave Kaliwo. Wa Mutharika offered no reason for suspending the head of the Anti-Corruption Bureau hours after Muluzi's arrest Thursday.

Only the bureau's director or deputy director can lead prosecution of a corruption case, Wadi told The Associated Press in a telephone interview late Monday. The deputy's slot has never been filled.

After a daylong meeting with anti-corruption officials Monday, Wadi said he concluded, "I had no choice but to order unconditional discontinuance of the whole proceedings."

The bureau reserves the right to act against Muluzi in the future, he said.

Muluzi, Malawi's first democratically elected president, has been dogged by allegations of corruption for years.

He faced two indictments. The first concerned $10 million in development funds from Taiwan, Morocco, Libya and Rwanda that found their way into his account. The second concerned $50,000 that the government allegedly channeled to Muluzi through Malawi's embassy in Tanzania.

Muluzi's United Democratic Front party called the arrest a continuation of the "political persecution" waged by the administration of his hand-picked successor.

Wa Mutharika, the current president, quit the party that put him in power last year. Several former government officials are either being investigated or are on trial for fraud and corruption.

Kenya v. Malawi

Loads of people have asked me over the past nine or so weeks how my time in Malawi compares to the time I spent in Kenya last summer. It's natural for me to want to compare the two experiences. Jing must get tired of me saying, "Yeah, they have that in Kenya" or, "Kenya was waaaay different." When you're in a new environment so different from your normal daily life, comparing your experience to anything remotely like it is almost automatic.

Last summer I spent six weeks in rural western Kenya; I lived on a sugar cane farm and went out every morning to other villages to teach classes about HIV prevention. I cherished my experience there, and my commitment to solving global health problems—especially in Africa—was cemented as a result of my time there. So, naturally, I was thrilled when I was selected by Duke’s Hubert-Yeargan Center for Global Health to come work for Family Health International in Malawi. I was eager to get back to Africa and to spend another summer working to do my part in the fight against HIV/AIDS. I saw the opportunity to come to Malawi to work as a continuation of my efforts in Kenya, as an experience that would be very similar to the one I had last summer.

But, for me, this summer and last summer have been marked by differences in almost every way. This time around I have volunteered for an impressively large global NGO instead of a grassroots CBO, lived in an urban capital a million times more modern than my rural farming village, worked mostly in an office instead of exclusively in the field, focused on palliation much more than prevention and spent my free time with one other American instead of a dozen other volunteers from around the world. Suffice it to say, it’s been different.

Difference, however, in global health learning experiences is a good thing. If I end up in a global-health-related career—which I hope I will—it will be critical for me to remember both experiences. Last summer I learned how a CBO works and how it can achieve real results on the ground. This summer, I have seen how international aid money flows from USAID to FHI to CBOs. I have seen how the international aid community can influence CBOs and greatly increase their capacity to deliver services to the people that need them. I now understand how the two types of organizations can work together.

If my last two summers have taught me anything, it’s that global health is a multifaceted discipline. There are innumerable things to learn and just as many angles at which to view global health problems. Economics, policy, ethics, environmental sciences, statistics, biochemistry and engineering all have a role to play alongside the more obvious discipline of medicine. In one summer internship, it is impossible to explore all these angles with any substantive depth. But coming from a background in policy, FHI has been a fantastic learning experience, given its constant interactions with USAID, the arm of the U.S. government that handles most all the U.S. money for international development. It has been genuinely intriguing to see the way that donor funding is filtered down to CBOs and how policies set by the U.S. government thousands of miles away materialize here in Malawi—a country that most Americans have never even heard of.

So yeah, they're different. But which one is better? Going out into rural areas, working with the actual people you are trying to help, forgoing showers and eating local food... the experiences of working in the field will always be close to my heart. There is nothing more gratifying than seeing the fruits of your labor and feeling as though you have made a direct impact on someone's life. But the more office-type work I have undertaken here has broadened my perspectives about global health, for which I am extremely grateful. I suppose I don't want to sell either experience short.

More Duke in Malawi

When Jing and I were going through orientations at Duke and at Family Health International's offices in Research Triangle Park, our program director from the Hubert-Yeargan Center kept hinting at the fact that she would love to come visit us while we were working in Malawi.

I didn't think the chances were too good that she would actually come out to see us. But I was wrong. Cynthia showed up on Tuesday to observe our work and learn about what FHI is doing in Malawi. During our meeting with Cynthia and the country office administration, both sides—Duke and FHI-Malawi—seemed genuinely enthusiastic about continuing their partnership. This has been the first time that Duke and FHI have partnered to send undergraduates to work in country offices. Part of the reason Cynthia came here was to determine whether or not this pilot program will turn into a regular partnership. Personally, I hope that it will.

Cynthia was here for a short time—only about 48 hours—but we managed to introduce her to the county office staff, have several long conversations about our thoughts on the program and take her out to the field to see a home-based care visit, an orphan visit and an FHI-funded nutrition garden.



Cynthia and Margaret, the FHI-Malawi country director.


Our meeting with Cynthia and Margaret and Alick from FHI.


Cynthia on a clinical home-based care visit.

Some People Keep These As Pets?

We did it.

We ate mice. In Dowa on Wednesday, the FHI district coordinator, who introduced me to the Malawian delicacy a few weeks ago, let me know that he had some more in his car if I was finally brave enough to try. I decided that I couldn't leave Malawi without giving it a go at least once.

So after a few hours of being in the field, we finally returned to his car. I went across the street to get a Coke, just in case. Jing went for a head, and I, a leg. But, while Jing's definitely had brain, eyes and skull, I maintain that my leg piece had considerably more fur. Jing's did look more inedible than mine though, I concede.

So we popped the little guys in our mouths and chewed like hell. The taste was like nothing I have ever had before. I guess it could be described as a distant relative of pork, but much, much saltier. Somewhere between chomping through this little guys femur, trying to gather enough saliva to swallow the fur, and trying not to gag, I realized that I don't think I'll ever be a contestant on Fear Factor. Jing and I both had a little trouble actually getting it down, but we did—without the Coke, which was a rule. Using soda to help you swallow? There's just no credibility in that when you're eating mice in rural Malawi—seriously.



The moment of truth.


Crunch.


I ain't never scared.


This is how it's really done.

Malawian Politics

Found this in The New York Times:

Malawi: Ex-Leader Arrested on Corruption Charges

"Former President Bakili Muluzi was arrested on charges that he had diverted to his personal bank account $12 million in aid donated by foreign governments. Mr. Muluzi, who was head of state from 1994 to 2004, is the highest official to figure in an antigraft campaign by the current president, Bingu wa Mutharika, his successor and now estranged protégé. Gustave Kaliwo, the head of the government’s Anti-Corruption Bureau, said two of the counts related to $50,000 the government sent to its embassy in Tanzania, which Mr. Muluzi is accused of pocketing when he visited the country. Mr. Muluzi remains popular and is chairman of the opposition party. He was granted bail until his trial “starts in due course,” Mr. Kaliwo said."

Nsima: It's What's for Dinner (and Lunch)

I fear I may not have given Malawian cuisine a fair representation when I posted about the mice on sticks, so I figured I’d go into more depth about the food here. Well, the main staple is nsima, a base made from maize flour. Maize (the non-genetically engineered version of what we call corn) is dried, ground up into flour. Then water is added and the pasty mixture is baked into an oval-shaped dollop. You eat it with your hands, dipping in (usually tomatoey) sauce or using it to pick up other food, e.g. beef or green vegetables. It’s very similar to ugali, which is the main staple in Kenya, but it’s softer, one step closer to porridge. Anyway, most Malawians eat this everyday, and most will say they have not had a meal if nsima wasn’t involved. This can frustrate FHI’s nutritionist a little bit since nsima has little nutritional value; it’s basically all carbs. But it’s really cheap and really filling, hence its popularity here.

Other really common Malawian foods are beef stew—often featuring especially fatty or bony parts of the cow—chicken, either fried or baked, served quartered, goat, and chambo, the type of fish that dominates in Lake Malawi. The beef, chicken and goat are not driving my taste buds too out of control, but I actually really like chambo. It’s a white fish and might be my second favorite kind of fish next to salmon.

As you might infer from what I’ve said about nsima, the diet here is very carb heavy. It sometimes takes a little effort to rotate the main carbs: nsima, rice and chips (fried potatoes). We can also get bread and noodles, but they are not as accessible in the restaurants here.

We eat breakfast everyday at the restaurant at the Golden Peacock. It includes chips, eggs, two pieces of toast and tea. For lunch, Jing and I usually walk to any number of restaurants in city center, where the FHI office is. Ali Baba’s is where we go the most probably. It has some Indian dishes and some of the more popular cuisine of the beef-stew-and-nsima school. We can get lunch there for about 400 kwacha, which rounds out to about $2.50. Another place we frequent near the office is called Time2Eat and is where our coworkers go most every day. It has a really simple menu, offering the traditional Malawian favorites and costing 280 kwacha for a meal. We have also gone to Chinese and Korean restaurants but they take a long time and are expensive. I have been to a “Burmese” restaurant twice, but am still a little unsure about the food there. I’m sure the sweet and sour chicken I ordered there will continue to haunt me for months to come.

For dinner we often eat at the Golden Peacock restaurant. Since we get back to work at about 5:30 p.m. and it gets dark by 5:45, it’s by far the most convenient place to chow down at night. Dinners are between 500 and 1000 kwacha. Sometimes we also walk down to Korea Garden, a hotel/restaurant combo about 150 meters from the GP. The food is pretty good there but it is noticeably more expensive, so I try to avoid it. The outdoor, poolside eating atmosphere is definitely a plus though. There are also two Indian restaurants in Old Town, so when we can muster a group together to walk or decide we can spare a few hundred kwacha on a cab there we go. They are also pretty expensive, but definitely tasty.

Otherwise, we just buy groceries and make our own dinners and snacks. It’s kind of hard to do because we don’t have access to a kitchen, but I’ve learned to be creative; I am now a die-hard fan of bananas with peanut butter.