Duke in Malawi

Farewell, Blogosphere

2006-08-11T12:04:00.000+02:00

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.

---
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

2006-08-07T11:47:00.002+02:00

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

2006-08-03T13:49:00.000+02:00

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

2006-08-02T16:25:00.000+02:00

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

2006-07-31T14:14:00.001+02:00

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?

2006-07-28T10:17:00.000+02:00

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

2006-07-28T09:50:00.000+02:00

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)

2006-07-17T09:55:00.000+02:00

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.

Making a Living

2006-07-12T13:45:00.000+02:00

In an e-mail I received from my mom a few days ago, she posed some questions about Malawi that I haven’t yet addressed in this blog or in e-mails to her. The questions seem so obvious, so simple, but at the same time I found them to be extremely difficult to answer. She wrote, “What moves or sustains Malawi, the economy, what do the people do for a living other than the street vendors? [What are the] attitudes towards women?” When doing any kind of development work, economics and the treatment of women are issues constantly coming up in conversation. And they are problems not easily solved.

Answering my mom’s question about what people do for a living should have been easy. I mean, I have been here for over six weeks now; the answer should have come to me right away. But I think the question itself was leading me down the wrong train of thought. In the U.S. we get up, do our 8-5 and get paychecks every couple of weeks—if we’re lucky. We refer this idea of working for your money making a living, which I think is what my mom was talking about. But the average Malawian isn’t making a living. I think of “making a living” as earning money to support a lifestyle. But rural Malawians (most of the population) don’t live in that once-removed world where they work to make money to buy things they need.

Instead, they work more directly for what they need. In rural areas, women will walk several kilometers to cut down firewood or get water from the river. They will spend the day taking care of their children, cooking food and tending to whatever crops or animals they may keep. Men will sometimes help with these domestic tasks, but often try to go out and make money by selling things (vegetables, baskets, tinsmithed miscellany), often with dismal chances of making any. This is why the market is overflowing with vendors.

Instead of making a living, most Malawians are just living, surviving, hoping they aren’t the next victim of disease or food shortage, just trying to make it until tomorrow.

When I think about the average Malawian lifestyle, I can’t help but compare it to my own. At Duke I am required to sign up for a $1400-a-semester meal plan. All this money is put on my DukeCard and all I have to do is swipe. I am about the furthest thing from growing or catching my own food. I’m also pretty far removed from paying for it myself. I often wonder if the average Malawian would even take me seriously if I told them about the Meal Plan.

So I guess that is my answer to the question of “what do people do for a living other than the street vendors?” Most Malawians live in the primary world; they’re not making a living. They’re just trying to live.

So what is fueling the economy? Well, the first thing to understand is that Malawi isn’t exactly skyrocketing into the G-8 anytime soon. Malawi is one of the poorest nations on earth, and the economy is in need of some serious boosts.

A few nights ago, Jing and I went to dinner with some people from northern California that Jing had met. We spent a long time talking about possible ways that the economy and Malawi as a whole could start moving more quickly in the right direction. Foreign investment, education reform and micro-lending projects seem to come up pretty often (well, at least in conversations in which I take part) as possible solutions to help boost the economy, but those are always very difficult to implement for a variety of reasons (The real kicker, I guess, is that if there was something easy to implement, it would have already been implemented). But one thing that has been particularly good, economically, for developing countries, especially Malawi, is the NGO presence here.

The number of NGOs here and the amount of donor funding flowing through this country is impressive, and the economic impact from that is most always positive. Hopefully that investment that piggybacks onto organizations setting up offices here can somehow translate into further economic growth. That, again, is difficult; it’s hard to have the money invested by foreign organizations get recycled in the Malawian economy. Many of the people that benefit from NGO money (landlords, restaurant and hotel owners, etc.) are not Malawian and don’t keep the money in the country or don’t care to put the money toward development related ends. Also, having lots of donor funding in a poor country can lead to dependency on the organizations and may not be a sustainable solution for the long term.

The way I am describing the Malawian economy seems grim. But, as one of the poorest countries in the world, describing what makes it and keeps it poor is often a depressing exercise. I don’t have any concrete ideas—or even a theory—to propose to improve the Malawian economy. There are many experts—both from abroad and from within Malawi—working to solve the economic problems here. All I can do right now is learn as much about it as possible and to wish them all the luck in the world.

Stay tuned for an entry on the treatment of women issue.

A New Use for Boiled Water

2006-07-12T09:44:00.000+02:00

“Have you seen the mice on the sticks yet?” asked our newfound Canadian breakfast companions.
“Excuse me?”
“Yeah, the guys who sell mice on sticks, like, on the side of the road.”
“Um, no, I, uh, haven’t seen them.”

As breakfast conversationalists, these Canadians were leaving something to be desired.

Only a couple of days after hearing the rumor, though, it was proved true on my way down to Blantyre. About two hours into the trip, the car slowed down and pulled over to the side of the road. I figured it would be another typical pit stop: grab some maize and a coke, stretch my legs, nothing too exciting. But then four or five men swarmed the car holding sticks with dead mice on them. These types of things have ceased to amaze me.

A winter-time delicacy in Malawi, my coworkers were delighted to have found the mice vendors. So about four sticks with upwards of 10 mice on each joined our carpool.
Boiled, they are eaten whole (fur, tail, head, guts and all). They are arranged on the stick with the smallest ones on the top and increasing in size as they go down. The smallest ones are the most delicious (reportedly). Someone made the really sick (but weirdly true) argument that baby animals are always more delicious meals than adult ones.

I didn’t try any, but I’ve heard only good things about their (reportedly) pork-like taste.

Maybe next time.

A More Positive Outlook

2006-07-07T10:43:00.000+02:00

Last summer and at times during my first couple of weeks here, I had trouble dealing with the magnitude of working in HIV prevention and care. It's such a huge problem; how much difference can I really make and is that worth it? Those are big questions and don't have easy answers. But recently—mostly as a result of my field work—I have been feeling more optimistic about global health.

TANGIBLE RESULTS EXIST:

Our time at the office before our field visit consisted of reading up on FHI and HIV in Malawi. That was important to do and I certainly learned a lot doing so. But reading about how the U.S. government gives money to USAID, then USAID assigns funds to FHI, then FHI funds implementing partners that, in turn, fund programs seems like a chain of bureaucracy that could never, ever get things done. But I was too cynical.

One poignant moment at one implementing partner's vocational school: the director of the organization came in, picked up a small green school-uniform dress that was to be donated to an OVC and said, "This is FHI funding."

Sometimes the safety net of bureaucracy that is so necessary when dealing with donor money can feel constraining, but it was great to really see a tangible, final result. The funding from the U.S. government, funneled into USAID, then directed to FHI, then doled out to this particular implementing partner, is really making a difference in these people's lives.

And it was also interesting to finally learn first-hand that this currency-flow is not just siphoned off at every level. FHI management integrates models of collaboration, participation and results orientation into every phase of its program activities, offering all the implementing partners (and even the country office) opportunities to improve their services. FHI, as a result of this collaborative structure, also provides job opportunities and economic boosts to the communities in which it works.

THINK ABOUT IT IN CONTEXT:

There are inevitable challenges when you are facing as big a problem as the HIV/AIDS epidemic or trying to eradicate poverty. But one very wise woman told me that you just have to think about the obstacles in context. While we may deal with drafting grant proposals, writing reports and patiently wading through language barriers, we should always remember that our frustrations and difficulties are not even in the same league as those faced by the people we are trying to help. "It almost seems the frustrations are a little bit of payback," she told me. I'm inclined to agree.

FIND THE EXPATS:

As I sort of alluded to in my entry "The Tooth," I have learned a lot from expatriates and other veteran development volunteers. They are a source of inspiration for me. People who have spent lifetimes seeking to make the world better, just because they think it's the right thing to do, make me feel like I should do even more than I am doing, and encourage my work. They are all over the place here, and I can't wait to meet more of them.

Let's do it.

Market Research

2006-07-07T08:55:00.000+02:00

I bought two Polo-brand collared shirts last weekend at Lilongwe’s main market. They cost me 200 Kwacha, or $1.30. A steal.

After my purchase, I came back—back down the hot, crowded, smelling-of-smoke market corridors, back over the bridge, back through rush hour traffic, back past the wood-craft hustlers, back back back back back—to the hostel, where I boasted my Deal of The Century. Joseph, one of the Golden Peacock employees, was floored when I told him that new versions of my latest wardrobe additions would cost 16,000 Kwacha back home.

To him, the fact that someone would spend that kind of money on shirts—that purchases like that were even happening on Earth, anywhere—was about as believable as someone telling me before my trip to the sprawling shanty-town market that I would find two Polos that fit me there.

The market is interesting in that way: you never know what you are going to get or see. I don’t love it just for the deals; I love it for its super-stimulating aliveness, for its shacks and its grass-thatched overhangs and its whatever-elses counting as storefronts, for its hellomyfriendhellomyfriends, heybossyoucomelooks and Igiveyougoodprices, for the ability to buy pretty much anything I can possibly think of, for its largeness.

The main market in Lilongwe.

But there is a side to the market invisible to meandering tourists. This other market boisterously and angrily emerges once I start asking questions.

Where are the toilets? How much money do you make? How many vendors will be forced out when the rainy-season-inflated river swallows the market’s outskirts?

There aren’t any. Not much. Too many.

It wasn’t always like this, I am told. In April, the government moved all the vendors that used to crowd the streets of Old Town to this main market. The government wanted to move all the vendors off the streets in February, but fearing a significant loss in profits, the vendors convinced the government to delay enforcement until the maize harvest. That way, they would have food to live on even if they weren’t making money in the market.

Had we been here two months ago, our walks to the minibus stop or to the grocery store wouldn’t be so uneventful—the vendors would have tried to sell us a hundred different things every time we walked by. But save for the newspaper sellers, the cell phone SIM card vendors, the wood carvers and the occasional vendor sneaking back onto prohibited territory, all the vendors have moved across the river into a centralized location. And they’re not happy about it.

A boy standing on the outskirts of the market, near the river.

The government enforced this policy to restore order to Old Town. Before, crime was high and the city blighted, or so say policy makers. I’m not really sure how I feel about the policy, as I arrived in Lilongwe after it was enacted. But it’s something that genuinely interests me. So I decided to start some research looking into the market relocation a little further—my own little project to keep me busy on the weekends. I talked with James, one of the wood-craft vendors for about two hours. He gave me the basic history of the relocation and offered his own opinions and what he thought the average Malawian thinks. I’ve also talked with a dozen other vendors in the main market. One of the men I met there gave me a tour of the proposed location for a second market. I feel like a bona fide expert in the subject now.

Most people I’ve talked to tend to think that moving all the vendors off the streets was a good idea. The city is much less crowded and significantly safer, they say. But most are upset about they way the government went about enforcing the policy. The market isn’t big enough to fit all the vendors, sanitation is nonexistent and most everyone is making less money. The proposed location for the new market will have a bus/minibus stop, sanitation and some actual buildings, but vendors almost uniformly think that it is too far away. “How will they make any money if it is a 25-minute walk from Old Town?” they ask.

The proposed location of a new market.

Without more information I certainly can’t fault the government for its actions, and I’m not 100-percent convinced that assigning blame is even constructive. But I’m looking into it a little further, because I think it is a representative microcosm of a lot of the social and economic problems facing Malawi, one of the poorest nations on Earth. Call it market research.

This billboard (owned by Clear Channel) has a picture of the Malawian president and says, "Fight Corruption. Develop Malawi."

Football Frenzy

2006-06-30T13:29:00.000+02:00

Like any good American, I don’t like soccer.

I find the sport slow and unentertaining, and I can definitely think of a lot of things I would rather do with my time than watch something I don’t particularly care for—especially here in Malawi. Sitting on my couch at home and half-watching a match is one thing, but sitting through an entire 90-minute contest—when I have a whole new country to explore and all my FHI work to do—seems kind of silly. Well then, why am I watching so much of the World Cup?

I have probably seen 60 percent of the matches so far. Since the beginning of the tournament I have had to learn the rules of the sport, figure out which teams are good and which ones aren’t and remember players’ names. Here in Malawi the World Cup brings together people from all nations in one common obsession and to not know what’s going on makes me feel like a bad citizen of the world. And who wants to feel that way? Certainly not me. And not Jing for that matter.

I don’t think Jing would ever feel embarrassed about that kind of thing though. His excitement for every ball played anywhere in sight of the penalty area can be heard throughout Lilongwe. But I digress.

With the help of the tournament, we have met a surprising amount of people and been introduced to a sport kept secret to most Americans but held close to the hearts of hundreds of millions of people around the world. And for that I am certainly grateful. We watched England’s first game with a group of five English university students we had met the night before. We met our friend Andrea when one game slowed down only to yield fascinating conversation about her extensive field research and experiences abroad. When cultural divides seem unbridgeable or conversations fizzle out, you can always ask which teams will play later that day, comment on how the Mexican referee with the slicked-back hair is ruining games or commend how well Ghana played. And it’s always easy to point out that the U.S. is probably the worst team. Ever.

I was watching every game for the first three or four days, but now I usually catch one every other day or so. I’m losing interest. Because even though I love the international camaraderie that the World Cup brings out, I mean, I’m still American, and I just don’t like soccer all that much.

Weekend Plans

2006-06-23T13:10:00.000+02:00

Since we have half days on Fridays, it's about time to leave the office. Before I go, I just wanted to let you all know that Jing and I will travel to Blantyre on Monday for a couple of days. Because we don't have the constant Internet access there that we enjoy at the office, the next blog update may have to wait until we get back on Thursday.

This weekend we are planning on going to the main market in Lilongwe. Most all of the clothes donated from the United States and Europe to Africa end up for sale at markets across the continent. I've already bought a t-shirt there and plan on buying some more cheap clothes. Who knows, maybe I'll end up wearing your old pants.

Also, an American graduate student we met a couple of weeks ago at The Golden Peacock is coming back to Lilongwe to hang out with us this weekend, so it should be fun to have the extra American company. She already has two masters degrees (cultural anthropology and public health) and is in Malawi doing preliminary research for her dissertation in medical anthropolgy.

N.B. We are working on getting more photos up on the blog. The website has been giving us some problems, but the photos Jing has already taken are really quite good.

2006-06-23T10:54:00.000+02:00

Namwera AIDS Coordinating Committee, one of FHI's implementing partners hosts a vocational school offering Orphaned and Vulnerable Children training in skills such as tailoring (shown here), tinsmithing, carpentry, typing, and computing.

The shores of Lake Malawi, seen from a hotel just north of Mangochi.

Rural Malawi, near Namwera

Dan, swarmed by students from Thincula primary school.

Village boys in Namwera, where a nutritional garden supported by Drip Irrigation Kits is being piloted by FHI.

Where Have We Been?

2006-06-21T14:25:00.001+02:00

Well we are back in Lilongwe. Gone for 10 days, we had the great pleasure of seeing most of the southern portion of Malawi as we visited several organizations that implement home-based care and provide support to orphans and vulnerable children with the help of FHI funding.

Since the beginnings of our several orientations for this experience, we have heard the terms HBC (home-based care), OVC (orphans and vulnerable children), IAs (implementing agencies), and vocational schools without really visualizing what everyone was talking about. After this trip, I definitely feel up to speed with all of the FHI lingo and (most of) the abbreviations and acronyms that permeate a lot of discussions regarding global health and development work. So that’s fantastic.

So I’ll give you a brief run-down of where we went. Last Sunday, we left Lilongwe to travel to Blantyre, the commercial capitol of the country, which is about four hours to the south. On the drive down, we drove on a road that runs along the border between Malawi and Mozambique, so it was really interesting to see another country, no matter how surface level it may have been. We stayed in Blantyre for a couple of days before heading down to Nsanje to visit a couple of FHI partners down there. It is in the southern-most part of the country and was pretty hot. We stayed the night in Chikwawa at a lodge on a game reserve, which was awesome because we saw a lot of antelope and monkeys. There was actually a pamphlet in my room that warned visitors to keep their doors closed because they’ve had a problem with monkeys coming in and stealing stuff out of the rooms. There was a frog in my toilet the whole time I was there. Tremendous.

Then we went to Mulanje. There we saw a vocational school for orphans and vulnerable children. There were about twenty kids of various ages learning carpentry, tailoring and tinsmithing. The aim of this program—and many others like it that FHI funds—is to generate income for and empower the children. In Mulanje we also saw a training session for future HBC volunteers. HBC volunteers do weekly visits to patients in local areas that are suffering from HIV, TB and cancer. They receive training from FHI-funded organizations on medical treatment, nutrition and psycho-social and spiritual support for the patients. We were lucky enough to sit in on one of these training sessions. The training was for adults, but took place at an elementary school, so when we arrived, we were mobbed by about a hundred little kids. “Mzungu! Mzungu!” Once Jing took out his camera, it was all over. There was nowhere to go. We were surrounded. Only after a few minutes was I able to wade out of the lake of smiling, laughing, curious kids. It was a warm welcome to say the least.

We drove to Blantyre again to stay the night before heading out to Mangochi the next morning (Friday). We visited another partner and saw another vocational school and then returned to where we were staying. Friday through Monday nights we stayed on the shore of Lake Malawi, which was awesome to say the least. The lake is huge; it is very beautiful and definitely a point of pride for Malawians. The administrative officer that had accompanied us since we had left Lilongwe headed back home over the weekend and then we met back up with FHI when the head nutrition officer of the country met us in Mangochi to show us some of the nutrition programs going on there and in Namwera (a small town in the district of Mangochi). We saw three different gardens that were funded by FHI-funded implementing partners. The purpose of the gardens is to encourage diet diversity and ensure food security during times of food shortages.

Yesterday we returned to Lilongwe and have settled back in nicely at The Golden Peacock, where we had a warm welcome from all the staff. Our friend Raki has left to work in Zambia for about a month. His replacement is here, living in his room, but we haven’t met him yet.

Riding a Minibus

2006-06-09T11:37:00.000+02:00

Minibuses are the main from of short-distance public transport in Malawi. They are about the size of the typical American minivan, but in Malawi, and in many other parts of Africa, they pack in twenty or more people. There are typically five or six rows with four people jam-packed into each. Personal space is nonexistent and getting to know your neighbor is required. The driver works with a conductor, who sits (or stands, depending on how full the vehicle is) in the second row, collects the money and determines where people need to get off.

We walk about ten minutes from the hostel to the grocery store in Old Town Lilongwe. There, we find the minibuses that are facing in the direction we want to go. We find the one that is headed to Area 12, or city center. If there are more than one headed in that direction, we look for the one that is most full because they don’t leave until all seats are occupied.

Once it’s full, the minibus takes off. Well…most of the time, depending on whether or not it stalls out. This actually happens a lot. Most of the time, it just takes a little convincing from the driver to get the engine to turn over, but sometimes he’ll find bystanders to help push to give it a rolling start. If there is no one around, people inside the minibus have to get out, push and hop back into the moving vehicle. I had to do that once in Kenya, but haven’t had the pleasure yet in Malawi. I still haven’t figured out why a rolling start helps the engine get going, but it seems to work.

So, once we’re driving, we head out of Old Town, pass the huge market, and speed down pass the nature sanctuary. Throughout the ride, the conductor collects each person’s 50 Kwacha, going row by row. It’s easy to stare out the window and watch Lilongwe go by, but there is a perfectly chaotic structure to the miniculture of the minibus that draws me in. The combination of people hustling to work, of friends meeting by chance on the same minibus, of the conductor trying to do all the transactions in his head, of people crammed up against perfect strangers. If you’re lucky, you get to see a mzungu (foreigner) use a minibus for the first time. You have the pleasure of seeing them uncomfortable, of observing their awkward, big bodies struggle for elbow room that doesn’t exist.

I often think about how a minibus full of Americans would fare. Us with our SUVs and one-person cars, with our oversized houses and insatiable desire for space. But I personally like it. I pretend that I’ve been living here my whole life. For a second, I am one of those rare white guys that speaks perfect, beautiful, insanely fast Chichewa—I’m just choosing to stay quiet on this beautiful morning, thank you very much.

There’s a big difference between the materialistic freedom of the United States, the ability to have basically whatever you want, and the freedom that you can only feel when you speeding through a small city half-way around the world in a structurally unsound van. I like both, I admit. But the latter of the two makes me feel alive, as if, for a moment, the fast, bumpy blur of my daily commute is exactly what I was born to experience.

Then we pass the Malawi Reserve Bank, a beige inverted pyramid, and I am thrust back into reality. Starting at that moment, we have to be sure to listen when the conductor calls for the ADL House stop, which is where we get off.

Day-to-Day Activities

2006-06-08T15:35:00.000+02:00

This is my half of the room, featuring me, my mosquito net, an empty water bottle collection, cereal boxes, peanut butter and my trusty blue backpack that I've taken to four continents. We spend a lot of time in the evenings here, relaxing after work.

This is the minibus stop in front of ADL House near where we work. We usually take one of these little vans--which hold up to 22 people, believe it or not--to and from work everyday. The drive is about 10 minutes and costs 50 Malawian Kwacha (about 35 cents). I'm pretty familiar with this type of transport, having ridden my fair share of matatus in Kenya and Uganda.

If we're lucky, we don't have to take the minibus and Alick drives us. I guess it just depends if our hostel is on the way for him. Something happened to his sedan and now he is driving a big farm truck around Lilongwe. He told us that he sold his sedan, but I told him he was lying, and he conceded. We still don't know what happened to the sedan, but I'll be sure to keep you posted. This picture was somewhere in between our initial shock of three-piece-suit-wearing Alick driving one of these trucks, our fleeting concerns about the vehicles safety and our realization that "after 5 o'clock, it's okay to tell lies."

This is pretty representative of what we've been doing the past few days: reading. There is a lot of interesting stuff that we have found on the FHI server and in their resource room. Jing is reading up on the requirements to receive antiretroviral therapy from the government.

The Tooth

2006-06-07T16:00:00.000+02:00

Last summer, toward the end of my six-week stay in Kenya, I bought a lion’s tooth necklace from the chief of a Masai village. I immediately put it on and knotted it, with no intention of taking it off. I let it hang from my neck as a reminder of the time I had spent teaching HIV prevention in the western part of the country.

For me, a retired literature major and professional leisure-reader, it transcended souvenir-dom and became a symbol.

It stood for poverty, misinformation, corruption. It made me remember the HIV-positive-only hospital wards, the malaria-induced funeral of a five-year-old boy, the street children in Kibera. But it also inspired me, gave me hope, grounded me upon my return to Durham where my biggest problems were B+s and lost DukeCards. In it were the faces and voices of my fellow volunteers: future doctors, social workers, teachers and policy makers bent on changing the world.

But the day before I left for Malawi, The Tooth--as it was affectionately dubbed by one of my favorite people--broke off from its leather string. Freed, it tumbled down into my suitcase as I was packing and burrowed into my clothes, readying itself for a return trip to Africa.

Not wanting to see it damaged or sacrificed to the gods of lost luggage, I packed it safely away in a drawer, subjecting it only to the Phoenix summer heat.

And there I stood in my room, left to ponder the significance of The Tooth’s Great Escape.

And it’s only now that I’ve spent a toothless week in Lilongwe that I’ve found a satisfactory answer--thanks to the ex-pats.

You see, in rural Kabula, Kenya, I had no interaction between anyone but Kenyans and my fellow volunteers—about ten in number. At the time, it seemed as though a whole new world was unfolding itself in front of my eyes, as though my understanding of the HIV epidemic was expanding beyond measure, as though I was now part a proud and united front of international altruists working to eradicate HIV and poverty in Africa.

But having conversations with foreigners aid workers and expatriates, I have realized that my scope was limited, my experience narrow. Rural Kenya is not urban Malawi. Nor is it Zimbabwe, Niger or Botswana. HIV and poverty--and all the other problems that piggyback onto those--affect each country--and each region of each country--differently. What I haven’t realized until now though is that, just as the effects are different, so should the responses be customized.

And there is rarely, if ever, agreement in the political arguments that always seem to proceed taking any kind of action. All you need to do is sit quietly and listen in any pub or at any hostel; you’ll hear the ex-pats, the travelers, the University students from around the world exploding with a fiery emotion, bemoaning dirty politics, greedy pharmaceutical companies and global apathy. You’ll be tempted to give up and lose hope because you'll be convinced that NGOs, grassroots volunteer-based activists and governments don’t work together as well as they could. For that reason, the solutions to Africa’s most dire problems are not simple, but unavoidably complex.

I myself, the child of 1970s activists, fellow at one of the leading nonprofit international public health organizations and representative of a rich, American university, don’t really know what I think about the Zambian government’s economic policies when my newfound Bolivian-born American ex-pat friend starts ranting to me about them. Although I’m inclined to believe her theories, I tuck them away for later consideration.

But I do draw one important conclusion from my conversation with her and discussions with a dozen others: governments, corporations and humanitarian organizations need to do more to get this continent on its feet, but the institutionalization of aid relief will never come before or without hands-on activism from individuals bent on making a difference--however small.

So I think I’ll need to find a new souvenir. I’ll need to keep it close to me, because I’ve already decided what it should stand for. It will remind me that although humanitarian work in Africa can seem too daunting a challenge, it desperately needs all the communities that I am apart of--a liberal family, an excessively intelligent group of peers, a wealthy nation, a vibrant Lilongwe--to finally stand up and face the greatest humanitarian disaster this world has witnessed.

I only wish I could buy a souvenir for everyone I know.

Beach Reading

2006-06-06T11:49:00.000+02:00

Interested in learning more about the global HIV/AIDS epidemic? Here's a link to the UNAIDS 2006 Global Report. It gives updates on the spread of the disease throughout the world and also shows the successes and failures in meeting goals set in a similar report in 2001.

http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp

Pictures from the Weekend

2006-06-06T09:32:00.000+02:00

This past weekend was our first in Malawi, and my first in Africa. On Saturday, June 3rd, we visited the Nature Sanctuary in Lilongwe. There was a special celebration for Environment Day, and many students and parents gathered at the Sanctuary for performances, skits, singing, and dancing.

Photos are Below:

A Malawian Girl looks toward the performance stage during Envinroment Day at Lilongwe's Nature Sanctuary.

We found a truck full of Emergency Food Ration Vouchers from 2005...

Dan exploring the North Trail in the Nature Sanctuary.

A caged Hyena.

Shortly after sunset in Lilongwe, Malawi.

The Golden Peacock Resthouse

2006-06-06T08:01:00.000+02:00

This weekend we spent our time relaxing around the hostel and further exploring Lilongwe. There haven't been too many exciting events to tell you about, so I'll tell you about the people we've met at the Golden Peacock Resthouse.

We’ve befriended an Indian guy named Raki who has lived in our hostel for two years. He is working in Malawi and Zambia in the textile industry, saving up enough money to return to India and invest in real estate. He has a car and took us out to Chinese food the other night, which left me with a suspect stomach this morning. Last night, treated us to authentic Indian food, which was really good. It’s nice to have someone showing us around and giving us advice on where to shop, eat, visit, etc.

We also met a really interesting girl named Gabriela who passed through here a couple of days ago. Born in Bolivia, she lives in Virginia and works in Zambia as some sort of agricultural consultant. She taught me a lot about southern African politics; she’s suspicious, it seems, of the Zambian government’s recent decision to raise the value of the Zambian Kwacha, a move she says hurts farmers and copper miners. Though interesting, I haven’t had the time to look into the issue. I’m still struggling trying to learn the requisite Malawian political history. She seemed nice, but after leaving the next morning, the owner of the hostel was glad she had left, calling her a "trouble maker."

The same night that Gabriela stayed at the hostel, I met two Spanish guys, one that was passing through visiting the other who works in northern Malawi in an orphanage. I talked with them (in Spanish) for about an hour about American universities and what I’ll be doing when I am here in Lilongwe.

Other characters around the hostel include: the two Pakistani guys, one of whom speaks broken English, both of whom refused to believe I was nineteen; the possibly-not-all-there English chap who is recovering from a bout of Malaria; Solomon, the almost-300-pound owner/manager of the hostel who is an old family friend of Raki’s; and Joseph, the Malawian guy who seems to do all the work around the hostel and appears to never, ever, sleep.

Well, that’s all for now. I may disappear into what is known in NGO-speak as “the field” next week, so contact me before then if you need to get a hold of me.

2006-05-31T10:21:00.000+02:00

5/30/06
9:30pm Malawi Time, 2:30pm Central Eastern Time

First night in Malawi. My flight arrived via Jo’burg, via London, via Chicago. In the period since Sunday afternoon, I have had two overnight flights and close to a 10 hour layover in London. I first set foot on Malawian soil at about 12:45pm local time. We were met at the airport by Alick, our in country coordinator from FHI.

He took us directly to our living arrangements, the Golden Peacock hostel in Old Town, Lilongwe. Lonely Planet Travel Guide for Southern Africa describes the Golden Peacock as having “large but shabby rooms, which vary in size and condition so check a few out.” This simple sentence somewhat applied to our situation. We were given the option of two small rooms with double beds. The second one had mosquito nets and the beds looked nicer so Dan and I went with that one.

The room is modestly small, but has a private bathroom. The sink and toilet both work well, except that the sink leaks out of the bottom and the toilet makes funny sounds while refilling after a flush. The shower dispenses only cold water, despite having both a hot and cold faucet, and there’s no curtain so a puddle forms after each shower.

After arriving, Alick left us to return to work while we stayed at the hostel to rest and clean ourselves up. Dan and I each took a good 3 hour nap. After dinner with Alick, Dan and I returned to the hostel and checked out the in-house restaurant. We each had a drink: I, orange Fanta, and Dan, Coke. He made a remark about how you can go anywhere in the world and still get a coca-cola. The statement immediately brought me back to what that Joep Lange from the Duke Global Health Symposium said, and I paraphrase: if you can get a cold coke or beer anywhere in Africa, why can’t you get AIDS drugs / condoms? That was certainly the case here. I have yet to see a condom distribution site or advertisement in my first few hours here...

Pictures below:

Dan at the Office

Back in Africa

2006-05-31T09:59:00.000+02:00

In the past two days, I’ve boarded four international flights, stepped foot on three continents, exchanged four different currencies and traversed nine time zones—but we’ve finally arrived in Lilongwe. It definitely feels good to have a permanent place to stay, to know where we will be working and to have a better grasp on what we will be doing for FHI while we are here.

Now a little more on the details of our stay so far:

The hostel we are staying in, the Golden Peacock, is about a ten-minute drive to the FHI office. We are sharing a room with two beds, dressers and a self-contained bathroom with a toilet, shower and sink. Compared to my plumbing-less time in Kenya last summer, this place seems like a palace. After starting off my time in Malawi with a quick nap, I spent the rest of the afternoon investigating my mosquito net and unpacking. There is a restaurant right next to the hostel where we had sodas last night and breakfast this morning. The English influence on this country is pretty evident already, as I can tell in part from the sausage-eggs-and-toast breakfast we had this morning.

The FHI office itself is very nice and has a noticeably professional atmosphere about it. Jing and I are sharing an office and both have our own computers with internet access, which I was not expecting. We have been given some time this morning to e-mail our family and friends and settle in to our new office, but later today we will meet with Margaret, the Malawi country director for FHI, and other members of the staff to determine exactly what we will be doing on day-to-day basis.

Ready to Depart

2006-05-27T11:08:00.000+02:00

As the time of departure draws near, I've spent a considerable amount of time getting ready for the trip. Having traveled abroad for most of last summer, I almost feel like a pro and packing has been fairly straightforward. I leave Phoenix on Sunday, fly to Los Angeles, then London, then Johannesburg where I'll meet up with Jing, and we'll fly together to Lilongwe. That's roughly two two-hour flights and two eleven-hour flights. Oh boy.

Although the long travel time looms in front of me, I am more excited than ever to arrive in Lilongwe and start working. The recent national media coverage of AIDS in Africa (I’m thinking specifically of last month’s Newsweek and this weeks NBC Nightly News series with Bono) and countless conversations with friends and family about global health have left me feeling inspired and ready to start working in Lilongwe.

Jing Luo

Dan Englander

20 Days Until Takeoff

2006-05-09T02:46:00.000+02:00

Finals are over. Now begins the full-time whirlwind of getting ready for 12 weeks in Malawi.
I've already bought plane tickets, filled out all requisite forms and been pin-cushioned at the Duke travel clinic--where I ran into Dr. Corey, the director of the Hubert-Yeargan Center. Looking ahead,
Jing and I are headed to our orientation tomorrow to learn what exactly we will do on a day-to-day basis in Malawi. We will also meet the FHI and Duke cadres that have made our summer possible.
Then I'll fly to my hometown of Phoenix, Arizona and stay there until my flight on May 28.
Earlier this week, I learned that HYC will fund a much more substantial portion of my trip than originally expected. I'm so thankful and more ready than ever to help in Duke's and FHI's commitment to global health.