Lunch

I'm really bored, so I'll just also mention that I had fun shopping in a local market today for fresh veggies. Got an eggplant, green onions, a red onion, a tomato, a carrot (sweetest one i've ever had), two green peppers and a little orange spicy pepper for less like 70 cents. Yum! Don't worry, I will wash and cooked everything thoroughly :).

Malawian lady near Nkhoma mountain

i'm the hyena

Much awaited pictures

Today was short, just went to Mwachipa to visit the ECD program. Played games like the goat and hyena with the kids, showed off my traditional dancing skills and learned to count to five in English :). Then the team dispersed to get ready for our trip to the lake tomorrow. We are bringing 2 live chickens to slaughter when we get there ... I will be eating beans.

Reveren

Dropped Matt off at the airport yesterday. Very sad to have him go and also to have my plane leave without me. In many ways it feels like I should be going home, especially since my classes technically start tomorrow. Also I really miss tofu and frapaccinos. Due to this never ending IRB process, I've extended my stay until September 18th.

Before heading to the airport, we spent a couple of hours at children's corner. I was happy to have a break from teaching activities. This time I just took pictures and videos :).

Today I went to church with Alton. It was wonderful, very small and simple - just brick walls, a dirt floor and a thatched roof. The choir of 5 sounded more like 100. Went to his home for nsima, eggs and greens. His wife was really happy to meet me and was very sweet, about half my size!

Hoping to have good news tomorrow.....internet cafe is closing now.

Soil Village

I can't remember the Chichewa name of the village we went to today, but it translated to soil village in English. Interestingly, KASO has a center at Fumbe (dusty) village as well. We held a community meeting to introduce KASO to the village leaders from several surrounding villages and a large group of men, women, and children (actually 3 separate groups). The people were very excited about the programs, especially the Early Childhood Development programs which they hope will allow their children to have an advantage once they get to primary school. They kept thanking Matt and I, which was a bit awkward because we were not really doing anything for them. They kept telling us, though, that we were the first white people to ever set foot in soil village.

On a side note- the biking to this village was awful. It was an hour away totally uphill (nice view from the top!) and up two major highways before getting to the nice safe trails. SCARY!!!

Anyway, it has been interesting to see the beginning stages of a community development project, especially one that is completely grassroots (run totally by and for the local people). It was amazing to see how excited the people were about the programs. The KASO volunteers made a point of emphasising community ownership, how KASO would provide the necessary resources (paint, materials for ECD, group therapy, etc), but that the community development committee would need to arrange for the local volunteers to run the center and to coordinate the production of bricks and the building of the center itself.

Yesterday, Matt bought some building materials to donate to KASO. He was really frustrated to see that they were struggling with, for instance, a level that only had one functioning bubble. Today was pretty funny. The arm of his bike pedal came off. So, he, Alton and Jonathan spent several minutes backtacking to find it and the bolt that came out. They used a rock to attempt to fix it. After saying "this will probably hold for about 30 feet" the pedal came right back off after about 10. This is particularly funny because my bike has been fine this whole trip and yesterday Matt's seat fell off AND his brakes went out. Now...I'm pretty sure my bike is the only one with brakes. Anyway today he was pedaless and brakeless and was flying down a hill
when along came a whilrwind (like a dust devil out west...kind of like a dirty haphazard small tornado) and he flew right into it smack dab in the middle of an intersection. I've seen a few whirlwinds by now and this one was serious...really dark and strong and thick. He actually dissappeared for a minute and I thought he was going to be spit out in Kansas. He was fine, save for a few scratches from flying rocks. I haven't stopped laughing.

Bricks

Quick Update: At the end of last week I got sick with a fever and body aches. I don't know what was wrong with me, but I felt bad for a couple of days and am fine now. Since I'm still waiting for approval (i'm incredibly sick of writing that), I have been helping to build a kitchen for one of KASO's centers. Went to the lake yesterday and finally swam :). Tomorrow we are travelling to the site of a potential new center and will hold a community meeting to introduce the concept to the village leaders and to the community.

week 4

Wow, I've almost been in Malawi for a month! Time to renew my Visa in the next two days.

Some highlights from the last week-

Early in the morning on Friday Jonathan's daughter (9 months old) died of Malaria. It was a pretty big blow for the whole research team, so we took the next few days off. I know that the infant mortality rate here is high, but I think it was the first time that I personally knew someone whose infant died. Unfortunately, white people are such a spectacle in the villages that the team decided it would be best if matt and i did not attend the funeral or the burial.

So, Saturday Esau took us to Nkhoma mountain (there was no children's corner because of the funeral). The mountain was gorgeous, rolling moutains and grasslands as far as the eye could see. We climbed to a pretty high peak, saw some lizards, had some ash blow into my mouth from a fire far far away. It was really dissapointing, though, to think of the rest of the research team burying Jonathan's child while we were up there. Jonathan was the children's corner coordinator, so all of the kids from all of the villages came to the service. I used some of the donations I received from people back home for nutritional support to buy nsima and vegetables for the kids who attended.

Sunday was the burial. I convinced matt to brave the minubus system with me. We caught a minibus to Salima where we saw the lake. The best parts were running out of gas, the frankenstein sew-up of the super cracked glass, and the fact that we missed the last minibus back and ended up stuck overnight, having to get up at 4AM to catch a bus back in time for Monday.

This week we've been doing things like printing the documents so we're ready when approval finally comes through. Today we visited Jennifer, someone i worked with here last time and who has been very sick. We brought her some staples like cooking oil, eggs, tomatoes, hand soap, washing soap, pawpaw and tangarines. She was taking care of a baby who looked to be about 10 months old. I saw his full set of teeth, though, and then asked how old he was. He is two years old, can't walk, can't talk, tiny, absolutely beautiful. I so wish I was doing my research right now...

Tomorrow we're rebuilding one of KASO's centers that has fallen apart in Yapa Village. We're going to paint and make bricks and try to help get things going again... Then Friday we're touring Baylor Pediatric AIDS Clinic and visiting the Grassroots Soccer rehearsal (a program that teaches kids about HIV/AIDS while playing on a sports team). Saturday is children's corner.

...next week begin data collection????

Sorry for the lack of updates- internet stinks. I've spent all my internet cafe energy working on my proposal (clarifications for the IRB in Malawi).

still waiting...

Well we did get the letter finally on Monday afternoon. Unfortunately, they needed some clarification on a few issues. I am waiting on a letter from a collaborator and then I'll be able to turn in the corrections for expediated review.

In the meantime....we are visiting the villages to let them know that we are delaying the start date a bit so that they don't think we abandoned them.

Monday

Today is Monday, the day that the chairman said he would have the minutes approved so that he could give me the go ahead (or not...we may have to make changes) to start collecting data. I can't remember the last time I was so anxious about something. A week of hoping that everyday is the day they'll approve my study has built up some terrible anxiety!

Since I'm sitting in a cyber cafe killing time until my driver picks me up and I really have nothing to report on my project, I'll just fill everyone in on what I've been up to. I'm thinking of this weekend as the beginning of Malawi part II - new lodge, new friends (Matt comes today!), and if all goes well today.....actually starting to collect data!

Tiane and Kim left about 36 hrs ago, so technically I've been by myself. I moved into a new lodge yesterday morning and now I'll be staying in a dorm-style room. It's much less roomy and the breakfast is less exciting, but it's a lot cheaper and the bed is comfier :).

Yesterday was dreadfully dull. Nothing in Lilongwe was open so I started reading a terrible romance novel (the English choices at the lodge were Chaos and Cupid or Oliver Twist). I can't believe I didn't bring any books to Malawi, I guess I forgot how much waiting there is to do here... Luckily Richard is bringing me some books to borrow today. I did meet some interesting people at the Lodge yesterday. A group of 10 of us went to dinner last night. A business man, some adventurers and some world changers (I'll post more about our conversations later).

Saturday Tiane, Kim, Mr. Hakamada and Mr. Noda (the Japenese guys we met at Korea Garden Lodge) went to Kuliani village for Children's Corner. Since we didn't have enough bikes for the guys, we hired two bikes. I rode one on the way into the village. It was great! I wish I could travel like that all the time, very comfy seat and the driver was much better than me at biking through rocks and potholes. Also they only charged us like $1.50 to go several kilometers (we gave them more).

We taught the older kids how to do the human knot again. They also taught us some Malawian games. And Malawian versions of games like volley ball (you can use your feet). I can't wait to teach some American kids the hyena goat game that I loved (I got eaten). I also taught them Red Rover b/c it was my favorite in elementary school. They also seemed to really like hang man (why are all my games violent???). We enjoyed sharing KASO with Noda and Hakamada, the volunteers there demonstrate a side of Malawi that many people do not experience. That the organization is totally run by local volunteers sets it apart from the development projects foreigners facilitate.

Once again, nine o'oclock has become ten and I am still waiting for my driver......Maybe I'll get used to Malawian time before I leave. Picking up Matt at noon!

Teaching the kids Red Rover

Taxi service

Malawian tug of war game at children's corner

dinner

Waiting for chicks to hatch

On Sunday we held a pilot study. It was really exciting to finally see the project in action! We conducted the pilot in four households in Kuliani, Alton’s home village. Each KASO volunteer conducted an interview, Tiane and I took the measurements, and everyone used our pilot checklist to evaluate each other’s performances. The interviews went well, especially the participants’ willingness to share information. The interviewers were not quite as familiar with the questionnaire as they could have been, so a few things got mixed up.

For instance, I knew something was wrong when a couple of the questionnaires indicated that the child had consumed every possible kind of food except milk in the past 24 hrs. I thought the people were just trying to impress us and decided that we needed to do a better job on briefing the participants on the importance of providing honest answers (although it’s already part of our introduction).

Yesterday when we held our pilot evaluation meeting, Charles had summarized the major problems and indicated that what actually happened on the diet recall section was that one person had asked what the child had eaten in the past 4 weeks (the timeframe for the food security section) instead of 24 hours.

We discussed all of the sticky spots we’d uncovered during the pilot, everything from how close to sit to the person you are interviewing to not reading the section headings before questions. Yesterday, the interviewers practiced interviewing one another.

We are all ready to get started, just waiting on the National Health Sciences Research Council to give us the go ahead. They met a week ago, but we’re still waiting on them to finish up with the paperwork.

Today Charles and I met with someone at the council. The minutes from the meeting have to be approved by the chairperson before they will tell us the results. Apparently there is a 50% chance that we will have to do some revisions on the proposal before we can get started with data collection. So, we wait. Charles says I must be as patient as a chick waiting to hatch.

Gule Wamkulu

riding in an ox cart

Preparing for the Gule Wamkulu

Children's corner bracelets

Sunday August 2nd

Today was Sunday, so the original plan was to have the day off. Since we had a very low turnout for our community meetings at Malimbe, however, we decided to go back for a second try today. Unfortunately when we arrived only the ECD coordinator was around. Four village chiefs and several women eventually arrived, but in the meantime they told us to wander around the village and take pictures of interesting things. Such interesting things included a couple of child driven ox-drawn carts, a huge potbelly pig, some little girls who wanted to hold our hands and some ladies carrying things on their heads who wanted their pictures taken.

When we came back, enough people had congregated that we could have the meeting. This was the 6th meeting and pretty much ran exactly the same way as the others. The only question asked was “when will the consent forms be given.”

As Charles put it, one of the chiefs finally admitted that the reason there were still very few attendees was that there was another funeral, complete with Gule Wamkulu. One of the running jokes in our group is that I am dying to see some Gule Wamkulu. It’s true, I’m fascinated. So, when they said that our audience was all at this funeral, I jokingly suggested that we take the meeting there instead. No problem, they said, we would just ride by on our way home.

Halfway toward the funeral village, Alton made a couple of phone calls. Before we knew it we had a full chief escort. At the village, the headman for 22 villages greeted us and introduced us to a lot of other chiefs. He also told us that we were welcome to take any photos or videos that we wanted (apparently that was really special!!!). The chiefs were all very thankful for the research project, as was a hopeful candidate for Malawian parliament. They insisted that we wait for the cemetery procession inside a house (where a distressed chicken was squealing under Tiane’s chair). We joined a group of hundreds of people in parading around two graves, one for the mother of the one we were grieving, and one for the one the ceremony was for. Interestingly, they were buried in 2007 and 2006. The ladies were all crying hysterically (as were their babies). So, it was not really a funeral, but a memorial service. Next it was time for lunch. We bought some chips (potato wedges) and fanta. The chiefs wanted to feed us nsima, but decided it was too cold to serve to visitors and brought us more chips and fanta.

By the time the big dance started, we had been at the funeral for a few hours. The big dance finally started with a few drummers and ladies dancing. Charles suggested that we go up and put 50 kwacha in the plates in front of the ladies and dance with them for a bit. So, we decided what the heck, so what if we look ridiculous? And we danced….. the crowd roared with laughter. They were cracking up. We made 25 kwacha each from amused onlookers. Later the volunteers told us that the crowd consensus was that Tiane was a much better dancer than me, but that by the end I was getting better. They said the laughter was not because we were terrible, but because the people had never seen azungu dance (I’m pretty sure it was both).
The most exciting part was the bike ride home. I am very happy I lived through it. We left at 4:45, just as the sun was beginning to set and were trying to get back to KASO before dark. So…..we biked as fast as we could through a mass crowd of people leaving the ceremony and over some really treacherous trails. I wish I had a picture, but it was all I could do to maintain control of my bike. I screamed a lot. It felt like driving a car on a video game when you’re trying to avoid all kinds of impossible obstacles, sand traps, people, hills, bumps, rocks, boulders, mud, holes…. but end up hitting most of them. My heart is still racing.

Made it to KASO exactly at dusk and back to the lodge at 6:00, just when the Japanese man next door said he would take us to Don Brioni’s for Italian.

Saturday August 1st

Today made me dizzy. It was children’s corner again, a program during which kids from ages 2-18 come to each of KASO’s five centers for developmental activities, socialization and a nutritious meal. Last week, we basically wandered around in awe of the program and the multitude of children in attendance, joining in to learn traditional dances or to play house with ECD as we felt compelled. This week, though, the volunteers had been really anxious for us to prepare some programs for the kids. Despite a full resume of babysitting, daycare, and youth group leadership experience, I found the task utterly overwhelming. Although I admittedly forced my result on the Meyer’s Briggs during my first leadership class as an undergrad (striking what I saw to be the perfect balance between being an introvert and an introvert, not I, not E, but X), I am an introvert (that just means I re-energize by being alone). Just being surrounded by a couple of hundred small children is totally overwhelming; add to the sheer volume of kids a set of language and cultural barriers and I am completely dumbfounded with what to do with them. Since April, I’ve been working on informed consent documents, IRB proposals and questionnaires, hence the task of entertaining dozens and dozens of kids was way out of my comfort zone.
Tiane and Tutu had brought along some glow in the dark string and beads, so we decided an easy project would be bracelet making. The kids loved it, but it was one of the most stressful things I’ve done since getting here, trying to hand out string and beads to that many kids. Then there were seemingly endless lines of late arrivals…kids dropping their bracelets…etc.
We taught two more activities, the human knot for ages 13-18 and duck duck goose for ECD. The human knot activity came after Charles (lead researcher for KASO) led a discussion and game on how HIV and AIDS affects poverty. During the game, the kids all took off a shoe and set it in front of them as a “parent.” Then, they ran around in a circle while “AIDS” killed some of the “parents.” Charles would yell “nsima!” (the staple food) and each kid would have to find their own or another parent (if theirs had died). The game was supposed to demonstrate how quickly the death of a few parents can lead to extreme economic burden on communities.
Anyway, the human knot went fairly well. There were so many teenagers that we had to do 4 separate groups, but at least 2 of them where able to complete the untangling. Duck duck goose was entertaining. I tried to ask Maria how to say goose in Chichewa, but she didn’t know what I was talking about. I had learned the words for chicken and duck, so we played chicken chicken duck instead. Nkhuku, nkhuku, bakha. My favorite part was that when we told the kids that if they got tagged they had to sit in the stew pot they sat in the middle stirring stirring stirring until the next kid took over.
In preparation for next week, any ideas of games or activities for kids ages 2-5, 7-12, or 13-18 that involve no props or resources, include dozens of kids and can be done in a small space would be much appreciated!
We’ve been spending a lot of time at the local markets, buying fresh veggies (ones that we cook for a looooong time), fruits (only ones w/ thick peels!) and rice. Today I also got some kernels for popcorn. Esau (our driver) asked if I had something that started with a W. I told him I had no idea what he was talking about. So, he pulled me back into a little shop and asked for this something that started with a W. The clerk laughed and brought out a large round woven plate. Esau dumped my kernels onto the round plate and tossed them around. Corn husk debris flew. It was a pretty efficient way of cleaning the kernels! Unfortunately when we poured the kernels back into the bag there was a hole, so half of them spilled on the floor.

Friday July 31st

Yesterday we had a great turnout for our last community meeting. Since a number of KASO volunteers live in Fumbe, the community was eagerly anticipating our arrival. Three village chiefs and a village headman (overseeing a number of villages) as well as many men and women were in attendance. As usual, the KASO team did a fantastic job of covering everything we had discussed –purpose of the study, voluntariness, and confidentiality- (Maria translated as the presentations were made in Chichewa). One aspect of the familiarization meetings that has fascinated me is the genuine interest of the volunteers to make sure that the people truly understand the project. Prior to beginning the community meetings, we had long discussions about presentation. One concern I raised was that people might be afraid of the word “research” and that we might want to use softer language- like “program” or “project” to convey what we were doing. However, the volunteers instead wanted the people to learn that research is not something scary, but something helpful to their community. So, they have taken a lot of time to explain not only what our project is, but to define “research,” dispelling myths that all research involves needles or “blood sucking.” It seems to have gone over really well.
My favorite question yesterday was, “what if a woman is very willing for her child to be researched, but has no child between the ages of 2 and 5, will you still allow her to be included in the research?” Charles answered the question by posing a question back, “If a boy wants to be a part of Gule Wamkulu (big dance), but has not yet reached the age of initiation, can he participate?” He continued with an explanation of why we can only look at kids between 2 and 5, but the comparison worked perfectly. Even in our research group discussions, the answers to many questions begin with “in Malawi, we have a saying….” Such as “you may go to the lake to see the lake, but you may find a hippo.”
I’ve learned tons more in the last week and a half than I did the entire time I was here before. Some of it is cultural, like the way that Malawians cup their hands when clapping for a chief. I am also learning from the way things have changed at KASO over the past few years. As an undergraduate I wrote a paper about the influence of the community mindset (found in most non-western societies in which people think of themselves as a part of a whole, as opposed to the individualistic American mindset in which people think of themselves as the whole) on the HIV/AIDS epidemic. Having heard such sayings as “HIV is in the nsima” I thought that it would be very difficult, once HIV had invaded a community, for individuals to formulate personal health beliefs that allow for the projection of outcomes that are separate from the health of the community as a whole (ie: that even though some neighbors or family members might be infected, they could prevent HIV).
I am very happy to say that I have changed my mind. The people we are working with believe that, as a community, they can stop the spread of HIV. There is a sense of empowerment in these communities that I did not see three years ago. One of the most obvious differences is the number of people who are on ARVs. In 2006, I participated primarily in home based care for people who were so sick that they were home-bound. Now, the number of people who are seriously ill has dropped dramatically. So, people are hopeful rather than helpless. Interestingly, I have heard people argue that access to free ARVs will dampen prevention efforts because people will no longer see HIV as a killer. On the contrary, I see access to these drugs as giving communities a degree of much needed control over the epidemic. Where once HIV was a death sentence, the realization that the virus can be, to some extent, tamed, is allowing for more open dialogue and the perception that health outcomes can also be changed. Of course, this is just my small take on an epidemic that is ravaging a huge proportion of the continent…but I find these to be hopeful signs.