Kudya Mutu

It’s been very busy around here since my post last weekend about Livingstonia. The first part of last week I spent meeting with the Community Department at Tidziwe, finalizing the tracing form, and working on some very basic preliminary analysis about demographic trends among patients who are lost-to-follow-up in clinical trials at the UNC Project. On Thursday, the bwanas (bosses) returned from their conference in Mangochi, and I had a meeting with them to discuss my progress and plans for the next few weeks. On Friday I had a training with the tracing teams, teaching them how to collect information on the new form and trying my darnedest to persuade them that it will make their lives easier. They were clearly skeptical – but we’re piloting the form this week and I’m excited about getting their comments and ultimately having a system that actually works.

For the next three weeks, I'll finish designing a new database that follows easily from the form, and probably my last week here I'll pilot-test that with the people in data management. During this time and when I return to the U.S. I'm going to be working on a more qualitative analysis of reasons for non-compliance among female patients in particular. There are a whole lot of spousal issues that keep women from staying enrolled in studies, and I really think that’s something that needs investigating. If I have time, I'll be working with the two students here from the geography department, on a study of HIV prevalence rates by geographic area. My plate has filled up really quick… I see a lot of potential for projects I could expand during an MPH program year in a couple years, which is exciting.

On Friday (Happy Birthday America!) after the training meeting, Irving invited Emily and I to have lunch with a Malawian friend of his, Michael. We drove out to Kauma, a relatively young squatters’ village on the outskirts of town, and had a fantastic, authentic meal of nsima, rice, chicken, greens, and boiled pumpkin – courtesy of Michael’s wife Mary. They’re pictured here with their daughter Phallus (nope…not kidding…and she was named after her grandmother…) in their mini-shop that they run from the front of their home. Michael’s two sons, Michael Jr. and Clever, attend boarding school in Blantyre, and are getting ready to take their big form 8 exams – a test for which they have a month to prepare, and one which determines whether they’ll be allowed to go to secondary school. Kind of a lot of pressure for a 13-year-old...

After lunch the guesthouse crew departed to celebrate the Fourth of July at Senga Bay, on the lake. We also hopefully gave Chris a good farewell party, as it’s his last weekend here before returning to the states to begin his MS4 year. Everyone who came camping with our group had instructions to dress as your favorite American. Unfortunately, while packing for Malawi, I made a point to leave at home: a) costume pieces, and b) any items of clothing that would unequivocally distinguish me as definitively American…so I didn’t have a lot to work with. But oddly enough, once at the lake we noticed that with the exception of Chris…everyone who dressed up as Americans wasn’t American.

We managed to do the Fourth in style…grilling out, beer, and fireworks! It was a lovely time but Emily and I went to sleep pretty early…so we could get up and take pictures of the sunrise!

and the monkeys...

We had to get back early-afternoon on Saturday for the BIG BARBECUE WITH THE CONGRESSMEN. The guesthouse has been abuzz about it for a month. Congressman David Price chairs a house subcommittee called Democracy in Action, and several of the members have been on a whirlwind tour of fledgling democracies in Africa – something like 8 countries in as many days. Exactly how this promotes democracy, well, we couldn’t quite tell that it promoted anything other than extremely tired and shell-shocked congressmen. Price, Mel Watt, Brad Miller (NC congressmen) and Cooper (TN) and Capps (CA) were among those in attendance, along with their wives, the U.S. ambassador and deputy ambassador to Malawi, the head of the Clinton Foundation, and all the Peace Corps kids. Our housekeeper, Godfrey, orchestrated a fabulous barbecue of goat, beef, and chicken, along with all the traditional sides, plenty of drinks, and even Malawian dancers to set the mood!

Go Heels! Congressman Watt, his wife Eulada, and all the North Carolinians from the UNC Project and the Peace Corps.

Dr. Vanderhorst with David Price and the Ambassador

Irving and Mina with UNC Project staffers

Last night Dr. Cohen (long-time chair of the ID department, pictured above
with the Clinton Foundation director) also charged me with a new (big) project.

Fellow MS2’s…we’re building a school in Malawi. Stay tuned.

Today Emily, Kim, and I made a walking trip to the market in town for provisions.
I took a few photos of that to better qualify “town.”

I think I've mentioned "Coffin Row" before...its a street on the way into town, about a mile long, lined on both sides with coffin workshops and furniture joineries. In the years before antiretroviral therapy, they were almost all coffin-makers...but now, fortunately, you see more furniture-making. Still enough coffins lining the street to make for an eerie walk.

Sometimes you just need a coke. And coke here is made with real sugar, not high fructose corn syrup...so basically it tastes 10x better and rots your teeth out 10x as fast.

There's a phrase in Chichewa, kudya mutu, which means "thinking deeply" - although literally, it means "to eat one's own head."Its been so nice to have these couple of days to eat my own head, - to digest the events of my summer so far, and to make a plan for work in my final three weeks here. This has been a really tough trip in a lot of ways - and no I don't mean not having hot water or anything like that. From a work perspective, I just feel like I've had to be pretty independent - figure things out for myself and be a big girl about it, haha. From a cultural perspective, it’s been interesting to visit a third-world country where I really feel like a spectacle, and not necessarily a welcome one. The dichotomy here between the haves- and the have-nots is painfully stark, and frustrating at times. Not to mention the language barrier is really difficult. At least in Peru I could communicate well enough. It is a huge breakthrough though to be able to speak even a few words of greeting or thanks in Chichewa. People will be giving me a wide birth and a suspicious look when they pass me on the street, but as soon as I say "Mwadzuka bwanji?" (good morning) or "mwaswera bwanji?" (afternoon) they break into a big smile and are always happy to respond. I think a lot of time the ex-pats just make no attempt to learn/speak Chichewa, out of some post-colonial snobbishness, and the fact that you can get along most places with English. I'm sure that’s irritating to the Malawians. Anyway, I do feel like I'm fairly acclimated now, though, it just took a while.

This summer, Eve Carson has been on my mind practically every day. In particular, whenever I find myself homesick or way out of my comfort zone, I think about her travels, the way she approached challenges, and all the people she managed to positively impact in far too short a time. I’m so lucky to be here, and am trying to live every moment of my time in Malawi.

Thanks for reading this unconscionably long post...or just skimming and looking at the pictures :) Tsalani bwino.