Exploring my surroundings

So many things!

In my quest to see/ hear/ smell/ taste/ explore as much as I can possibly can around me here in Malawi, these past two weeks have been packed pretty full.  I will try my best to give a brief synopsis of what I have been up to.

Thyolo District Hospital:
I went with the ICEMR research team on one of their visits to meet up with the Malaria Coordinator, the DHO (District Health Officer) and the DMO (District Medical Officer) in order to introduce myself and explain the project that I am working on.  It was an excellent visit, despite the FREEZING cold rain that lasted all day.  When I'm in the field I wear long skirts like the other women on the research team, and this time brought along a chitenje (fabric traditionally worn by women wrapped around the waist as a skirt) just in case I needed an extra layer. Definitely a good idea since the unusual winter rains eventually soaked through most everything. The turnout by patients in the hospital even reflected the weather, having only 5 patients presenting with malaria and almost no new patients after noon.  The majority of the day was spent escorted around by a clinical officer named Oswald after the morning handover meeting (which was mostly spent outlining the new treatment procedures for ART's starting the first of July). During the slow times Oswald and I chatted about differences in dating customs, who he will vote for in next years presidential campaign, the rivalry between the local football teams (Bullets and the Wanderers) and how nsima completes every meal like no other food. Another entertaining and productive day in the field.

Satemwa Tea Estates:
Wow. That's all I can say.  We had driven past the tea plantations on our way to Thyolo and Mulanje, but seeing the endless fields of bright green tea leaves contrasted to the red earth was truly breathtaking. The girls and I drove out to the Huntington House, built in 1928 and managed by the same family ever since.  Originally a tobacco farmer, the owner brought over the first tea plants in Malawi. We took a tour of the picnic grounds at the very top of the mountain on which the tea is planted before heading down to the house, now a fairly exclusive and ridiculously beautiful b&b, for high tea.  We brought our fancy skirts particularly for the occasion :) It's not very often that we get dressed up around here so being lady like and sipping on 3 kinds of delicious tea, scones and cream, finger sandwiches,  cookies, and coffee seemed to be as good excuse as any.  I loved touring around the old house, and of course the food was absolutely exquisite.

Carlsburg Brewery Tour:
Every Wednesday at 2pm there is a free walking tour around the local brewery in Blantyre, and FINALLY everyone had a free afternoon to go explore.  The tour... was a little suspect. Our guide seemed to want to rush us pretty quickly through places that I'm not entirely sure we should have been walking through. But it was totally entertaining, and it ended with a beer tasting, aka drink as much as you can until they kick you out at 4pm.  We got our fill of greens, special brew, and kuche kuche while bonding with the Canadians who also showed up for the tour.  They happened to be on a 12 month tour of Africa and Asia, and before we knew it we had invited them on our Mount Mulanje trip for the upcoming weekend!

Mount Mulanje Camping Trip:
This is what I have been waiting for :) It's taken a few weeks of planning and sorting out, but last Friday Abbie, Dee Dee, Evan, Jenna and our new Canadian friends Cat and Germie were on our way for a three day, two night adventure on the Mulanje Massif. It's this gigantic mountain with 20-30 peaks and a dozen or so huts on top that you can stay overnight as you explore around the plateau.  A 4.5-5 hour hike got us to Thuchilla hut, where we set up our base.  Thankfully no other hikers were using the hut besides us, allowing us 7 to somehow fit onto the 4 provided mats and 5 sleeping bags we brought, all lined up on the floor in front of the fireplace to keep warm. The following day we hiked to the summit of Nadalanda peak, at 8,558 ft. Hi lights included breathtaking views, squeezing through a fairly small crevas, and having the best picnic lunch on the peak as clouds began to roll in.  That evening we shared our site with 15 Scottish high schoolers working on their Duke of Edinburgh award (they all had to tent camp, thank goodness for us and our 4 mattresses... not sure if they would have spread that thin lol). Loved chatting with them around the campfire and feeding off their excitement.  Our final day was spent hiking down the way we came just in time for lunch at Mulanje Pepper, where we celebrated with pizza and delicious fanta. Despite some sore legs, everyone agreed that the weekend was a success :)

Blantyre Malaria Project

This post is probably way overdue, but it took a bit to get my bearings here at work and to fully understand my part in this gigantic malaria project.  I will do my best to outline the work being done here and the role I have been given, for those enquiring minds that have been wondering what exactly I'm doing on the other side of the world.

The huge project that I am part of is called the Malawi ICEMR (International Centers of Excellence for Malaria Research) and is headed by Terrie Taylor, DO at MSU.  This is one of ten regional sites throughout the world that has been granted funding from the NIAID (National Institute of Allergy and Infectious Diseases) in order to address malaria as a global health concern.  Specifically, the Malawi ICEMR is working to identify, understand, and evaluate interventions that target the determinants of malaria disease. The hope is to target these by tailoring specific prevention and control strategies in specific seasons and geographic locations as well as outline parameters of evaluation the impact of such strategies.

Ok, so my part in all of this.  I report to Atupele Kapito-Tembo, a PhD in epidemiology, to establish an intervention database.  There are many different organizations throughout the regions in our study (Chikhwawa, Thyolo, and Blantyre) but little is known about their impact on the malaria incidence, which interventions work best for each region, and what percentage of the population is being targeted ect. The first few weeks that I was here started a bit slow, working to finalize the questionnaire that I will eventually use to collect all the information that we are looking for.  While waiting for revisions and comments on our work, I continued to gather information from other branches of the project in order to better understand how it works as a whole.  Aside from visiting the Chikhwawa District hospital, I also rode along with another student collecting data from houses in Blantyre (they are interested in the distance a house is from agricultural or animal husbandry and its relation to malaria incidence) and helped with PCR work in the lab (tracking the life cycle of the malaria parasite in blood samples taken throughout the region). It was incredibly interesting to me to see each piece of such a large project, all working independently yet the data collected all being used to answer overarching questions.

From here on out, my primary task is to meet with the malaria coordinators in each of the three districts, compile a list of all the malaria projects within their area and the contact persons for each.  Then the scavenger hunt begins to track each of these people down and administer the questionnaire we have finalized.  Finally, the data that I have collected I will then add into the project server, to be used for epidemiological tracking in order to better understand how the interventions are working throughout the region.  I am really excited to be working on a project with such an amazing network of students, doctors, researchers and professionals within the public health field.  I'm looking forward to what the next month brings as I set about completing this project!

Entrance to the Chikhwawa District Hospital

Malaria RDT (Rapid Diagnostic Testing) room

Making notes in a patients health passport after RDT

Pediatric unit check in

A Clinician in the pediatric unit

Courtyard in front of hospital

Malawian Life Thus Far

So, there has been some pretty exciting happenings here for me, (unexpected road trips, field work, ect.) but I decided I wanted to write a bit about the area that I'm working and living in first before sharing all the extras :)

For those that aren't aware, I'm currently living in Blantyre, Malawi on a road with no name down the street from Queen Elizabeth Central Hospital.  As a matter of fact, most places here have no street addresses, much to my google map dismay.  The only way to get where you need to go is through elaborate narratives from someone who has been there before.  "Oh yes, you get to the main road, take the roundabout, when you see the concrete sign obscured by the small tree, veer left then take the third house on the left.  If you hit the train tracks you have gone 4 streets to far..."Ooookay. 

Immediately upon arrival, I was introduced to other students working on MPH or PhD's through the ICEMR project.  Most, but not all, are from University of Michigan or Michigan State working on different parts of the malaria research (due to the fact that Terrie Taylor is a main contact  here).  Together we make up a psudo family that works to help each other figure out life here in this country.  It's actually a great system, because as new arrivals become the veterans, we can pass on all the knowledge we have gathered and give it to the newbies.  

My daily routine thus far consists of waking up and walking over to the other guest house across the street, where the other students are living.  I make coffee and breakfast as they finish getting ready then we walk to work together.  I work at the MAC (Malaria Alert Center) within the huge medical complex that surrounds Queens.  It takes about a half hour to get there, passing an intricate web of clinics, patients and families out on the grass, medical students passing by, and the ever present roosters, chickens, and crows looking for scraps of food.  

At lunch I often head over to a cafe to meet with the MPH students, talking about how the research is going and what is planned for the evening.  Once work is done for the day I head back to the guest house where (if there is no power cut) we use the internet/ chat with family and then spend the evenings playing games and all around entertaining ourselves in ways only public health nerds can :) 

After I have had my fill of Pandemic or hearts or viewings of various movies people have brought from home, I head back over to my side of the street.  This often involves having the gateman walk over with me, as I check to see if I have been locked out.  If not (yes!) I jimmy the gate open and wake up half the guard dogs in the neighborhood.  If the gate is already locked (NO!!) I have to bang on the door until I wake up the guard (who comes with keys and a machete) and ALL of the guard dogs in the neighborhood.  Yeesh guys, I do this every night.  You would think we would get a better routine down by now lol. 

Obviously there are variations on this theme as different opportunities pop up, but you get the gist.  Also for your reading pleasure, here are some of the things that I have discovered during my time here in Malawi:

Power outages are frequent, mostly occurring at 5:30pm (when people are getting home and they switch on their lights) so if I am in the middle of a gchat/video chat convo with you and it all shorts out around this time, that is why lol.

People here do not run here for exercise.  According to Terrie it is thought of a huge waste of precious calories and they will often make fun of you as you run down the streets.  True story. 

I am a mzungu.  This chichewa word refers to a white person, but after a little research I have also traced its origin  back to "someone who is ever moving around wanting to see everything" because that was the way Europeans would act after arriving here.  I'm ok with this label, this seems an accurate description. 

My name here is SaLah. It is apparently common to switch r's and l's in words so when someone asks my name, they first think I'm saying Stella, then realize "oooh, Salah!"  I found this to be way more deep rooted than previously thought when spotting a sign that read "Grobal" instead of "Global" on my way to work.  

That is all for now!  Will be posting more soon! 

Me on my visit to the Chikwawa District hospital, more on that later

The road I live on

The MAC where I work (yes there are roosters in this pic)

The view on my way home from work

The usual suspects when I talk about hanging around with the MPH students :) just after a brunch outing

Traditional Malawian meal, Nsima with pumpkin leaves and beans

Ndasangalala!

Ndasangalala! My new favorite chichewa word, which means "I am happy!" I have officially been on the African continent for about a week now, and remembering my promise I will attempt to fill you all in on my adventures thus far.

I began with a flight from Detroit to Amsterdam sitting next to a church group headed to Cape Town for some mission work (and the guy sitting next to me actually was from Michigan and knew where Wayland was!), where I didn't have much of a layover and headed to Cape Town. Before long on my second flight I began to piece together that the guys sitting next to me on my flight actually happened to be the camera men/ divers that produce SHARK WEEK! So excited, they gave me their business card when I mentioned I had visited quite a few places in SA that the were going to shoot and said they would let me know when the footage aired.  So my trip was off to an excellent start meeting quite a few interesting people on the commute :)

I stayed in Hout Bay, Cape Town for the next three days with Rob, a very good friend I had met before while living there. He was gracious enough to act as our driver and social events organizer while crashing in his cool mini apartment (used to be a horse stable) off of his parents house.  Was able to catch up with coworkers in the city center to check out their new office space, show my cousin Sajel around town, see some friends at the Hout Bay market, but most importantly, get some quality time running in the mountains!  On Saturday JT and I woke up before dawn to get a jump on the day with a 3.5 hour run starting from East Fort and heading over the mountain.  I felt as if I hadn't ever left, all the life and energy returning.  I am fairly certain I had a grin plastered across my face the whole way.

After Cape Town, I headed to Lilongwe, Malawi via Johannesburg.  The plan was to catch a bus for the 5 hr ride to Blantyre that day, but customs took ridiculously long and I missed the bus, meaning I had to book a room at a guest house and find transport in the morning. Fortunately I made friends with an Engineers Without Borders volunteer who helped me find a place to stay and a sim card for my phone so that I could get word out to my office here that I would be coming the following day.  In an act of serendipity, I met a woman from Massachusetts who had hired a car to take her to Blantyre the next day and offered to give me a ride! So I was able to ride (relatively) hassle free in a stuffed full car across the country (on the way I found out that when our driver stopped to drop off some food for a family friend we were introduced to a woman who was one of the first social activists in Malawi!) and finally arrived in Blantyre Monday night .  Terrie Taylor, the lead on the ICEMR project here, invited me and a few others for dinner at her house that night to welcome and introduce me to some other researchers working here.  It was an amazing experience to be able to sit down with such a legend in the Malaria field, I feel extremely privileged to have had the chance to interact with her on a personal level.

As of now I have been on the job only two days, but feel optimistic about the work that I will be doing.  I feel like it will take a whole post in itself to describe the project and my part in it, so I will save that for later. Until then, know that I am settling in well and can't wait to sit down and write more about the place I will be calling home for the next two months :)

Hout Bay at last :)

Saturday morning run in the mountains 

Village on the way from Lilongwe to Blantyre

Sunset on Lion's Head overlooking Cape Town city center

Produce in Malawi

Sunset from the guest house in Blantyre