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