Fine dining? Not really.

Between the power outages and temporarily living in a guest house, my home dining options have been limited. I do have a stove top, a fridge and a kettle, but these appliances are of limited use as they require electricity. I have not succumbed to licking dry powdered soup mix, but banana and peanut butter sandwiches are beginning to wear on me. It doesn’t help that Jon once showed me a video of a banana singing an annoying song, Peanut Butter and Jelly Time. The eternal repetition of that song in my head while I eat just adds insult to culinary injury.

Today, however, I encountered the holy grail of vegetarian delights: soy milk! I think that my intestines, and my dry breakfast cereal, actually applauded! Now, as you can see on my counter, my life improved significantly. Behold my treasured soy milk ($5); my breakfast staples of Bran Flakes or Special K ($8); my electric dinner of instant soup improved with fresh veggies ($1); my dark night dinner of peanut butter (not pictured: bananas); plain yogurt; instant coffee (coffee pot arrives in shipment…someday); and the ubiquitous Golden Goodness (in yellow baggie) – a type of soy flakes packaged in Zambia that often contains a few “guests” as an added protein treat!

When I move into my (and soon, our) new place on Saturday, I’ll finally be able to shop, chop, and cook for myself. Details on the conclusion of the house hunt to come…

Malawi’s new faith: Gay bashing…

On the cover of today’s “The Sunday Times,” one of Malawi’s principle newspapers, is a headline that reads, “Bingu Speaks Against Gayism”. The article goes on to note that the President described homosexuality as “as foreign culture and tradition that Malawians did not know before”. [The basis for the increased attention is a current legal battle in Malawi in response to the arrest and subsequent jailing of 2 gay men for holding a marriage ceremony. The crime of homosexuality, alone, is punished with 14 years in prison; the marriage punishment appears, so far, to be torture and life in prison].

The article continues by noting that the President, a devout Catholic, referred to homosexuality as “un-Malawian” and suggested that homosexuality is practiced by people who had Satan sitting on their heads, thus causing men to wish to marry other men. But it gets better! The Secretary General of the Muslim Association of Malawi, not wanting to be left out or presumed to hold accepting attitudes towards homosexuals, opened the Malawi Interfaith AIDS Association annual meeting by telling his fellow clergymen that “Malawi would be doomed if homosexuality is legalized”. He continued his remarks by noting that Malawi “is a purified nation” and that both “national and international disasters are caused by God’s wrath because of man’s sins such as homosexuality.” Who knew gay people had such power? The Vice-President, attending the conference, said nothing (which I consider a blessing).

The response from those in support of gay rights, or human rights, has been……(hello? anyone out there?)…severely muted. The Director of LGBT issues at Human Rights Watch did issue a letter to President Bingu urging him to respect human rights and stop the alleged torture of the two gay men while in jail. Other donors are threatening to reduce or stop funding if human rights violations continue.

The opinion pieces in the newspaper today (headline: "Human Rights Watch's Letter on Homos Is:...") assert that this letter and donor responses cross the line [colonialism!], are undemocratic [how dare they address the president and not the judges], and that these men are not human anyway [if you are not a part of the majority, you are not given rights].

The local, supposedly gay rights organization, oddly named the Centre for Human Rights and Rehabilitation (CHRR), is to hold a 2-day meeting for lesbians, gays, bisexuals, and transgender (LGBT) to discuss a road map of action to decrease stigma and discrimination. The address of the meeting is posted in the paper. Now, you tell me: how high do you think attendance will be?

The men return to court on Wednesday.

Tea break anyone?

I am pleased to announce the arrival of a real African café, The Afri-CAN Café! It arrived on the back of a trailer just 2 nights ago, and now it sits on the hospital grounds, serendipitously placed right in front of my Lighthouse office. It is an incredible example of re-purposed materials: a shipping container refitted with a laminate floor, metal chairs and tables, and a small oven. At the end of the day, they just pull back up the sides, and it’s secure for the night. Delicious muffins and scones, with less than stellar instant coffee, make for a great break in the day. The muffins are affordable: about $0.50 a piece. Instant coffee: $0.75; instant coffee with instant milk: $1. Sadly, I have yet to see any actual Africans there, but I assume that the hordes of international doctors, students, and visitors will move on, allowing the locals to sample the tasty treats. My treat for any visitors!

Happy 36 to me!

My boss announced my birthday today at the morning meeting. This followed right behind the announcement that the snake was killed, but that the security guard was unsure if the snake killed was the one in question as there were additional snake sightings over the weekend (sigh). After telling everyone my age, he asked for a babysitter for me, which I found odd. I found it stranger that multiple people volunteered for the responsibility, some of whom I do not yet know, making me slightly uncomfortable. As it turns out, the birthday girl gets a free mini pizza for lunch and the “babysitter” gets free pizza too. So, I am not as popular as I thought, but I did get a veggie pizza and a lunch companion. Beats another day of beans and greens!

Yes, I will answer to the name, “Cow.”

Today, President Bingu wa Mutharika is getting married! As the celebration is right down the road, I walked down a few minutes ago just in time to see the groom’s pre-wedding car (and ~30 accompanying vehicles) enter the grounds. I snapped a quick photo of the car – festooned with ribbons and traditional cloth created with the couple’s photo. The streets around Lilongwe (at least the ones for his procession) are newly tarred, blooming flowers line the road, trash is cleaned up, and it looks lovely. It also likely cost a small fortune for Malawi, but everyone likes a party with an international who’s who of politicians and dignitaries. I saw license plates from as far as Rwanda, a multi-day drive, and I saw Robert Mugabe's motorcade pass as well. Obviously, I was not invited; instead, I am a shut-in for the morning due to traffic and security.

Almost two weeks in, and as you would expect, my Chichewa pronunciation is deplorable (but hopefully improving). I am sure that people find my current attempts at greetings and repeating people’s names amusing. In response, I feel only slightly guilty for commenting about some people’s difficulties trying to say my name. For context, the letters “R” and “L” are pronounced similarly and often written interchangeably by many Malawians (immature expats smirk when recalling news of the election on the radio or TV). So, here I must answer to a name that sounds, most unfortunately, like they are calling me “Cow.” You can imagine the impact on my self esteem. Moo.

Despite my newly-acquired bovine status, work is going well. I’ve been shadowing coordinators and department directors learning about Lighthouse’s testing, treatment, and care programs for HIV and TB. It is incredible to briefly observe what these professionals encounter repeatedly every day. For instance, I sat in on an afternoon with a nurse during follow-up ART (anti-retroviral therapy) visits. These typically-quick visits are used to resupply individuals with their meds, verify pill counts to gauge adherence, and inquire about side-effects. She saw over 20 patients the first hour: 3 children under age 6; 5 adolescent girls; 1 teenage boy; and adult men and women of all ages. Complicated cases were referred to an on-site clinician (equivalent to a physician assistant). By the time the 4th young girl, age 14, walked in, I thought I would cry. It is not that I don’t know about the high HIV prevalence among adolescent girls (up to 5x the rate for adolescent boys), it’s just the overwhelming difference between reading the statistics and seeing the individual faces. To cover my face for a moment, and suck back tears, I glanced at one young woman’s chart: she tested HIV+ at age 16, already at WHO stage 4 (translated: fairly close to death) and weighing 28kg. Now, 3 years later, she is asymptomatic, 58kg, and looks beautifully healthy. The miracle of ART!!! For another much-needed dose of optimism, you should read about one of Lighthouse’s most amazing accomplishments: the adoption of an electronic data system (which we still can’t do in the States) . It makes me feel very lucky to be a part of this place.

A quick glimpse at Red Dog’s acclimation

Today, I received a sweet story from my mom about Red dog’s progress adapting to life in St. Louis. Two days ago, when she and Red were out for their morning walk, a gardening crew was working in front of a house down the street. They were pulling out some awful-looking, mostly-dead ground cover that they put in last year. Red sniffed around for a second, and my mom chatted with them about the unfortunate demise of the plants. Yesterday, when they walked back by the house, the same crew was laying grass sod -- the kind that Red loves -- and she proceeded to roll…and roll and roll and roll and roll! The gardeners were equally amused, egging her on and encouraging her to pay special attention to pressing down the seams. By now, she is now happily back on the couch ensconced in pillows. Sadly, if Red were here, she would have likely been eaten by the guest house’s angry, mange-ridden Rottweiler.

“You’re welcome to Malawi!!!”

After five weeks of frenetic preparation, 1000 pounds of goods shipped, and 48 hours of transit, I’ve arrived in Malawi – my home for the next two years. For those of you who do not know, I’m the new Monitoring and Evaluation Technical Assistant at Lighthouse Trust – Malawi’s only integrated center for HIV prevention, treatment, and care. Although I will actually be employed at the University of Washington through their Global Health Department’s NGO, I-TECH (International Training and Education Center for Health), I’ll be working with a team of 9 members of the Monitoring and Evaluation (M&E) unit, reporting jointly to the Lighthouse director and the I-TECH Country Director. It is a pretty ideal position for me – finally able to put all those years of sterile academic prep to use in the field. Plus, considering that the estimated HIV prevalence in Malawi ranges from about 4% in some rural areas to over 30% in some urban pockets, I should be able to truly make a difference. I’m excited! I might be a little scared too.

A few quick glimpses into my first few days:

• Photograph: a "typical" vegetarian meal at a restaurant. Hmmm. That's ketchup in that bowl, not soup (and, no, I did not ask for it).
  

• My temporary lodging at the guest house is fine (with terrible internet access); my coworkers are eager (almost desperate) for me to begin work; and, in the 2 years since I was here, there’ve been all sorts of important developments like the arrival of soy milk, green curry, and tahini! Oh happy days!
  
• Thursday, I woke at 6am to the loud knocking of the guesthouse caretaker. I crawled to the door, only a few hours after I finally managed to fall asleep, to hear that my ride was here – 3 hours early. As I walked out the driveway towards the waiting car, the driver saw me and called out, “Not that one! A different white one.” Nice. Let’s hope the dawn parade of expatriate women will not continue.
• On my first full day in the office, Friday, the entire 60-member clinic staff held a special introduction meeting. There are several dozen major linguistic groups in Malawi, but English is spoken almost everywhere, and my work will be conducted entirely in English. All the Lighthouse staff also speak Chichewa -- the predominant language of the central region of Malawi. Although the meeting was conducted in English, the concluding remarks were in Chichewa, punctuated with an English warning, “SO BE CAREFUL,” followed by a communal gasp. From the language change, I assumed the comments had something to do with me. Luckily or not, the Director believed that the closing comments merited English translation and calmly repeated, “A black, Puff adder snake has been spotted several times in the building and in the garden. It is highly venomous, SO BE CAREFUL.” Then, he turned with a smile and said to me, “You’re welcome to Malawi!”
  

And that’s week 1 in Malawi.