Malawi Madness

So Malawi is a bit different than expected. Work is a little frustrating but the country is GORGEOUS. So the first day I went to work, I wanted to figure out how Andrea and I could be in more control of our project. I suggested that we pause the interviews that are being done and that Andrea and I go (and Matt too of course!) to Mangochi, where the interviewers are located. The understanding was that the interviewers speak English but aren't computer literate so we would be typing up the interviews as they articulated to us. We were told that we were going to be staying in a Guesthouse at the College of Medicine. However, after driving 4 hours to Mangochi, we found that the Guesthouse was full to capacity. We had been instructed to bring EVERYTHING that we had taken to Malawi on this trip so we had a ton of stuff. Instead of that hostel, we were driven to some other place that would have been fine if I didn't have almost everything I owned with me. So then we ended up staying at some fancy hotel instead but we split a single room by three to save money. Poor Matt slept on the floor. Sweet part of the night is the hotel owner took us to all the sweet places in Mangochi!

We got up early, loaded all of our stuff into a car and moved the the College of Medicine hostel. Only problem is the Professor had not checked out yet. So we loaded up all the stuff in the front of the room and I went to work while Andrea and Matt guarded it and fixed her chair. It was a bit frustrating because I was deferred to and I didn't completely understand what was going on. Also frustrating was the fact that the interviewers didnt speak English so we still had to enlist the help of University students for the translation. Somehow I already feel so tired here.

BUT THE GOOD NEWS! We are here by the lake for a week and then 4 days in the National wildlife park and then off to Lilongwe for a conference with the rest of the team and touching base with my boss from Hopkins. Malawi is absolutely stunning and the people are fantastic. I don't feel overwhelmed to walk alone (except maybe at night because I am always assuming I am going to get mugged wherever I go). Lake Malawi is beautiful as are the villages that surround it. I could seriously see myself living here.

Sorry the update was boring today, more later...

Malawi Arrival Excitement

July 27, 2009

I arrived in Malawi on the 25^th. I flew into Lilongwe and was delayed for hours at the tiny airport there. Apparently we had to wait for the flight from Johannesburg to arrive and for all of the passengers to go through immigration and customs before we could embark on our 30-minute flight to Blantyre. It was pretty boring but I made friends with a Scottish guy and passed the time sitting on the upper deck and waiting for flights to arrive. Finally, the flight came in and we boarded. When we landed in Blantyre, I got off of the plane and collected my bags. I walked from the baggage claim down to a hall of people waiting. I looked around for the driver for the Centre for Reproductive Health, Mr. Asidi. As I did, a man walked up to me and took my bag from me. I asked, “Mr. Asidi?” thinking that it would have been plausible for those at the College of Medicine to have offered him a description of me. He responded affirmatively and we walked down the hall. When we got outside, he asked where we were going and I responded, “to Jeanne’s house- the same place that you took Andrea and Matt.” It then dawned on me that this man was just a taxi driver and was NOT the man I was expecting. I went back inside and tried to find Mr. Asidi but he was not there. I was really confused and this guy, Sello, asked me what was going on. I explained my situation and he told me that he also worked at the College of Medicine and that we could share a taxi to the school where we could pick up his car. He was really nice but I decided against it. Instead, we used the internet connection to look up Faustin’s phone number (a friend who had gone to Hopkins with me and is from Blantyre). At that point, I called Faustin (who I think was on a date) and told him that I was stranded. Both he and his girlfriend immediately came to rescue me. As I was waiting for them, I began to notice that the airport was closing. The flight from Lilongwe had been the last flight for the day and everyone was leaving- taxi drivers, airline staff, passengers etc. A South African woman and her British friend asked if I wanted them to wait with me. I said yes and then they suggested that they bring me into town so that it would be easier for Faustin to find me. Since they were both women (and it was getting so dark!) I decided to go with them. We met up with Faustin and him and his girlfriend very kindly took me to where I was staying. Sheesh. The whole situation was unnerving but the airport was less overwhelming than the one in Accra so it didn’t bring me to tears. Plus, everyone had been so kind- from the College of Medicine employee to the taxi drivers to the women that helped me out. After I got in, we went to dinner and I went to sleep!

The next day, we got up and walked ALL AROUND Blantyre. Andrea and Matt had already explored a lot and have a fantastic understanding of the city. We went to the Shoprite complex (not the same as in New Jersey) and I got a phone and some other things that we needed. We went home and took a break before going back into town to the downtown area. Blantyre is pretty adorable and would be a good mix for me in terms of an African city with all of my favorite amenities. There are some enormous houses in the neighborhood where we are staying as well as more disadvantaged areas elsewhere. As often happens in Africa, the disparities are severe. Andrea had been filling me in on the fistula project and it appears to have gotten far beyond our control. She indicated that the interviews were almost complete and discussed her frustration at being only able to understand English. A lot of times, she was not included because all conversations were simply conducted in Chichewa. I was feeling pretty disheartened about the project. I had put a lot of time into planning the project and getting IRB approval and it seemed like the project had been hijacked and was no longer under my control (nor did it include my participation).

This morning at work, we talked to Effie and Davie (two coordinators at the Centre for Reproductive Health) and suggested that Andrea, Matt and I relocate to Mangochi (closer to the villages where the fieldwork is being done). Mangochi is on Lake Malawi and Andrea and Matt have said that it is really beautiful. I am excited because it will help us to be more involved in our work. More to come later…

Flight to Malawi

July 25, 2009

Today I flew from Addis Ababa to Lilongwe and am waiting for my flight to Blantyre. There is literally nothing to do in this airport besides sit on the outside deck and wait. Surprisingly, there was an Avis car rental counter so I went to see how much renting a car would be- no one was behind the counter. Flight was fine but a bit delayed. As we finally boarded the plane, I felt as if I had been thrown into a marketplace. People were pushing past, cutting lines, and all sorts of aggressive as they hurried to board the plane. Overall, the flight was fine. I bought the book “Hospital by the River” by Dr Catherine Hamlin at the fistula hospital so I read a bunch of that. I already feel at ease in Malawi- people remind me of Ghanaians in their friendliness and constant greetings and smiles. Lilongwe (the capital) is already much much smaller (and more manageable!) than Addis so I am hoping that Blantyre will be as well. More when I finally arrive.

Flight to Malawi

July 25, 2009

Today I flew from Addis Ababa to Lilongwe and am waiting for my flight to Blantyre. There is literally nothing to do in this airport besides sit on the outside deck and wait. Surprisingly, there was an Avis car rental counter so I went to see how much renting a car would be- no one was behind the counter. Flight was fine but a bit delayed. As we finally boarded the plane, I felt as if I had been thrown into a marketplace. People were pushing past, cutting lines, and all sorts of aggressive as they hurried to board the plane. Overall, the flight was fine. I bought the book “Hospital by the River” by Dr Catherine Hamlin at the fistula hospital so I read a bunch of that. I already feel at ease in Malawi- people remind me of Ghanaians in their friendliness and constant greetings and smiles. Lilongwe (the capital) is already much much smaller (and more manageable!) than Addis so I am hoping that Blantyre will be as well. More when I finally arrive.

Last Day in Ethiopia

July 24, 2009

Today was a great day in and around Addis. Tamerat and Tefera left today for their religious trip and are coming back in just enough time to pack and head to the United States. Berhanu and I took the van and drove about 40 km out of town. It. Was. Breathtaking. Probably the most beautiful place I have ever been. There were mountains in the distance with fields of green in the foreground and cattle and sheep grazing while the boys taking care of them looked on or whipped them to keep them out of the road. There were farmers everywhere and fields freshly plowed. Small children walked in groups along the street going to villages and homes that were mixed up in the landscape. Rain came and went all day (which I am sure is what keeps the place so green and lush. We stopped along the side of the road as two rams butted horns over and over. Honestly, it is a pretty hilarious way of fighting- sort of like an old style dual. Staring each other down, they backed up, and then took a running start and bashed heads. They repeated this over and over and over until one ram got tired and gave up. Shortly after the weaker ram gave up, all 3 rams started chasing after one ewe, trying to shoulder the others out and win the advantage. The poor ewe just kept running away from all of them. Anyways, the whole situation provided me with a great deal of entertainment.

Once back in Addis, we went for lunch at some Ethiopian restaurant that Berhanu knew. We got a fasting plate (since I am not really eating meat while I am over here) and some well-done kitfo. Despite my best intentions to avoid meat, I was ALL OVER the kitfo and hardly ate anything else. It was so so so delicious. After that, Berhanu had some errands to run so we drove around town a bit. At our stop in the Ethiopian Airlines office, I met a French couple from Brittany, France whose luggage had been lost on their flight. This was their first time in Africa and they planned to spend 3 weeks traveling through Ethiopia. I cannot even imagine how exasperated they must have been. First time in Africa, lost luggage, can’t even speak people’s second language. I have a hard ENOUGH time being fluent since most people speak Amharic and a subset of those speak English. I am back at the hotel now, ready for a nap, workout and a shower and then potentially meeting up with another Hopkins student who lives here. Tomorrow I am off to Malawi. Ethiopia is gorgeous but I am ready.

Rough Day

July 23, 2009

Homesickness hit me like a ton of bricks today. I woke up and realized that today I would be totally on my own for going around Addis. I don’t know why exactly but the thought overwhelmed me. I would have felt a million times more confident with just one other person…even a twelve year old person- someone to run ideas by and someone to judge different things. But I was all that I had. So after sleeping in and moping around a bit, I decided to take myself around Addis. I walked about 2 miles and ran into a beauty salon. In Ghana, I had done my hair in braids (with extra hair weaved in to make them thick enough) so that I didn’t have to worry too much about drying and styling my hair. I figured that this would be an easy thing to do on my solo day since it would take quite a while and I wanted to have it done regardless. The whole procedure took like 5 people and somehow came to the grand total of 260 birr or 22 dollars. This price is amazing compared to the hundreds that Americans pay to have theirs done at home. I tipped pretty generously and then headed back to my hotel for a nap and a workout. I then got on the internet for a bit and am hoping to watch a movie and go to bed. This was not my most adventurous day (by a long shot) but it was what I could manage. Tomorrow I am going to force myself to go into town, even if I just walk around all day. I want to go to the market (Merkato) but I am a little afraid of getting in there and not being able to find my way out. 150 days until I am home is the theme of the night. Missing home so much. Everything will sort out when I get somewhere where I am more stable and know some people I think. Come ON Dana. Pull it together.

The Addis Ababa Fistula Hospital

July 22, 2009

This morning I woke up early and went outside for a walk around the hotel. It wasn’t anything exciting but I liked walking around and doing some things for myself. I bought some more phone credit since I used all of mine yesterday being homesick and calling people. I then grabbed a tiny cup of coffee and relaxed at the café downstairs. After this, I went back to the hotel and waited for Berhanu and Tame to get ready to go. We went to the fistula hospital but missed our turn and ended up getting there about 20 minutes late. I joined up with a group of Americans on a mission that was taking a tour of the hospital. Although the tour provided information on things that I knew (such as how fistulas occur), overall it was excellent. I saw the “Oprah Winfrey building” which was clearly labeled as well as the operating theater, the recuperation room, the classrooms and the PT/rehad room. The guide quoted a 97% success rate for fistula repair (which is shockingly good) and also discussed the fate of the women who are repaired as well as untreatable. The hospital teaches literacy, numeracy and craftsmanship so that these women have skills with which to support themselves. We also saw the maternity ward where former patients come at about 6 months of pregnancy for checkups and are referred to a local hospital for elective cesarean section when it is time to deliver. Of course, I bought a bunch of their crafts as well as a book by Dr. Catherine Hamlin (one of the co-founders of the hospital). The fistula hospital is a pretty incredible example of public health, community development and women’s empowerment. Catherine Hamlin deserves the Nobel Prize.

After the trip to the fistula hospital, we were off to lunch (after a quick trip to try to track down Ben’s grandfather- no success!) We went to a Dutch/American restaurant (I am sure in an attempt to make me feel at home) and I had lasagna of all things! Haha whatever it was delicious. Once we got back, we found the elevators out so I had to huff and puff up the seven flights of stairs. Addis is at crazy elevation so even the simplest of tasks can make you winded! I feel like a fat old lady!

After a quick rest, we headed out to the National Museum, where I saw a replica of Lucy (apparently the real thing is in New York City- go figure) as well as some Ethiopian cultural artifacts and some crowns/thrones/robes of Haile Selassie and some other emperors. Overall, the things in the museum were pretty cool and quite diverse in nature. The only disappointment is that I don’t know if the artifacts and paintings are being maintained as well as something would be if it were in the Smithsonian or some other American museum. Weather is nice- it is the winter so it is a bit rainy but otherwise pleasantly chilly. Merkato market was moved tomorrow so that I could adequately prepare and wear jeans and a money belt instead of a silly dress and a purse. Time for a nap and then off to the gym to sweat and huff. Miss and love you all.

ETHIOPIAAAA

I am just one day into my trip to Ethiopia and Malawi. I arrived in Addis Ababa early in the morning on Monday and had a ride waiting to take me to Yoly hotel. I had anticipated staying with Ben’s mom’s friend but his brother owns a hotel in the center of Addis and they decided to have me stay there. The hotel is gorgeous. I have a kind size bed, shower and toilet (hot water!), flat screen tv, one of the nicest gyms that I have ever seen and even a driver to take me around. Holy cow did I luck out! Yesterday, after a shower and a power nap, Berhanu, the driver took me all around Addis Ababa and showed me the palaces and the shopping areas as well. He lived in DC for a few years (and managed Dukem) and was using all sorts of analogies to describe where we were. “And this is the U street of Addis Ababa….” Most interesting thing was probably the “Lion Zoo” for only lions in the center of the city. Apparently it has about 23 lions and nothing else. I will probably go back and take a look at “Lucy,” the oldest remains of a human ancestor that have been found to date in the National Museum.

Next came the best part of the trip: we went to the highlands of Addis Ababa and drove up a mountain until we could look down on the city. It was such beautiful forest you can’t even imagine. All the way up the mountain, we saw women with tons of firewood attached to their backs like a backpack. I wanted to take pictures but didn’t want to be obnoxious so I didn’t. Berhanu explained that these women climb up the mountain around 4 am, gather the wood and start their descent around 3 pm. SUCH hard work- I honestly don’t think that I would be able to do it. There were beautiful churches and all sorts of things to see up there. We then went by the fistula hospital. I have an appointment for today at 11:00 am but we were in the area and wanted to see if they would be able to fit me in. Alas, they could not and I felt kind of dumb for having dropped in. BUT the hospital is actually very beautiful- it has its own compound area with lots of greenery and pets too! There was a big German Shephard, Xena, who really liked me (probably because she sensed that I was scared of her). But I walked by the hospital area and into the Administrative area and classrooms. All of the women that I passed were curious and shy but had big smiles.

I then came back and had a very American evening- went and used the gym, finished my book, and watched a movie on my laptop.

I got up pretty early and walked around the streets alone. A bit different from Ghana- I think that the Western presence is a bit larger here so not so many people calling out to me. I felt like I blended in a little better or maybe I am just getting used to being the obruni in Africa. Just had a cup of coffee and today I am going back to the fistula hospital and then to Merkato- the huge open air market. My biggest goal there is not to get the iphone that I have been loaned stolen. I have been so careful to avoid flushing it down the toilet. Overall, I am happy here so far but still a bit homesick. I wish someone was here to adventure with me! This will probably subside when I get to Malawi and a more stable situation with lots of people that I know and some work to do. I love and miss you all already. Thanks for following my blogJ

malawiiiiiiii

I am about a week from leaving for Malawi and the usual anxiety is setting in. How to leave for so long and what will be here when I get back...

I am going to Malawi as the internship portion of my Master's program. We will be doing in depth interviews with up to 47 women and their family members who have had obstetric fistulas and have undergone surgery approximately 2 years ago. Obstetric fistula is an obstetric morbidity that results from obstructed or prolonged labor. During the course of prolonged labor, the baby's head lodges into the vaginal canal, causing tissues there to die. When the baby finally decomposes and comes out, many of these tissues come out as well, leaving gaps in the mother's anatomy. This results in women who leak urine and/or feces through their vaginas either through vesico-vaginal fistula (VVF) or recto-vaginal fistula (RVF). These women often smell due to leaking urine and are heavily stigmatized by their families and communities.

I will be in Malawi from July 25th (following a quick stop to Ethiopia) to December 20th and will try to update this blog throughout that time.