Happy Fall Y'all!

Happy Fall Y'all!  Just wanted to send cool wishes for fall in America from hot, steamy, dusty Malawi.  Currently, sitting in an office wincing at the thermometer reading of 41C (~106F).  So Happy Halloween, Happy Thanksgiving, Merry Xmas, etc!!!!

CONGRATULATIONS ST. LOUIS CARDINALS...WORLD SERIES CHAMPIONS!!!!  Tried explaining baseball to Malawians who have never heard of nor seen a game without much luck :(  Maybe I'll get a team started here...

Much love,
Sorry Zed

Hitching a ride on the back of a Chibuku Shake-Shake delivery truck!
Chibuku is cheap, thick, and filling beer that stinks.

What I'm Doing Here, Part II: Peer Education & Hope Kit Training

FHI 360 has been funding and monitoring Youth Friendly Health Service (YFHS) activities in collaboration with the Salima District since 2008.  Seventeen health centres throughout the district implement YFHS.  In July 2010, I conducted a training aimed to improve YFHS throughout the district by training health peer educators.  Through funding from FHI 360 and Peace Corps Malawi, 51 participants were trained in peer education techniques and facilitation.  Thirty-four youth and 17 service providers from the 17 health centres in Salima district attended the five day course.

The training comprised a variety of health topics with a special focus on HIV/AIDS prevention.  Each participant received a Hope Kit, a HIV prevention tool that provides and emphasizes activities and actions that individuals or groups of people can take as steps towards HIV prevention or mobilizing communities to respond to the AIDS epidemic in Malawi.



Salima Peer Educators!

Hope Kit Activity

Before the training, it was observed that YFHS were under-utilized by youth in Salima district because trained health personnel were either transferred to other health centres or too busy to properly allocate time and commitment to YFHS activities.  In training 34 youths in peer education and the Hope Kit, young leaders will be able to continue YFHS meetings and facilitate discussions amongst peers regarding health, education, and goal setting.  YFHS service providers attending the training gained refresher skills and acquired the Hope Kit as a tool to educate not only youths that attend YFHS, but also community members that seek services and health education.

The Hope Kit approach was initiated by the Malawi BRIDGE project in order to reduce the incidence of HIV/AIDS in Malawi through multilevel efforts that seek to change people’s behaviors, attitudes and perceptions regarding the transmission of HIV/ and AIDS.  The Journey of Hope is a set of practical experiential learning activities designed to address a range of HIV/AIDS related issues in particular HIV prevention. It guides participants to develop life skills that can help them deal with different situations, linked to staying healthy and achieving their goals and dreams in life.  The Journey of Hope provides one of strategies that call for all Malawians to be empowered to choose positively when making decisions. These choices are based on practical experiences that young people as well as adults face in real life situations.

Nditha! (Yes, I can!)

Objectives:

1.    To equip the participants with Peer education techniques and methodologies, knowledge and skills, which they will be using in disseminating sexual reproductive health and HIV/AIDS messages to their peers in the communities.

2.    To promote ABC prevention methods among youth and young people in the surrounding communities. 

      Follow up

Each youth developed a three month workplan to facilitate peer education sessions in their communities.  I am following up with each youth, observing teaching sessions, and providing feedback.  So far, the youth are enthusiastic about peer education.  

Me swimming in a sea of Hope Kits!

Reflections...

Admittedly, I fail at this blogging thing...Sometimes I'm really into it, other times I'm fully aware that I have a global audience of people I've never met (which makes me nervous)!

I've been in Malawi for 13 months now...my, how time flies!  So here's a quick review of what I've been up to in Malawi since my last blog in May.

June:

-Participated in Universal Mosquito Net Distribution program with PSI and Peace Corps.  In Salima District, more than 190,000 nets were distributed.

Manets!  These long life treated nets will provide protection for 3 years!

Women carry manets home. 

-Visited Kuti Game Ranch in Salima.  Walked 3 hours to get there.  Avoided a puff adder. Saw some zebra, ostrich, and deer-like animals. Sadly, none of them are Malawian, except the puff adder.

Alexis with Ostrich

Zebra stripes!

-Site visited my friends in Balaka and Ulongwe.  Hung out at Mvuu Lodge & Liwonde National Park.  Saw some hippos in the Shire River.  Ran away from some elephants.

My friend Chloe and I sailing across the Shire River!

Mvuu aka Hippos!

July:

-Celebrated the 4th of July and my 1 year anniversary of being in Malawi at Kande Beach.

-Malawians rioted against the current economic crisis and unpopular politics.  Can't provide my own take on what's going down in Malawi, but here is a good article to summarize the situation:  IRIN: Malawi's 'Arab Spring'?

-Trained 34 youths and 17 health center staff in peer education and the Hope Kit (blog to come).

August:

-Facilitated sessions on HIV and peer education at Camp Girls Leading Our World (GLOW).  Camp GLOW is organized by health volunteers in Malawi each year.  Check it out:  Camp GLOW

-Attended Mid-Service Training in Dedza with my fellow health volunteers.  Wow, it really has been one year of living in Malawi!

-Observed trained peer educators do what I trained them to do!  Awesome!!

Thanks for all your love and support this past year!  Twelve months of service left, and I'm hoping they are filled with success, adventure, and work.  

We Biked to Lake Malawi!!!

My sitemate, Alexis, and I cycled to Senga Bay and back in one day.  In total, we biked 40km.  That's right, we're awesome!

You can see a photo of me on Alexis's blog:  http://alexisinmalawi.blogspot.com/2011/05/sally-and-i-biked-to-senga-bay-last.html

Maholiday ku Tanzania

My friend Kim from Atlanta came and visited me in Malawi.  We embarked on an African adventure through Malawi to Tanzania via minibuses, buses, trains, boats, and planes!  From Lilongwe, Kim and I headed to Karonga, the northern-most district in Malawi to visit an orphanage.  From there, we walked across the Malwian-Tanzanian border to catch a minibus to Mbeya, the train depot city.  From Mbeya, we rode 24 hours on the Tazara Train Line through southeastern Tanzania.  Once we arrived in Dar Es Salaam, we took a ferry boat to the magical island of Zanzibar.  For three glorious days, I soaked up the sunny warm rays on the sandy white beaches of Paje.  Afterwards, I returned to Dar Es Salaam to hang with another American friend, Colleen, before my return home to Malawi.

Here is my journey in photos:

Tanzanian-Malawi Border

Green bananas!

Driving that train through the Selous National Park

Selling coconuts from the train window

Arrived in Dar Es Salaam after 24 hour train ride...

Dar Es Salaam Skyline via the Indian Ocean

Goodbye Dar...

Hello Zanzibar!!

Old Fort in Stone Town

Cute resort at Paje Beach!

Even in a tropical paradise, you need to be
greeted by some animals.

Creamy white sandy beaches of Paje

My own private beach

The Indian Ocean

Paje at Sunrise

Paje at Sunrise

Fisherman at Dawn in Zanzibar

Ode to Lake Malawi

My New Years Resolution for 2011 is to explore more of Lake Malawi's beautiful beaches!  (Easy enough for me to accomplish!)  And to avoid Schistosomiasis as much as possible...

Lake Malawi is a respite, a relaxing getaway from the trials of being a PCV in Malawi.  Thankfully, I live within 20km from Senga Bay, a place I frequent as much as possible even in the rainy season.

So here is where I've been so far...

CHIPOKA BEACH

Chipoka is about 40km from Salima.  I visited Chipoka Beach Lodge as part of a field visit.  There is a local community based organization (CBO) in this area that targets vulnerable children.  After our field visit, we dined on the beach with this beautiful view.

Chipoka Beach Lodge (My Corona Advertisement Shot)

Malawians wash and launder in the waters of the lake.  And the shoreline was reedy...prime location for Schisto.   

Malawians Utilizing the Waters of Lake Malawi

SENGA BAY

The closest beach to Salima, Senga Bay has a variety of hotels, resorts, restaurants, bars and other hot spots on the beach for Malawians and tourists to enjoy.  I find myself here often because of its convenience and beauty plus I need to get my swim on.  A top tourist destination is Livingstonia Beach, a Sunbird Hotel resort.  

Livingstonia Beach

NKHOTAKOTA

Located in the Central Region of Malawi, historically Nkhotakota district played a direct role in the ivory and slave trade of Malawi.  Today, its economy is driven by fishing and rice production.  It is not an area where one can swim due to the numerous reeds (Schistosomiasis breeding zones) and fishermen.  But it is indeed a beautiful fishing community. It is also a malaria prone area, benefiting from numerous mosquito net programs.  Unfortunately, many of the nets are used instead for fishing, as illustrated below.  

  

Fishermen Use Mosquito Bed Nets to Fish

Fishing Boat

Iwe in the Sand

Retired Fishing Boats Among the Lily Pads

Damaged Dock

Fishing Village along the Lakeshore

My travel buddy and I ventured to Satima Inn.  The inn was built in the 1960s out of old shipping boat materials.  The owner is awesome, the food is delicious, and the scenery is breathtaking.  The dorms are also reasonably priced, and the showers are nice!

Satima Inn, the Hidden Jewel of Nkhotakota

KANDE BEACH

AKA "Candy Beach," the water of Kande Beach is crystal clear.  I literally soaked in this water for several hours enjoying the tranquility and quietness of the Lake.  The resort is difficult to reach,  so there aren't many people.  It is more of an oasis surrounded by villages tucked away from modernity.  Unfortunately, I didn't take many pictures because I was enjoying the water so much.  But this is definitely, so far, my favorite lake spot.  

Not only was the scenery beautiful, but the food was absolutely delicious!  The service at the resort was top notch, with an adorable waiter eager to serve you.  Oh, and I finally found real chocolate cake (no photo though, I ate it all up!).  The dorms were reasonably priced, but the showers were tragic...rusty water flowed from the pipes, and if you were able to find a shower without rust, the water was cold.  But to adapt to the poor water situation, bathe in the Lake.

Rainclouds Form over the Water

Kande Beach Chalets

NKHATA BAY

Further north along the lakeshore, one will find Nkhata Bay.  Yet again, the beaches are beautiful and the water clear (except right after the rains).   Tucked away from the town, Chikale Beach is a worthwhile hike to scenic sands and warm water.  

Chikale Beach

View of Nkhata Bay Town

My friends and I stayed at Big Bluestar Backpackers, a popular destination amongst PCVs.  There are cute and homey shacks along the shores.  The food is pretty good.  And if you are lucky to be there on your birthday, they will bake you a cake.  There is a bar that plays reggae music and provides cold refreshment.  But the best part of this hostel is the view of the Lake.

Big Bluestar Backpackers Lounge Area

Seen from a distance (below), the Ilala ship docks in Nkhata Bay.  The Ilala is the largest and pretty much only ship in Lake Malawi that travels along the lakeshore.  In the near future, I plan to board the Ilala on its week long journey from the southern tip of Cape Maclear up to the northern Likoma Islands.

The Ilala Boat in the Distance

Obviously, I've seen much of Lake Malawi and find myself plotting my next venture to the beaches.  However, Malawi has more to offer in the form of National Parks, mountains, and hiking.  Plus  many friends are scattered across the country, doing a variety of good work to showcase to an eager visitor.  I hope to explore more of this breathtakingly beautiful country in the remaining 1.5 years of my time here.  

What I'm Doing Here, Part I

Mkuta Mwana (Surround the Child)

FHI is working in partnership with government entities, health facilities, CBOs and local NGOs to provide comprehensive care and support services for 18,000 vulnerable children and families (VCF) affected by HIV/AIDS in Salima by 2013.  These services include health, education, social welfare and livelihood services, and interventions aimed at ensuring children’s’ successful transition to adulthood.  The Mkuta Mwana program works within the district development framework to strengthen existing community systems and services, while also providing tailored services through a select team of CBOs reaching children and their families through community volunteers, CBCCs, primary schools, and health centers as entry points.  Currently, the program has reached over 12,000 VCF.  The program works with district government structures, 17 health facilities, 13 CBOs, one collaborating partner, 3 local NGOs, 10 TAs, and 44 PLHIV support groups.

Specific to health, Mkuta Mwana works with the District Health Office (DHO) to help improve basic infrastructure and train healthcare workers at 17 local health facilities.  Thirty-four health personnel were  trained in Youth Friendly Health Services (YFHS) in early 2010, which provided support to make health centers more youth-friendly, such as the sensitization of staff, the provision of recreational equipment and health information, education, and communication materials. 

Youth Friendly Health Services

Malawian youths (ages 10-24) do not have adequate nor equitable access to sexual and reproductive health  and HIV services. Prevailing health problems facing young people include:  sexually transmitted infections including HIV/AIDS, early pregnancies, malnutrition, alcohol and drug abuse, and mental health problems.  To address this health disparity, the Malawian Ministry of Health adopted Youth Friendly Health Services, defined as:

Youth Friendly Health Services are high quality services that are

relevant, accessible, attractive, affordable, appropriate and

acceptable to the young people. The services are provided in line

with the minimum health package and aims to increase

acceptability and use of health services by young people.

FHI collects monthly service provision forms from each of the health centers located in the Salima District Health Office.  Reporting has been untimely and not all health centers turn in reports.  Reports include service profiles on youths ages 10 to 24 with services including family planning information and services, condom promotion and provision, sexually transmitted infections (STI) management, HIV/AIDS Testing and Counseling (HTC), prevention of mother-to-child transmission (PMTCT), anti-retroviral treatment (ART), post-exposure prophylaxis (PEP), peer education, ante-natal care (ANC), maternal health delivery, post natal care, post abortion care, and other health services.  

In a three month period between November 1, 2010 and January 31, 2011, 11,362 youths sought out YFHS at Salima District Health Centers.   One third of these services were categorized as Other, including malaria, nutrition, prevention of substance use, psychosocial support, injury, management of sexual abuse, etc.  More than 12% of YFHS visits were for HTC, an average of 457 HTC visits per month by youths.  However, an average of 87 youth males received HTC services per month compared to 370 HTC visits per month by female youths.  Also of importance, more than 12% of YFHS visits were pregnancy related.  Only 10% of visits were for family planning information and services.  It is imperative that more information and guidance be provided to youths in Salima regarding HTC, family planning, and maternal health.

Since November 2010, I have helped monitor YFHS within the Salima District.  Of the 17 health centers, 13 YFHS activity days have been observed.  At these activity days, youth congregate at local health centers to participate in recreational activities such as soccer, volleyball, cards, and bawo (local Malawian game).  In addition to participating in physical activities, youth also listen to health talks from trained health personnel on topics such as HIV testing, family planning, and condoms. While I visit the youths, I chat with them about their health needs and perceptions.  Currently, our conversations are limited due to my lack of Chichewa fluency.  I also recently procured updated health education posters, charts, and stickers for health centers to post throughout their facilities.   

I will continue supervising this activity along with the District YFHS Coordinator for the next 1.5 years of my service as a Peace Corps Volunteer.  Plans for the YFHS program include training of 34 youth (half girls, half boys) and 17 additional health service providers to become peer educators in their communities.  Youths and health personnel will be provided with Hope Kits, a prevention tool that provides and emphasizes activities and actions that individuals or groups of people can take as steps towards HIV prevention or mobilizing communities to respond to the HIV/AIDS epidemic in Malawi.