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. 

Xmas Vacation

I'd like to share some photos from my Xmas trip at Cape Maclear, Zomba & Blantyre.  Had a fantastic time with new PC friends...

For Xmas, I joined several PCVs at Cape Maclear.  On Xmas Day, I went snorkeling among the beautiful cichild fish of Lake Malawi.  After snorkeling, the group had a wonderful Xmas dinner @ Gecko Lounge.

The Island where I snorkeled

Boat that took us snorkeling

View from boat on Lake Malawi

Fish Eagle going for the dive

Malawians Bathing & Washing on beach @ Cape Maclear

Xmas Dinner @ Gecko Lounge

Goodbye Cape Maclear

So the day after Xmas, we ventured along the road toward Zomba.  Zomba was the first capital of Malawi and is a busy city as a result.  The area is also known for the Zomba Plateau.

Storm is a brewing over Zomba Plateau

Here comes the rain

View of Zomba

Harry Potter-esque Chess Board @ Ku Chawe Sunbird Hotel

View from Zomba Plateau

Another View from Zomba Plateau

After chilling out and eating excellent food, I headed down to Blantyre, the largest city in Malawi.  I visited PAMET (Paper Making Education Trust) of Malawi, which makes paper products out of Baobob bark, banana leaves, and elephant dung. I was a bit squeamish of the elephant dung, so I bought several cards and a journal made of the other materials.  There is a club in Blantyre called Club Mustang Sally, so of course I had to check out the place...the bar had a pool inside that no one swims in.

Mustang Sally

After my tour of Southern Malawi, I headed back home to Salima.  My site mate had just arrived back from a trip to the States for Xmas.  We decided to extend our vacation one more day by going to Senga Bay, my second home in Malawi.

Baboons living by the lake

Momma baboon & baby trying to steal our chips

View from my swing :)

Safari Beach Lodge View

And that my friends, is how I spent Xmas & NYE sans decorated tree, snow, presents, or champagne.  But it was oh so worth it!!

Packing List

So there is a new group of volunteers coming to Malawi in February. I remember perusing many blogs leading up to my departure to discover the must needed items I should pack. So here is a list of things I'm very grateful I packed, and some things I wish I hadn't bothered bringing.

**I over packed and my luggage was 100 pounds, way over the 80 pounds PC allows you to bring. For the record, I had a luggage fairy watch over me the entire trip cause I  paid little in luggage fees. I pleaded my case to many airline employees that I'm a new Peace Corps volunteer and couldn't pay the exorbitant fees. However, this didn't work for anyone else, so be warned. I believe those with oversized luggage ended up paying $150+ out-of-pocket to bring their stuff.**

Clothing:

-long skirts

-capri pants (I live in an urban area so am able to wear these often)

-tons of tank tops (Seriously, it gets hot in most areas of Malawi and you will wear them often)

-jeans

-bathing suit (You can definitely bring your bikini/2 piece, even Malawian women wear them)

-sweatshirt (for those super cold days in Dedza training site)

-leggings (long and knee length)

-tons of underwear 

-several bras including sports bras

-2 Rain jackets (1 lightweight & easy to carry, 1 heavy duty one)

-Keen Sandals (or Chaco's, Tevas...the quintessential PC accessory)

-flip flops (PC will give you some for shower shoes)

-tennis shoes

-pair of nice, closed toed shoes for those professional moments

-shorts to lounge around in

-hiking socks

Camping Gear:

-headlamp (most used item!) & batteries

-tent (brought a 1 person tent, which is fine, but wished I had something bigger) w/fly (for rain)

-sleeping bag

-sleeping pad (invest in something lightweight and comfortable)

-Leatherman or equivalent

-quick dry towel (absolutely amazing)

-hiking boots

-tarp

-bandannas

-sun protective hat

-2 Nalgene bottles

-carabiners

-bungee cords

-hiking backpack

-sunglasses

Personal Care Items:

**You can get most toiletry items in country, but not during training so bring enough to get you by for the first 2 months. These items can be really pricey in Malawi, so it is nice to have your favorite items sent in care packages.**

-contacts & solution (If you wear them, you should bring them. Yeah, yeah, Peace Corps doesn't want you to bring them, but I'm really glad I did.)

-2 pairs of glasses

-plenty of waxed dental floss (PC at this time does not provide the waxed version...)

-several tubes of your favorite deodorant

-couple of toothbrushes

-1 tube of toothpaste for training

-enough shampoo & conditioner to get you through training...and then have friends/family ship you your fave stuff 

-brush/comb

-favorite face wash (rarity in Malawi)

-enough razors to get you through training

-Ped Egg/pumice stone (Your feet will change into new creatures that you never knew could exist, so bring something to scrub them with)

-nail files

-nail clippers

-sunscreen

-your necessary medications & vitamins

-sanitary products for training...suggest Diva Cup and/or tampons with cardboard applicators (easily burned). PC medical office will provide you with this pads & tampons as needed, so you don't need to buy them in country.

-makeup for the ladies...you'll be glad you brought it

-several sticks of my favorite Chapstix

-Ear Plugs...roosters, cows, and goats wake up super early, shouldn't mean you have to!

-Q-tips

-several travel size containers for shampoo, conditioner, etc...its easier to use these than carry around large bottles of your products when traveling

Electronics:

-Netbook (strongly recommend bringing your laptop or netbook, you won't regret it!)

-iPod

-Speakers that iPod plugs into to recharge (best thing I brought no doubt!)

-Camera

-Rechargeable batteries

-Solar battery charger

-Solar crank radio

-2 pair of headphones (in case I lose one)

-adapter/converter

Miscellaneous:

-umbrella

-games (I brought Scrabble, cards, Uno)

-puzzle books (crosswords, sudoku)

-pictures of family & friends

-spices

-Crystal Light (recommend the fitness version for those days when you need electrolytes and ORS just doesn't taste good)

-American dollars (PC will safe keep up to $750 USD. Cash is great when you want to travel outside Malawi.)

-sharp kitchen knife

-address book

-envelopes

-American Forever stamps (often volunteers travel back to America and can mail letters for you easily)

-journal

-sewing kit

-scissors

-duct tape

-reading books

-Malawi travel guide such as Lonely Planet

-your favorite candy, gum, snack foods

Host Family gifts:

-candy from America

-little plastic toys for kids

-stickers

-or calendars, things from your hometown

Things I wish I had packed:

-external hard drive 

-waterproof bag/back pack (rainy season is no joke and you don't want to ruin your electronics or other precious items)

-pajama pants...i just miss them so much!

-electrical tape (just in case your computer cord begins to fray or you have a termite infestation in your walls and want to cover the holes)

-calendar

-small, non-stick fry pan (had one sent in care package and has been a life saver)

-rain protector for hiking backpack...waiting for transport in the rain is unpleasant enough, even worse when all your things get soaked!

-cute, fun, girly clothes

-galoshes for the rain!!!!!

Things I wish I hadn't packed:

-slip (PC makes it seem like a must needed, big deal item. However, it is ok to not wear them.)

-solar shower (It's so hot in my area that the water is already warm, but some people do find them very handy)

-medical kit because PC will provide you with a medical kit that has everything you could possibly need during your two years

-white clothing...nothing stays white, nor could you ever wash it well enough to make it look pearly white ever again

Hope this helps!

The Gingerbread Man has Runaway to Malawi!

My niece's kindergarten class in Arkansas is working on a class project:

"Hi,

I'm the Gingerbread Man. My friend is in a kindergarten class at Pottsville Elementary. They will be reading lots of stories about gingerbread men the next few weeks, especially one about a gingerbread man that runs away. So I've decided to runaway too! Your friend is helping me. They were asked to send me somewhere fun that they would like to know more about, and they chose to send me to you! Please send a postcard from your area back to them at school. They will track my progress all across the US, and maybe even outside the US. This picture postcard will be posted on a large map. This will help the kids learn about different parts of the world. I know my friends will enjoy hearing from you and learning where I have run. Thank you for your help!

Got to run...

The Gingerbread Man"

(So instead of sending a postcard, because it will take 2 or more months to get to America and Xmas will be over, I've taken photos and recorded a short video of the Gingerbread Man hanging out with children in Chifundo, Salima District, Malawi.)

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The Gingerbread Man has run away to Malawi!!

Malawi is a small country in southern Africa about the size of the state of Indiana. The country's primary language is Chichewa, but numerous other languages are spoken throughout the country. More than 12 million people live in Malawi. The country is divided into three regions. I, the Gingerbread Man, have runaway to Salima located in the Central Region to visit a Peace Corps Health Volunteer.

Christmas in Malawi isn't celebrated the same way as in America. Malawians celebrate Christmas by attending church services with their families and preparing a feast that includes meat. Meat is a rarity in Malawian diets because it is expensive. Most Malawian families live on less than $1 a day, not enough to provide meat on a daily basis. Because of poverty, Malawians rarely exchange gifts on Christmas Day, don't decorate a tree, or bake gingerbread cookies. In fact, ginger is a rare ingredient in Malawi. Therefore, most cookies (or biscuits as they are called here) are made of ufa, or maize flour. Maize is also known as corn.

For some Malawians, gifts are exchanged on Boxing Day, the day following Christmas. This is an English tradition. Boxing Day, Dec. 26, is a time for parties and if they can afford to, exchange gifts of clothing or chitenjes, patterned cloth that is worn like a skirt by women.

I was very popular with children here in Salima, Malawi. To show their joy, they invited me, the Gingerbread Man, to a dance party, Malawian style. Children play music on drums made of plastic buckets or metal pots. 

Christmas ya bwino! (Merry Christmas)

Gingerbread Man in a village in Salima. Many Malawians in this area are farmers. You can see the farmland of a family behind me.

I've made new friends in Malawi. December in Salima, Malawi, is the end of hot season and beginning of rainy season. Imagine it is like Arkansas in the summer.

No Christmas trees in Malawi. Instead, the Gingerbread Man is hanging out in mango trees.

Ginger is a rarity in Malawi. Therefore, the Gingerbread Man is made of ufa, or maize flour, in Malawi! She looks like she is going to take a bite out of me...eeeek!

The school schedule in Malawi has three terms. The first term begins in September and ends with exams in the beginning/middle of December. Children have a month off to help their families plant seeds in the fields.

Christmas ya bwino chokera ku Malawi (Merry Christmas from Malawi)!

The First 3 Months

This week, I will travel to Dedza for In Service Training (IST). IST is designed to reconnect first year volunteers and for PCV counterparts to become involved in the development of community projects. The PCV and their counterpart will continue to create a mutual bond and further the process of working together in a constructive and positive manner. In addition, language, technical, medical and safety and security sessions will be held to further train the PCV.

IST follows the first three months of service. Hard to believe, but I've been in country for 5 months now...time just flies by. You are probably wondering, "What have I been doing since swearing in as a PCV?"

Hmmmmm, well....the first three months have been a great transition for me. I've adapted to life in a Malawian town, made new friends, struggled with communicating in Chichewa, tested my patience with the Malawian energy company ESCOM, and devoured my weight in mangoes. The first few weeks were spent cleaning my new home and learning to cohabitate with spiders, roaches, lizards and my watchman.

Nyumba Yanga (My Home)

In the past three months, I've also become quite popular among the neighborhood children. I host weekly dance parties in my yard where the ana (kids) dance to Lady Gaga, Jay-Z, Bob Marley, Beyonce and Black Eyed Peas (their favorite).

Get that dirt off your shoulders

I've been assigned as a health volunteer to work with the Mkuta Mwana (Surround the Child) project in Salima, Malawi. The program's purpose is to help meet the needs of vulnerable children and their families in Salima district by: a) directly providing quality services and support; and b) strengthening local systems and the capacity of organization, government, households, and communities to more effectively meet those needs efficiently during and after the program, which ends Dec. 2012. The program focuses on four specific domains: health, education, livelihoods and social welfare. The project works with 16 implementing partners, three of which are health related.

Specifically, I have been tasked with expanding Youth Friendly Health Services in the 17 health centers throughout the Salima District. I will also help train support groups for people living with HIV/AIDS (PLWHIV) in Positive Living, a Malawian based strategy for PLWHIV support groups. I will also provide guidance on health related campaigns with implementing partners. 

I've got my work cut out for me for year one of PC service; however, for the first 3 months I didn't know my place and was seriously wondering what I was doing here in Malawi as a PCV. But apparently this is exactly how I'm supposed to feel the first three months. Now, I am looking forward to the journey ahead :)

Malaria in Malawi (& Darkly Dreaming Sally)

ok, I admit that I'm not very good at this blogging thing...its been a long time since my last entry. I'll try harder :)

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Malaria is endemic in Malawi and a leading cause of mortality and morbidity. Malaria alone causes 30% of deaths in children under the age of five. Malaria is even more prevalent in areas surrounding Lake Malawi, Salima (my new home) included. The Salima District Hospital is promoting a campaign to conduct Indoor Residual Spraying (IRS) in every household within the district to prevent malaria in the upcoming rainy season which begins in January and lasts until April. More than 110 people die of malaria every day, nearly half of them under the age of 18. Below is the WHO report on malaria in Malawi, as of 2008:

http://www.who.int/malaria/publications/country-profiles/profile_mwi_en.pdf.

Because of the threat of malaria, PC requires all PCVs to take malarial prophylaxis and to sleep under an insecticide treated net (ITN). I’ve been prescribed mephlaquine. Ah, meph…it’s a drug with a long list of side effects including vividly disturbing dreams and insomnia…which is really affecting me during this extremely hot season in Malawi! The other day it was 38C which is the equivalent to 100F…whew, its hot!

My dreams can be described as tame (friends visiting where I'm actually sleep walking to my door to let them in) to really bizarre and scary. I even dreamed there were ants in my bed, started talking in my sleep, and then woke up my friend up with my ramblings of attacking ants. Ok, I'll share one disturbing dream...one day I accidentally bit into a piece of meat on a pizza (fyi, I'm a veg). That very night, I dreamed that I was a cannibal.

Needless to say, I'll be discussing switching medications with the PCMO (PC Medical Officer) the next time I'm in Lilongwe. I just write this blog to A) educate others on malaria in Malawi; B) warn future PCVs about meph; and C) to let my friends and family know that other that nightmares and a few sleepless nights, I'm doing quite well in Malawi. I'm fortunate in that I am able to prevent malaria...malaria would be more unpleasant that a couple of sleepless nights and crazy dreams.

On a good note, PC Malawi is teaming up with PSI/Malawi to distribute 20,000 insecticide treated nets (ITNs) to Malawians before rainy season. 

Swearing In as an Official PCV

On September 1, 2010, 34 health and education trainees were officially sworn in as Peace Corps Volunteers while standing next to both the American and Malawian national flags. The event was held at the US Ambassador's estate (currently, Malawi is sans Ambassador) in Lilongwe. The estate was breathtakingly beautiful including a tennis court, swimming pool, and well manicured garden.

Red, White and Blue-tonniere

The Oath

I was impressed with how great everyone looked, we cleaned up well! You'd never guess we were learning how to shower via a bucket bath, use the pit latrine without falling in and avoiding the spiders, and carry water on our heads without completely soaking ourselves.

At the conclusion of the ceremony, the new PCVs and PC staff enjoyed delicious appetizers and desserts. We even had pseudo-chocolate cake. I'm not sure real chocolate cake exists in Eastern Africa...even in Ethiopia, the cakes would look delicious with what appeared to be mouth watering chocolate icing and cake; but alas, just kidding, not really chocolate. So I'm now on a mission to find real chocolate cake in Malawi ;)

Pseudo-Chocolate Cake

And of course, we all posed with the cakes before devouring. This was our last day together as a combined group of health and education volunteers. The following day, we each set off to each of our new sites. Bon voyage!!

The New PCVs of Malawi :)