Kristen DeCelle's Malawi Diary
August 2006--August 2007
Following her graduation from Davidson College, Kristen DeCelle, under the sponsorship of First Presbyterian Church's Witness and Service Council, was able to accept the invitation of LISAP (The Livingstonia Synod AIDS Programme) located in Malawi, Central Africa to serve in Ekwendeni for 12 months. What follows are her reflections on her work gathering data about AIDS services and her life in Northern Malawi.
Print-friendly version of reports that Kristen helped to produce:
Livingstonia Synod AIDS Programme (LISAP)
IMPROVING VCT, ARV AND PMTCT
SERVICES AT EMBANGWENI AND DAVID
GORDON MEMORIAL HOSPITALS;
IDENTIFYING HOSPITAL WORKERS’ AND
CLIENTS’ PERSPECTIVES ON THE
SERVICES. (PDF Format)
Kristen on the shore of Lake Malawi
26 August 2006
I am sitting outside under a dodgy tent outside Heathrow Terminal 1. My flight does not leave for 11 more hours.
Met two girls whose parents were missionaries in Kenya and somewhere in eastern Europe. These two were headed off to school in Germany.
I am thankful for a let up of the heat. The British were apologizing for the bad weather, but in comparison to Georgia, this feels quite nice.
I am thankful to be here in the UK and especially for the individuals who arranged my car ride from Gatwick to Heathrow.
What will it take to stop the spread of HIV? Some say behavior change is the answer, but that method will not be accepted by all.
27 August 2006
Made it to Malawi and am sitting in the Gaston’s living room. Driving through Lilongwe to Mzuzu I was struck by the beautiful landscape with mountains that have been rounded off on top in contrast with the stark poverty and desolateness of the people along this road.
I met the McGills and their six children (all African). Maurissa and John visited as well. John is here on a Fulbright scholarship and is looking into ways to enhance a University’s internet access. Maurissa, his wife, is interested in painting and specifically in local people’s artwork and how the Malawians make pigments. I hope to get to know all of them better.
Today was a hundred good days put into one. I met so many people and so many were nice to me. I feel bad that the Langstons were robbed at knife-point, fortunately no one was hurt. The Langstons, who also have 6 children, have taken over the Crisis Nursery from the Dimmocks who have left Malawi after being here for years. Jessie Dimmock is a freshman at Davidson and I enjoyed meeting her a week ago. I need to be especially diligent to try to prevent such a thing from happening to me. I wonder if there is anything I can do for the Langstons.
Conversations have been very good. I am astonished that the government is trying to charge 10% on Jim McGill’s water project. You’d think that someone who was already a volunteer in the country and doing a project for the good of the people would not be hindered by a high tax.
Ekwendeni, Northern Malawi
August 28, 2006
Today was a rich people day. I visited LISAP’s headquarters and met the infamous secretary Joyce. Lazarus is quite funny.
My house is nicer than I expected and I discovered that there are vast possibilities for a hot shower. I just have to heat the water outside, but it is automatically pumped inside.
I’m living with the Gastons for a few days until I can get my house stocked. Their kids Katy and Daniel love Africa and are extremely exuberant and happy. I like the Gastons a lot and have found Andy Gaston to be an unending fountain of information.
I learned of a 10-year old who is trying to take care of her 3-month old sister who is in the Crisis Nursery. The father comes around every so often and is rumored to expect money for giving the 3-month old up.
I am going to send pictures, but I am going to wait until I get to know people better. In the past, I have felt uncomfortable going up to people and asking if I could take their picture. The landscapes here are really breathtaking. There are mountains all around. They have rounded tops, which set them apart from anything I’ve ever seen, but they cascade off into the distance. Those of you who have seen the Smoky Mountains will be able to get a mental picture of what these mountains look like. I will try to send some pictures of inanimate objects tomorrow.
August 29, 2006
I moved into my house today. I shopped for items in Mzuzu such as milk, chicken, Rice Krispies, and cheese. Highlight of the day included talking to and eating with Helen who has been a missionary in Zambia and in Malawi for quite some time. She teaches science at a girl’s high school.
The theme of today could have been “don’t buy new when you could use old.” I was repeatedly reminded by Andy that certain items I wanted to buy were in the house or were easily attainable. I wanted to replace the mosquito net, but Andy encouraged me to repair the holes as opposed to buying a new net. At first this really bothered me because the net looked a bit dodgy and I don’t like to smell old mosquito nets and I knew I would be spending a lot of time under it.
On the other hand, I don’t really need another one and it is wasteful. I think I am so used to being wasteful and not even thinking twice about it that when I am surrounded by people that waste nothing it is a shock.
Helen told me that she was going to replace papers which line her cupboards and her help was astounded. I keep going around the house thinking of all the things I could replace, but don’t really need to, but I would like to. I’m not sure what I’ll end up doing.
Home in Ekwendeni owned by LISAP where Kristen lived for her time in Malawi
August 30, 2006
Every day is filled with so many conversations that it is hard to process all the information I am receiving. I started work today at around 7:30 am. I had an extended conversation with Landson who is in charge of communications for LISAP and has written some interesting articles for the newspaper pertaining to LISAP’s activities.
Before I left for Malawi, I was gifted with software to make websites and I have thought that I could help LISAP to develop a website if they felt this would be helpful. Since LISAP already has formal reports for multiple years, it would be an ideal way to communicate this information to others.
I had not run this idea by Andy, but I mentioned it to Landson who was just ecstatic about it, so much so that I walked back to my house to get the software and we installed it together and he started finagling with it. I then thought that maybe making the suggestion so early on was not the best move. I have been warned by so many people to sit back and try to understand the situation first, which I think is a good idea. One main reason I think making the website might not be in LISAP’s best interest is that so few people have internet access in Malawi, that the website would not benefit the people of the Livingstonia Synod unless through it the program could garner funds. It seems that the communication may best be served in distributing pamphlets in the local language or putting up billboards, or doing activities which will directly affect the people. All of those activities cost money. On the other hand, I feel that giving someone else the chance to make the website will empower Landson and give him ownership of the process and a useful skill. It’s a toss up. I just hope Andy is not mad.
I went to an awesome Bible Study tonight with 5 Malawians and 4 expatriates (all British except for me) focused on Joshua and Caleb’s desire to go into the promise land but the Israelites refusing. We talked about seemingly “impossible” tasks and I could not help but think about the challenge of trying to get the Malawians to have safer sexual practices so as to help curb the spread of HIV. I just had read a journal article which spoke about how despite knowledge of how the disease is spread, some people will engage in dangerous activities. We also talked about the balance between relying on God v. strategizing and making your own plan. It seems that Joshua and Caleb were being asked to strategize and that being a faithful person and yet paying attention to worldly circumstances are not mutually exclusive options.
Here, the British outnumber the Americans. I was impressed by the joy that the Malawians have. At several points they started laughing. I am having trouble understanding their humor or comments they make to one another. The Malawians seem to have trouble understanding my accent as well. Maybe if I had a British accent, I would be able to communicate easier.
Village Life in Northern Malawi
September 1, 2006
I am humbled yet again by the kindness of the Malawians. One of the pull strings for a light bulb had come loose and a LISAP employee came to my house and stood around 7 feet off the ground on a ladder for around 30 minutes trying to fix it. He had gone to Mzuzu to purchase the device and originally he thought it would cost only 200 kwatcha but it ended up costing 750 kwatcha, which in US dollars is between 5-6 dollars I think. He called to make sure it was ok that he purchase it at this price and then brought me a receipt. At one point, this man also wanted to stack two chairs to reach the light bulb, but I said, “yayi,yayi” (no, no). I could just imagine this person falling down on my account. Instead, we were able to stack a chair on the Pelican case so that he could test the light bulb. He was supposed to be somewhere else, but he stayed late and finished the job and got the light working again.
LISAP does not run on Africa time, as I learned this morning when I was late for prayer meeting. These employees work fairly legalistically from 7:30-5:00 with a 1.5 hr. lunch break. Getting ready in the morning takes so much longer and I had left late already and then I got lost getting to LISAP. It should only take 5 minutes to get there, but somehow I ended up wandering around at the school sports field. There are no direct roads to LISAP and I have to go on smaller paths and I am still not that familiar with the landscape.
I am blown away by the fact that the vast vast majority of people delivering HIV/AIDS services are volunteers. Several people made comments before I left regarding how strange it was that LISAP did not cover my anti-malarial drug costs or pay for my ticket over here. After seeing how little money this organization has to work with, I am glad that they are not paying me anything or covering any of my costs. Having the house is a great asset that they have been able to provide.
September 26, 2006
I got the idea yesterday that my next project at work could be tracking down the committee members from the Presbytery HIV/AIDS committee, whose meetings have currently been canceled because of low attendance, and act as a consultant to try to understand why there was a decline in the membership of the meetings.
The coordinator of the Presbytery HIV/AIDS committee was able to meet with me in Ekwendeni after work and he gave me contact information for 5 or 6 individuals who were coming to the meetings and 3 who weren’t. I was hoping for mobile numbers, but only one of the people had a mobile phone. Everyone else I am going to have to travel to their village and then arrange a time to meet through the parish minister. I learned that for 2 individuals the minibus will take me to the CCAP congregation, but the people I want to speak with live 5 and 7 kilometers away and no minibus goes there. So the coordinator recommended that I work with the pastor as the intermediary and work with him to communicate with the others. I will work tomorrow to see how many of these pastors have mobile phones. If I can call to initiate the meeting times, that would be much better than having to travel there to set up a meeting and then travel back to have the meeting.
I went to visit the HIV/AIDS youth center today which is part of the Ekwendeni Hospital. I continue to be impressed with the number of people the hospital believes they are having some impact on through various outreaches. They estimate that during a 3 month time period (April to June) they contacted over 27,000 people and handed out over 100,000 condoms.
The weather here is still quite picturesque-between 70 and 80 degrees F.
I continue to be charmed by this town, by the huge purple Jacaranda tree I pass everyday on my way to work, by the sense of community I feel. I have never consistently greeted and been greeted by so many people everyday. People where I have lived and studied have always been so focused on what they were doing, the deadlines they had to meet, and tasks to complete that there was not time for idle chatting.
I fluctuate from being utterly annoyed with people’s requests for money, to being moved to tears by people’s gratitude, to feeling inadequate to chip away at the the massive and complicated problems at hand, to being awe inspired at the singing (I hope to be able to send everyone clips from the church services once my new digital recorder arrives), to feeling so happy to be here. I think that a lot of the intense sadness that I grappled with in Mwandi, Zambia has been eliminated by the fact that I am not working in a hospital face to face with death and disease. In the villages, I have seen a lot of people who look to be ill, but it is not as intense as the stories I hear from the British medical students about their experiences in the hospital.
Ekwendeni, Northern Malawi
Sept. 31, 2006
There are so many things I could talk about, but I have to get this e-mail off quickly and get to Mzuzu and then back for the wedding reception, so I’ll summarize.
On Wednesday, I initiated a talk with Andy about various issues I was having. One of the issues involved difficulty in knowing how I should approach editing the staff written work. So far two staff members have asked me to edit written work of theirs. After working alone for an hour and a half on one written work, I decided that that method would not help the staff to learn rules of English grammar. So now I edit side by side trying to explain rules of grammar the best I can. The quality of the writing needs to improve. Oftentimes, I cannot interpret what the author is trying to say. I struggle to know how to be constructive and yet to not be patronizing. I feel like I have erred on the side of not suggesting as many changes as I would make if it were my own work, because I don’t want to discourage them. I do not have a sample of what one of these monthly reports should look like, nor do I understand the audience or the purpose of them and so I feel that my ability to be helpful is limited.
Despite numerous attempts to get a meeting together with Alice, Lazarus and Andy to discuss my role at LISAP, this meeting has not taken place. From my conversation with Andy, I have outlined what I interpret my role at LISAP to be and I will at least distribute this for comments, but a meeting would be really helpful. I would go into more detail, but time does not permit.
I went to night prayers last night. People pray for 12 hours overnight from 7 pm to 7 am, the purpose of which I believe was to pray for an upcoming evangelism event. I stayed for a little over an hour and a half. The leader fortunately started translating some prayers in English for me, but all of the singing was in Tumbuka. During the first hour or so, we sang songs. I was one of the only people who had a song book, which I had found several weeks ago in the house. Lack of song books is a continual problem during worship services too. There was probably between 20 and 30 people there when I left. Twice now, I have experienced being in a situation in which people were praying out loud individually. Coming from a culture which does not pray different prayers simultaneously aloud, it seems awkward to pray out loud individually and all at the same time and so I mostly pray silently. I was surprised to see several young girls there. At one point there were three girls sitting to the right of me with no parent in sight. They stayed for about an hour and then left. I wonder if they are orphans.
Today, I went to a very lively wedding. The bridal party had beautiful silk light blue gowns and then men were wearing western style suits. There were 3 or 4 sets of junior bridesmaids and junior groomsmen all of which knew an African dance and processed slowly down the aisle doing this dance quite skillfully for their age (they must have been between 6 and 10). Then, there were two kids who were dressed as a mini bride and groom which followed the junior bridal party, and then there was the main bridal party who had a more sophisticated dance and the men and women did the same movements. The bride and groom didn’t really dance, but seemed to process more solemnly than the rest. I didn’t see the bride smile once, which was a bit distressing and I am not sure how to interpret that observation. Rev. Mvora preached on Rev. 2 and I imagine a similar reflection to the one he gave yesterday at prayers for LISAP, which was quite good. I’m amused that he reused the same text for the office prayers and the wedding, but I guess he could have applied the concept of loosing interest and fervor to marriage, just as well as you could to office work. I don’t know what was said, however, because it was all in Tumbuka.
I consistently feel underdressed and am going to have some outfits made next week. I don’t know why I did not think to bring dress clothes. I have never been in this position and for that reason I think it is a good experience to know what it feels like to not look as nice as everyone else and to not rely on my appearance to make me feel good about myself. At the same time, I will be glad once the outfits are made and the dress clothes arrive from my parents.
My parents were able to successfully ship, within 12 business days or so a huge box which is encouraging. Everything arrived unharmed. I can’t wait to watch “Cinderella Man” –a brief taste of home! What a great movie as Jamie, and Sandy will remember with fondness our outing to see that film.
Grandma Grace, your letter arrived here. Grandma Pam, your two letters arrived here as well, but no sign of the sleeping bag----yet.
I love you all and hope you are all experiencing the joy of Africa vicariously through these letters.
On a more hilarious note, mom and dad, you are going to have to send me a LaGrange Daily News to take a picture with that does not have women wearing pants on the front page. I can’t take that newspaper out of my house!
October 4, 2006
I went to the field today to GVH Manjolo Moyo, Mawira, and Mtwalo to observe LISAP’s microfinance projects-village savings and loans scheme. People form groups of 10-25 members, these groups agree on a minimum amount of money to save per week and once there is enough funds, loans are made and ideally microenterprise results. LISAP has an 18 month contract with CARE Malawi. During this time, they hope to train 150 groups and make provisions for the project to continue under community based facilitators at the end of that time. They have thus far trained 41.
I ate raw sugar cane for the first time today. For those readers who don’t have a mental image of sugar cane, think bamboo. The Malawians put the end of the sugar cane in their mouth and tear off the sweet insides. Unable to accomplish this feat, I started trying to peel the sugar cane with my hands and LISAP employee Auster told me that my I might cut my hands on the outsides of the sugar cane. All the while, the women who formed the microfinance group at Mawira were laughing at this white woman attempting to bite off a piece of this sugary snack. At one point I had my first bite, and was within seconds of swallowing, and my colleague said, ohh by the way, don’t swallow it, just suck the sweet juice out and then spit it out on the ground!
Three out of the four microfinance groups were running into problems with record keeping. The money the treasurer physically had differed from the amount stated in the ledger book and in all cases the amount that the treasurer actually had was more than was recorded.
Auster, who is heavily involved in the microfinance project, told me that he felt people spent there money foolishly, and did not know how to save. When I inquired what excessive items people bought, he said beer. I then spoke to a CARE Malawi representative named Jeremiah and asked him what the most common small business was that people developed and he said beer brewing. I’ve been amused at this irony throughout the latter part of the day. I’m not entirely convinced that buying alcohol is the most common excessive expenditure or that Malawians have a lot of unnecessary expenditures. Today, bananas were talked about as a luxury item, which astounds me, because they are so plentiful in Malawi and quite cheap. What a Malawian might see as unnecessary an American might call an essential.
October 6, 2006
At the beginning of the day, I had to decide between two meetings: microfinance wrap-up discussion with the CARE Malawi representatives or the Synod department meeting. LISAP is a department of Livingstonia Synod along with education, health, evangelism, justice and human rights etc. and it is trying to stay in communication with the other departments and involve the other departments at their HIV/AIDS trainings when applicable.
Before the microfinance meeting, I was talking with Jeremiah. He sifted through some photographs of youth activities and pulled out a photo of a young woman with her arm around a young man. In my opinion (and this is coming from someone who by 99% of people’s standards in the US is socially conservative and dresses modestly), there was nothing provocative or even remotely exciting about this picture. Yet, Jeremiah explained to me that maybe not in my culture but in Malawian culture this posture was bad, and would lead to bad actions.
I resisted the urge to comment and asked a few clarifying questions, but I think that not offering my opinion was the right move. I thought back to a conversation I had with my housemate Fransiska in which we talked about a newspaper article I had read titled, “Tight trousers Spread AIDS.” This article in the Malawi newspaper “The Nation” described a participant’s comment that women wearing tight trousers seduce men who are unable to resist having sex with them and so tight trousers spread AIDS and should be banned. I don’t understand why there is all this emphasis on conservative dress and not actions. Fransiska and I now have a running joke about Malawian clothing modesty standards and other conservative norms which in our opinions do not serve the desired goal of reducing sex. When we discover such customs we explain the reason for those customs tongue-in-cheek as “because that would lead to sex.” Fransiska cannot wear shorts even while running, “because that would lead to sex.” At the University of Livingstonia women used to be able to wear trousers but now trousers have been banned. Women can’t wear trousers, “because that would lead to sex.” In many churches, adults will not talk to the youth about sex until they’re ready to be married because talking to the youth about sex and HIV prevention and actually informing them clearly “would lead to sex.”
I’m not discounting the idea that there are contributing factors to young people’s decision to have premarital sex, but ultimately I feel that it is a person’s decision and not the fact that they have trousers on.
This is not my observation, but on one side of the globe it is considered more provocative for a woman to show her top half of her body and on the other side of the globe, the bottom half is the most provocative.
I guess my feelings about the dress go along with my feelings about making rigid rules for young men and women to interact. I had friends who went to colleges where it was school policy to not have people of the opposite gender in dorms after a certain time. I think people spend a lot of wasted energy on compiling a laundry list of do’s and dont’s (avoiding awkward issues) for unmarried young men and women and not enough time talking about decision making and building character.
To paraphrase Rev. Bota, it’s the adults who have failed, because they have avoided frank conversations with the youth because they are afraid the youth will ask a taboo question or they won’t know the answer.
October 12, 2006
Yesterday, I observed an “Open Day” at Emanyaleni. A Church of Central Africa Presbyterian (CCAP) hosted the event in which 17 community based organizations (CBO) performed dramas/read poems about AIDS/sang. From all I have heard about the skits, and seen an example in “The Constant Gardener,” I had never witnessed them first-hand; so yesterday was quite a thrill.
Most of the pictures are from the open day.
• I felt that mutual infidelity was depicted adequately as a cause of HIV, but one-sided infidelity should have been emphasized as well. I voiced this concern to the coordinator of the event afterwards.
• While there were 17 CBOs there, I would have expected the Emanyaleni community presence to be stronger.
• It was refreshing to see the drama groups come out in the open about the causes of HIV and even act out mock sex in some of the skits. I was urged by Glyn (the LISAP zone coordinator of this area) to say a few words of encouragement. I contrasted what I observed in Zambia two years ago with the denial and the unwillingness to talk about AIDS in the open to what I was observing there today. (The situation in Zambia has evolved considerably since my visit in 2004)
On the subject of talking about prevention in the open, I have decided to make a commitment to go to as many Christian Youth Fellowship (CYF) events as possible and on Monday I attended a talk entitled “Securing Salvation.” One of the elders talked about premarital sex and mentioned “going for testing” (although he to my knowledge didn’t mention HIV/AIDS by name). I wish there would be more emphasis on the positive aspects of male-female relationships and discovering the mysteries of each other in a healthy way rather than a simplistic condemnation of premarital sex and male-female dating relationships. The talk was difficult to follow or else I’d summarize. The two speakers’ idea of a translation was to say part of a sentence in English and then the rest in Chitumbuka . At one point, the speaker started making all sorts of hand motions, the youth started laughing, and then he addressed me in Chitumbuka. I said, “I’m sorry, I have no idea what you are saying.” Maybe he thought I was fluent by the way I had greeted him at the beginning. He then explained to me in English that he was talking about premarital sex. I had gathered as much by the
I have continued to interview HIV/AIDS committee members in the church to discuss the problems the committee is running into.
• Transportation and meal costs is a problem
• Lack of training in HIV/AIDS prevention and care
• Unclear idea of what the committees should be doing.
My initial assessment is that these committees were formed last year because someone thought it would be a good idea to have the CCAP churches involved in HIV/AIDS work. While these committees have officers, most lack a vision for what sorts of activities the church should be involved in, but there are notable exceptions (one being the church which hosted the Open Day). Another exception is Rev. Kaonga. He articulated that LISAP could not be in the rural village every week, neither could the hospital, but the church was there and could disseminate HIV/AIDS messages. He talked about a man who had become open about his status two weeks ago in church. Interestingly, Rev. Kaonga feels that if only church members talk about their personal experiences with the disease, those members will not have credibility unless LISAP or the hospital comes and validates what they are saying. This type of rejection reminds me of Jesus not being accepted in his home town. In Kaonga’s opinion, congregants would not accept information from within their congregation. When this man who was HIV positive got up to speak for a second week in a row Rev. Kaonga said that there were disgruntled people which Rev. Kaonga interpreted as them not believing that the HIV positive man knew what he was talking about.
I liked some aspects of the Bible Study this week. We were focusing on the story of Esther and the idea, “for such a time as this,” Esther was put into the royal house to save the Jews from genocide. I thought about my pursuit of speaking with these committee members and trying to know why these HIV/AIDS committees have broken down. I started to question whether the Ekwendeni Presbytery churches were being effective at all in the HIV/AIDS fight, and then I spoke to Rev. Kaonga. He talked about the HIV positive man who had come in the open about his status in church, and then he talked about the fact that at times when the hospital and LISAP cannot be there that the church can. I had actually not been looking forward to meeting with Rev. Kaonga because I had learned about other meetings which had taken place with Rev. Mvula and I thought that my meeting was redundant and would be looked on by Rev. Kaonga as an annoyance. After we finished talking Rev. Kaonga thanked me and said, “I hope that we can work together.” Now, it is typical in Malawi for people to thank you profusely, but the fact that he went that extra step to indicate that he wanted to continue this discussion meant a lot to me and made me think that maybe these conversations weren’t being redundant and that there is a reason for my interest in the HIV/AIDS committee. I ended up being able to speak with another committee member at the Open Day, and then two more people (one of whom had cycled 7 km to get there) earlier in the week.
I leave you with the question Modecai asks Esther which is an apt question for all of us,
“And who knows whether you have not come to the kingdom for such a time as this?” Esther 4:14b RSV
Love you all,
Open air Anti-AIDS drama presented at Mombwe West in Northern Malawi
October 29, 2006
Snakes, Spider, and Sickness
Apologies for the delay on the updates. I spent 4 days in Livingstonia, Malawi on holiday spending time with a couple University of Livingstonia students. Two student teachers had been my neighbors in Ekwendeni and they invited me to return to Livingstonia with them after their student teaching was finished.
I rode up on a bus called a “Costa?” which was bigger and nicer than a minibus, but we were still considerably squished together. I have gotten used to my personal space being invaded in most public gatherings from church to wedding receptions to public transportation. This ride was no different.
Livingstonia is known as the “Warm Heart of Malawi” and the scenery is even more breathtaking than the pictures. I heard an excellent sermon by a lecturer at the University which mentioned HIV/AIDS by name and repeatedly. Later I had the opportunity to meet this lecturer at his house and talk more with him about HIV/AIDS and he inquired about cultural norms with US youth. He talked about how many professors had died of AIDS at the University of Malawi because they had slept with their students, promising them higher marks. He then said that he has seen what AIDS has done to people and that he would never want that to happen to his wife. “All women are not for me, but just this one woman.” His wife is also a lecturer at the University and she had tea with us. During the course of the discussion I mentioned that I didn’t see men and women holding hands in Malawi, and he abruptly said that he and his wife held hands. Later when this couple walked me back to the guest house he made a point of showing me that they were holding hands. It was quite refreshing to see his courage first in preaching a great sermon and then in living what he had spoken about.
During my trip to Livingstonia, I went on a four and a half hour hike to the “water source” which is a concrete open channel which carries water for the residents of Livingstonia down the mountain. We had just reached the top and I saw a large boulder I wanted to rest upon. I got onto the boulder, looked down and saw a snake with red blotches, and about a one inch diameter moving in our general direction. I said to Rose, one of the student teachers, “Rose it’s a snake.” She didn’t hear me or maybe I was speaking incoherently and so I repeated louder “ROSE IT’S A SNAKE!” We looked for the best way off the rock in the opposite direction and then ran way. It may have been a mamba…or puff adder! There are a number of deadly snakes in Africa, and despite the fact that I was assured by Dr. Stanback that they weren’t much of a threat, I saw 2 in this one day, whereas he saw 2 in his entire 2 years in Namibia! And this one was not running away from us. The second one we saw did, but this one was definitely coming towards us…and no Matt and Mac I wasn’t just being paranoid.
Anyway, onto the spider…The morning I left, I looked up the tile wall in the bathroom and saw what looked like a tarantula (attached). I have gotten to the point with many insects that I no longer feel the desire to kill them and or get them out of the house. Seeing as how this tarantula was moving nowhere quickly, I got out my camera and zoomed in (on my camera) for a closer look to quote the now deceased Steve Erwin!
Unfortunately, after returning to work from my four day weekend, I began to feel ill. I thought I was just dehydrated and so I walked back to my house to get water and along the way lost my breakfast. I spent the next 12 or so hours absolutely miserable calling International SOS, my parents and Dr. Gaston. I was told by International SOS to start taking levaquin, but being the good minimalist UK doctor that Gaston is, he told me this was unnecessary and that he doesn’t recommend taking anything for the first 24 hours. It was actually a good thing I didn’t because by the next morning I was beginning to feel better. It still was miserable to be sick in all this heat, but luckily I have a nice fan that I kept on me. It isn’t nearly as hot as Georgia, but without air conditioning anywhere you feel the heat.
January 2, 2007
I steal the appropriate phrase from Cornell West as a title for the below reflection.
I write this reflection after a three day bout with an allergic reaction to an unknown cause. My face had become swollen especially around my left eye and I began to look like a Chinese person on one side and then on the other I looked American. I wanted to send my parents a photograph of me through my cell phone with the caption “Chinese or American?,” but I couldn’t get the picture to send.
All joking aside, I was getting pretty frantic on the third day of these strange symptoms. My left eyelid started to close up even more than on the second day and my right eye seemed to be starting to go the way of the left.
I had moved to the Gastons on day 2 after consulting with Andy about how the McGills’ cats could be causing the allergic reaction. There, I had taken Piriton tablets (antihistamine) for around 24 hours. I had also called the insurance company International SOS, a service which is expensive, but has been absolutely fabulous. This insurance company gives medical and security advice in addition to evacuations. I can get a US doctor on the phone in 2 min every time I call, and I have never had trouble getting through. The bad part of the service is that their best providers in country are limited mainly to Lilongwe and Blantyre. Lilongwe is a 4 hour drive away. On public transportation, it may take 8-12 hours. The International SOS doctor was recommending that I go to see a doctor in Lilongwe, but I really couldn’t envision how I would get to Lilongwe without expending a lot of money and time, and I was wondering whether it was really necessary or if I could wait until Andy got back from the lake. I was also considering the possibility that the minibus would get into an accident on the way to Lilongwe.
So on day 3, I was sitting in the Gaston’s house with their house worker Mr. Moyo and I cannot get through on my cell phone to the taxi driver, Andy, or the Scottish Missionary Helen that I know when it dawns on me that there is an American physician working at Rafiki orphan village who has a very well-stocked clinic. The woman that runs the clinic was widowed about a year ago and she has moved to Malawi to be the physician to the 15 orphans that stay at the center.
I toured Rafiki orphan village a few months back and attended the ex-patriot Bible study. I had mixed feelings about both the tour and the Bible Study. The facility is lovely, and like with any opulent place there is a feeling of comfort one gets by being surrounded by nice and clean things. For those Davidson College readers the experience of living in Ekwendeni and then going to Rafiki Orphan Village would be analygous to living in a house near the Ada Jenkins Center and then moving to Birkdale village. Pat Dochety once said as we entered Birkdale Village, “Ohh, you just feel good when you drive in here.” I wish I could say that being in Malawi has cured me of western materialism and longing for nice things, but it really hasn’t. I was challenged in an interview to reflect on the many values that missionaries bring to countries which may in many cases have nothing to do with the Gospel of Jesus Christ and I did not know what to say because I had never given the question much thought. Seeing these Americans though, who had founded this organization with all of its wealth, and having countless other experiences in which I recognized that before most people see me as a Christian, they see me as a white person I have been forced to grapple with the question, “What values am I bringing to Malawi?” After all, the children do not go through the streets shouting “Christian” at me, but rather “mazungu (white person),” “give me money,” and “give me biscuit” all phrases which have everything to do with money and race and really very little to do with Christianity.
Getting back to the topic of my prior experiences of Rafiki, I observed the children eating in the dining hall and noticed they were eating nsima with knife and fork and not with their hands. I have grown rather fond of eating with my hands. Eating with my hands, makes me feel like I am making an effort to blend in with the culture. It’s fun to roll the nsima into a ball and then scoop up sauce and other relish with the molded dough. It really is not as gross as it sounds (even for a complete germ-o-phobe like myself) because you always wash your hands before eating. To get the sauce properly in this nsima which is approximately the consistency of play-dough it is more conducive to eat with your hands. When I expressed my surprise that the children were eating with knife and fork, Laura explained to me that they were teaching the children etiquette. Now if I were to take the postmodernist argument for a moment I could say, there is not anything innately superior to eating with silverware over using your hands (especially if you use hand sanitizer before and after meals). In addition to this, the children are not being taught the local language despite being told the contrary. With the little Tumbuka I know, I tried to speak with the children and only the guardians were able to talk with me.
When I went to the Bible Study, the people were nice to me and we had a lovely steak dinner with chocolate cake. The study, however, is designed to be exclusively ex-patriot. Having attended for several months another study in Ekwendeni which was approximately 50% Malawian and 50% ex-patriot I had come to deeply value the contributions made by the Malawian participants. Another factor contributing toward my annoyance with the Bible Study at Rafiki was the fact that women could never lead the study. In Ekwendeni, the leader of the Bible Study rotates every week to every participant in the group regardless of age, gender, or prior experience. I felt like the environment was so “nice” that it was restrictive in terms of feeling free to express my opinions, but comforting in terms of being able to eat nice food in a beautiful environment.
So that’s a long tangent to explain the history between Rafiki and me. But, when I ran into this health problem, Rafiki came to mind and that well-stocked clinic and Dr. Elaine. I called Laura, a 23-year-old missionary working at Rafiki who plans the children’s diet. She was currently at lunch, but said that she would speak with Dr. Elaine for me when she returned to Rafiki.
In the meantime, I called a taxi to go the 25 km to Ekwendeni to get Benadryl, not wanting to be bothered by a minibus. International SOS told me that Benadryl was stronger than the Piriton that I had been taking for the past 18 hours or so and so it was important for me to make the effort to try to get the Benadryl. I thought on the way to get the Benadryl that maybe I should come and go quietly from Ekwendeni because as soon as I started talking to people I would be pressured to go to the local hospital. After being in a hospital in rural Africa for 3 weeks, I knew I would feel uncomfortable being treated in one. I went into my house, found the benadryl and went to get some boiled water out of the refrigerator only to find that it had frozen solid. I don’t normally curse, but at this moment I definitely did, but I think the situation justified it. I went next door to Helen’s house. I stood on her porch looking like a Chinese American mix, trying to explain through tears that I needed water because my refrigerator had frozen it all. She was able to give me water. I explained to her that International SOS recommended that I go to Lilongwe and that I didn’t know what to do. She recommended that I see someone locally first and asked me if I wanted her to call the nurse Mphatso. Feeling desperate, and not knowing when Elaine might call back, I agreed. To give some background, Mphatso raises 9 orphans, none of whom are hers. She received a scholarship to go to school in the UK and was there for around a year. Mphatso came, looked at my face, and was hesitant to make any sort of diagnosis. She recommended we call Dr. Kayuni, which we did. I offered that I could go to where Dr. Kayuni was, but was told he was already on his way up the hill to see me. He examined me and said that I was undergoing an allergic reaction and recommended that I be given an antihistamine injection, along with antibiotics. Less than 5 minutes after this prescribed course of treatment, I get a phone call from Dr. Elaine in front of Dr. Kayuni. I have to admit, I was thinking to myself, “Praise God!” a way out. At first I walked out of the room while I was on my cell phone to Dr. Elaine because I felt I was being rude to Dr. Kayuni and I wanted to hide what was going on. I then decided to go back into the room and had an awkward conversation back and forth between the two doctors in which I asked Dr. Kayuni to defend why he felt it was an allergic reaction and not an infection. He said it was possible that there was an infection, but that the eye would have been tender if this was the case.
The thought of getting an injection in rural Africa, when I did not know for sure that they did not reuse needles or if the antihistamine bottle was contaminated, really made me feel uncomfortable. I thought that Elaine would be able to offer a wider assortment of drugs in a clean environment and I did not think that Dr. Kayuni was correct in his diagnosis and I wanted to see what Elaine would say. So, I thanked Dr. Kayuni and Mphatso and said I was going to see a doctor in Mzuzu. I have no idea what Dr. Kayuni was thinking, but he did not seem visibly annoyed. He really had every right to be annoyed.
Just two days earlier, I had learned that a woman had waited 4 hours to be seen at Ekwendeni Hospital for stomach ulcers, and yet Dr. Kayuni made a house call to try to help me out. Granted, an allergic reaction has greater urgency than stomach ulcers but I wonder whether he would have treated me with the same promptness had I been Malawian.
Elaine was able to stain my eye and determine that the cornea was not scratched and then gave me gentamycin eye drops, Allegra, and Cipro. Maybe this treatment was overly interventionist, but there is something comforting about being around someone who is hyper about health. I showed Elaine the prescribed treatment from Dr. Kayuni and she said that she agreed with the diagnosis and that my eye was not infected. She did say that oral antihistamines have about the same absorption rate as an injection and so she did not see a reason for me to have to get an injection.
I was then invited by Laura to have dinner at Rafiki, to watch a movie and to sleep at her house. Not having any New Year’s Eve plans, liking to watch movies and knowing that the food will be spectacular I accepted. We ended up eating a salmon dinner, (with salmon brought from the US) with angel food cake. We watched Madagascar and then slept. I got a lovely hot shower the next morning from the nicest shower I have seen in Malawi and I was able to drink Soy milk that I absolutely love.
My experience has made very clear to me the inequalities in health care and the fact that 99% of people in Malawi would not have had access to the prompt relief that I got. I feel very lucky and relieved that I can now see out of both of my eyes, but feel more keenly aware of the fact that we live in an unfair world.
Why is it that just because I’m white, American, and have money that I should have relief from physical suffering…relief that others because of where they were born may never receive?
The relationship question is a tricky one. What do I say to Dr. Kayuni? I don’t normally find myself in the position of being so close and a part of inequality. I am supposed to be living with the people, trying as much as possible to be one with them, and yet here I was reinforcing the divisions. Yet, I don’t regret what I did to protect myself, and I think I would have made the same decision if I had to make it again.
A Morning in the Life of a White Woman in Mzuzu, Malawi
To give people a sense of how much nationality and race matter I will give the following snapshot of my morning.
I decide to walk to my meeting in Mzuzu with the Primary Health Care director for the synod. I encounter Mr. Moyo, who works in the Gaston’s house, who despite the fact that he bikes every day around an hour and fifteen minutes to get to the Gaston’s house, each way cannot believe that I am walking to town and flags down a car who has a driver he knows and encourages me to get a ride with her into town.
I politely refuse. There is no reason why I cannot walk. I need the exercise, this is how most Malawians get around, I am sick of paying the exorbitant taxi fees, and I feel I am doing penance for being out of solidarity with the Malawians.
And then another car offers me a ride into town…which I again refuse. Next, I come to the psychiatric hospital and a beggar greets me and asks for money, which I say no to.
I meet Laura who has graciously offered to bring the Cipro to me that I had left when I stayed over at Rafiki for New Year’s Eve. I then am approached by Gideon who has approached me before and who seems to approach many white people in Mzuzu. He tells me that there is no food at home to feed the four people in his family and asks me assistance to buy maize flour. I tell him I cannot help him and he persists and I finally tell him to please leave me alone.
I then go to People’s (which is a supermarket) and buy bottled water to take my pill with and I am waiting in line. There is one person ahead of me. I have a single bottle of water, when a man cuts in front of me in line a phenomenon which happens about every single time I go shopping. I talked to Laura about this and she says that the same thing happens to her all the time as well. My initial inclination is that this is racially motivated, but then I explore the possibility that it is because neither Laura nor I stay as close to the person in front of us as a Malawian would and so people do not realize we are in line. Today, however, because of how few people were in the shop and the fact that I was within a foot of the counter, I feel pretty confident that the cutting was racially motivated. I tell Laura that I never say anything when this happens even though it sometimes irritates me. I know that white people have cut in front of black people so many times that maybe in some way I feel like I am righting the wrong of the past. Also, there is something liberating about realizing that I am not going to react. I do not need to be first. I can wait. I refuse to be an impatient American. It is easy, however, to forgive the injustice of being cut in front of in line. It must be much more difficult for Malawians who see Americans with all of their possessions, opportunities, and privileges to love us and try to get to know us as people. As much as Laura and I both complain about the difficulty of forming friendships with Malawians which are genuine and not based on financial dependency, I have to ask myself the honest question of how earnestly have I been trying to form friendships with Malawians outside of a working relationship.
While LISAP was doing the survey, a minister gave me the following advice about what my attitude should be towards Malawians. He said first and foremost, “Love us” and then “suffer with us” and finally “help us.”
I think all three of these tenants have their values, and to embrace all of them simultaneously would be ideal. So I leave the minister’s challenge to me as the challenge for myself as well as the readership because if we can do those things with the people we encounter I think God would be glorified.
Wishing you a restful break,
Kristen DeCelle Niahara Na Shumba (I have been given a Malawian last name)
All four photographs were taken at Sambani Lodge at the LISAP Christmas party. The body of water is Lake Malawi. I do not know the children in the photograph. The woman with the black LISAP shirt is Charity. She has worked at LISAP for 8 years and is in charge of the home based care program and orphan projects.
LISAP Vehicle approaching settlement on Lake Malawi
February 3, 2006
Sometimes you meet people with stories of faith in God so compelling and beautiful that you question your own critical attitude towards reckless abandonment to God
Several weeks ago Christian Youth Fellowship (CYF) had testimony day and one young woman named Keesa shared her story pertaining to the MSCE exams. For Malawians who have aspirations of going on to further education beyond secondary school, this is the most important test for them, similar to the SAT or ACT in the US. The MSCE exams cover different subject areas and students typically sit for 6 of them. Roughly 70,000 students take the exams and only 30,000 pass. Keesa had already taken several exams and was sitting for one of the last ones which she thought was going to be geography. She opened up the test packet and realized that a different test had been sent to her than the one for which she had registered. I do not fully understand why the situation could not have been rectified by the people who made the error, but she knows how the MSCE and testing generally goes in Malawi and I trust her judgment that nothing could be done.
She decided to take the test anyway. Although she had not prepared to test on this subject, she had taken a course in the past. I did not get the full story because it was told in Tumbuka and someone who sat next to me was summarizing only every few minutes. I talked to Keesa about her story afterwards as well. She commented that she thought she had done well and that God was with her.
I walked back to my house focusing more on anger towards the system that had let this happen to her. In the US, if there is anything which compromises a testing environment, my impression is that something can generally be done. I can remember how my roommate at Davidson, Alina, was going to take one of her exams and for whatever reason it was not at the testing center. The proctors called the professor and got the situation straightened out, and the student did not suffer. Here in Malawi, students deal with the stresses of power outages when they are taking these exams, and some of the exams go on until 10:00 at night.
Her ability to see the situation in such a positive light was baffling to me who still could not get past my own anger of the injustice which had done this to her. From what I remember of her comments, she gave credit back to God for having been with her through the exam and she felt that she had done well. Those who are most cynical might have surmised that this is some sort of coping mechanism, a way to feel good about situations which are out of their control. I admired her attitude which to me was superhuman considering the situation, but I guess with too much cynicism, I did not really believe that God had guided her through the exam. Her comment at the end that she thought she had done well, I brushed off and did not really believe as well. I had admired her, but I did not fully embrace or know how do deal with her conviction that God had been with her and had helped her to do well.
Several months passed, and I was picking up a package from my parents at the post office. It is a bit awkward to walk to through Ekwendeni with a box from overseas, not that I don’t absolutely love receiving their contents, but I just feel that people are looking at the box longingly and that wealth puts a barrier between me and the people here. For the most part, I do not fear being robbed in Ekwendeni in broad daylight and so the concern is not that someone is going to take my belongings it is that people see that box and I perceive think “She’s not like us.”
So I was feeling a bit guilty about having the box in the first place, and I run into Keesa. I think that maybe if I share some things out of the box the barrier will break down a bit and so I get one of those Sweet and Salty Nut granola bars and hand it to her and Keesa accepts it and says to me, “Do you remember the testimony that I gave and the questions you asked me about it afterwards about the MSCE exam? I received a credit for it.” Not knowing entirely what this means, but judging by Keesa’s smile that it was good news I congratulated her and as I walked away. In a country where roughly 3 in 7 pass the MSCE, Keesa had done it despite the fact that one of her exams was in a subject she was not planning on taking in the first place.
Her story evokes a discussion of the concept of a relationship between people and God, and how much we do verses how much God does. While at Davidson, I was invited to attend a charity dinner at which the founder of Doctors without Borders, Bernard Kouchnere (spelling) was the featured speaker. The rabbi who gave the invocation talked about the concept of crops and how we plant the seeds but God waters them.
I think regarding Keesa that she must have studied the subject well and clearly her own efforts contributed to her success. Her own conviction and the result of the seemingly unfortunate situation leads me to believe that maybe God was there with her, guiding her. I think in the west, it is difficult for us to depend on God because we can control so many aspects of our lives. The areas that we can control, I think, oftentimes overshadow the vast arenas of our existence that are totally out of our control: where we were born, who our parents our, and our own innate abilities. I think total and utter dependence on God is a dangerous thing and sets one up for disappointment. So, how do Christians get the relationship of what we do and what God does in an appropriate and faithful balance?
Andy led devotions for LISAP staff on Friday and read from the book The Samaritan’s Imperative. The author, Michael Christiansen, helped to lead a workshop that I had the opportunity to observe the first week I was here, for ways ministers can become involved in HIV/AIDS work. He speaks and writes from first hand experience, having been a pastor in San Francisco at the time that the HIV/AIDS crisis in the US was growing. His church actually helped to set up a needle exchange program. There were two factions in the church. One faction decided to do ministry to the “innocent” victims of HIV/AIDS such as children who had gotten blood transfusions with contaminated blood and maybe spouses of HIV+ people. The other faction felt called to do ministry amongst those who had contracted the disease through their own actions: the homosexuals and drug users. Micheael was the pastor and oversear of both groups. In his book, Michael writes (something to the effect) that we should abandon ourselves to compassionate ministry as well as we should recklessly abandon ourselves to God. Two ideas come through. We should be doing something, and also we should be trusting God to lead us. I’m not sure how we are supposed to get to that point or if we will ever fully know that we are doing God’s will, but Andy’s observations were an appropriate lens through which to view what happened later on in the day.
So what exactly have I been doing at LISAP? I have been learning using help menus and with some input from my housemate Franziska, how to use Microsoft Access to create forms into which we can enter our data from the survey. It was easier to collect our data in matrices and that way we could get information for up to 10 groups on a single questionnaire, but that format has turned out to create problems when trying to se tup a data entry form. Also, for some questions the reponse was a list of items and other questions we only got single responses, and so to try and put the answers to one survey with such a variety of types of answers on one spreadsheet is challenging. I weighed the pros and cons of using SPSS, Stata, Excel, and Microsoft Access for data entry and decided with Franziska and her boyfriend’s help (who is getting a PhD in statistics) that Microsoft Access is most conducive to easily entering data once you have the form set up. Data entry begins on Monday. It has not been the most glamorous few weeks, but I have been challenged and if Access turns out to be an easier program to do data entry in than Excel, I can train the M & E (Monitoring and Evaluation) officer, Grey, in how to use it. He has been busy this past week traveling learning about our projects in Chitipa. Also, the secretary, who is taking computer lessons already, will be able to learn how to use a new software program. So, I think, these past few weeks of struggle might help out LISAP in the long run beyond when this survey has been entered and analyzed.
Malawi is currently in the hungry season because food has run out or is running out from last year’s harvest, and maize from this year has not ben harvested. Knowing the hungry season comes every year, LISAP proposed to the National AIDS Commision (NAC) to distribute 20 million kwacha (~$143,000) worth of food to PLWAs (Persons living with HIV/AIDS) as well as orphans. This is a very complicated process to determine who the food should be targeted towards, figuring out how to monitor whether the distribution had any impact on the PLWA’s health, as well as trying to receive such a large quantity of quality food from companies which sometimes put less food than promised in bags. I am not involved in this process at all, but we discussed some issues in a technical staff meeting, so I have heard about and admired the ambitious nature of the plan.
There are so many stories to tell, but those will have to wait for another day.
Blessings to all of you as we seek in different parts of the world to discern the will of God for our lives and with hopes that we will learn how to abandon ourselves to compassionate ministry and faithfulness,
February 13, 2007
I had a few interesting experiences this past Sunday. At 8:00 am, I went to church. The scripture was about the good shepherd laying down his life for the sheep, which on most days I would be very intrigued by, but on this particular day, I had not gotten very much sleep and I could not follow the sermon and my mind was wandering to other things.
After church, I went to CYF (Christian Youth Fellowship), where members could name any verse in the Bible they did not understand and the group would discuss it. Quite lively discussions ensued 90% of which were in Tumbuka, and thus I couldn’t follow the perspectives being given. Fortunately, the name for the books of the Bible and numbers are in English, so I could follow what passages they were quoting, but as far as people’s commentary I could not understand it. I took about a 2 month break from my Tumbuka lessons during the survey and house sitting in Mzuzu, but since the holidays I have wanted to start my lessons again. My Tumbuka teacher, however, has had to cancel my lessons due to illness these past 2 weeks. I like in CYF feeling like I am part of the group and being treated the same as everyone else. When I went on the pre-marriage retreat I made a point of sleeping in the same accomodation as everyone else and eating what everyone else was eating (except for 2 meals which I ate at home). Fishane, who sometimes leads the discussion, speaks in English some of the time as does another young man Charles, but everyone else speaks in Tumbuka despite the fact that it is suppposed to be “English CYF”. I am happy that they do not feel obliged to speak in English just because I am there, and I have surely experienced the opposite where people have gone to great lengths to accomodate me, but it frustrates me that I don’t know what people are saying. I keep telling myself that my peers do not need to speak in English or translate for me what is said, I need to learn to speak Tumbuka. I just don’t feel like I have the time or energy to put into learning it.
One of the issues being wrestled with was the concept of grieving the spirit and how one who commits sins against the Spirit will not be forgiven, but the son of God will forgive. The leader of the discussion challenged the group to give examples of what sins would be against the Spirit as opposed to other types of sin. I love how there are concepts in the Bible that this group picks out every week that I have never heard of nor thought about. I am quite impressed with how thought-filled, knowledgeable, and intense this group is. Out of all the Bible studies I have participated in, I have never experienced one where people quote scripture so frequently and argue concepts back and forth like these people do. My experience in CYF brings home the point that Christianity has been in Ekwendeni since the late 1800s, and these people have thought about these concepts and have stayed fervent in their study of the Bible, while in my experience reading scripture has not been so emphasized.
CYF let out shortly after 12 noon, and I decided to go deliver beans. A few weeks ago, I went to visit three of the orphans picked to be assisted by the Men’s Guild Orphan Project. I helped this organization to write a proposal seeking funds for this project. Assisting a group to write a proposal sounds like a good idea in theory, but in practice I found the experience of working with the fundraising chairman to be disheartening. One day, I’ll have to explain further because that experience merits a longer reflection. The first orphan, Brenda, had had Polio and lost the use of her legs. I found her sitting on the floor with her feet bent back at her knees. She has lost both of her parents. Her grandmother cares for her, and from the looks of things cares for her well. I learned that she is not able to use the pit litrine and so her grandmother has to pick her up and help her to use the restroom outside. When I asked the grandmother what Brenda needed, she said, a toilet that she can use inside that is accessible to her. I find it disturbing to think about how difficult this grandmother’s life must be caring for this particular grandchild. The difficulty that this old woman must face carrying this disabled young woman must be considerable. Brenda has limited verbal abilities as well. One thing I remembered her grandmother saying is that she likes beans more than nsima.
The second orphan I visited, Trevor, was looking ill and appeared to have some sort of skin infection on his head. I asked the guardian whether he had been to the hospital, and his guardian responded that he was going to wait some time to see if it went away on its own. I think Trevor at age 7 has HIV/AIDS, which is a terribly sad thought, and I hope I am wrong.
I don’t know when I first got the inspiration to deliver beans, but I fought the inclination with every argument from: it isn’t sustainable, families will develop a dependency on me, it is not sophisticated or cost-effective, it is paternalistic, and it is mixing basic survival needs with religion. I think about a line in Romeo Delair’s book Shake Hands with the Devil: the Failure of Humanity in Rwanda wherein he was annoyed that the UN was questionning whether they should be protecting Rwandan citizens from the genocide by housing them near the rest of the UN troops. I believe Delair’s response, was that if the UN was not there to protect the lives of Rwandan citizens, what was it there for? And so I think that if I am here with the aim of helping in some small way with HIV/AIDS and I neglect to do anything for the individuals that I see and know are in legitimate, desperate need, what am I here for? I think I get a bit frustrated spending so much time behind a computer working on the survey data entry. I now estimate that we have interviewed approx. 700 groups, and so the data entry process is no small task. This task is what LISAP really needs me to be doing and that the information should be helpful to the program. Sometimes, I feel really removed from the community and HIV/AIDS problems when I am in an office all day. Today, Andy put up a “Do Not Disturb” sign on the door of the room where Joyce and I were doing the data entry and I added Dante’s line, “Abandon Hope All Ye Who Enter Here.”
So I somehow got the idea a couple weeks ago to buy 100 kwatcha (roughly 70 cents) worth of beans and deliver it to the families of the two orphans. I had forgotten exactly where the two orphans lived and so I had to ask around in the general vicinity where I thought they would be to find them. Sure enough, without too much trouble, they were found and the beans were delivered. It is really quite a small gift even here. It might feed the orphans for 2 or 3 meals, but I want to do something. I really don’t know what the guardians are thinking. They seemed happy to see me back again this week with another small bag of beans. I almost did not go this week, but something led me to go. I had just left CYF and I was fantasizing about making pizza, but I just felt led to go and I dismissed every argument which told me I should not go, with the overwhelming sense that “This is the right thing to do”. I think for me delivering the beans is about remembering people and situations. On some deep level people everywhere have a longing to know that God will not forget them. At its core, the Christian message says that God lifts up us ordinary people. If God became man to die for us, that understanding elevates our status from being a mere human being to being a person beloved by God. I cannot understand why God is allowing the crisis of HIV/AIDS to happen to these people, and I do not think I will ever get a satisfying answer on this earth to why there is this tremendous suffering. People argue that the African sexual culture lends itself high rates of HIV, which is true, but not the whole story. When you sit in a room of 50 girls and ask them why girls and boys have sex and the first reason they give is “money,” the role of poverty cannot be ignored. Then you ask the question, “Why does God allow poverty?” and I have never gotten a satisfying answer to that question either. I have to believe that God does want suffering to be eased and that God does not forget us.
In the afternoon, after delivering the beans, I did get to make pizza. Two teenage girls who I had met in passing had informed me that they wanted to come to my house on sunday. We had set the time a week ago. I was thinking they said they would come at 1:00, but they came at 2:00. I think this discrepancy was more a product of my remembering incorrectly what time they would come than them being late. I have to say, I really wasn’t looking forward to the visit. I felt like the girls were going to ask me for money and I just really wanted to enjoy my pizza. I had started to roll out the dough for the pizza and I had not heard a knock and the time was getting further and further away from 1:00 pm. Joyce, the LISAP secretary who was helping me do the data entry was scheduled to come to my house at 2:00 pm and I was running behind on my pizza making due to the beans delivery. Suddenly, all three people appeared at my doorstep at the same time. I welcomed the girls, and began talking to them while I was continuing with the pizza. They opened up their basket and started offloading about 10 mangoes as a gift into my fruit basket. It was an incredibly nice gesture. I offered them some apples which they accepted, and then remembered some chocolate I had in the refrigerator. I really didn’t want to share my pizza. I was hoping that the conversation would end and that I could start working with Joyce on the data entry. I chopped up tomato, and onion for the pizza and had just finished chopping up the cheese for the pizza. I had the cheese in a bowl, and the girls asked me what it was. That was the question that decided things for me. We were all going to eat the pizzas: Joyce, Johnierre, myself, Rose, and Malumbo. It turns out Joyce had never eaten pizza before either, so we had a fun meal mid-afternoon. Rose and Malumbo said they couldn’t eat any more right now, but that they wanted to take some home.
The girls also presented me with a large “Youth Alert” sticker which they placed directly on my shirt. I was thinking to myself, “You have got to be kidding me.” They proceeded to tell me how they were a part of a youth club and gave me two posters, one of which the English translation is something to the effect of “A real woman waits,” and then the other one was the equivalent for men. I really don’t understand why they wanted to give me these posters and stickers, but it seemed to be a goodwill gesture. I always feel like I’m put in a tough position with the abstinence/condom issue because I am strongly for abstinence outside of marriage, but at the same time I don’t want people to die and if I knew promoting which method or combination of the two would save more people from getting HIV/AIDS in light of the poverty I would promote whichever one would be more effective. Because my time at LISAP has been spent conducting a survey, I have not been on the front lines of the abstinence/condom debate, and therefore have not had to come to terms with this issue. When these posters were presented to me, however, Joyce suggested that I ask the girls whether they were going to wait. My first thought was that was none of my business, and that I did not know these girls and I don’t like putting people on the spot about sensitive issues. The question was coming from the Malawian, so I asked, and they said that they were. I could be as cynical as the Peace Corps worker that I spoke to who was distressed that her group of adolescents sang a song to her about abstinence after she had spent 3 days talking to them about condoms. She said that all of the girls knew they weren’t going to abstain. To that comment, I think, “and who is pushing whose culture onto whom?” Anyway, I told the girls that that was great and that I have waited as well and I was proud of that. Joyce then added her own personal testimony about abstinence. Retrospectively, the conversation was very short sighted, because we never spoke about the huge problem of spousal unfaithfulness. I really was not intending for the conversation to turn into a plug for abstinence, but I follow the general principal that people have the right to express what they believe and because the girls brought it up to begin with, I felt a little encouragement would do no harm.
And that all was just one day....
Blessings on Valentine’s Day,
February 19, 2006
Today was an important day. I had traveled to Embangweni with Paul Mkandawire (Synod PHC Director) and Mark Gama (driver), to do preliminary research for the study on VCT utilization. Embangweni is about a 2 and a half hour drive from Ekwendeni and we had traveled there the previous day to get an early start today. I felt sort of bad, because despite the fact that we had booked in advance for 3 rooms, and the person who booked for us had gone again in person to reconfirm our coming the day of the booking, when we got there, there was only one room still available. Our rooms had been given away to someone else. When my fellow travelers learned there was only one room, no one even discussed who would be the one to stay in the nice (in a relative sense) guest house...me. The others began making other plans for where they would stay. I didn’t complain. While we were on the survey we stayed in several “dives” and I really don’t think that I can handle another experience where I don’t know how to use a new variety of toilet! I really would like to understand what is going through these Malawian’s minds when they are so nice to me. Several times Paul Mkandawire insisted that I ride up front in the Land Cruiser. Now, if I were in the US, I would take this as a nice chivalrous gesture. Here, however, I just feel like I’m an imperialist to sit in front. I don’t understand the dynamic at work. I am flattered by the gesture, but I don’t understand it in light of other experiences I have had here. When you are in your own culture, most of the time you understand implications behind actions such as men opening doors for women. In many settings here though, women sit on the ground and men sit on chairs. In a single day, I was told by Auster who is a LISAP employee that I should ride up front in the car and then I was told (not by Auster or a LISAP employee) that I needed to sit on the ground with the rest of my friends (fellow women). So I don’t really understand how sometimes women are given special priveleges and then other times they’re treated as inferior to men.
We spent the morning speaking with the PHC director of Embangweni Hospital Jeffrey Mwala. Paul Mkandawire has been an absolute delight to work with. He has a very structured way of thinking, a public health degree from somewhere in the UK, and a deep knowledge of the culture here, which makes him a great mentor for me. I wish every morning could be spent thinking about objectives and predicted outcomes of a study with brilliant compassionate people. The study will cover the idea of access to VCT (Voluntary Counseling and Testing-which is the process through which willing participants receive an HIV test). We hope to examine dynamics within households. If one person is tested, how often is that person’s spouse and children tested. After a person is tested, who does he or she tell about the experience if anybody and what does he or she tell people. We also hope to examine challenges institutions face in administering VCT services. I learned today that an average of 5 working days a month, Embangweni hospital has to turn people away because there aren’t enough kits.
In the afternoon, we met with the director of HIV/AIDS services at the hospital, Joyce, as well as the only full-time VCT counselor, whose name I have forgotten. I really enjoyed meeting Joyce, who was able to in a succint but thorough manner explain to me all of the HIV services that the hospital offered and reminded us that we had not included factors which affect the youths’ access to VCT in our study plans.
We finished our day by copying VCT records. Unfortunately, we left Embangweni at 5:00 pm which meant that for around an hour or so we were traveling in the dark, which is not ideal in Malawi. Before we left, I heard the news that we were taking a patient with us. I was not the most thrilled when I heard this, just because the thought of traveling 2 or so hours with a person who is ill is not the most appealing thing to me, but it was the right thing to do. The patient needed to go to Mzuzu Central Hospital and we were heading right through Mzuzu on our way back to Ekwendeni. The men had already gotten in the back and so I again got in the front, thankful actually that I would be further away from the patient. I looked behind and saw an older looking woman and thought that she didn’t look very ill. I went on to finish an article that Paul had which was written by some Canadian group of churches on the Christian Church’s response to HIV/AIDS and then I read another article on The Church and PMTCT (Prevention of Mother to Child Transmission). At one point, the IV bag of sugar and water fell from the ceiling of the Land Cruiser where it was attached to one of the beams. Some of the contents had fallen on Victor Gama (Mark Gama’s brother) and Paul, but Paul knew how to put it back together and the bag was reattached to the top of the land cruiser. At the point of all of this commotion I looked back and I realized that the patient was not the older woman, but the man who was incredibly emaciated who was lying in her arms who I later found out was most likely her husband. He was so small that at an initial glance I hadn’t even seen him. When we dropped this man off at the hospital, Mark and Paul got out of the vehicle and helped this frail man to walk into the hospital, one person standing on each side. I wonder what it would have been like to be that couple, to be the woman holding her husband who was so sick, probably in the end stages of AIDS. I wonder also what it would have been like to be the man who was so sick and still concious and most likely aware of what was going on. The couple had crossed the border from Zambia and must have had quite a journey to get to Mzuzu. The man didn’t cough throughout the trip but as he left the vehicle he breathed in and his lungs sounded congested. I just cannot fathom the extent of both of their suffering.
I really didn’t feel comfortable doing anything to help. I know that the virus is not passed through intact skin and that if I were to help him out of the vehicle, I would have most likely been fine. I am not willing to put myself in the position of touching a patient with my bare hands, who I don’t know if he has sores or not who is most likely in the end stages of AIDS with a high viral load. Even being the complete germ-o-phobe that, I am I feel ok about shaking people’s hands who have revealed to me have HIV. I eat with HIV+ people off the same dishes that I use. I think that this crisis demands that people act rationally and not distance themselves unnecessarily from those afflicted with the disease, but I am not willing to put myself in the position that Paul and Mark put themselves in. Multiple people I know including the youth at the church have expressed concern that I might get HIV/AIDS and I have said that there is nothing that I am doing which will expose me to HIV/AIDS. Towards the end of the summer, after I had given a couple of talks about what I was going to be doing and hearing some of the questions, I started to include basic facts about HIV/AIDS in my talks and I think I will do so here as well.
How Do People Get HIV?
HIV is a virus, which in infected persons is found in semen, vaginal fluids, blood and breast milk.
• HIV can be passed during vaginal, oral or anal sex.
• HIV can be passed while sharing needles.
• Health workers caring for people with HIV can get HIV from needle stick injuries.
• HIV can be passed from a mother to her baby during pregnancy, childbirth or breastfeeding. (Programs to prevent mother to child transmission are getting better all the time). Most of the time pregnant mothers who are HIV positive will have children who are HIV negative.
• Having a blood transfusion with infected blood before 1985 which is when in the US this country started screening blood for HIV. As a historical note, in China thousands of people have become infected with the virus through donating blood plasma in exchange for money.
I agree strongly with what the anthropologist/physician/professor Paul Farmer says, that poverty is so closely linked with HIV transmission. I read a book at the beginning of my stay here called something to the effect of The Hyena Wears Darkness: Risky Cultural Practices in Malawi. This book is based around the theme of wife inheritance, which is a cultural practice in which if a husband dies, the wife is to marry the husband’s brother. That practice must result from a need to ensure economic stability, but in the era of HIV has lead to many people becoming infected. As I wrote in my previous entry, while attending the pre-marriage retreat the girls while on their own listed “money” as the first reason why unmarried girls and boys have sex.
As a sidenote, I have heard several times from different sources that people just have more sex in Africa. I was sitting in the Land Cruiser today thinking about how blindly I have accepted that assumption without seeing any sort of study objectively showing that finding. It would be interesting to know.
It is amazing how long I can work at Livingstonia Synod AIDS Program and not come face to face with AIDS and then when I do I do not know how to react. AIDS’ devastation is sad, very sad. I feel incredibly blessed though, that I have been given tasks to do here which are very interesting to me and that I don’t have to be in the intensity of the hospital. I am also glad that I have not been put in a position where I have had to make a decision about the abstinence/condom debate. I have a great amount of sympathy for the position the churches are in on this issue, because it is a tough issue and taking one side or the other just doesn’t seem right to me.
As a closing thought, Rich Mullins writes about an experience in which he picked up a hitch-hiker who smelled very bad. Unable to withstand the stench any longer, he lied to the man that he was getting off at the next exit and had him get out of his car. He felt bad about doing that and reflected something to the effect of, “If faith doesn’t cost me anything then I am ok with it, but when I have to let a man ride in my car whose smell will remain there long after he leaves then I’m not sure it’s such a good idea.” I don’t think that we should all put ourselves at risk by allowing strangers into our car or putting ourselves in potentially risky situations with others who have diseases (although doctors and nurses do this every day), but in some way our faith requires us to get in the middle of the world’s problems and try to fight for justice for the suffering poor. I haven’t got a clue how that battle will be won, but if I ever doubted that there was a battle, seeing this man who had traveled all the way from Zambia, emaciated in his wife’s arms is enough evidence that there is a battle going on. Paul and I had a discussion about how difficult it is for HIV programs to become self-sustaining, and I am continually frustrated with the seeming lack of attempts at sustainability. But that battle must be fought on a different day because I need to go to bed.
Signing off after a long day in Malawi,
March 24, 2007
Sometimes when I am most busy doing data entry/analysis an opportunity presents itself to be helpful in other ways. I was sitting at my computer typing in comments from the 670 group representatives that we interviewed. The time was 11:30 am and I was looking forward to working for 30 more minutes and then going to lunch. Alice came over to me crouched down beside me so that her face was at my level and she said slowly with a serious tone that there was someone I should meet who has an important behavior change concern and that the conversation would only take 10 minutes. I should know by now, that rarely do meetings about complicated issues here take only 10 minutes. I was annoyed to have yet another interruption, but I politely said I would come and got up from my computer. As I walked to the meeting room in LISAP, I thought about what I could have done which offended someone to the extent that I was going to get a lecture on behavior change! It turns out the visitor was a teacher, Lincy Mvula, from the Ekwendeni CCAP School for the Disabled. One of her students had recently been raped and was pregnant. Her hypothesis was that many of the young women are raped as they travel long distances to and from school. She asked if LISAP did anything to help the disabled and both Alice and I said that we currently did not. In the past, LISAP had organized vocational trainings, but this year we were focusing on other areas.
Alice explained that she did not know what to tell her. Lincy further explained that she is the only teacher for 20 disabled children/youth. Having worked with disabled young adults in high school, I know how incredibly challenging that must be for her to have so many disabled youths to teach. She says the government pays for her salary, but outside of that there is no money for classroom materials.
I thought for about two seconds about offering to help edit a proposal, but remembering my previous time consuming experience with the Men’s Guild Orphan project decided against it. I then thought, that I should just tell her I am sorry and that I could not help her. Lincy went on to describe how she had applied 9 of her students to MACOHA which is a handicapped school in the capital city Lilongwe. Although she sent the applications in June 2006, she still hasn’t heard anything. I thought, how hard can it be to try and figure out what happened to those applications?
Well, harder than you might think. We looked up the phone number in Lilongwe and called on my phone. I had Lincy talk but for some reason the person she was talking to hung up on her. I tried calling back but the person did not speak English very well and got frustrated and hung up as well. As Lincy left, I told her that I would keep trying to figure out what happened to the applications. I really liked Lincy and admired what she was doing for these youths. She did not ask for money directly, but she just wanted to know if Alice knew of anything which could be done to help her and the youths’ situation. She was the type of person who lives fighting for people who many in all societies believe are not worth spending time and money on. We talk a lot in church about standing up for the poor and what an excellent example she is of doing just that.
That day, I must have called the school 5 times. Several times I was not able to get through at all. I decided to get Fikire (who works in accounts at LISAP) who is a native Chichewa speaker to do the talking. We learned that the applications are not sent to the Lilongwe office but to Zomba. We asked for the number of the MACOHA in Zomba, but they said they did not have it. I consider it pretty pathetic that the headquarters of an organization did not have another office’s phone number. We were told that the number was in the phonebook, but it wasn’t. Believe it or not, the size of the Malawi phonebook (yes, the whole country), is about as big as the LaGrange phone book. I then tried to call back to MACOHA and could not get through the rest of the day.
I then forgot about Lincy and trying to reach MACOHA to find out about the applications until I saw her come back to talk to Alice. She had prepared an analysis of her situation because Alice had suggested that might help. After seeing her, I regretted that I had forgotten to pursue the matter further. The next opportunity I got, I worked to get through to MACOHA Lilongwe again. I asked Alice how well she spoke Chichewa and she said “Very Fine.” So I handed the phone to her and she got a number for Zomba. We called Zomba and got through the first time and talked with someone who deals with the applications. Unfortunately, he was away from the office and could not access the form. Alice said that she pleaded with the man saying that this woman was desperate. He then said that Lincy could call on Monday at 9:00 am.
I went to see Lincy, but she was not at her school. An older woman who knew her said that she would give her the message and wrote down the details. I do not know if anything will come of the phone call, but it looks as if it might be fruitful. The success of finally getting through to two important people in solving this simple question “made my morning”, so I thought I would share the story.
On another note, we are starting to learn some interesting information from the data of the survey. We asked how many Home Based Care (HBC) patients were registered as of the end of the month of October and out of that number how many patients died during the month of October. We separated the patients by gender and age. It turns out that in both men and women for 0-24 year olds ~20% of the patients died and for 25+ year olds ~10% of the patients died. Franziska, my housemate offered the suggestion that if HBC takes care of any ill patients, then possibly the young people are dying of Malaria at a higher rate than adults which might account for the discordance. I suggested that possibly, young people for some reason come under the care of Home Based Care later than the older group. People would die with greater frequency, therefore, because they would be sicker when they started their care. Another interesting thing observed was that we had a high drop out rate (over 50%) for all of the vocational skills we teach youth: bricklaying, tinsmithing, sewing and knitting, and carpentry and joinery. We asked youth how many members in the group had ever been trained by LISAP in the following areas and then out of that number how many had dropped out. I hope this knowledge will be used to revise the trainines.
I hope there will be many more interesting findings to follow and the data will assist LISAP in planning programs of increasing effectiveness. The GPS points have been given to a person in Ekwendeni who knows how to use ArcView software. Once we have a map produced, which I think can be converted into a jpg, I’ll send it to you all so you can see where LISAP is working.
If you want to pray for special needs of LISAP here they are:
• The victims of HIV/AIDS all around the world
• Hippopotamus Honde (youth officer) was involved in a serious motorcycle accident in which he broke some bones in his wrist and had to have metal pins put into the bone. The swelling has gone down somewhat. He was smiling and walking around LISAP today even though he had a whole arm cast.
• Some of the maize that we delivered had been contaminated with an insect whose name I cannot spell and it was not useable. The HBC/OVC (Home based care) and (Orphan Care) acting officer is trying to figure out the extent of the problem.
• It is an ongoing struggle to put together a monitoring and evaluation program in a world where transportation is very expensive and many places have no access to telephones. The monitoring and evaluation officer is a very dedicated individual. He is coming into the office on Saturday and Sunday and it seems that whenever I work on weekends, he is there or has been there.
• The Office Runner, Dexter and his wife just had two twin baby boys.
On a different note, my parents are coming to visit me during the month of May and I am so excited about them coming! When they come they will mark the 6th and 7th people from First Presbyterian Church of LaGrange, GA to visit places in Africa (Kenya, Swaziland, and Malawi) in the past year. Who would have thought that this very special congregation would have chosen to become involved in the joys and sorrows of people on the other side of the world? I have come to realize that seeing other people’s poverty makes me recognize my own and I would like to think that in the interchange that we have with people of different cultures (when in the right spirit and attitude) we begin to heal each other’s wounds. Historically, there are probably more negative cross cultural relationship stories than positive, but I would like to think that for the most part my experience here has been beneficial to both parties. The people in Malawi, I feel, have reminded me of the importance of laughter, being kind to strangers, making time for conversation with people, praying more earnestly, and what it feels like to be supported and loved by people especially the Christian Community. These people that I live and work with as well as First Presbyterian Church of LaGrange, Georgia, Davidson College Presbyterian Church, and Central Presbyterian Church are taking off the rough edges of my heart, as I once heard in a speech and have left me feeling completely and utterly loved. I was told by Ben Mathes, director of Rivers of the World, that I had to let other people help me in this journey to get to Malawi. Here, I hear about and witness a lot of sad things: frequent sickness of other people, children with swollen belly, people who do not have the money to get transport to get ARVs, women who are forced have transactional sex to meet basic needs, infidelity, and learning a close friend is HIV+. Knowing the huge outpouring of support for my time here and projects, knowing that I am being prayed for, and experiencing daily random acts of kindness from the Malawians has been a resonant theme from my time here that I will never forget and adds a lot of love to the sad situations I see.
May the Lord Bless you and keep you, may the Lord make his face to shine upon you and be gracious unto you, May the Lord lift up his countenance upon you and give you peace,
I hope you are well. I am doing well in Malawi and have been back to work one week after having a glorious 3 week holiday with my parents. Busyness with work has kept me too long from writing an update and this one focuses much on my holiday, but I hope to have another letter out soon with my LISAP work information.
1. Road Trip Around Malawi with My Parents
3. Laston's Death
1. Road Trip Around Malawi with my Parents
I welcomed my parents to Lilongwe, Malawi the capital city on May 3rd. At Kamuzu International Airport, there is an open-air observatory where one can watch the planes, and I saw their plane land. Recent theft at the airport had removed critical devices helpful for landing and so now all planes must land under manual control. British Airways has discontinued all their flights into Kamuzu for this reason-but that did not stop the DeCelle family vaction!
I have been amazed by the impact that the opportunity I have been given to volunteer in Ekwendeni has had on me, my family, and supporting churches and friends. I would like to think that we have been transformed into people with a more accurate perception of people in this part of the world. I am fortunate to have parents who not only supported my Malawian experience, but who wanted to experience Malawi for themselves.
My parents and I embarked on a 1,200 mile journey in our Avis Rental car from Lilongwe- driving on the left side of the road and navigating roundabouts. Highlights from Lilongwe, the capital city, included seeing the Crisis Nursery-a home for infants up to age 1 started by the Presbyterian Mission Co-workers Frank and Nancy Dimmock. The home has ~25 infants who will either be adopted or go back into the villages to stay with family once they have reached age 1 and are easier to care for. HIV positive babies have the opportunity to receive ARVs.
Driving 8 hours got us to Ekwendeni. Unfortunately, my dad had to drive around an hour in the dark, which is not recommended. My family has difficulty getting an early start on vacations, and we were estimating the journey to take less time than it did. We learned after the first few trips that we needed to double driving times that people gave us. Driving in Malawi should have its own guidebook. There are bicycles and people walking on the edge of the road-and frequently in the actual lane. There are many old, slow moving vehicles which need to be passed. I drove for around 3 hours north on M1 to Ekwendeni (overall on the trip I drove about ¼ to 1/3 of the time), and because of the quantity of people in and around the road driving was a bit unnerving.
Close Calls in Cars
A theme to driving in Malawi might be "close calls." I was riding with 4 other people back from Embangweni last night after a long day of questionnaire revisions and logistical planning when I noticed 2 bikes in the middle of our lane with the right-most bike moving towards the centre line. The vehicle we were moving in was moving down the road probably at 60-70 miles and hour and swerved around these bikes. I honestly thought we were going to hit one of the bikers and I shouted "Oh my God, oh my God," but fortunately we missed them. No one else in the car seemed to have been as concerned as I was that we were going to hit one of the bikers.
I have yet to be in a vehicle that has hit a person, but I have been in vehicles which hit a dog and one that hit a calf. If I had to analyze the problem, I would say that lack of money forces the roads to be of minimal width, most of time not accommodating adequate space for bikers, walkers, and cars. Most trucks have not been replaced and are decades old because of lack of money. The situation results in thousands of "close calls" everyday—ones which would be unacceptably close in the United States, but that are common place here. I notice that I instinctively or out of habit put a larger distance between myself and the vehicles if I am walking than most Malawians-but I am not trying to travel by walking on main roads. Many Malawians do not have a choice whether to have "close calls" or not because they have to transport goods for their livelihoods. It is surely a terrific site, to see a bike with 6 feet of stacked cut logs on the back of it, but sad to think of the risk that people take on bikes. I heard about a child who was killed a few months ago by a minibus between Ekwendeni and Mzuzu.
I would really like to see statistics on relative road safety in the US verses Malawi. The statistic from the US from a few years ago was that there were 40,000 annual car deaths ~115 a day. Because of how many walkers and bikers are sharing the roads with the cars, I would imagine it is much more dangerous to be on the road here.
This picture was taken from "The Avis" (affectionate name for our rental car). Note the man walking on the side of the road competing for space with the cars. This is an example of a main road running through Malawi.
My parents lived with me in my house in Ekwendeni for 5 days and met many co-workers and neighbors. They went to Christian Youth Fellowship and were impressed by the earnestness of the youth. We were discussing the Lord's Prayer and got into some interesting questions such as "Where is heaven?" They experienced a lively church service with multiple choirs who sang. Other highlights from Ekwendeni included visiting a Community Based Child Care Centre (CBCC) linked to LISAP. This forward thinking centre grows food for the children on the property of the church, thus being much more self sustaining than other CBCCs. Water here has challenges, as people are currently using a hand dug well around 25 m deep. A bucket is lowered into the pit to get water, but unfortunately the bucket had been recently dropped in the well. The well is out of use until someone can crawl down the well to retrieve it. We also had the opportunity to visit a LISAP microfinance project in which a group of women get together to save small amounts of money every week. The women then loan out the money for others to start small businesses.
I loved Nyika National Park which is in the north of Malawi. Although it took 8 hours to get to Chelinda Camp and several times my dad and I left the vehicle to determine the depth of puddles to see if we could pass, Nyika was unique and worth the trip. Roughly 7000 km above sea level, Nyika's landscape contains many rolling treeless hills cascading one after the other. We went on a walking safari and saw zebra, bushbuck, and roan antelope. It was a first for me to see zebra, and being in this mysterious landscape was a thrill.
We are wearing winter coats because of the 40 degree F temperature in this high-altitude location.
Beautiful Golden Hills of Nyika
Reflection on Long Walk to Freedom
After Nyika, we drove to Nkhotakota Pottery on Lake Malawi known for its Malawian-made pottery for sale. I enjoyed the opportunity to read at the beach. Over the course of the holiday, I read the entirety of Nelson Mandela's Long Walk to Freedom. I was torn in my opinion of his decision to embrace an armed struggle through the militant wing of the African National Congress and reminded of the observation that it is sometimes difficult to fight evil without becoming part of the evil. One has to admire Nelson's foresight in desiring a country where blacks and whites live together and both make up members of the government.
The world seems to lack leaders, like Mandela, who have the ability to unite groups of fighting people in a way that decreases violence and allows people to simply live.
Under apartheid, black South Africans could not vote and many were taken from their homes and relocated. Mandela wrote about an African inferiority complex, which is something I have observed as well. In trying to plan research/monitoring projects with Malawians, I observed people do not have a lot of confidence in their own abilities. People were reluctant to volunteer, for example, to be on a task force responsible for the planning of the survey while I would be on holiday. A Kenyan who had been assigned to a hospital in Malawi made the observation after witnessing the reluctance to take up responsibility at the meeting that there is such a lack of empowerment here in Malawi (he was speaking relative to Kenya). Both of the projects I have worked on have required extensive planning with Malawians. I hope that the opportunity to help plan and carry out these projects will increase their confidence. I saw evidence of this upon returning from holiday as Gray had finished rough drafts of the questionnaires.
I heard on the BBC just yesterday that there are massive strikes going on in South Africa in which workers want a 12% pay increase. A woman who was traveling with us on Safari remarked that while she was in Cape Town, South Africa there was an enormous amount of tension which made walking alone dangerous. All of these examples show that a truly free South Africa has not been realized, but there are few men like Mandela who can accurately claim to have brought about a new level of freedom to an oppressed people.
We next visited Liwonde National Park known for its hippos. Here we stayed in "tents" of sorts and could hear the hippos expelling air from the comfort of inside the tent. There were plenty of warthogs and monkeys around right outside the tents!
Picture of the Shire River with a hippo in the middle. (Look for the cattle egret sitting on top of the hippo).
The final stop of our trip was South Lwangwa National Park in Zambia. I had to include the below picture because I am amazed at the beauty of these lions-and no I do not have a telephoto lens on my camera!
And Dr. Case will be pleased to hear that we saw a leopard and followed it in our vehicle for a couple minutes. Dr. Case and I had the opportunity to see a leopard briefly in Chobe National Park in 2004 in Botswana and it was quite a thrill for her at least. I can remember seeing its tail as it dashed off into the bush.
It was sad to see my parents leave, but I think they left feeling better about me being in Malawi having seen it for themselves. It is a special treat to have those you love come to appreciate the things that you care about.
Leah Singini Off to School
Thanks to everyone who contributed to Leah Singini's fund to go to Business College. We have raised at least enough money for her to get a certificate which will take 6 months. After those 6 months, I will find out her progress and then send a follow-up e-mail. She seems to be excited about going to school and was eager for me to sign the form from the school indicating information about the donor despite the fact that the form is not due until July. I put "First Presbyterian Church of LaGrange" under the donor not wanting to put my own name, but maybe it would have been more accurate to "E-mail Distribution List." Thank you all, wherever you are who contributed.
Thanks to Presbyterian Women of First Presbyterian Church
I would like to personally thank Presbyterian Women of First Presbyterian Church, on behalf of LISAP, for your very generous donation to the organization. As I explained before to the understanding coordinator of the fundraising Donlyn Aiken, it is difficult to get donors to pay for administrative costs of organizations and so having a donation with undesignated funds is very helpful.
Thanks to the Youth of First Presbyterian Church
The 11 balls bought with the money from the car wash were distributed to youth clubs by the behavior change officer Alice Ngosi sometime in May.
I have been asked by one of the 5 boys living in a very small house behind my house if anyone would like to donate money for a volleyball for a team that he has started. The ball he wants for the team costs between $28 and $35 dollars. If anyone would be interested in providing funds for this ball please e-mail email@example.com and I will personally buy the ball.
3. Laston's Death
Laston Nyirenda worked as the acting Home Based Care and Orphan Care officer for LISAP while Charity was in Kenya getting further training. He had helped to plan the Baseline Survey, and I remember his willingness to look over the questionnaire at the last minute along with another co-worker. He had had a series of illnesses over the last few months but somehow managed to distribute the maize and likuni phala (peanut butter like food) to People Living with HIV/AIDS (PLWAs) and orphans and vulnerable children.
He died while I was on holiday, although I did not learn of his death until I got back. I suspect Laston had HIV/AIDS, although unfortunately, even in an HIV/AIDS organization the power of stigma has prevented at least one other co-worker from being open about their status.
I was looking though a notebook this morning and I came across his distinctive penmanship. He had helped to translate the Frisbee logo into Tumbuka. For many people, AIDS is a problem which has become cliché and there is a sense in which "everyone" is working on it, but I feel this is very far from reality. My assessment from being here is that "the laborers are few." LISAP could do so much more with a larger staff and especially with more involvement from the church and community. AIDS is still rarely talked about in sermons or in prayers. Laston's death is a reminder of the magnitude of the tragedy of this disease which has cost the world 25 million lives over 25 years.
When I went to Africa the first time, for just a month, it was difficult to get to know people with any sort of depth. Consequently, I came away with a sense that AIDS is a huge problem but I had not made personal connections with Zambians. Here, the people who have HIV are those that I am working with and in some ways I have stopped focusing on "the problem" of AIDS because I know people LIVING not just dying with the disease. But knowing people both living and dying with HIV/AIDS makes me realize that "the problem" is a downright tragedy.
If you would like to pray for the ministry of the Livingstonia Synod AIDS Programme here are several items:
Hippo Honde is having surgery again on his arm next wednesday (which was badly broken in February a work-related motorcycle accident). The first time he had surgery on it, the surgeons incorrectly attached his bones.
The family of Laston Nyirenda
Discernment for how to fill the HBC/OVC position.
Finalization of the Baseline Survey Report. Unfortunately, all of the tables are grouped by Presbytery and may need to be grouped by District which will affect the text of the report and will be very time consuming.
Questionnaires' revision for the HIV/AIDS services in 2 hospitals.
Meeting on June 6th of the Presbytery HIV/AIDS Committee for Ekwendeni-that they would discern what they can do to be helpful.
In the Hope that Christ Gives,
This is my last reflection. Contained within is
Week of Prayer and Fasting July 2-6, 2007
Utilization of HIV/AIDS Survey July 9th-August 3rd
Youth Sunday and the Sweetest Gifts August 5, 2007
Enjoy. I fly home August 19-20th and I am very sad to leave but looking forward to being with you in person.
Week of Prayer and Fasting July 2-6, 2007
After sensing a general decline in spiritual fervency, the Christian Youth Fellowship (CYF) executive committee decided to call a week of prayer and fasting. Attendance at the joint fellowship of English and Tumbuka CYF groups had dwindled as well as the lunch hour fellowship attendance. At first when I heard about this decision, I thought that these people do not know what decline in spiritual fervency looks like. The earnestness with which most of these youths seek God has left an enduring impression on me. Perhaps their alertness to changes amongst the group is evidence of that earnestness.
By fasting for a week, this did not mean literally fasting for a week, but fasting until 4 pm every day. I have only fasted on 2 or 3 other occasions and that was only for a day. It was a week before the pretesting was to begin for the utilization of HIV and AIDS services survey and I struggled to discern the degree to which I should participate. I ended up developing a cold and deciding that for me to fast while feeling lousy with a big week ahead of me was not wise.
The theme of the week was taken from Isaiah 40:30-31 which says “Young men may grow weary and faint, even the fittest may stumble and fall; but those who look to the Lord will win new strength, they will soar as on eagles’ wings; they will run and not feel faint, march on and not grow weary.” In other translations, the verse reads “those who wait on the Lord...” The whole idea of the prayer and fasting week was not “normal” by my standards, but I found the experience to be helpful. It caused me to turn my attention from my own individual projects, to the concerns of the larger group. Since the beginning of my attendance at this group, I have wanted to simply worship with them, not to lead them. At work I have been in the position of managing two projects, and have come to the conclusion that in addition to the projects in which I am the team leader, I need to be in groups in which I do not have to be “the leader.”
I left this reflection for several days because I did not know how to describe in a way which was accurate how much it means to me to be to be able to worship with these people. Everything I wrote did not quite capture the significance or the power of worshipping Jesus with these people. The closest that I have been able to come is Ephesians 2:14 which says “For he is our peace, who hath made both one, and hath broken down the middle wall of partition between us.” Of course, that verse is written in reference to how the Gentiles and Jews have become one. The Bible says that in the beginning the Jews were the chosen people, but then God decided that everyone should have equal access to God through Christ regardless of whether you were born Jewish. There are still big differences between us and gaps which may never be filled, but I am joyful because of the unfeigned unity that I feel.
This is a random picture of Alice and me.
Utilization of HIV/AIDS Survey July 9th-August 3rd
During these weeks, 11 enumerators, 2 supervisors and I, pretested and conducted a survey in two hospitals (Embangweni and David Gordon Memorial) looking at ways to improve HIV and AIDS services specifically Voluntary Counseling and Testing (VCT), Antiretroviral Drug Distribution (ARV), and Prevention of Mother to Child Transmission Services (PMTCT). We had 4 objectives:
1. Identify clients’ and hospital personnel’s perspectives of the quality of VCT, ARV, and PMTCT services at Embangweni and David Gordon Memorial.
2. Identify whether health personnel are communicating certain key messages about ARVs and PMTCT to their clients and certain key messages about ARVs to community members. (For example, does a person on ARVs and random people in the community know that ARVs stop the replication of the virus in the body? Do women who have gone through the PMTCT program know that nevirapine helps to prevent mother to child transmission of the virus? Do people believe there is anything which can completely cure someone of HIV?)
3. Identify the sources from which clients get information on VCT, ARVs, and PMTCT and community members get information on ARVs.
4. Identify whether VCT, ARV, and PMTCT clients who are married disclose to their spouse that they have accessed the service. Identify who people who have gone through ARV or PMTCT services have disclosed that they have accessed the service.
5. Identify ways to encourage more youths to go for VCT.
There were 5 questionnaires designed, one for each of the following groups: VCT clients, ARV clients, PMTCT clients, Hospital Personnel, and Community members (to assess ARV knowledge).
Some interesting things which are coming out of the surveys include a suggestion from one hospital to have HIV test kits in the maternity ward, and so women who come to deliver and who have not been through antenatal clinic can be tested if they want to be. This would enable a greater number of women to receive nevirapine which can help prevent mother to child transmission of HIV.
While I was in Livingstonia in David Gordon Memorial’s catchment area, I got the opportunity to see a number of villages. In the catchment area there are 46 villages and we randomly selected 10 and out of each of these 10 villages. We would enter the village and asked permission from the village headman to conduct the survey. Then we tried to find the centre of the density of houses. Then we spun a glass bottle on the ground and whatever direction it pointed we went house to house looking for 5 males between the ages of 15 and 49. We spun the bottle again and went looking for 5 females in the same age range. Wandering around villages and up and down mountains, going to people’s houses was my favorite part of the survey! It was the second time being in Malawi that I got a sense of the idyllic setting of the village. Sometimes when I go to villages I feel like there is an oppressive atmosphere because of the illness and the poverty, but here I felt surrounded by beauty. I am sorry that I do not have pictures, but I have developed a personal rule that I do not take pictures of people unless I have their permission and I know them. Although wealth will always be a barrier to people being together, there are things that we can do to minimize differences and I think refraining from taking a picture in many cases is appropriate.
Anyway, in one of the villages we met 3 people who had never heard of ARVs. With this particular village identified, it is my hope that the hospital could target this village for education campaigns on ARVs.
One of the surprising findings to me was that only about half of the women who had gone through PMTCT at one of the hospitals knew that nevirapine is to help prevent the baby from getting HIV, which means that the women are not being adequately informed.
Out of the focus groups that a woman named Carole came and did at the secondary schools, the youth have suggested that a VCT located at the school would be helpful. What this would mean would be that the hospital one of the days in a month could go to the schools on mobile clinic.
I don’t know what the final data entry will yield, but there are several individual circumstances which are quite sad which will remain in my mind. There was one girl who was just 9 years old on ARVs. I don’t know how to deal with that reality emotionally. It is a tragedy when anyone gets HIV, but when a 9 year old child has it, somehow that is worse. There was a woman who was around my age who had gone through the PMTCT program whose husband was living somewhere else. This woman had gone into labor and she felt she was treated rudely by the nurses when she asked for nevirapine. She was told the labor was not established enough for the nevirapine to be given and so she went back to waiting. By the time she delivered it was too late and she never received nevirapine although her child did. I hope that her story will help the hospital to ensure that this does not happen again.
Picture of the enumerators approaching a village in Livingstonia
This is a picture of the group of enumerators, driver (right) and supervisor (centre) at David Gordon Memorial Hospital. I tried to make a joke to make people smile, but upon failing to provide an adequate joke someone from the group said something that made everyone laugh...although I am still not sure what it was!
Youth Sunday and the Sweetest Gifts August 5, 2007
Youth Sunday was a roller coaster of emotions. I had been asked to say the intercessory prayer. The intercessory prayer is to pray for church activities, the welfare of the people, leaders (church and secular), and world events. I still don’t feel comfortable praying impromptu and so I had written down everything I wanted to pray about.
At the beginning of the service, however, a young man gave a testimony about being cured of HIV. It was very uncomfortable for me to hear what this man was saying. What made me most upset was the assertion that people just needed to pray harder and then they would be cured as well of HIV. On one hand, I appreciated his story because it must have been an amazing experience for him to have been tested once positive and then negative. I have convictions about how God has worked in my life which other people would probably scoff at and I am not in any position to judge this person. But one logical explanation could have been that they switched his blood sample with another persons and he was never HIV positive. What grates at me most is the assertion that all of the truly faithful will be physically healed, which is not Biblical. God chooses to heal a select few for God’s glory. I was in a strange position because I had not yet said my prayer. On one hand, I did not want to be combative and I did not want to make this person feel bad, but on the other hand the assertion that people just need to pray harder to be cured of HIV was not Biblical and I think potentially was hurtful to the many people there who were HIV positive.
So I decided to add to be prayer that we rejoice with this brother here who was healed and we pray for the millions of faithful followers who are not healed. In the mystery which we do not understand you choose to heal only a few and we know that many times the only answer to our prayer is your silence, but we have faith that you will comfort us and heal this aching in our hearts.
I talked about this afterwards with a British medical student who said she had liked what I had done with the prayer in response to what had been said. I still do not know for sure if it was the right thing to do. I have learned here that even if you feel strongly that what you believe and are saying is true, that does not mean that saying it is necessarily the best thing to say. I felt like with the way the Malawians cheered and clapped for this man that maybe people were not ready to hear that God is not going to cure everyone and perhaps it was inappropriate for me to use the prayer as a forum to address that issue, but I stand by what I said and I hope that it was comforting to many in the congregation.
I received two very sweet gifts on Sunday, one from CYF and one from the Men’s Guild (I worked with the Men’s Guild to write an Orphan Care proposal). CYF executive committee felt that it would be good for me to have a CYF uniform and so approached the Session (governing body of an individual Presbyterian church) about the idea as well as the idea that the uniform ceremony be done in church. I was informed about all of this on the Friday before Sunday. I was deeply flattered that they had gone to the trouble to arrange all of this and pay for the uniform, bowtie and badge. In the picture below, Tiko (who is Alice’s daughter) is putting on the uniform at the Tumbuka service.
The Men’s Guild got me a hardback copy of the NIV translation of the Bible. I think this gift came out of seeing me with Bibles which were paperback and falling apart. I also read from a relatively obscure translation called the Revised English Bible which was the translation I was supposed to get for Davidson, but I find that no one I know reads from this Bible. They both were really sweet gifts and I am once again humbled by their generosity and love.
This reflection will most likely be my last reflection. Over the next week or so, I am having people over to my house for dinner to say goodbye. Around 40 youth from CYF are going to climb the tallest mountain around Ekwendeni called Bwabwa and have a worship service in which I am one of the people speaking. Over the last week I found someone at Mzuzu University here who can help me with the software analysis programme SPSS. There are a few more things I need to do to get the data for the map ready before giving it to the map software guy. As well, I need to rewrite the results and discussion of the report in a different format than it was previously written. I don’t know how all of this is going to get done, but I am going to try. I hope to get the map with all of the main areas where LISAP is working printed when I go to Lilongwe.
I would like to thank everyone who made it possible for me to be here and who made it possible for me to do the work that I have done while I have been here. I have struggled a lot and learned a lot, and realized that I have a lot to learn. I look forward to the opportunity to see you in person and to learn what life has been like for you over this past year. Anything that I say will be inadequate to thank the people on this list for all of the support they have given me. All I can say is that I am grateful to have had the opportunity to go to Malawi for this year and have become more convinced through the faith, love, and hope of the people here that God will never desert us in our times of struggle. We may question why bad things happen to everyone and feel like silence is the only answer to our prayer, but God will be with us if we seek him. In the words of Jesus from Matthew 28:20 “Teaching them to observe all things whatsoever I have commanded you; and, lo, I am with you always, even unto the end of the world.”
June 15, 2007
I promised a reflection based on work experiences.
Baseline Report Challenge and Finding
In November and December, 2006 the Livingstonia Synod AIDS Programme conducted a census of groups which had affiliation to us to find out information such as but not limited to: Number of volunteers in the group, number of people trained in the group, and number of beneficiaries of the group. Previously, the organization had no updated records of the community groups which it had affiliation to. It did not have a list of different “areas” (area is a geographical term which indicates a place with several villages) it was working with. We hoped that during the survey we could collect locations for the affiliated groups to produce a map showing locations of our work in the northern region. While we were on the “census” in the Northern Region of Malawi we collected 217 pairs of location data in the form of longitude and latitude with the datum WGS84 (if the term datum means nothing to you, you are not alone).
Upon coming back to the office, I typed the hand written coordinates and submitted them to a person who works in the development department also staying in Ekwendeni. He came back to me and said that the coordinates were in the Indian Ocean-never a good sign. He sent my data to another person in Lilongwe who works with GIS, who similarly had trouble with the data.
I was told that to use the ArcView mapping software we should have collected the coordinates in Universal Transverse Mercator (UTM), but neither the person in Ekwendeni or in Lilongwe knew how to convert them, but both said it was possible. So I e-mailed my dad who is quite interested in GPS technology and is a proud Geocasher-which is a game for people to hide small items places and then post the coordinates on the internet and then others can take their GPS’s and find these “treasures.” A few times in Dayton, OH the DeCelles went “Geocashing” as a family. Anyway, a website was found to convert these coordinates and we changed the Longitude and Latitude WGS84 into UTM NAD 83. The process of conversion took quite a bit of time. The internet here is fairly slow and every time we would type in a pair of coordinates there was around 30 second delay. Special thanks goes to Annabel and Kirsty, two British medical students who offered to help me with this process which ended up taking around 12 hours.
But the story doesn’t end there.
I then resubmitted another file to the same person working in development, who came back to me and said the points were not in Malawi. At some point in this whole process, I got out a map which had latitude and longitude labeled and located one of our points and felt that the coordinates were appropriate, and so I did not believe that the points were incorrect.
While my parents were here, I had the opportunity to personally visit Lilongwe and one afternoon I met with the GIS specialist who was able to produce a map in roughly 10 minutes with the converted points. I have learned that sometimes, the only way to get things done here is to personally visit people.
But the story doesn’t end here.
I then talked with the PCUSA mission co-worker Jim McGill who works on water and sanitation, and he said that the coordinates needed to be in the datum ARC60 in order to be able to properly overlay with existing map features. In other words, when the computer software is producing the map it has the capacity to include previously saved boundaries of Malawi such as districts, presbyteries, and a country outline. It can also include roads and natural features such as rivers. All of these other “levels” of the map have been collected in UTM ARC60.
So my dad took out his GPS which he had brought on the trip. We compared NAD83 to ARC60 for several coordinate pairs and it turns out that in one direction they are only about 300 meters different and in the other 80 or so meters.
So I made the corrections to my spreadsheet and brought it back to Ekwendeni where the worker was able to finally put the coordinates on a map. I am still waiting for coordinates for around 10 areas, but below you should see around 90 areas marked. This map is a work in progress, but it gives a visual of where we are working.
We are still working through problems of being able to find the whole northern region on one map to be displayed on an 8 ½ by 11 in page. I realize also that we do not have a scale on this map. The northernmost point to the southern most point (of the northern region) covers a distance of about 200 miles.
To contact Kristen please click HERE: