What follows here are just my thoughts and words. No fact checking, no spell checking, no promises of great insight or good grammar. Just me dumping the words in my head to words on the screen. Bear with me... sometimes it's a bumpy ride.

Wednesday, September 22, 2010

The Crush of Children

No, this isn't going to be another heart-wrenching story of children orphaned by AIDS.

This is an episode that was recalled to me as I was looking back at some photographs.  We had visited a village center and been treated as guests of honor with singing, prayers, testimonies and dancing.  At the end, there was the usual photographing of the multudinous children.  I had the idea to squat down, you know, to be a kid level for some picures with the kids.  Thankfully (for me), I managed to drag down two of my fellow cohorts with me.  Well, we learned very quickly that this might not be the smartest thing to do.

The children, in their excitement not only of having us crouched down and far more within reach to touch and rub or pound our heads and shoulders, but also at having additional photo opportunities,  thronged and surged forward in a crush of jockeying for better position.  We were soon nearly overtaken.  Look very closely at the photo below... You can see me, and just below my left shoulder is one blue eye and the forehead of fellow traveler (and GAIA Board President - eek!) Marty, and then one child away from me to my right, the nearly drowned head (eyebrow & eye, really) of my roommate Nadia.  We are laughing on the outside, but on the inside we fear we are milliseconds away from being trampled to death by  6,000 exuberant village children.

Alas... we did survive. And  - perhaps needless to say - learned NEVER to do that again! (Although it did make for a pretty hysterical picture.)

Whew.

Sunday, September 19, 2010

19 September 2010

Being home now for a week, talking to people, casually, about my trip, and looking back over photos, I am aware that this is a journey that has left a distinct impression, and that I think will stay with me for some time. Reliving parts of my days in Malawi through the veil of memory necessarily sacrifices some of the immediate detail, but the impressions have had some time to simmer in the stew that is my head, and I still try to find some context and understanding.

There are the "simple" things - like the sights, sounds and smells of being in a completely different culture on the other side of the world. I thought maybe I’d touch on some of those, as they continue to bubble to the top of the stew.

But then there’s the deeper things - the experience of seeing so intimately into the lives of people so far outside of my own personal frame of reference. It feels odd, false but not really, to sit in my house where I have so much, and know that a world away there is a woman who goes to bed with the sun, because she has no electricity, in her one room, dirt floored hut on a reed mat for a bed with maybe a blanket, maybe only a couple of chitenjes for cover. She may have a husband, or she may be the sole caregiver for her grandchildren because her own children have passed away. She will get up when the sun rises and wash her clothes in the river and spread them to dry on the bushes. She will walk to the local water pump and fill her bucket with water which will have to last her the whole day - for cooking, for washing, for drinking - and carry it back to her hut on her head. She will gather wood for her fire, a large bundle of branches, or buy a supply of charcoal, and carry it back to her hut on her head. She will shave the maize and spread the kernels out to dry in the sun. And later grind it into the powder that will be the basis for the main staple of her one or two meals a day. While she is tending her cooking fire, or sweeping the dirt around her home, she may see a car drive down the narrow, rutted road that she walks to get to the market, to the water pump, to the river, to the village center. And in the back seat are women - white women, azungu - waving to her. And, as she smiles and waves back, what does she think about us?

So... not to wax rhapsodic about all of this, but I did run across a quote (unfortunately, I don’t know the source, so I cannot give proper credit). It helps me keep a bit of a handle on the struggle I have with my Malawi journey: "Although the world is full of suffering, it is also full of the overcoming of it."

Saturday, September 18, 2010

Home at Last ...

Sunday, 12 September 2010

After too many hours on airplanes and in airports, I am happy to report that I am back on Petaluma soil.  I have deliciously showered off over 30 hours of international travel.  Unfortunately, both Nadia's and my checked bags are still apparently sitting in Joberg.  We have been assured they will be delivered - hopefully in the next couple of days.  Hopefully with a minimum of items missing.

Thank you all for "listening" to my travel journal.  And for your periodic responses, comments and support.

Signing Off From Malawi ...

Friday, 10 September 2010

 We have, in the last two days, had the following oh-so-Malawi (/Africa) experience: Our lodge ran out of water for a day. Our office had no electricity for a day. And today the city of Blantyre has no petrol in any of the gas stations. We are lucky this last happened at the end of our trip, or we may not have been able to do all the driving we did to see all of our projects.

Malawi is a country which shares both Christian and Muslim faiths. There are several mosques around. Each day there are the traditional Calls to Prayer, which are lovely and somewhat haunting. Happily, I don’t usually hear the first morning call (at sunup, which is something like 5:30 AM). But each evening, I have watched the brilliant orange-to-pink-to-blue-to-purple sunset and heard the melodic prayer.

We visited a project where GAIA provides micro loans to women, and heard the women describe for us the impact these loans have made in their lives. It was uplifting and enlightening. We heard tales of a grandmother who cares for her orphaned grandchildren and can now afford to pay their school fees. Plus she was able to buy herself a bicycle and rides it proudly to the bank to deposit into her savings. We heard several stories of women who were able to build stronger houses with good roofs for their families. And we heard stories of women who’s husbands work with them in a family enterprise. Story after story included "pay for my children to go to school" and "able to feed my family, even in the time of drought". It was a wonderful respite from the heartbreak of the previous days. But don’t be mislead - these women are still barefoot, living in a remote village, in a hut with dirt floors and eeking out a living. It’s just that they are learning to make and save a little money, which makes a big difference in a life with otherwise very very little.

I’ve been asked if I am ready to leave. The answer is both yes and no. I miss my family terribly. Guiltily, I will admit that I miss my shower (and the water pressure of home). Once home, I think I will miss my GAIA family. It is an outstanding group of folks with whom I’ve been privileged to share this incredible journey. And I will miss the GAIA staff who I’ve come to know and with whom I have so enjoyed working side by side. Alas, I don’t think I will miss the smokey air I romanticized a bit early on. I will not miss the beggars in the street, with twisted legs or hungry bellies. I will not miss the barred windows and doors. I will not miss my mosquito net. I will miss seeing the children so eager to come and greet us, eager and shy simultaneously to touch us. I will miss the delicious harmonies and joyous songs of the women. I will miss learning a bit of Chichewa and surprising Malawians when I try to use it. I will miss the lovely cadence of the English spoken by the Malawians. I will miss the "James Earl Jones" laugh of one of our drivers. I will miss seeing something new and different so many times a day, each and every day. This has been the trip of a lifetime, to be certain. Just remember - if you ever come.... just bring carry on.

As they say in Chichewa.... Bye Bye!

More RRO&F ...

ITEM: I was surprised to see so many plants I recognized from Hawaii. The climate - tho understandably dryer than the tropical island air - is apparently similar. There are plumeria trees (but the air is not fragrant with their scent - the blooms are over for the year, and most of the trees are bare), palm trees, sugar cane, banana trees, hibiscus, bouganvilla, guava, papaya, avocado and even macademia nut trees.

ITEM: I have seen more albinos (pronounced "albeenos" by the Malawians) in these last two weeks than ever before in my life. I have so far counted 8 - 7 children and one adult. Apparently, it is simply a recessive gene and not all that terribly uncommon. I asked if these children were treated or looked upon any differently. No, they are not.


ITEM: "Mass transportation" is via mini-bus - a small van (much like the old Volkswagen buses) with four rows of seats which are usually packed full of more often men, but periodically also women. The mini-buses are notoriously dangerous. We have seen the aftermath of several collisions.

ITEM:  Doing all the driving we’ve been doing, I am acutely aware of a puzzling mental disconnect. We leave the urban area and drive on a ribbon of asphalt that slices through the landscape of footpaths, dirt roads, clusters of huts and periodic crossroads with market stalls and cement block shops. Cars are few. We share the road with countless people walking great distances between markets, often times the women carry their children tied ingeniously to their backs and have large baskets or flats of bananas or tomatoes, or buckets full of water atop their heads. We share the road with bicycles, also loaded up with stacks of wood, huge bags of charcoal, crates, more people, anything that can be carried. We share the road with chickens, and goats, and the periodic cart being pulled by 2 oxen. Cars driving 50+ miles per hour speed past all the children spilling out of the primary school and walking back home. This road is clearly progress and provides an artery of smooth travel for at least a portion of these people’s journeys. But it seems like the cars don’t belong here.

I feel that in many ways Malawi is a Tromp de l’oeil. The landscape is strikingly beautiful, from the majestic Mulanje Mountain rising up out of nowhere, to the lush expanses of tea fields, to the charming thatched roof huts on a hillside village, to the vast Lake Malawi with its beaches and bays; from the intricate brickwork and delicate minaret arising from a Muslim temple to the imposing and ancient Christian church which watches over the surrounding center from its beautiful stained glass windows; and from the beautiful and quick smiles of the Malawian people that you just pass on an urban street or wave to from the village road, to the resilient and captivating children. From a distance - it is a lovely place to behold, a picture to another time. But knowing the stories, the truth, of the people who must scratch out a living here leaves you with an altogether different impression.

Random Ruminations, Observations & Factoids ...

ITEM:  The weather we hit was unseasonably mild. We have had very temperate days, maybe mid to high 70's, and most nights have remained still pleasant, say high 60's - low 70's. Most nights have sufficed with just a light sweater. It is not the warmer, humid air which I was anticipating (consequently, my hair has been up in a flat, lifeless ponytail more often than not, rather than down in the soft wavy curls I get in Hawaii). In Malawi, they do not observe the four seasons to which we are accustomed. Rather, they have the dry season (which we are at the end of), the hot season (which is what is coming next) and then the rainy season (which is when mosquitos and malaria become rampant). Now having been out on many of the dirt roads which serve as the only way to the remote villages in which we work, we understand why passage during the rainy season becomes far more treacherous, and indeed, sometimes impossible.

ITEM: I now understand more about the smoke and fires and haze that often fills the Malawi skies (and which, by the way, make for vibrant and spectacular sunsets). There are village cooking fires. Also, there are piles of trash that are burned everywhere. Periodically, you can tell that someone has thrown in some plastic as the smell becomes harsh and acrid. Some of the fires in the surrounding countryside might be specific burns lit by usually young men in order to flush out the mice, which they then trap, grill and sell by the roadside, kebob style. It’s called embewa. I do not have first hand knowledge of this, but I am given to understand that you can get your embewa with or without the fur still on. Of our two drivers, one indicated he did like embewa, while the other emphatically did not.

ITEM: In the more urbanized areas, Malawi is a country of vigilant security. Every business in the downtown area has iron grillwork over its storefront windows and doors. When you venture off a main street to go into a residential neighborhood, you pass through a security "gate" (a stanchion across the road much like a railroad crossing, which is raised and lowered by the guard standing there). Every residence is walled. Atop the walls are often lines or rolls of barbed wire. In some places, jagged spires of broken glass have been affixed to the top of the brick walls to deter any would be wall-scalers. To enter a "compound", your driver honks his horn. The guard inside peers out through a peep window (a la Wizard of Oz... remember the fur hatted and gloved sentry at the gates to the Emerald City?) and, upon recognition, opens the driveway gate. The homes also have barred windows and doors. Even in the outer office areas, there are walled and gated compounds with the same entry criteria. At our GAIA office, on a side road, which is also within it’s own brick walled compound, I note that even the interior doors to the individual offices remain locked. And the keys are skeleton-style keys. Our Country Director pulled a large bundle of probably 30 keys out of his pocket - all skeleton keys on a ring, like a wild west sheriff or jailor. It is my understanding that much of this security consciousness is not necessarily because there is awful thievery now, although it must have been the case at some point. In a society where so many are so poor, you learn to protect what is yours.

ITEM: In the southern region, there are acres and acres and acres of tea plantations. As far as the eye can see the rolling hills are carpeted with the lovely low green tea plants. It is disturbingly beautiful. Particularly when you learn that the land and plantations are owned by British companies. The tea workers, who carry large baskets on their backs and must walk the miles of plants harvesting tea leaves at a back breaking stoop, are paid 57 MKW (Malawi Kwacha) a day. That is currently equivalent to approximately $.33. A day. It is unconscionable. There is only one plantation owned by a Malawian business man - but apparently he treats his workers no better. Shame on him. Also, when the British took over the land for the tea growing, they also wanted to be sure that no Malawi villages could be built in the areas surrounding the plantations. So in many places, part of the beauty that you see is because there are forests of blue gum trees (very much like our Eucalyptus) planted in perimeters and other strategic locations. The trees are planted close together so that no huts can be built there. And this is some of the best land and climate for farming.


Today was a hard day

Monday, 6 September 2010

We made another visit to a gathering of three of our villages. We traveled over an hour south from our base on the main, paved road. Turning off the pavement, we bounced and cajoled our way another 30 minutes through a very densely populated area to our destination, waving at the exuberant children along the way. After the traditional greetings, prayers, dances and speeches, they asked the orphans to all stand up.

In these three villages, the population is 6,398. In these three villages, there are 296 orphaned boys and girls. In these three villages, there are 105 guardians caring for these children who have no mother or father. In four of the villages here, GAIA has 12 Community Care Givers (village women who help care for the people with HIV AIDS, as well as lending a hand with the orphans). In these three villages, I failed to ask the number of HIV AIDS patients there are, but we were told that there are 28 patients who currently have Kaposis Sarcoma (KC). We went back down the road a short ways to visit one.

Her name is Mtima ("Heart"). She is 38 years old. She is sitting on a mat, legs extended, leaning on her hut, nursing her five month old daughter, Jacqueline. Her right leg and foot, not covered by her chitenje, are covered with sores and grossly swollen. That is where the KC has erupted. She speaks softly and slowly through our interpreter. She has two married daughters - Frances, 18 and Elisa, 20 - who live nearby, and a school age son (maybe 12 or so years old) named Zinane. They all come to meet us as well. When she was pregnant, she was required by the government to be tested for HIV. Tragically, she learned that she was HIV+. Upon learning this news, her husband divorced her and left; she has not seen him since. She has had her three older children tested for HIV. They are all negative. She cannot have the baby tested until she is 18 months old. Mtima is encouraged to breast feed exclusively for 6 months, and then stop. It will take until Jacqueline is 18 months old before the mothers antibodies are gone and the test will give a true picture of the baby’s status. Mtima has now started a regimen of ARV medication, which she has to walk to the district hospital - several kilometers away - each month to get them. The KC is painful, and causes numbness in her leg. She indicates that she is also experiencing heart pain as well. She struggles to feed her children, getting help from her two older daughters, but it is not enough. In spite of all of this, she has hope for the future.

The statistics I relayed above are for only 3 particular villages in Southern Malawi. The story of Mtima is one that is repeated in villages everywhere. I don’t know the greater statistics of how many villages, how many orphans, how many with HIV. I only know that the numbers are many, the need is great. And yet the children smile and laugh. And the women sing and dance.

Sometimes It is All About the Women ...

Friday, 3 September 2010

It is Friday. Our agenda includes a visit to Mpala Village where a major donor is going to improve and expand an existing primary school. Also there is a stop at one of the clubs which is part of our youth activities program, and then another presentation ceremony at Nsona Village Center. It turns out to be a very full, non-stop day, starting at 8:00 AM and not returning to our lodge until 4:00 or so (where we finally have lunch).

The Nsona ceremony was in many ways similar to that of Duswa Village. We are heartily greeted, sung in, given seats of honor for the presentation. The surrounding crowd is easily as large as the previous. There is, as with every gathering - large and small - that we have attended, an opening prayer in Chichewa. There is the introduction and greeting, again, as with each and every gathering we have attended, we are invited to "Feel Welcome and Feel at Home". They are happy that we have come all the way to Malawi to see them. It should also be mentioned that in this male-dominated culture, our emcee is a woman. There is more drumming and dancing. And HIV AIDS support group does a song in which they sing "We should hold each others hands while we fight this disease," as they hold each other’s hands in a circle and raise those joined hands to the sky. They finish their song with "Let them talk about use. We went to the hospital and we have been treated. Let them talk about us." There is still a lot of stigma around people who are HIV+. It is a courageous thing not only to be tested, but to be willing to let your status be known.

There is testimony from an HIV+ man who tells his story: That in 2008 he was tested and was found to have HIV in his blood. He was disappointed, and considering ending his life. He was very sick. But then he got on ARV’s and is feeling much better. He entreated everyone to get tested. He said that in ARV’s there is strength. He has more "fire" (energy).

There is testimony from a guardian - an elderly grandmother who cares for the orphans left when her daughter died of AIDS. She has no husband and must care for the children by herself. She recalled that before GAIA came she had no clothes to dress her orphans. Now they have dresses and area able to attend school.

And, again, there was the joyous dance of the caregivers ... and the intrepid Azungus. We are considering taking our show on the road when we return to the US. We think you might be almost as entertained as were the villagers.

Finally, as with every gathering in Malawi, we closed the ceremony with a brief prayer. Amen.

Our previous stop had been at a carpentry training club where currently 8 teenaged boys and 1 girl (what a wonderful thing!) were learning to build furniture so that they had a way to support themselves. They apprentice together for 6 months, and then "graduate". They had already sold many of the things they had made - tables, chairs, and a beautiful hutch (which they called "a display"). A very enthusiastic and well-spoken 20 year old Victor - after his greeting of Feel Welcome and Feel at Home - introduced each of his fellow club mates and explained that when they sell something, the funds are then used for additional materials and supplies and for the training of the new young people that come into the club. He said that this carpentry club was helping them to reach their goal of becoming productive youth of Malawi.

Our day started with a meeting at Mpala Village with four of the chiefs (all men), the head of the Primary School (a man), several of the teachers (all men), the head of the school management committee (a man), the PTA chair (a woman - at last!) and the school groundsman (a man). There was one other woman present, who was somehow involved in school management, but she did not introduce herself. And here we were - 9 white women, 2 Malawian woman (our program managers), one white man and one Malawian man (our country director). The majority of our presentation to them was delivered by a 32 year old woman who’s family foundation will be doing the lion’s share of the funding for this project. She did an outstanding job of presenting the plan, all the while carefully including and inviting village participation in every decision and, with the help of our Country Director, ensuring buy-in by the village to promote a successful project.

We decided later that the local assembly may have been a bit flummoxed at not only all of the women present and the positions that each of us holds, but also at the fact of a young woman having such a leadership role. This proliferation of powerful women is not, to say the least, the Malawian way.

A Celebration, Malawi-Style ...

More Thursday, 2 September 2010

We were treated to an amazing gift today. It was planned that we would visit the Duswa Village Center, where people from three local villages (where GAIA has just this year begun working since early this year) have gathered for a celebration in our honor. The Village coordinators worked with the members of these communities and planned a presentation especially for us.

It began with the traditional Malawi welcome, I call it "singing us in." As our vehicles arrive and park, a large cadre of (mostly) women come swaying and clapping and singing a joyous call-and-respond song about GAIA. They are followed by many, many children. We are, quite literally, mobbed as we pile out of the cars. Handshakes and Malawi "hugs" (cheek to cheek, first right side then left) and smiles upon smiles upon laughter and smiles. It is eminently clear - they are genuinely happy to see us, and to welcome us to Malawi.
There is a large open area where many people have already gathered and sat, along with several rows of chairs that have been set up, leaving the center empty to serve as a stage. We go down a sort of reception line of 15 Village Chiefs (one of whom is a woman), and then are seated in the row in front of them. All around us, nearly as far as we can see, there is a sea of people gathered to be a part of this day. (We later estimated we thought between 400-500 people, and 2/3 of those were children.) The first item on the agenda is the Malawi national anthem being sung by a group of some 20 high school students, boys and girls. It is a lovely song about peace and freedom, raised in the rich harmony of Malawi voices. Next came a skit, written and performed by some teenagers.

Then came the members of an HIV AIDS community support group (all of whom are HIV+) who did a song and dance. Then another skit. And then the Community Care Givers from the 15 Villages came out for a song and dance. It looks so simple and so elegant when these women in their colorful chitenje’s are stepping and swaying to the beat of the single drum, again voices raised is triumphant and jubilant harmony. There is a loose, rhythmical groove, some more subtle than others, shoulders and hips, arms and feet all moving to the cadence of the Malawi song. They dance in a double circle in the center of the crowd. And then, - to the utter joy and amusement of the surrounding crowd - we Azungu joined in. Now that must have been a sight to behold. I was busy trying to get the steps right, along with just enough hip action, and arms going in the right direction - carefully trying to follow the women on both sides of me. Just when I thought I had the pattern down, it all shifted to a new cadence, a new song, a new rhythm and entirely different footwork. Luckily, this step came more easily, so I was able to concentrate more on what the rest of my body was supposed to be doing - concentrating, yes; succeeding, doubtful. Looking down the circle to my fellow US delegates, we were all laughing and bobbing around some of us mostly in step, a few of us, not so much. I am happy to report not one of us was doing "the white man overbite" (I know you all know what that is). It was so much fun, and, apparently, quite the crowd pleaser.

The ceremony ended after some brief speeches, and then we slowly made our way back to our vehicles. Again - mobbed with children, all wanting to shake hands, to have their picture taken, to try their English, to hear our Chichewa... to be noticed.

It was a soul quenching affirmation of the reason we are here.
video

The Miracle of a Mobile Health Clinic ...

Thursday, 2 September 2010

This day we travel to a fairly remote village in the southern Mulanje district to see one of our mobile health clinics in action. It is the Muloza clinic and today, Thursday, it is held in Mdala village, using a church as it’s base. There is one clinical officer, James (he is not a doctor, but very much like a physician’s assistant in the US), a Nurse Midwife, a Nurse Aid and the driver. When the clinic arrives, people have come from villages all around and lined up to be seen. As the others unload, the driver performs "triage" - assessing the people waiting to be seen, to pull the most critical cases to the front of the line. Any cases of cerebral malaria are seen first and immediately dispatched to the Mulanje Hospital, several kilometers away.

The clinic’s day is underway when we arrive. As has been the tradition here in Malawi, we are "sung in" by those standing outside the clinic. The crowd is primarily women, most with babies on their backs. We enter the church-cum-clinic and see people seated and waiting. Some will see the Nurse Midwife for pre-natal check and possible HIV testing. (We now know that if we can test a pregnant mother and determine her HIV status before she gives birth, certain drugs can be administered to both mother and newborn which will reduce the risk of mother-to-child transmission at birth. This is a significant step in the continuing fight against HIV AIDS.) There is a table set up that holds the supply of medications that have been given out based on the examinations. In another room, at the front of the church/clinic, is where the Clinical Officer sees the villagers.

We spend one hour in the exam room with James, the Clinical Officer, and watch him as he goes about his work. The patients are willing to let us take their picture and ask a few questions. I think our presence may have slowed James down from his usual pace. Many of the people today are tested, found positive, and treated for malaria.  In one hour today, he sees 25 people. If he were to do this for 7 hours today, he would see nearly 170 people. We understand the numbers are actually larger - not all the people who come see the Clinical Officer, some see only the Nurse.


While we are in with the CO observing, we hear just outside that a clapping game has begun.  Soon, there is a rousing rendition of "Head, Shoulders, Knees & Toes" being taught by several members of our troop and sung with the children who are waiting to be seen.  For nearly a half an hour, there is singing and clapping and laughing floating through the open windows to the rooms where the sick are being seen and gently treated.  It is a welcome intrusion.

In some respects we are lucky today. Of the 3 patients in our hour who received HIV testing, no one’s results come back positive. We are happy to share in the good news with a relieved 59 year old farmer, a young single man, and a 35 year old mother. (They do a "quick test" which consists of a finger prick for blood. If the test shows positive, they do a follow up test to confirm the results before informing the patient. The tests take approximately 5 minutes to process. Once a person gets a test, they leave the room to wait before returning for the results. This way the CO can continue to see the remaining people.) We do however witness a follow up with two other people who tested positive previously and have returned for additional counseling, instruction and some interim medications. One is a 30 year old wife and mother. Among other things, she was advised to bring in her last born child to also be tested. Also to bring in her husband to be tested. Also seen in follow up is a 25 year old father and husband. He was found to be HIV+ a month ago, has not yet been to the clinic to get started on his ARV regimen, and is now presenting with Kaposis Sarcoma and swollen lower extremities, as well as a growth in one eye. He is the father of 2, plus he takes care of his sister’s three children, as she has passed away from AIDS. He indicates that he has not yet told his wife. (The clinic staff, however, report that she has been to the clinic with the children, and it is possible she has had herself tested, but has not yet told her husband.) We have no words to give him, only a Zikomo (thank you) for allowing us be there.

A Grandmother, A Mother, and a Daughter ...

More Tuesday, 31 August 2010

Leaving the orphan support organization, we head further up the dirt road to visit with a woman who has AIDS and is cared for by her mother. Her mother appears to be perhaps in her 60's, but I don’t know this for sure. She speaks some English, is impassioned about the work of the caregivers and speaks reverently and appreciatively to us. She is a guardian (someone who helps take care of the orphans) as well as provides home based care to her sick daughter. She stood during the ceremony/presentation to tell us this: "I am a guardian. And you are our guardians." It is a powerful message delivered in that room.

We arrive at an area further up the hill with an immaculately clean  homesite. There are two well kept huts, a small fenced in pig house, a large circular basket-weave maize storage, a screened toilet area and a fire area. A woman slowly emerges from one of the huts and we gather around her and sit in the shade of the hut. A small boy of about 3 or 4 runs over to lean on her lap, hold her hands, and watch us. She says, with the help of an interpreter, that she would like to tell us her story. She is soft spoken and she tells her tale with a simplicity and poise that belies the heartbreaking reality. Her name is Sarah and she is 40 years old. Her husband is dead. She has three sons, the youngest is the child with her now. His name is Promise. She has a daughter, Asale. Three years ago, she gave her daughter a blood transfusion. Shortly after that her daughter started getting sick all the time. They finally tested her and found that she had AIDS (the transfusion was before they were testing blood.) Asale was 9 years old at the time. She was able to get on ARVs (Anti-RetroViral drugs) and is doing very well today. She is in school, but the only person at school who knows her HIV status is the teacher. The children think that she had TB (which she also did). There is still a certain amount of stigma attached to those who are HIV+. Sarah had been very sick herself, but was doing better now (although, clearly, she is not feeling entirely well). Her mother lives in the other hut and helps to take care of her.


While this is certainly not an easy story to hear, it becomes heavier still when I learn that after 10-15 years, a person on ARVs will begin to become drug resistant. If she cannot get second line drugs, she will die. This means she could be about my age. It also means that Asale will be between 19-24. What does the future hold for these women?


It is nearly the end of second day of our visits, there is yet much more to come, and I am already fighting the crush of overwhelming helplessness.

It Really Does Take a Village ...

Tuesday, 31 August 2010

You know we all make fun of the Hillary Clinton axiom, but we have seen the real thing in action with real people, and I now know it to be true. We headed south about an hour and a half today to visit one of the village AIDS support organizations that GAIA supports. We were up in the hills a bit, on a single track dirt rutted road, passing through one small poor village cluster after another before reaching our destination. We were greeted with singing as we decamped from our vehicles. Much handshaking, smiling, "Mule bwanji (mooli bwangee)" (Hello/How are you). Many "welcome, welcome"’s, and "Thank you"’s from the adults. Curious children - some wary, some gregarious - all pretty fascinated gather around us, and their numbers increase as stragglers come running in. We’ve learned the best thing is to take their picture and then show it to them. That brings the bigger smile, a giggle or a full laugh. They are enchanting.

We are escorted inside the Mission, a small simple building and there is more greeting from yet more villagers. We are seated in a row along the front, facing the congregation. Mostly children on our left, and adults on our right. The two young men who run this program explain some about their work, the orphans, the guardians and how very much they appreciate the support of GAIA. We provide funds which allow a vehicle to come and transport the HIV+ children to the Baylor Clinic (which is back up in Lilongwe where we came from) for treatment. Jimmy, one of the young men, says that "There were many problems, but now the problems are reduced." We learn that he attributes several factors to the increased health of the children: access to medical care and the wonderful guardians [these are the adults who care for the orphans - sometimes they are family members, like a grandmother, but many times they are simply villagers willing to take an orphaned child and care for him or her in addition to their own children]. Moises, the other young man in charge of the organization, adds that in 2007 they had 7 HIV+ children in their care, now they have 21, all doing well in school. He said that they are very proud of these children. They had the children stand up. There was rousing applause for them, and we beamed encouraging and proud smiles at them.

And then it hit me: Each of these children is HIV+. Not only that, each of these children have lost their parents and are depending on the kindness of others to take care of them. And these children have nothing. Compared to our frames of reference in the western world - no i-pods, no designer jeans, no house full of furniture and TV... you get the idea. And yet each of these children smiled at us and thanked us. Take a minute to think about that. It’s nearly enough to knock the wind right out of your heart.

Malawi Smells Like Fire ...

Monday 30 August 2010

You know that smell in a campground, usually late in the evening or early in the morning when most campfires are either just out or just being rekindled? That slightly hazy, charcoal smell? That is what it smells like here. In the villages, food is cooked over an outdoor fire. In some fields they burn the grasses or trees, presumably to amend the soil.

Awoke this morning to a cacophony of birdsong. So many different trills and coos and twitters (and not the electronic kind). There is a bird here with a coo very much like a Maui bird, only with more rhythm. I’d give it an 8 on the American Bandstand scale - nice melody and easy to dance to. There is also a not-too-close by rooster. And last night, I heard what are apparently wild hyenas in the distance. Now that’s an interesting sound.

Lilongwe is one of the largest cities in Malawi. It is the seat of current government. There are factories and car dealerships, hotels and commerce - but all distinctly different from anything familiar. Residential neighborhoods are called areas, and you cannot see anything as houses are sheltered behind brick walls. There are people walking everywhere. There is traffic at the roundabouts at 5:00 pm. The main roads (at least so far here in the northern Lilongwe area) are paved, but every side road, every path, every "shoulder" is red Malawi dirt.

And as we head out of the City this morning on our way to visit a Mission Hospital a couple of hours away, we begin to see greater Malawi. Scattered along the road are small groups of homes, huts really. In the villages, houses are often built of brick but roofed with thatch, or aluminum or a quilt of long, narrow tree branches. Some have thatch walls. Some are clay/adobe that maybe once had fresh paint, but alternating seasons of rain and dry have weathered and pocked and stained them otherwise. There are few windows. There are children everywhere. There are people walking and riding bikes along the road, between villages and on paths the run off presumably to a village deeper into the plains. There are many many goats, some chickens, a pig or two, and oxen-pulled carts. I even saw a white donkey. There are dogs, but not for petting or cooing over.

As we approach a "town center" the number of people increases significantly. Some have set up small stools or tables to sell their wares - tomatoes, beans, unidentifiable things. There are men sitting around under the meager shade afforded by trees. Women, wrapped in colorful chitenjes, walk with large loads of items balanced on their heads, many are barefoot. Children stand by the road and often wave enthusiastically. Most are barefoot; their clothes are worn, tattered, torn, ill-fitting and shabby. This is but a glimpse of what is to come.

We leave the main paved road and turn onto a rough dirt road that travels more intimately through several small villages. We get a closer view of the rural life. After several miles of this, as we approach St. Joseph’s Hospital at Ludzi, we first come upon the church. It is a very, very large, brick church, with stained glass windows, much like you would see really anywhere. Around the corner, we turn into to the gate that leads us to the hospital grounds. There are several buildings, all the single level red brick. There are people milling or sitting near most of them. Because of our number (we are 10), we caravan in three vehicles, each with a Malawi driver. People tend to notice when this many cars show up and once and 10 white people (Azungus) pile out. So we have dubbed ourselves The American Show.

We go first to the new maternity clinic that GAIA built - there is a lovely plaque at the door acknowledging this. We are greeted and escorted by a very petite Sr. Bernadetta who pretty much runs the place. By some amazing providence, we walk in to the delivery room minutes after a baby has been born. The nurse is just putting her on the scale as we enter. As you can imagine, every woman in our group "ooooooh’ed" in chorus.

There were five beds in the room, two of which were occupied. One with the brand new mother now suckling this brand new life. In the bed next to her, was a young woman in the throes of labor. The room, except for the 8 or so of us women clucking around and taking pictures, was very quiet. We did not even realize there was someone in the neighboring bed at first. The curtain got pushed aside, and I saw her lying on her side and slowly trying to turn over or get comfortable, with just a soft moan crossing her lips. We learn later that it is the Malawi way for a woman to stoically and quietly endure her labor and deliver her child. It’s astonishing.

We then visit the next two wards down the hallway where the other new mothers who have delivered in the last few days are resting. It is dormitory style with about 8 beds each. Both rooms are nearly full. Young woman, aged from 16 to 38 are sitting on their beds, with little bundles either asleep under the covers or feeding. They are shy, but allow us to take their pictures. When it is explained to them in Chichewa who we are, they bashfully smile and nod. We learn to say "Zabuna sonse" (congratulations) to them - and they laugh a bit, but smile more broadly. They let us come and see their precious new babies.

Across the hall are two more wards where the expectant mothers who have traveled some ways in from the surrounding villages and are waiting for the labor to start. They come early so that they can deliver their babies in the safety of the hospital. The hospital has no staff or facilities to feed the incipient mothers, so they must bring their own caregiver. These caregivers cook on the outside fire. I forgot to ask where the caregivers sleep. These young women were a little less shy and very happy to have us take their picture.

We then walked to another building, the pediatric hospital, to see a 2 year old boy, Charles, who ad been burned in a cooking fire. This apparently happens in villages with alarming frequency. At night the children awake and are cold because they have little or no blanket. They go out to the fire pit, and sometimes back up too close and fall, or trip and fall in face first. Charles had burns all along his back and buttocks, had just been sedated in order to have his wound debrided. Next to him was another tiny boy, obviously in a lot of pain who had just been scrubbed on his hands and stomach where the color was burned out of his skin. The mothers were sitting with them, quietly taking us all in. Not so many smiles in this room. Walking out through the main ward, the large room was full of beds with sick children (mostly malaria), each one attended by a parent (mostly mothers, but there were one or two men). It was a very quiet room. Not somber, just quiet. (We were assured that once we were out of the building, the parental chatter would resume - and mostly they would be talking about us!)

There were several other outbuildings - Receiving, which included a long hallway waiting room, reminiscent of a train station, a pharmacy with sparely stocked shelves of antibiotics, anti-diarreals and other medicines, some exam rooms and a chapel. Then there was the quarantine building where people with contagious diseases were sequestered. There was a little girl with big Keane eyes watching us parade by with fascination.

There is more this day... but it’s late and this has gone long already.

Welcome to Africa ...

Sunday 29, August 2010

I met an engaging young Malawian man on the plane trip from South Africa to Malawi. His name was Nyson. Turns out he is a clinical officer for MSF (Medecines Sans Frontiers/Doctors without Borders) for the Thyolo Hospital in the southern region. I had him teach me some Chichewa (which I had been minimally studying), but of course I’ve forgotten nearly everything. We chatted on and off for the duration of the 2.5 hour flight. He asked me about how the US likes having a black president, the cost of renting a home in the US, the cost of buying a home in the US, and what the main source of income is for the US. I was stumped. Of course to me, the US is such a large and diverse nation of so many differing political opinions, incomes, homes and possible home prices, I couldn’t begin to intelligently respond. Not that that stopped me from making stuff up - all presented with the caveat that "It depends on where you are...." But what is our main source of income? It was at that point I told him I should have done some studying before I came, as I was not in the least able to answer his question. I think for a man who comes from a country that relies most heavily on tobacco and tea, he doesn’t understand how I can not know what my country goes to the bank with. Intellectually I know he knows that the US is big, etc - he was clearly an intelligent person - but in his gut, his experience, his "world" if you will, is far more limited. It was an interesting exchange. He also chatted up the Japanese gentleman to his right, inquiring about which direction he was reading his book (bottom to top and back to front). He was just one of those gregarious, curious people. What a nice introduction to Malawi. I asked him what his favorite thing about Malawi was. After a very brief pause, his reply was this: "Peace. We are a peaceful nation. We will always help each other, if someone needs something. And we are very welcoming. People are always welcome in our home, and in our country. We are glad you are here. We appreciate all the things that people like you do to help us here in Malawi." I gave him the candy from my in-flight lunch to bring home to his four year old son, also named Nyson. It was a charming welcome to Malawi.

And then we got off the plane.

Customs was easy, if not effusively friendly. Then we had to wait for and retrieve our bags. Picture this: Take your average baggage carousel, pint size it by about 1/3, and place it up against a wall with only about 3 feet of clearance at one loop end. Hide the rear 1/3 of the other loop end behind a wall. The effect is that now you have less than ½ of the rotating "belt" which is available for viewing and retrieving the merry-go-round of luggage. Then place another wall approximately, oh let’s say 6 feet (or 5 people deep’s worth) away from the main length of usable carousel, so that effectively now there is a short hallway of access. Now slowly parcel out the luggage from not one, not two, but three arrived flights (of full 150-ish passengers). And put nearly all of those passengers at the limited access carousel vying for their luggage. It was a mass of surging, tip-toe standing, reaching, bobbing and weaving humanity with no regard for personal space. I have christened it the Mosh Pit of Baggage Retrieval. Happily, it was not every man for himself. As the belt slid by, the cry of "That’s my bag" would have a chorus line of arms trying to grab the elusive bag as it docilely slid by, only to finally be plucked up 5 people away and awkwardly handed back, bucket brigade style, to its rightful owner. Once the dizzyingly repetitive parade of luggage finally presented your own bag, with the help of others as previously mentioned, you then had to squeeze your way through the bodies pressing forward, like salmon swimming upstream to spawn.

Although I feel I made several new friends at the baggage carousel - between the commiserating, the weightlifting, the stepping on and being stepped on, all with a smile - and the ridiculous sojourn in Joberg (although, again, I feel a strange kinship with Alfred, our usurious porter), I am going on the record with my first hardline recommendation for anyone considering travel to Malawi: Only Bring Carry-On.

We finally arrive after a short drive - on the wrong side of the road (can you say Former British Colony) - at Wendels Lodge. An idyllic haven where our group has taken over 6 of the 7 rooms. There are two great dogs - Mufasa (a golden retriever) and Shotzie (looks like a shepherd mix). I miss my dogs. It’s just lovely here - go to the website (www.WendelsLodge.com). It really is like that. The proprietors are Tom, a German ex-pat master chef and his wife Mel, native of what used to be Rhodesia. We had a short afternoon respite followed by a large, delicious and filling American-style dinner. We set off tomorrow morning for a 2 hour drive to Luzi Hospital (where GAIA recently built a maternity wing), which is almost to the Zambia border.

And so ends my first night in many back in a bed. And my first night of several to come under mosquito netting. And my first night in Africa.

Page One, Line One

Friday 27 August / Saturday 28 August 2010:

I'm officially on my way. Out of not only my comfort zone (although it is surprising how quickly one can adapt... at least so far), but out of my country. I've never been so far from home, all by myself. It's strange. I know my husband has done this (in his younger years). And my children have actually done this. But here I am, 52 years old,flew to London by myself for the first time ever! Exciting? Eh. Interesting? Yes. Tiring? Yes, but so far manageable. Granted, I'm sitting in an airport waiting area, counting down from the first hour or so of an 8 hour wait until the next flight. And my clock says is 4:00 in the morning in my head. So, we'll see how this goes!

The flight from SFO to Heathrow was quite easy - considering it was 10 hours long. I had the luck of a window seat with no one right next to me. And my one-seat-over seatmate was an American ex-pat who's been living in London for the past 17 years. A PsychoAnalyst no less. Delightfully, she did not try to diagnose my dreams or my relationship with my mother. Interestingly, she, in fairly rapid succession, drank two personal sized bottles of wine (after admitting she'd not eaten all day, had stayed up until 1:30 the night before, and gotten up at 5:00 am). Shortly after the meal - while I was having a blissful snooze under the delicate ether of a pharmaceutical aid and a bloody mary chaser - she apparently got up to use the loo (see, I fit right in here in jolly old London already) - and then fainted. Gee, I wonder what could have contributed to that? Any way, there was minimal fuss and she was well taken care of. I only noticed that she had been gone an extraordinarily long time when I awoke once to find my personal movie had ended, used the facilities myself, dozed back off and awoke to find her just coming back . I still didn't think much of it. Maybe she found a crew member in need of emergency analysis. Maybe she joined the International Mile High Club - she is recently divorced, afteral. It was when I noticed that she had a full water bottle that roused enough curiousity for me to basically say "Hey, how'd you get a whole bottle of water?". She then told me her saga (waking up on the floor in front of the WC, being tended to in a special sort of nursing area, given juice & water, puking, being tended to some more, and finally being returned to her seat). I commisserated and tut-tutted and said she should rest, etc. As much as I hate little cups of water, I didn't want to go through all that just for my own bottle of water.

So Heathrow, here I am. So many foreigners! Oh, wait. I suppose I am one of them. Lot's of Francaise being spoken. Lot's of great British accents. Heard a lovely Scottish brogue. And then of course there’s the gutteral glottal german-speak. Lots of women in scarves, shawls, fully covered. Lot's of turbined men. Just not what we're used to in our little corner of California.

I'm hungry & getting a headache. 4:30 AM on my computer. 12:30 PM on the wall. Next flight at 7:00 PM. Good lord, it's gonna be a loooong day.

Page One... or is it Day Two?

Saturday 28 August / Sunday 29 August, 2010

So, I can totally identify with Tom Hanks in The Terminal. I believe I have, in fact, made Terminal 5A at London Heathrow my home away from home. I know where the best plugs are (well, actually, which ones don’t work), I used every possible bathroom in the place. I had my first solo dining experience (in a real restaurant, Anna). Well, an airport restaurant, which I’m sure was far easier! And I’ve test driven multiple chair locations and can recommend some for comfort, some for best people watching venue, some for quiet getaway and serene scenery. Turns out the flight that was supposed to be leaving at 7:00 (or 19:05) was delayed at least an hour. So it wasn’t until 20:00 hours that I left the hellish haven that was 5A, took the train to 5B and proceeded to wait an additional 45 minutes before board the plane. By a stroke of some god-sent luck (or maybe some really excellent karma returned to me), I ended up with two empty seats next to me. I settled in for a little private movie, my veggie meal, a lovely little pill and stretched out across all three seats with all the pillows and all the blankets for a delightful nearly 7 hour, badly needed snooze.

Just before boarding I met up with my roommate for the duration of the trip, fellow GAIA staffer Nadia. And thank heaven, because without her I would still be in a queue in the Johannesburg airport. Literally. No, seriously.

Of course British Air in SFO could not (would not?) check my bag all the way through to Malawi - only as far as Johannesburg. So when we landed in Joburg, we had to go through customs (easy - my first stamp in my new passport!), then collect our luggage (easy) (but #@(*#(*!! my bag was heavy) and then traipse back up to "check in" to South Africa Air. Just us and 6 million other travelers. Oh, okay I exaggerate. It was only 4 million. Between our flight getting out of Heathrow nearly 2 hours late, and then having to do all this, our 3.5 hour layover was suddenly only 1 hour. And the check in line alone was a possible 3 hr line (before security & customs). Uh-oh. So... I asked a porter for some help, and he sped us through both getting our bags checked and getting boarding passes. Seriously, he just went to the head of lines and railroaded us through. He made it clear that we should hurry, he was very fast and this was a very big favor he was doing and he should receive a tip. I said I only had US $. He had no problem with that. So for a $40 bribe... uh, er, tip (sorry, IRS no receipt), we made our connecting flight and found the rest of our party. Hooray. I think there are still people waiting in that line a Joburg (this was a "normal" Sunday morning. I can’t imagine what that place looked like during the World Cup!!?).

But the travel fun isn’t over yet. Oh no. (Hey, if I had to do it in 48 hours real time.... you can settle down with this novelette.)