Malaria makes the Big Time

For those of you who have been following along at home for some time, you probably already know that I’m a malaria geek. So when a new report hits the media with a lovely tale of how malaria is on the run in this part of the world, it’s really pretty exciting. In Rwanda, malaria deaths have dropped more than 60% in a few months, just by those in a position to do so making sure that enough mosquito nets and effective malaria treatments drugs reach the population.

Malaria has received more attention and consequent funding in the last few years than in has since the failed global eradication campaign of the 1960s and ’70s. The efforts of the Roll Back Malaria Partnership, Global Fund for AIDS, TB and Malaria, the World Bank Malaria Booster Program and the President’s Malaria Initiative have mobilized incredible resources and political support to half the burden of this disease.

Battling malaria should be a simple issue. The politics are not as controversial as with HIV/AIDS, the technical issues are less complicated than TB, and there are more resources available than clean water has. As the report says, all we need to do to get mosquito nets and treatment drugs to those who need them most: kids under 5.

I can tell you from first hand experience that this small feat is not quite as straightforward as it sounds. Even with the wealth of global funding available, there is often still not enough money to go around. It’s only recently that the mosquito net manufacturers have been gearing up their production facilities quickly enough to respond to the need for product. The new artemisinin-based antimalaria drugs need to be stored at cool temperatures - much cooler than health centers in the tropics where electricity is a constant challenge.

I spent most of my days trying to find a way to make things happen, whether it be ensuring that trucks have fuel to carry drugs to where they need to be or working with the Ministry of Health to determine which drugs to order in the first place. At the end of the day, it’s hard to believe I’ve accomplished more than a few sent emails. But reports like this one are enough to make one believe that baby steps will take you where you’re going. It just takes patience.

In search of…

I’ll admit it. I’m not that well- adjusted semi-integrated expat that reads the local paper every morning. In fact, I’m not even sure I could name the local paper without taking a pause to rack my brain. So when a friend mentioned the fuel shortage the other night over a glass of wine, I hadn’t the foggiest clue what she was talking about.

But sure enough, she was right. When I pulled up to the trusty BP after work, there were bright orange cones in front of all the pumps and I heard from a colleague that there were lines of cars stretching down the road outside the gas station at Crossroads (Malawi’s answer to a shopping mall).

There seem to be several theories about exactly what has caused the crisis. The first story I heard was that the tankers with Malawi’s regular petrol supply were being held in Zimbabwe and that the Malawi Revenue Authority had flown down to Harare in an effort to rescue them.

Then I was told that the sad troubles in Kenya has stopped ships from coming into the port at Mombasa, creating a shortage of supplies all the way down to land-locked Malawi. But that too was dispelled when I was told that Malawi’s petrol supply usually comes into the port at Dar es Salaam, Tanzania or Beira, Mozambique, notably closer than Kenya.

All I can tell you for the moment is that the Total station at Foodworth shopping plaza has petrol. And they haven’t even jacked up the price. Yet.

Out of Africa

I spent the holidays this year visiting the charming Emerald Isle keeping up friends from Kinshasa. First we went down the coast in search of Fungi, the friendly dolphin. He was no where to be seen.

Then we went up the coast to check out the famous Cliffs of Moher. They were no where to be seen.

We braved the Shannon River for the Christmas Day Swim to raise funds for Limerick’s Marine Rescue.

Had some close calls.

And saw some stunning spots.

But mostly we hung around in pubs.

I can now say with confidence that I’ve seen the real Ireland. Slainte!

Echoing the cri de couer for Congolese women

The fact is, no matter how you slice it, eastern Congo is one of the worst places to be a woman today. It is a daily struggle to avoid fleeing one’s home, suffering a rape that ends in HIV infection or permanent physiological damage, losing a child to preventable, treatable disease. Rape is a tool of war and once women have suffered the act itself, they are often turned away by their communities afterward.

This week Extra Extra, who has been tracking the recent upsurge of violence in eastern Congo, writes about the cri de couer of Congolese women.

I left Congo nearly 7 months ago but I still think of her each day, half in hope, half in mourning. Congo has a long road ahead and I walked away from the small piece I had to play in her lifepath. Through my work in Congo, I knew of women who went to the field each morning wearing female condoms to protect themselves against the possibility of their own rape. It is that knowledge that still weighs heavy on my heart.

It’s in that spirit that I ask each one of you not to forget that these women are out there, looking for hope. Read their words at the Declaration of North Kivu Women and an open letter from the women of Rutshuru, read their stories at Women for Women International, understand the issues at Amnesty International, see how one man and his team have helped at Panzi Hospital in Bukavu. Think about donating. But whatever you do, don’t forget these women.

Miracle on 34th Street

I still remember the first man to give me a rose.

I was 14 and standing in a back entrance to the subway at Penn Station on 34th Street. A homeless man who had been selling roses stopped and gave one each to myself and my two friends. God bless you.

It was my first trip out with the Midnight Run, an organization dedicated to bringing the gap between the homeless and those with homes in New York. Several times a week since 1984, community groups of all sorts have gathered food, clothing and blankets to distribute to New York’s homeless population. The Midnight Run is headed by a man who himself spent several years living on the street and once told me the story of how his shoes were stolen off his feet while he was sleeping in the park.

On a given Saturday night, we loaded up the vans and head out around 9pm, passing by a caterer in the Bronx where we picked up leftover hot food: roasted pig, pans of paella, fresh bread, and rolled into Manhattan somewhere around 11pm. Our regular route took us down the West Side, stopping at the Boat Basin as we headed toward midtown. I still occasionally walk past the Citibank ATM where a group of us sat eating birthday cake one cold winter night. In the early days before the city moved the homeless out of Central Park, it was our best stop with bonfires in the winter and roller-blading parties.

This is what the Midnight Run is about: connecting with people whose lives are totally different from yours even though you live mere feet from one another. Each stop was anywhere from 30 minutes to an hour as we caught up with friends and chatted about our lives with whoever showed up that evening in search of a sandwich, a spare pair of socks, a razor. A conversation. The Midnight Run is not about a solution, it’s about being human.

Over the course of my high school career, I got to know a few people very well: Tracy, the transexual addicted to her walkman and dancing; Murray, a tall thin HIV+ man who lived under a staircase in Harlem; a round-ish couple who had met and married on the street; the gay couple that lived in a dumpster adjacent to Central Park. People would disappear for months and reappear (I went to Florida for the winter!). You never knew when to worry, when to give up, when to give in.

Everyone has a story: a divorce gone bad, an addiction. Mostly mental illness. Jupiter’s Wife a documentary that details a schizophrenic young actress’s decline to life as a street person with a pack of dogs in Central Park touches best on how life on the street happens, the struggle to get into housing and the fall back out of it.

Here in Africa where people believe Americans are born with a silver spoon in the mouth, grow into car keys at the age of 16 and have welfare to fall back on, I can honestly say it isn’t all roses.

I think his name was Ernie. I’ve mixed his story with other people’s in the years that has passed since. But this is what I remember: he gave us each a rose and said God bless you and that was the beginning.

Who you gonna call?

It’s more than vaguely reminiscent of the 1984 classic Ghostbusters. The protective gear, the spray cans, the coveralls. Bill Murray wasn’t around to see it but this week, Malawi set off to rid herself of some demons: the female anopheles mosquito, carrier of malaria.

In Nkhotakota, one of Malawi’s lakeshore districts, 26,000 households will be sprayed with a biodegradable insecticide that should keep mosquitoes out of people’s homes through the wet season due to start any day now. Furniture and personal belongings are cleared out so the indoor walls of the house can be sprayed with a time-release chemical based on pyrethrin (think citronella). Because the Anopheles mosquito bites predominantly at night and rests on walls after biting (we all need a little digestion time), spraying is a good way to keep mosquitoes at bay.

Malaria is still one of the biggest killers of children in the world - along with diarrhea and pneumonia, poor nutrition confounding it all - and Malawi is certainly no exception. With about 6 million cases annually, the disease detracts from work productivity and school attendance, not to mention the cost to families.

Stay tuned to find out how much spraying really does cut the transmission of malaria around here. It’s the kind of thing that might just change someone’s life.

Initiation

We got shipped out last week to get culturized. It’s like Malawi boot camp: same food at every meal, village kids everywhere, hotter than hell. We spent 10 hours a day in class learning about Malawian culture, beliefs and rites. We all have rites, from christenings and bar mitzvahs to fraternity hazing to last rites; we are a species who use the traditional to contextualize, to add meaning.

Malawi, along with neighbors Zambia and Mozambique, have male secret societies called the Gule Wamkulu. It is the members of these secret societies that dress in costume, unknown men inside, to attend rites representing Mother Earth, the British Colonialist, and…the fire dancer?

We were told at our course that the fire dancer, Maninja, attends initiation rites demonstrating the dangers of playing with fire, i.e. HIV but somehow I think there was some prior meaning.

(courtesy of Amy Gottlieb)

We were told that in Malawi, between colonization, Westernization, and urbanization, these rites aren’t practiced so much anyone. But not three days later, driving through the Zambia bush, we saw the fire dancer running along the side of the road to a ceremony.

Saved

‘When the missionaries came to Africa, they had the Bible and we had the land. They taught us to pray with our eyes closed. When we opened them, we had the Bible in our hand, and they had the land.’
Jomo Kenyatta, first president of Kenya

As early as the 1840s, missionaries have played a central role in shaping colonial and post-colonial Africa. From David Livingstone who landed here in Malawi and Johann Krapf, the first European known to see Mt. Kilimanjaro, missionaries have left a heavy footprint on the development of modern Africa. Even today, the deepest corners of Congo hide aging Catholic priests for whom Europe is a distant memory of youth.

Today, Sub-Saharan Africa is a patchwork of denominations: Anglican, Presbyterian, Catholic, Lutheran, Methodist, Pentecostal, Baptist, several home-grown churches such as the Congolese Kimbanguist and of course, Muslim. The Christian missionaries were the first Europeans to trek into the interior of Africa en masse and were certainly a large portion of the Europeans who remained there, living outside of the major urban centers.

Aside from outright conversion, missionaries were instrumental in constructing the first schools and health care institutions in much of rural Africa, introducing western medicine and literacy while learning to speak local languages. In fact, it was (predominantly black) missionaries returned from the Belgian Congo Free State (Belgian King Leopold’s private property) who first reported the extent of the European abuse and torture, starting what author Adam Hochschild refers to as the first global human rights movement. And it is missionaries to the Congo that Barbara Kingsolver’s amazing novel The Poisonwood Bible speaks of: one who assimilates, marries a Congolese and sails up and down the river bringing medicines to far-flung villages; the other who pushes his family and village to the brink in an effort to complete the divine transformation to Christianity.

Unlike the colonists, missionaries still speckle the African countryside. Many are involved in humanitarian relief, providing health services or teaching but there are still pastors among them, come to preach to the masses, to save souls.

It’s one hell of a legacy to leave.

Hungry Hungry Hippos

Even though I’ve been charged by a rhino and an elephant, more than any other animal, I have a healthy fear of the adult hippo. I have an even healthier fear of the hippo calf since it means there’s an over-protective mother nearby.

I will defend myself by noting that I am not the only one who harbours such fears. When a group of Malians visiting a Member of Congress in the upper Midwest was taken on a boat ride, the visitors all shook with fear until the Congressman insisted that hippos cannot survive a winter in a frozen river.

In Congo, I know of an American missionary doctor who was forced to leave his work site after a female doctor was killed by a hippo, leading the villagers to believe the doctor’s shape-shifting powers had allowed him to dispose of a rival.

But despite my most rational of fears, I spent a few hippo-happy days last week. It started with a junket to the edge of Liwonde National Park to stay at the Hippo View Lodge for a meeting. The hippo theme was vaguely reminiscent of that cute dancing purple hippo, almost inducing amnesia that hippos are reputed to kill more people in Africa each year than any other animal despite their vegetarianism. The conference facility even had a hippo-shaped sink.

There were plenty of live hippos around as well, which could be easily seen on our boat ride up the Shire River. While my colleagues oohed and aahed over the burbling snouts rising above the water’s surfaced, guffawing and diving, I watched the sneaky bubbles headed straight for our boat. Eventually large dark eyes popped up not particularly far from the boat to give a good solid stare at the intruders.

You may be rolling your eyes by this point, wondering why I’m making such a fuss. After all, we were in a proper boat.

On Saturday, that was not the case. I had taken my trusty kayak to the Lilongwe Sailing Club’s spot at the dam to enjoy a bit of solitary paddle time. Just as I was getting ready to put in, the caretaker scanned the water with his binocs to check for the dam hippo. While I have never seen the dam hippo, she is well-known members of the LSC.

“Stay away from that area.” The caretaker gestured generously to the other shore of the dam. “The hippo is there with her baby.”

Baby?!

Barring immaculate hippo conception, the presence of a baby can only lead me back to my college biology roots to presume that there might just be more than one dam hippo. So if the posts here suddenly stop and my mangled kayak floats ashore, you know who the culprit is.

Waiting

Having grown up in northeastern America, it’s something I may never get used to: in this corner of the earth, it only rains during part of the year. Summer and winter translate into wet and dry. When it’s dry, it’s bone dry, crackling, dusty, brittle dry. Green stands out like wealthy crook amid boundless poverty. The dust is the first thing you feel in the air when you awake in the morning. It lines the corners of your shelves, your windowsills, your life, a full-fledged invasion. Your skin, the earth, your lungs seek droplets of moisture and savor each tiny allowance.

I moved to Namibia in early June and didn’t see rain until November. I was on my way to Botswana when the rain began. I stopped the car, stood barefoot in the middle of the empty highway and tilted my face skyward.

In Botswana, the currency is comprised of pula, meaning rain, each composed of 100 thebes – raindrops.

I haven’t been here nearly as long but the last two weeks, the pressure has been building. It’s something inexplicable, the feeling that the rain is coming. Until yesterday there wasn’t a cloud in the crisp blue sky but we are animals and if we listen with the core of our being, we can feel the rain coming.

And there it was: as I walked out of the office yesterday, one sole raindrop tumbled from the sky onto my face.

This afternoon I awoke from a nap to a grey backdrop that had pushed out Lilongwe’s habitual blue in under an hour. Within minutes the facade cracked and the heavens came tumbling town.

When it rains for the first time, the sensation is intense. The smell comes before the sound of the beating of the earth, before the screen of pellets wavers before your eyes. It’s a rich smell with all that has been hiding in the earth rising to greet the long awaited water. It is dramatic transformation before your eyes.

The rain ebbs and flows, lightening and then strengthening again as thunder swoops though, but the smell stays strong, occupies the air with force, declaring its presence so surely that there can be no doubt that the rains have come.