Who would want to climb Mt. Kilimanjaro when you could run a MARATHON around it!?

Absolutely not related to work in any way, but...there is a marathon in the foothills of Mt. Kilimanjaro in Moshi, Tanzania in March. I happened to come across it in some Runner's World email or one of those. Although the race would probably be over before I got to mile 4, that would be a pretty awesome place to run. It would mean running a lot of laps in my backyard...

Remember when you celebrated day 100 in elementary school?

So it is almost time to celebrate 100 children enrolled in my study! I'm thinking 100 tambalas (= 1 Kwacha = $0.007) since it may be hard to find 100 pieces of Trident Spearmint Gum or 100 pieces of macaroni...

Today, I opened a third site at a village called Chamba and we probably screened more than 90 children in about 2 hours. We are all getting this down to a science from teaching the village health assistants, to setting up the most effective "patient flow" model in the field. I just wish there was a way to get from here to there without having to leave at 4:45am...and that is before the rains are here! I hope the cars hold up, it's always great to make it out and back without a visit from a mechanic or the help of some boys along the road.

Anyway, the day to day stuff is going well too. There are always lots of logistical issues to deal with, but those are boring details of research...and adjusting to the concept of "African time."

For now, I should work on secondaries for med school applications, watch an episode of House, read some "Unbearable Lightness of Being," and get to bed. Another early morning awaits.

-dkm

These are the days of miracle and wonder...

Today was great. I doubled my enrollments in Mwakwila village, increasing the total from 24 to 48 children enrolled in the study. We saw about 90 moms in about 2.5 hours. It was really incredible. In Malawi, it is very common for women to sing songs about just about anything. It is almost like watching a Broadway show (like Grease) when all the characters just all of a sudden burst into song and all seem to know the words. Our nurses will just say, "amai, imbira pamodzi nyimbo" ("Moms, let us sing along") and the words are "Chiponde ndi mankwhala" meaning "Chiponde (peanut butter) is medicine!" They sing it over and over in a tune that everyone knows, and they clap and dance. It's great. So, I've at least learned the song, even if my Chichewa is pretty poor. We had representatives from the Clinton Foundation visiting with us today, and I think they really enjoyed watching a clinic in full swing. It gets pretty hectic, but we have 2 nurses, 8 health assistants, 1 food distributor, and me...so its a big team!

After the clinic, Rosemary (one of the nurses) and I went to look for one mom who we have been helping out a little extra. She has 7 children, and she and the last born are HIV+. She walks about 7 miles every two weeks to come to our clinic for her daughter. Last time I saw her, she was still doing well, but we didn't find her at the clinic today. We learneds she had been admitted and was in poor condition. So we went to visit her at her room, and to bring her some things we collected this week (flour, sugar, and some soap). I guess I've never really seen someone actually dying of AIDS. I've met so many HIV+ women and children, and I see orphans whose parents have passed way from AIDS, but seeing someone I knew dying is really difficult to deal with. I told her that we better see her in two weeks...but she pointed to the sky and told me it will be G-ds choice. It was really hard to keep it together in the room with her. These are the people that make you want to be there to help, but it's so hard. I better toughen up.

Well, there is always more to tell, but I'll call it quits for today. Me and Ella (my kitten) need to get back to work for tomorrow.

-dkm

A New Friend

Shhh...don't tell my puppy, but I got a kitten! She is SO small, probably less than 1 pound but she wont stay still long enough to stand on the scale. I have named her Ella, since I have Mr. Charlie "Chester" Parker, my boxer at home. Ella is all different colors, but her face is half orange/white and half black/brown. She likes to nestle herself between my chin and my neck, and crawls up onto my shoulder while I do chores around the apartment. I got her last night, and she slept on my pillow all night with me. She's so cute! Anyway, she keeps me company :)

Just wanted to share the news!

-dkm

Some funny things to share

Everyday we see and hear something strange. These are the things that make the day interesting, and since I can't share them at the dinner table, I thought I'd just put them up here for all the chuckle about...

Today I was driving behind a minibus, and there was an ad taped onto the back window saying "WIFE WANTED. CONTACT 09 290 051." Hey, nothing wrong with being straight forward right?

Yesterday, I was driving one of my nurses home. She's sweet, but between the two nurses, shes a bit more...manipulative. I am contemplating getting a kitten to keep me company, and I asked how to say cat in Chichewa. She said "Shashi". I thought that was adorable and thought I'd name the cat Shashi. I came home and told my wonderful house helper, Sheena, and said "Sheena, I am thinking of naming it Shashi!" She looked very suprised. I said, "it means cat in Chichewa right?"...apparently cat in Chichewa is "mpaka" and shashi is a very slang word meaning "very rich person." This is make for an interesting conversation at work on Monday...

Well, besides the usual weird things you see here - rats being sold fried on a stick along the highway, guys begging you to buy mops when you pull up to get gas - that's about all for now. I'll keep you all posted....

Now I need to add the prospective husbands phone number into speed dial. You never know when you might need one of those guys around... just kidding

Life is a road and I want to keep going...

Three Weeks! Things here are moving along well, and I am preparing to open my third research site in a village called Chamba. Our days are quite exhausting, but its easy to be motivated when you are surrounded by such warm people. I love my team, and the HSAs (village health providers) are so eager to help. Here are some of the highs and lows of the past week or so:

Last week, we had a small fender bender on Sunday night. We (the other student researcher, her boyfriend and I) were hit by a man who claimed to be a detective. Funny that his car wasn't insured or registered properly... It was cold and rainy out, so we agreed to touch base sometime on Monday to figure things out. Luck for the driver, she left Malawi on Monday morning! Anyway, once the guy found out I wanted to go through insurance, it seems he may have changed his mind. Perhaps now he'll think twice about driving an unregistered/inspected vehicle...

This past Tuesday I visited a Buddhist monastary. It was the most interesting place - so spiritual. The "master" monk, an "enlightened soul" as they refer to him, apparently had a vision while in Taiwan that he was meant to open 50 orphanages throughout Africa. He has opened a huge one in South Africa, Zimbabwe, (one other African country) and now Malawi. This place was absolutely incredible. It was hard to believe I was still in Malawi. The builds were incredible. Every detail was attended to, with even the tiles having been imported from Taiwan or mainland China. Currently about 200 orphans live in beautiful little self-standing dorms. They have bunk beds that sleep 10 to a room, but the place is immaculate. Every bed made, every shirt hung and pant folded. The master did a prayer for us, a chant or mantra and explained all about the curriculum these children have. They learn meditation, kung fu, chinese and basic principles of buddhism, but just the basics. It must be very difficult to adjust the children to life in this monastary. The temple is enormous, with HUGE (and I mean HUGE) gold statues of different buddhas. It was an incredible experience.

And today I was reminded of why this research is so important. An elderly woman brought her grandson, Matalitso, to us two weeks ago. The child was born in September 2006 and weighed just 3.0kg or 6.6 pounds. I think I weighed more than that when I was born. Today, just 2 weeks later, the child has gained almost 1 whole kg! I still don't think I have seen a child that wasted, his skin was paper thin and hung from his arms as if an oversized shirt. We fed him at the clinic, but he struggled to swallow. He is too sick to be enrolled in my study, but he is still recieving our RUTF food for therapy and I only hope that he makes it back in two weeks for follow-up. His mother passed away, and his widowed grandmother is left to care for him all alone. This is why I'm working here.

I hope you are all doing well. Please write me emails, call me, or for the really ambitious, snail mail. I miss everyone - whereever you all are!

Time Flies When...

Since my last entry, so much has happened that it will be hard to catch-up in one (readable) post. So here goes:

I opened my first site on Friday, July 27 in a village west of Blantyre called Mwanza. It is a relatively large district hospital, and we arrived early in the morning. Each Friday, a singing/acting/dancing troupe performs skits related to health topics. I enjoyed a small show about how important it is for husbands to respond to their pregnant wives. In the skit, a stubborn man ignores his wife and his dismissal of her needs ends with her dying from preventable causes during childbirth (if you took Dr. Wall's classes at WashU - this is Why Mrs. X died in action - and why I want to do international medicine). Anyway, this play drew a HUGE crowd of people and everyone was singing and dancing as they learned about this issue. Very creative way of educating people who live far off the paved roads.

At Mwanza, we screened somewhere around 120 children, of which about 20 qualified for my study. Today, in another village called Mwakwila we screened about 50 children and enrolled about 12. It probably doesn't sound like huge numbers, but things here grow by word of mouth and I am really excited about this initial turn out. Today many of the children were severely malnourished and many were HIV+, which makes them ineligible for my study. It is so hard to see so many moms come to the clinic with children who are so sick. But, at the same time, it is also so wonderful to see their huge smiles when peanut butter gets stuck to the roof of their mouth. There is so much work to do here, but even since last year when I was here, so much progress has been made.

In between these visits, I travelled to Lilongwe, the Capitol of Malawi, to meet with the US Ambassador, Alan Eastham and the Fulbright advisors. After a tough interview from Ambassador Eastham, I was warmly welcomed and it seems that there are a lot of organizations who have heard of this project. I am going to present to the alumni organization of Malawians who went on Fulbrights to the US. Also, the Rotary club and a few others have asked about the project - all very exciting!

So, that is the gist of the work here. It is a lot of traveling - many nights in bed by 9pm and up by 4am. Somehow, in Africa, it feels refreshing to go to bed early and wake up at sunrise. And, plus, it means back in the states you can call me as you go to bed and I am waking up!

Send some emails (DMatilsky@gmail.com) if you have a chance - or if you are ever at a Mobil station and venture in, pick up a $5 African calling card and give me a call! (011-265-9-921-656...dont forget the time change! 6 hours ahead of EST, and 7 after daylight savings - they don't do that in Malawi).

Miss everyone at home!

-DKM