Tonight, something spectacular happened. All the data has been entered for 1224 children. All their food groups recorded, their outcomes tallied. Excel worked its magic, sorting and summing. Of a total of 1224 children accurately enrolled, I have complete data for 770 (the remaining children still need to be followed up for a total of 8 weeks or until their weight-for-height z-score is greater than -2 standard deviations, which ever occurs first). So who wins?
Let’s remember the players: milk/peanut Ready-to-Use Therapeutic Food, soy/peanut RUTF, and the standard of care for moderate malnutrition, corn/soy blended flour. We know that over all, milk/peanut RUTF works 95% of the time and the CSB flour works about 55% of the time. The goal of the study is that the soy/peanut RUTF performs as well as a therapeutic treatment for moderate malnutrition as it’s milk/peanut cousin. The study has been designed to be able to determine statistical significance within 5% difference.
Drum roll please….
SOY AND MILK RUTF WORK THE SAME!!!! CSB PERFORMS SUBSTANTIALLY WORSE IN THESE CHILDREN! (However, our rate of recovery with CSB is significantly higher than the percentages published in the literature, which is great and probably has to do with the amount of education and one-on-one interaction our nurses have with each and every patient, compared to the traditional method used to distribute this supplementary food).
For me, this makes all the mud, tarantulas, lack of electricity (going on 3 days now with no hot water, lights, fridge or stove), 45 days of straight rain, and on and off water supply TOTALLY worth it. The study is working!!!!! If you can’t tell, I’m beyond excited.
Someone have some champagne…toast to soy beans, peanuts and Malawian babies!
-dkm
Monday, January 28, 2008
Thursday, January 24, 2008
Malawi: Gymnastics, Driving: __________
Answer: Balance Beam.
Explanation: After reading the entry from Tuesday, you probably have the idea that driving in Malawi is ever an adventure. But Thursday must have felt jealous, because yesterday topped it all.
When considering the answer to an analogy such as the one in the title above you want to look for the pattern (here we are looking for small parts of a whole). Balance beam fits particularly well here. You’re prepping to tumble across a 4-inch piece of wood, 4 feet above the ground (the massive holes and ditches with parts of the road falling off even a foot). Sure, you’ve practiced many times before, occasionally falling off (ahem, Tuesday’s adventure in the mud trench). But then you get up in front of that judge (the whole village who runs to the street to watch) and all of a sudden everything gets harder. The skills feel harder and performing without a .5 deduction for a fall (visits to the ditch) or a .2 deduction for a wobble (car dancing in the mud) makes you feel so triumphant.
With that concept in your mind, imagine what it was like to drive out to Chikweo village, a site very far from a tarmac road. The sky just opened up and torrentially down poured halfway through enrolling 45 (!) new study children. All I could think was that the balance beam we had to cross to get back to pavement was more rickety, older, thinner and higher than the standard 4 inch, 4 foot high beam.
The road had been morphed into a small white water rapid river. Everywhere that the road was broken, small rapids gathered. The water was several feet deep, opaque, and running down fast. I was in a line of 4 cars – Ramsay ahead of me, and 2 cars behind. We stopped as we approached the only remaining dry spot and waited for about 10 minutes to see if the water level would go down at all. Of course it didn’t, and the brave (or stupid) Pajero driver behind me got impatient and just went for it. When he made it to the other side, the pick-up behind also followed. Now it was just Ramsay and I… he went first. Me alone (with passengers of course). With a bit of encouraging cheering from my peanut gallery (preparing to mount the beam, “Go Danny! You got it! Stick it!”), I went. What a serious adrenaline rush.
Probably not perfect form, a few bent legs and unpointed toes, but it was a pretty decent performance…maybe a 9.0.
And…we’ve made it to 1200 children. Pretty awesome :)
Explanation: After reading the entry from Tuesday, you probably have the idea that driving in Malawi is ever an adventure. But Thursday must have felt jealous, because yesterday topped it all.
When considering the answer to an analogy such as the one in the title above you want to look for the pattern (here we are looking for small parts of a whole). Balance beam fits particularly well here. You’re prepping to tumble across a 4-inch piece of wood, 4 feet above the ground (the massive holes and ditches with parts of the road falling off even a foot). Sure, you’ve practiced many times before, occasionally falling off (ahem, Tuesday’s adventure in the mud trench). But then you get up in front of that judge (the whole village who runs to the street to watch) and all of a sudden everything gets harder. The skills feel harder and performing without a .5 deduction for a fall (visits to the ditch) or a .2 deduction for a wobble (car dancing in the mud) makes you feel so triumphant.
With that concept in your mind, imagine what it was like to drive out to Chikweo village, a site very far from a tarmac road. The sky just opened up and torrentially down poured halfway through enrolling 45 (!) new study children. All I could think was that the balance beam we had to cross to get back to pavement was more rickety, older, thinner and higher than the standard 4 inch, 4 foot high beam.
The road had been morphed into a small white water rapid river. Everywhere that the road was broken, small rapids gathered. The water was several feet deep, opaque, and running down fast. I was in a line of 4 cars – Ramsay ahead of me, and 2 cars behind. We stopped as we approached the only remaining dry spot and waited for about 10 minutes to see if the water level would go down at all. Of course it didn’t, and the brave (or stupid) Pajero driver behind me got impatient and just went for it. When he made it to the other side, the pick-up behind also followed. Now it was just Ramsay and I… he went first. Me alone (with passengers of course). With a bit of encouraging cheering from my peanut gallery (preparing to mount the beam, “Go Danny! You got it! Stick it!”), I went. What a serious adrenaline rush.
Probably not perfect form, a few bent legs and unpointed toes, but it was a pretty decent performance…maybe a 9.0.
And…we’ve made it to 1200 children. Pretty awesome :)
Tuesday, January 22, 2008
I've never "worked" this hard for a tan...
Today was yet another African experience that I will probably look back on and blame for the early onset of gray hair. Although there was not a cloud in the sky by the time I turned off the paved road onto the dirt path, yesterday must have dumped buckets of rain in Mulanje district. The road was SOOOOOOO bad, worse than anything I have ever driven on before (and remember, I drive like 5-9 hours per day on these roads). There were massive ditches and crevices in the road, let alone the trenches on either side of the path filled with 2-3 feet of water and lined with overgrown reeds and rice plantings.
As I approached a particularly muddy section of this gray clay soil, I decided to divert slightly to the left to avoid the largest patch of soft, slippery mud. The tall reeds growing on the side gave me a false sense that the road was strong, and just as I passed through the worst of the mud, the road gave way on the side and half of my car slid into the trench. The car listed at an incredible angle, such that we had trouble getting out without sliding to one side from gravity. We waited in the blistering sun (responsible for the aforementioned "tan") for nearly 1.5 hours until enough men gathered around the vehicle. With 16 young men sporting washboard abs and shoulders only a subsistence farmer can have, we somehow managed to lift the car back onto the road. Unfortunately, it cost me my cell phone...the most important commodity I had out in the middle of no where. The phone was dropped in the mud water, and died on the scene.
The rest of the road was equally terrible, and I gave my forearms a great workout by squeezing the wheel with all my might for the remaining 20 minutes of driving out to the health post. The actual clinical visit wasn't too bad and we managed to make it back to Blantyre without incident. However, I then came to find out that we are almost out of soya chiponde, the very food I am out here working to prove works. So, I start making the necessary phone calls (source the raw beans, buy the beans, find a driver to pick them up) but when I get to the part about roasting the beans (essential, otherwise they are completely uncooked and inedible) I found out that the roaster runs on paraffin (gas) and...Malawi has been out of paraffin for some time. With the current gas hikes worldwide, Malawi can't afford to import paraffin. So, f*ck. That means this weekend will be devoted to roasting 100kg (220 pounds) of soy beans in my itty bitty oven on a cookie sheet...
Top it all off with me backing up into the FedEx truck and breaking the damn tail light and you have a glimpse of my day today.
But hey, I got some color.
-dkm
As I approached a particularly muddy section of this gray clay soil, I decided to divert slightly to the left to avoid the largest patch of soft, slippery mud. The tall reeds growing on the side gave me a false sense that the road was strong, and just as I passed through the worst of the mud, the road gave way on the side and half of my car slid into the trench. The car listed at an incredible angle, such that we had trouble getting out without sliding to one side from gravity. We waited in the blistering sun (responsible for the aforementioned "tan") for nearly 1.5 hours until enough men gathered around the vehicle. With 16 young men sporting washboard abs and shoulders only a subsistence farmer can have, we somehow managed to lift the car back onto the road. Unfortunately, it cost me my cell phone...the most important commodity I had out in the middle of no where. The phone was dropped in the mud water, and died on the scene.
The rest of the road was equally terrible, and I gave my forearms a great workout by squeezing the wheel with all my might for the remaining 20 minutes of driving out to the health post. The actual clinical visit wasn't too bad and we managed to make it back to Blantyre without incident. However, I then came to find out that we are almost out of soya chiponde, the very food I am out here working to prove works. So, I start making the necessary phone calls (source the raw beans, buy the beans, find a driver to pick them up) but when I get to the part about roasting the beans (essential, otherwise they are completely uncooked and inedible) I found out that the roaster runs on paraffin (gas) and...Malawi has been out of paraffin for some time. With the current gas hikes worldwide, Malawi can't afford to import paraffin. So, f*ck. That means this weekend will be devoted to roasting 100kg (220 pounds) of soy beans in my itty bitty oven on a cookie sheet...
Top it all off with me backing up into the FedEx truck and breaking the damn tail light and you have a glimpse of my day today.
But hey, I got some color.
-dkm
Monday, January 21, 2008
Post Scriptum
PS - Thank you to everyone who leaves comments on this blog. It's fun to know that people are reading along, even if some of the entries are long and less exciting than others. I do read them, and just wanted to say thanks for responding!
Bed time for me now.
g'night.
Bed time for me now.
g'night.
The little engine that could...
Remember that story? "I think I can, I think I can, I think I can..." That was how today felt. Read on...
A quick note to bring everyone up to speed on the new visitors: this past Wednesday a girl named Johanna arrived from Australia. She has just finished her final exams from 4th year medical school and will be working with me in Malawi for the next 2 months. She's a really interesting person with lots of very cool life experiences- she was born in Austria, lived for a few years in Germany, then moved to Columbia where she spent most of her childhood, currently lives in Australia while her family lives back in Germany and South Africa. She also lived in Peru for a bit of time as well. She is an avid rock climber in Australia, and just started to do some gymnastics in order to increase her strength and endurance for climbing. She's been great, and quite a trooper. The past few days have been far from easy.
So, this morning we left the house at 5:15 and headed out to round up the troops. With a few small glitches (passed a nurse waiting for us at one place and waited for her for 20 minutes at another place, almost had engine failure in the Hilux, etc) we headed out for Chamba health center. Chamba is a bit far away, about 2 hours driving or so from Blantyre. We turned down the dirt road and proceeded a short distance before meeting our first baracade - a 2 ton truck stuck in the mud going nowhere. Okay, turn around - back down the dirt road, back to the paved road, and down another dirt road. About 15 minutes into that, we find the road is literally broken. Completely unpassable, strike 2. We have strike 3, and 4, and finally we are directed down a very shady looking road. LOTS of water, mud everywhere and to top it off, a maize field. We were literally driving with maize plants pouring into our car window as we passed. Clearly not a place of a vehicle, but we made it and it opened out to the middle of a soccer field. Off we went to the clinic, 5 hours after we left the house.
What next? Every woman from 9 villages with all of her children. And enormous, ominous rain clouds. Somehow, the stars must have aligned in our favor. Even though we didn't finish seeing all the moms until late in the afternoon (we finally got home after 8pm - talk about a long day), the health workers really kept the moms organized and calm while we screened and evaluated each and every child. Johanna taught me to palpate the spleen and we saw tons of kids with splenomegaly, something you apparently hardly every see in the West.
On the drive home, we dropped a patient at the hospital who was suffering from severe anemia and clearly needed a blood transfusion. After that, we passed a large crowd of people who all looked very distressed, their bikes strewn across the paved road. We ended up reversing up the road to find out that an ESCOM (Malawi's electricity company) truck had hit a cyclist and didn't stop. So we drove this man to the police station and hospital (he had a broken wrist only), before finally heading back towards Blantyre.
Phew...what a day!
-dkm
A quick note to bring everyone up to speed on the new visitors: this past Wednesday a girl named Johanna arrived from Australia. She has just finished her final exams from 4th year medical school and will be working with me in Malawi for the next 2 months. She's a really interesting person with lots of very cool life experiences- she was born in Austria, lived for a few years in Germany, then moved to Columbia where she spent most of her childhood, currently lives in Australia while her family lives back in Germany and South Africa. She also lived in Peru for a bit of time as well. She is an avid rock climber in Australia, and just started to do some gymnastics in order to increase her strength and endurance for climbing. She's been great, and quite a trooper. The past few days have been far from easy.
So, this morning we left the house at 5:15 and headed out to round up the troops. With a few small glitches (passed a nurse waiting for us at one place and waited for her for 20 minutes at another place, almost had engine failure in the Hilux, etc) we headed out for Chamba health center. Chamba is a bit far away, about 2 hours driving or so from Blantyre. We turned down the dirt road and proceeded a short distance before meeting our first baracade - a 2 ton truck stuck in the mud going nowhere. Okay, turn around - back down the dirt road, back to the paved road, and down another dirt road. About 15 minutes into that, we find the road is literally broken. Completely unpassable, strike 2. We have strike 3, and 4, and finally we are directed down a very shady looking road. LOTS of water, mud everywhere and to top it off, a maize field. We were literally driving with maize plants pouring into our car window as we passed. Clearly not a place of a vehicle, but we made it and it opened out to the middle of a soccer field. Off we went to the clinic, 5 hours after we left the house.
What next? Every woman from 9 villages with all of her children. And enormous, ominous rain clouds. Somehow, the stars must have aligned in our favor. Even though we didn't finish seeing all the moms until late in the afternoon (we finally got home after 8pm - talk about a long day), the health workers really kept the moms organized and calm while we screened and evaluated each and every child. Johanna taught me to palpate the spleen and we saw tons of kids with splenomegaly, something you apparently hardly every see in the West.
On the drive home, we dropped a patient at the hospital who was suffering from severe anemia and clearly needed a blood transfusion. After that, we passed a large crowd of people who all looked very distressed, their bikes strewn across the paved road. We ended up reversing up the road to find out that an ESCOM (Malawi's electricity company) truck had hit a cyclist and didn't stop. So we drove this man to the police station and hospital (he had a broken wrist only), before finally heading back towards Blantyre.
Phew...what a day!
-dkm
Saturday, January 12, 2008
When DOOM fails...
DOOM is supposed to be a skittish woman's best friend... the end of all household insects' unfortunate lives. I've come to appreciate the smell of the noxious chemicals, a wonderful mix of organic compounds. However, as evidenced by its lack of killing power on the millipede (see previous entry), DOOM is not match for the true African trooper. So tonight, when the giant, black, awful tarantula showed up again, and DOOM failed, we needed to take more serious measures...
Kathleen and Liz came back from Zanzibar today and Dr. Manary took our visitors off to Liwonde National Game Park for the evening. So, I invited the girls over for a run (which was unsuccessful due to the extraordinarily heavy afternoon rains), and we sat around all day sharing stories of the week, of huge enrollment days, wading in mud, endless rain, but also white sand beaches, spice markets and new Swahili vocabulary words. After dinner, we talked about the coming week and Liz started to explain how one can find a safe, clean resthouse in Malawi. She referenced the need to check the door to be sure you can lock it from the inside, how you should inspect the bathroom, and just as she explained that the next thing to do is pull back the bedsheets to look for bedbugs...Kathleen screamed!
TARANTULA. Number 4 is it? Of course it sent me screaming on top of a chair, and Liz jumped on top of the couch. Kathleen, the only brave one, grabbed the DOOM and sprayed tons at the 5 inch creeper. No luck - it ran. I screamed a lot more. It must have sounded like a bunch of 9 year old girls at a sleep over party in here. I told Kathleen to grab a thin wood carving of a Massai warrior and poke at the spider, now hiding under the bookcase. With these assassination attempts clearly failing, I called in the reserves. The SecuriCore Guard watching our gate outside. I had no clue how to say spider in Chichewa, so I just told him to follow me to my house. When he saw what the commotion was about, he grabbed the dust pan, lurched in for the kill, and laughed all the way home.
Crisis resolved. My best guess - a baboon spider. Google it, it's awful.
-dkm
Kathleen and Liz came back from Zanzibar today and Dr. Manary took our visitors off to Liwonde National Game Park for the evening. So, I invited the girls over for a run (which was unsuccessful due to the extraordinarily heavy afternoon rains), and we sat around all day sharing stories of the week, of huge enrollment days, wading in mud, endless rain, but also white sand beaches, spice markets and new Swahili vocabulary words. After dinner, we talked about the coming week and Liz started to explain how one can find a safe, clean resthouse in Malawi. She referenced the need to check the door to be sure you can lock it from the inside, how you should inspect the bathroom, and just as she explained that the next thing to do is pull back the bedsheets to look for bedbugs...Kathleen screamed!
TARANTULA. Number 4 is it? Of course it sent me screaming on top of a chair, and Liz jumped on top of the couch. Kathleen, the only brave one, grabbed the DOOM and sprayed tons at the 5 inch creeper. No luck - it ran. I screamed a lot more. It must have sounded like a bunch of 9 year old girls at a sleep over party in here. I told Kathleen to grab a thin wood carving of a Massai warrior and poke at the spider, now hiding under the bookcase. With these assassination attempts clearly failing, I called in the reserves. The SecuriCore Guard watching our gate outside. I had no clue how to say spider in Chichewa, so I just told him to follow me to my house. When he saw what the commotion was about, he grabbed the dust pan, lurched in for the kill, and laughed all the way home.
Crisis resolved. My best guess - a baboon spider. Google it, it's awful.
-dkm
Friday, January 11, 2008
Half Way Around the World, Postal Workers are Equally Impossible
My apologies in advance if you have friends or family members who proudly wear a blue uniform with the USPS logo on the lapel and enjoy defying every rule of customer service...but rest assured the Malawi Postal Service carefully must select equally miserable people to stand behind their counters. Read on:
My friend Kathleen was unsuccessful at purchasing a Post Office box here in Malawi. The wait list for a PO Box is very long and nearly impossible to side step. As a favor, I offered to let her have packages (for Christmas) sent to the Project Peanut Butter address. Her package (mailed on December 19) arrived in Malawi on January 7 and was cleared and delivered to the Blantye Post Office today. I recieved the package slip which read as follows:
Kathleen Klaus
c/o Danielle Matilsky
Project Peanut Butter
P.O. Box 32664
Blantyre 3
MALAWI
At the counter, I presented the package slip and provided my driver's license for identification. The next thing I know, the package is put down in front of me but the woman takes my license. She returns with the manager who then proceeded to tell me that the package does not belong to me. I gently explained that "care-of" means that I am authorized to pick it up. He disagreed. For some reason, my patience with postal people wears thin pretty quickly, so I then insisted that in fact I was supposed to and expected to pick up the package. This quickly escalated to me basically yelling at this guy and he starts to preach about the laws in Malawi and all sorts of bologne. By now, I have spent 20 minutes waiting for this damn thing, my friend Kathleen is in Tanzania to take the GRE, her phone doesn't work there, and I have now launched into the whole, "I work at the College of Medicine, I am late for an important meeting, I work with very sick children and I don't have time for this..." blah blah blah.
It ended with him wanting to keep the package slip (my only claim to this package). Ha. I didn't think so. I reached across the counter, crumpled the triplicate slip in my hand and proudly reminded myself that I am my father's daughter in some ways..."You, sir, are f*cking ridiculous." I stormed out...and slammed my car door.
I really hate the post office.
In other news - the total for the week came out to be around 180 new study enrollments- SOLID. Very exciting! I am devoting this weekend to updating the database, organizing myself and coming up with a plan of how I will wrap up enrollments. We are currently operating at a total of 12 sites! I'm pretty excited. The next few weeks will continue to be very hectic and busy as the hungry season hits full swing. Also, new researchers and visitors are coming all the time, with the next one being a physician trained in Australia named Johanna that will be joining my study team.
And finally - I got my third medical school acceptance - George Washington in Washington, D.C. I am still waiting to hear back from Albert Einstein and WashU, but I'm pretty excited about the prospect of having the choice of three different cities for med school!
-dkm
PS - I reread some of these entries and have to apologize for some of the poor quality writing that comes out. I guess I am using the blog as a quick and dirty snapshot of the things that come up every day!
My friend Kathleen was unsuccessful at purchasing a Post Office box here in Malawi. The wait list for a PO Box is very long and nearly impossible to side step. As a favor, I offered to let her have packages (for Christmas) sent to the Project Peanut Butter address. Her package (mailed on December 19) arrived in Malawi on January 7 and was cleared and delivered to the Blantye Post Office today. I recieved the package slip which read as follows:
Kathleen Klaus
c/o Danielle Matilsky
Project Peanut Butter
P.O. Box 32664
Blantyre 3
MALAWI
At the counter, I presented the package slip and provided my driver's license for identification. The next thing I know, the package is put down in front of me but the woman takes my license. She returns with the manager who then proceeded to tell me that the package does not belong to me. I gently explained that "care-of" means that I am authorized to pick it up. He disagreed. For some reason, my patience with postal people wears thin pretty quickly, so I then insisted that in fact I was supposed to and expected to pick up the package. This quickly escalated to me basically yelling at this guy and he starts to preach about the laws in Malawi and all sorts of bologne. By now, I have spent 20 minutes waiting for this damn thing, my friend Kathleen is in Tanzania to take the GRE, her phone doesn't work there, and I have now launched into the whole, "I work at the College of Medicine, I am late for an important meeting, I work with very sick children and I don't have time for this..." blah blah blah.
It ended with him wanting to keep the package slip (my only claim to this package). Ha. I didn't think so. I reached across the counter, crumpled the triplicate slip in my hand and proudly reminded myself that I am my father's daughter in some ways..."You, sir, are f*cking ridiculous." I stormed out...and slammed my car door.
I really hate the post office.
In other news - the total for the week came out to be around 180 new study enrollments- SOLID. Very exciting! I am devoting this weekend to updating the database, organizing myself and coming up with a plan of how I will wrap up enrollments. We are currently operating at a total of 12 sites! I'm pretty excited. The next few weeks will continue to be very hectic and busy as the hungry season hits full swing. Also, new researchers and visitors are coming all the time, with the next one being a physician trained in Australia named Johanna that will be joining my study team.
And finally - I got my third medical school acceptance - George Washington in Washington, D.C. I am still waiting to hear back from Albert Einstein and WashU, but I'm pretty excited about the prospect of having the choice of three different cities for med school!
-dkm
PS - I reread some of these entries and have to apologize for some of the poor quality writing that comes out. I guess I am using the blog as a quick and dirty snapshot of the things that come up every day!
Wednesday, January 9, 2008
Crazier and Crazier
Ready for this?
121 ENROLLMENTS IN ONE DAY!!!!! Today made the day at Chikweo (where we are going tomorrow) look like a cake walk. There were so many moms at the very tiny, tiny clinic building, which was fine until the rain started to POUR. The result was 600 women trying to cram into one room the size of my den at home. Not to mention that the roof was tin so it was very loud, and there were no real windows so it was very dark inside. At one point the mothers were so crowded that I couldn't tell who came first, and when I took a child from a mom who may not have waited her turn, the women nearly had a fist fight right in front of me. All my Chichewa went out the window as I screamed, "STOP IT! STOOOPPPP!!!" Eh, little response to that until the HSA took control.
After hours and hours of that in addition to running out of food and data cards and everything else, we managed to make it back to Blantyre after 5 pm and still had tons of errands to run. We were supposed to travel to Namandanje for tomorrow's equally huge Chikweo visit (a ~3 hour drive) but decided to house all 10 of our staff members here at my house, and we plan to depart at 4am sharp tomorrow to make it out to the village by 7:30am.
Then to top it all off, another GIANT tarantula. On my foot with all 10 people in my house listening to me absolutely scream at the top of my lungs. Good thing Ramsay (our driver) was here to kill it and get it out. I was told this type bites (who knows if it was really a tarantula, but it was the biggest, hairiest, black spider I've ever seen!)
Dr. M is around so I won't hog the computer any more. Will update more at the end of the week.
-dkm
121 ENROLLMENTS IN ONE DAY!!!!! Today made the day at Chikweo (where we are going tomorrow) look like a cake walk. There were so many moms at the very tiny, tiny clinic building, which was fine until the rain started to POUR. The result was 600 women trying to cram into one room the size of my den at home. Not to mention that the roof was tin so it was very loud, and there were no real windows so it was very dark inside. At one point the mothers were so crowded that I couldn't tell who came first, and when I took a child from a mom who may not have waited her turn, the women nearly had a fist fight right in front of me. All my Chichewa went out the window as I screamed, "STOP IT! STOOOPPPP!!!" Eh, little response to that until the HSA took control.
After hours and hours of that in addition to running out of food and data cards and everything else, we managed to make it back to Blantyre after 5 pm and still had tons of errands to run. We were supposed to travel to Namandanje for tomorrow's equally huge Chikweo visit (a ~3 hour drive) but decided to house all 10 of our staff members here at my house, and we plan to depart at 4am sharp tomorrow to make it out to the village by 7:30am.
Then to top it all off, another GIANT tarantula. On my foot with all 10 people in my house listening to me absolutely scream at the top of my lungs. Good thing Ramsay (our driver) was here to kill it and get it out. I was told this type bites (who knows if it was really a tarantula, but it was the biggest, hairiest, black spider I've ever seen!)
Dr. M is around so I won't hog the computer any more. Will update more at the end of the week.
-dkm
Thursday, January 3, 2008
Murphy's Law
Murphy must have developed this law after living in Africa during the rainy season.
Let me explain: Many of you may know that our project has a "fleet" of cars - 7 in total. And you may have also heard me say that the fleet is hardly ever all in working order. Why don't I give you an example?
First the cast of characters:
The Pajero (age: 1,398 years)
The Hilux (age: 100 years)
The Diesel Nissan (age: 98 years)
The Red Truck (age: 999 years)
The Drifter (age: unknown, old)
The Column Shift (age: 97.5)
Liyaka's Colt (age: 98)
The setting - 2 hours south of Blantyre, at Chikwawa then 3 hours north of Blantyre, "the villages")
The schpiel:
Given that my project is growing faster and faster as the rainy season goes on, and after the disaster of last Thursday, I hired 4 more staff nurses. As an orientation, I invited them to our Wednesday site at Makwila health center in Chikwawa District. Since there were so many of us, we took two cars on the 2 hour drive down the escarpment. For those who can't picture this, imagine the hills and curvy roads of San Francisco, and then elongate those roads for 40 km (26ish miles). I was driving the Hilux, and Ramsay in the Pajero. We made it down the escarpment without a problem. As soon as we reached the bottom, we were approaching a police stop and - my brakes failed. I couldn't stop! Of course, we stopped after rolling a lot longer than we should have, and I made Ramsay switch cars. I got into the Pajero, and Ramsay started off ahead of me in the no-brake Hilux. With every bump and hole, it felt as though the sides of the Pajero would just fall off like a cardboard box that gets too wet in a cartoon. But, instead, we just got stuck in knee deep mud instead. My poor nurses, in their white uniforms, had to get out and push the car without their shoes on and then wash their feet in a nearby river. Okay, that was part one.
The next leg of the trip is the 2 hour drive back to Blantyre, plus a 2.5-3 hour drive up to the villages. Of course, the Hilux had to go to the mechanic to figure out what was wrong with the brakes. The plan was to pick up the Diesel Nissan and use that as the second vehicle for the day. But that car needed wheel alignment. So I took it to the wheel alignment place, and found a line of 4 cars waiting - an estimated 3 hour wait. Not possible since we had such a long drive to get to the villages. Luckily, I passed Liyaka driving along the road to my house. Thinking quickly, I asked if we could switch cars and I could take his Colt and he could get the wheels aligned in the Nissan - no problem.
Ha, no problem until I got almost to the village and the Colt decided that it no longer wanted to pull the car in any gear. First gear - 4,000 - 5,000 RPM. And the sky decided to spice up the night with some rain in the pitch black. Greatttt. We manage to get to the village, only to find in the morning that the car won't go at all. So, I had to tow the Colt ALL the way back to Blantyre - it took more than 3 hours, especially since the rope I bought kept braking so the cars kept getting separated.
So, that's not EVERYTHING that could go wrong right? Add the fact that the HSAs at one of the two new centers we were opening got the dates mixed up and all the mom's had shown up last week for the first enrollment day, the flying ants that were falling from the sky all night like snow, and the fact that my guests are living in the new house but that none of the plumbing seems to be working and voila! you have Murphy's Law.
Yet, this is Malawi, the land of devout Christians. So what do they say? We are thankful for still enrolling 55 new children in one day today, we are thankful that the brakes held out all the way down the escarpment, we are thankful that we were able to get the car towed all the way back this afternoon, despite all the challenges.
Let me end on a happy note - this past Monday I saw the President of Malawi! Woooo! It was so cool, a story of it's own. Needless to say, he drives a damn fancy car.
To all you kids at home bitching that you don't have the nicest, newest car - be thankful you don't need a fleet just to get by...
-dkm
Let me explain: Many of you may know that our project has a "fleet" of cars - 7 in total. And you may have also heard me say that the fleet is hardly ever all in working order. Why don't I give you an example?
First the cast of characters:
The Pajero (age: 1,398 years)
The Hilux (age: 100 years)
The Diesel Nissan (age: 98 years)
The Red Truck (age: 999 years)
The Drifter (age: unknown, old)
The Column Shift (age: 97.5)
Liyaka's Colt (age: 98)
The setting - 2 hours south of Blantyre, at Chikwawa then 3 hours north of Blantyre, "the villages")
The schpiel:
Given that my project is growing faster and faster as the rainy season goes on, and after the disaster of last Thursday, I hired 4 more staff nurses. As an orientation, I invited them to our Wednesday site at Makwila health center in Chikwawa District. Since there were so many of us, we took two cars on the 2 hour drive down the escarpment. For those who can't picture this, imagine the hills and curvy roads of San Francisco, and then elongate those roads for 40 km (26ish miles). I was driving the Hilux, and Ramsay in the Pajero. We made it down the escarpment without a problem. As soon as we reached the bottom, we were approaching a police stop and - my brakes failed. I couldn't stop! Of course, we stopped after rolling a lot longer than we should have, and I made Ramsay switch cars. I got into the Pajero, and Ramsay started off ahead of me in the no-brake Hilux. With every bump and hole, it felt as though the sides of the Pajero would just fall off like a cardboard box that gets too wet in a cartoon. But, instead, we just got stuck in knee deep mud instead. My poor nurses, in their white uniforms, had to get out and push the car without their shoes on and then wash their feet in a nearby river. Okay, that was part one.
The next leg of the trip is the 2 hour drive back to Blantyre, plus a 2.5-3 hour drive up to the villages. Of course, the Hilux had to go to the mechanic to figure out what was wrong with the brakes. The plan was to pick up the Diesel Nissan and use that as the second vehicle for the day. But that car needed wheel alignment. So I took it to the wheel alignment place, and found a line of 4 cars waiting - an estimated 3 hour wait. Not possible since we had such a long drive to get to the villages. Luckily, I passed Liyaka driving along the road to my house. Thinking quickly, I asked if we could switch cars and I could take his Colt and he could get the wheels aligned in the Nissan - no problem.
Ha, no problem until I got almost to the village and the Colt decided that it no longer wanted to pull the car in any gear. First gear - 4,000 - 5,000 RPM. And the sky decided to spice up the night with some rain in the pitch black. Greatttt. We manage to get to the village, only to find in the morning that the car won't go at all. So, I had to tow the Colt ALL the way back to Blantyre - it took more than 3 hours, especially since the rope I bought kept braking so the cars kept getting separated.
So, that's not EVERYTHING that could go wrong right? Add the fact that the HSAs at one of the two new centers we were opening got the dates mixed up and all the mom's had shown up last week for the first enrollment day, the flying ants that were falling from the sky all night like snow, and the fact that my guests are living in the new house but that none of the plumbing seems to be working and voila! you have Murphy's Law.
Yet, this is Malawi, the land of devout Christians. So what do they say? We are thankful for still enrolling 55 new children in one day today, we are thankful that the brakes held out all the way down the escarpment, we are thankful that we were able to get the car towed all the way back this afternoon, despite all the challenges.
Let me end on a happy note - this past Monday I saw the President of Malawi! Woooo! It was so cool, a story of it's own. Needless to say, he drives a damn fancy car.
To all you kids at home bitching that you don't have the nicest, newest car - be thankful you don't need a fleet just to get by...
-dkm
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