Well, I have arrived! After an uneventful but l-o-n-g series of plane rides we got to Lilongwe around 1 pm Malawi time (6 hours ahead of EST) yesterday. Friday was a busy day! Upon our arrival, Mariah, Timica (the two other UNC med students) and I came to the UNC guesthouse. The guesthouse is where visiting UNC researchers, physicians and students stay. I’ve never stayed in such modern facilities in the ‘developing world’ and I find myself feeling both pleased and awkward/guilty. Much of the culture shock that I have experienced on previous trips abroad has been due to adjusting to cold showers, toilets that don’t flush and co-inhabiting rodents. Here at the guesthouse there is wi-fi, cable and plenty of hot water to go around. I think all of these amenities will help make the transition easier, and will enable me to be more productive on the actual work. It does, however, make me feel uncomfortable to be living such an American lifestyle when Malawi, as a country, is so poor. Knowing all of the good work the UNC Project does helps assuage some of these feelings, but they persist none the less. I’m sure this is just a drop in the bucket in terms of the moral and ethical quandaries that this trip will bring up so I will leave that for now to report on the rest of the day.
One great thing about the UNC guesthouse is that it practically shares a campus with Kamuzu Central Hospital (KCH) and the Baylor Lighthouse facility (for pediatric HIV/AIDS treatment) so after dropping our bags we walked over to KCH to meet our future colleagues and supervisors. During my meeting, I found out that my two supervisors (one from UNC, one from Baylor) will both be gone for the first few weeks of my stay. Thankfully, they have worked out a schedule for me to do rotations on the pediatric wards of KCH, Lighthouse and some outpatient clinics so that by the time my research work begins I will have a good idea of what goes on in all of the facilities where we will be working.
In speaking with other people working at KCH, I heard of the familiar ups and downs of research in the ‘developing world.’ A common frustration was difficulty getting IRB approval on the Malawian side (as I understand it, all projects must be approved by the researcher’s home institution and by a Malawian IRB). I also heard of problems I became familiar with while working in Nicaragua: scheduling meetings that no one attends, problems with staff and patient participation etc. My research in Nicaragua taught me that, as much as possible, the most productive way to deal with these issues is not fight them but try to work with them (eg. incentivize attendance and participation) or when all else fails, just go with the flow. While it may not be official data collection, you can often learn as much from talking to the people around you as you can in administering a survey. Hopefully once I get actual assignments and deadlines I can keep this laid-back attitude.
After our meetings at KCH, Mariah and I went for a short jog to work out some of the kinks we acquired on the plane. The weather here is perfect for outdoor exercise, mid 70s in the day and mid 40s at night. When we started our run we heard the call to prayer from a mosque in Old Town, Lilongwe; Malawi has a significant Muslim population. It’s the first time I’ve ever lived somewhere with this custom, and I find hearing the call five times a day quite beautiful.
Last night we had Indian food for dinner; there is also a sizable Indian population in Malawi (keep your eyes out for an upcoming “About Malawi” page that will have more exhaustive information on the people and culture of Malawi.) Then we headed off to a farewell party for one of the Infectious Disease Fellows who has been working here for the past two years.
This was my first introduction to the large and active ex-pat community in Malawi. This is a phenomenon that I haven’t encountered before with such force. Like living in the guesthouse, there are certain benefits to having a social circle of people who enjoy activities such as running, yoga, and cooking Westernized dinners, that Malawians may be more hesitant to engage in. It is also nice to know there are people who approach this experience with similar perspectives. However, it seems counterintuitive for me to travel all the way to Malawi and work on a project that directly relates to the behavioral habits and well-being of Malawian people only to then spend my time hanging out exclusively with Europeans, Americans and Aussies. For me, it brings up many questions of socioeconomics and race that are difficult to enumerate and even more difficult to resolve. For fear of this becoming a never-ending post I won’t elaborate on those now, but expect to dedicate at least full posts to some of these issues down the road.
Post-party I slept for 12.5 hours and awoke feeling refreshed and ready to take on my first full day in Malawi. One of my major goals for my first two weeks here is getting the traditional Malawian greeting down. While many people here speak English, Chichewa is the native language. In Chichewa you never just say “hi” the exchange (in Chichewa) is as follows:
Muli bwanji? How are you?
Ndili bwino, kaya inu? I am fine. How are you?
Ndlili bwino, zicomo. I am fine thanks.
Zikomo kwamberia. Thank you very much.
There are different variations on this depending on time of day, and infinite ways you can alter it depending on the person you are addressing. For now, I’m just trying to learn the most generic version. So far I can get the first line out if I am the one initiating the conversation. If I don’t initiate, I get completely thrown off and reply in some incomprehensible mumble-jumble. This is why I am also focusing on ‘zikomo’ which means thank you and ‘pepani’ which means sorry/excuse me. I find these phrases are almost always considered polite.
I have also found that running is an excellent time to practice. I call out “Muli bwanjni” as I pass and by the time that it is my turn to respond I am long gone. On second thought, this may not be the best practice but it boosts my morale as I run along calling out a greeting in Chichewa and then motivates me to run quickly before the ‘conversation’ comes to the part where I should respond “ndili bwino, zikomo” -which I find very difficult to pronounce.
After an afternoon of shopping for vegetables and chitengas (spelling approximated), the traditional fabrics Malawian women use as wraps and to carry their babies, I’m back at the guesthouse trying to learn Chichewa and rest up for another full day. So for now I’ll say tsalani bwino! (Stay well)
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