Technical Difficulty

Having a rough go with the internet today. What's a travel recap without photos? They are rough on the uploading today. Updates will continue on their regular schedule--hopefully!--tomorrow.

Livingstonia

After trekking across the Nyika Plateau (next post!) we stumbled (quite literally: it was hot, we were tired, and this was on the top of the hill) into the town of Livingstonia, a municipality created by Scottish missionaries at the turn of the century to convert and educate the locals as well as play a part in the stopping of the slave trade. It's a surreal place that at times makes you think you're in (at least what I imagine to be) a tiny English town on a cross roads. There's a big church:

The light inside was fantastic, especially in a meeting room in the back:

And the stained glass in the front:

We met a few English medical students who were serving at the local hospital for two months. They were staying in the founder's old house, appropriately named The Stone House:

We soon said goodbye to our guide Chip (more on him later) and headed over to the local university which was made up of beautiful brick archways, one after another:

Next it was the the city center where we had a tea and a scone and quick one way ticket to rural England and back:

After enjoying the little town for a few hours, we hiked to our resting place for the night, Lukwe, a stunning lodge perched 4,000 feet above the lake. Photos tomorrow!

The Past Week: Chinteche

Starting last Sunday (the 14th) a friend of mine, Asif, and I headed north for a few days of hiking and a couple on Lake Malawi. We drove to Rumphi, took transport into Nyika National Park, hiked 55km east to Livingstonia, hiked 15 km more to the lake shore, took public transit back to Rumphi (and the car), and then drove to Chinteche for the weekend on the beach. I'll be working back with a new post each day about each step of the trip. With that in mind, let's start with Chinteche, a strip of beach in northern Malawi:

The beach weekend was mainly a gathering of Clinton Health Access Initiative (Serena's employer) employees, sans Serena. Odd. She was in southern Malawi at Mt. Mulanje for a retreat, while I was on the lake swimming and making sand castles. We were renting out the same house from November's Thanksgiving weekend but with a totally new crew and without our mascot Bay. Here's a dark photo (the sun was simply too perfect and bright for the camera) of the gang:

We swam and read, ate and chatted, built sand castles (unfortunately can't find a photo!) and buried bodies.

Craig (below with smoothies) and I thoroughly enjoyed jokes about Germans from the Tasteless Jokes book that brought down the house.

An excellent weekend with good company and perfect weather.

Trippin'

The blog has, unfortunately, suffered in the last couple months as we have settled into normality and taken on the fairly simple rhythm of life here. The last few weeks, though, have been filled with trips abroad and domestically and those stories will be told, with photos, here. Look for posts in the next week, starting with the most recent trip and moving back. Enjoy!

Things That Occurred

It's not often a friend from ten years prior drops in while living in Malawi, but that's just what happened last week when Chris from the Journey of Hope arrived at Lilongwe International Airport. We were so busy having fun that this is the best picture I snapped from the three day binge:

It's hard to tell what Chris is doing. Perhaps he is raising his hands in praise of Mother Earth for making such a beautiful place. Or, perhaps jumping to the sky after I pinched his tookis. Likely, though, is that this is the moment of realization that microscopic snails living in the lake waters are entering his blood stream. No worries mate, you've got pills.

We had three days, here's a list of the awesome things that happened:

1. Chris arrived with nothing more than a small backpack. What did he bring considering this efficient packing? A loofah. Why? Because he just got his back waxed. Good start.
2. We immediately went to lunch where lots of rich white people hang out. I ate a delicious hamburger, but Chris hasn't been in Africa long enough to realize just how delicious it was. He ate a salad that, in all likelihood, gave him haunting stomach issues. Should've warned you mate.
3. Off to the lake (see above). 
4. Woke up and Colorado St (his alma mater) and Oregon won their first round games!
5. Kayaked to the island in the background of the photograph above. Snorkled. Fish followed Chris and nibbled on his feet and legs. Foreign food. Chris was allergic and snotted all over the place. Is it fratty to mention that? Oh yeah.
6. Cape Maclear is an interest destination where tourism and traditional life mix together. Chris and I took a stroll into town where, among other things, we were Pied Pipers, except instead of music we played our white skin. The kids swarmed. Friendship Visit v. 2013
7. Swam to the platform in the background (that photo is really coming in handy). That is all.
8. At dinner Chris has the genius idea of a fire/drink/fireworks night. So we did. The fireworks were purchased at a Chinese store in Lilongwe just for such an occasion. Happy 4th of July!
9. On the return to Lilongwe the next morning, we stopped by the Mozambiquen border. Long story short: Christ (Chris) wanted to step foot in and did some illegally. Well done, sir. Well done.
10. Dinner with friends followed by a casino run. We fondly call the local blackjack table "The ATM." It didn't disappoint.
11. On the ride home at 2am, the lovely Malawi police pulled us over. 45 minutes and a call to our embassy later and we were released with orders to go to the police station the next morning (Sunday) at 7:30 to pay a $7.50 fine. It would cost more in gas to drive to the station than to pay the fine.
12. Departure the next morning. JOH 2003 Reunion Tour complete. Guys, where you at?

 PS Serena claims I was "really fratty." Chris and I thought each other was about exactly the same 10 years later sooooo... this is a likely accusation.

Broken Market

So here we sit, in bed by candle light as the electricity is out. A perfect opportunity for blogging! To our left a generator buzzes and lights blare. To our right a generator buzzes and lights blare. One of the beauties of living somewhere with power outages is to enjoy the quiet darkness. Unfortunately we get all the bad--no hot water, no cooking, no lights--and none of the good--the neighbors are blazing away with loads of noise and light.

Self pity aside, this raises an interesting example of a broken marketplace. Those with money who consume the most electricity have generators so they do not feel the ill effects of the underdeveloped grid and insufficient production capacity. In turn, that means the normal market forces--consumers wanting better service--does not take full effect, as those with the biggest microphones (the rich) do not exert pressure for improvement.

Compounding the problem is that the electrical utility protects certain areas of the city where the richest and most politically influential residents live. If you live in Areas 3, 11, and 12, for example, you experience far fewer outages than in the middle and lower class Malawians neighborhoods.

So, for those of you who are pure market capitalists, I give you Exhibit A in a long list of possible examples where the market fails.

PS As I typed this, the lights came back on. Thought you should know.

Noise Pollution

There is an ongoing debate with many of my urban-loving friends about life in cities. They say cities are full of action: culture, restaurants, people, events! I say cities are full of negatives: concentrated pollution, crowds, noise! Plus, you get the benefits of a city with a simple visit and return home. Anyhow, it is a never-ending debate because, really, we're both right.

That aside, my time in Lilongwe and Malawi in general has highlighted two things: crowds and noise pollution. Malawi is one of the most densely populated countries in Africa and it shows: there are people everywhere. Walk down the street: people. Go to the market: people. Climb a mountain: people! Today while taking Bay for a walk through corn and soy fields: people, people, people! 

To what does this lead? Noise pollution. Cars on the road with horns honking. Music from stereos. People chatting on phones and haggling on prices. Construction workers constructing. Generators generating. I rarely find myself without some combination of human noises. Finally, today, while wandering about the aforementioned corn and soy fields I found something: quiet. It was beautiful. Birds chirping and breeze through the grass was all that filled my ears. My city-dwelling friends should try it some time.

Doggy Training Classes

 Remember when Bay jumped through a window? He's been much better behaved since then (other than the hoarding). But on Saturday we took him to the vet to make sure that some itchy patches on his skin were benign (they were) and also took advantage of the doggy training classes that are put on by the LSPCA on Saturday mornings. Bay got to be the example dog for heeling (see above). He didn't exactly rock it but he definitely wasn't the worst dog out there. He gets a little anxious around all the other dogs which makes me wonder how he ever survived at the LSPCA for a year and a half.

While Zach worked with Bay and the teacher I took a stroll to see the other dogs awaiting adoption. Look at this cute little female one. Sad.

Places We Go: The Living Room

 Ahhhh the weekend. On Friday night we booked our tickets for a vacation over Easter weekend (details coming soon) before heading to The Living Room for a birthday party. The Living Room is a new restaurant and bar in Lilongwe. The party was loud and crowded so we quickly exited in favor of spending a few hours at the casino here in town which is named 'American Pirates.' Neither of us are gamblers (at all) but we have friends here who make it fun to play blackjack for a few hours and the buy-in is only 300 kwacha per hand (385 kwacha = $1 right now). We won 5,500 kwacha, whoop whoop!

Since The Living Room also serves delicious iced tea and veggie quesadillas we headed back for lunch on Saturday. The outside porch is comfy and breezy and perfect for the gorgeous sunny days we've been having recently. Afterward Zach played in a soccer game at the local stadium (they won), we got dinner at our favorite Indian place with some friends visiting from Lusaka and then went to a birthday party with delicious funfetti cake from America.

Any guesses about where we booked our vacation for?

Dogblogging: Found This Week in Bay's Bed

Tuesday: Vegetables
Thursday: Money (I snatched it away from him before taking a picture because...it's money)

Getting Malaria

Malaria is endemic in Malawi but Zach and I don't take any prophylaxis. Crazy? I don't think so. We live in the city next to good medical care and with quick access to rapid diagnostic tests, unlike many people living in malaria zones. So for us it's a better option to risk that we'll get malaria and get treated quickly than to be sure that we'll rot our insides with a year of malaria prophylaxis. Of course, things are a little more complicated than that but that's the gist of it. However, not being on prophylaxis means that I force Zach to get a malaria test every time he runs a fever - and quickly.

As you can tell, Zach got sick last weekend and had the pleasure of receiving a malaria test while laying in his own bed. There's a benefit to being on the same team as the malaria guy at work - he has a stock of RDTs and knows how to use them. Unfortunately the test doesn't have a spring loaded finger prick so Cary had to just smash the needle into Zach's finger (ouch!). We got some blood on the sheets after three attempts at a hard enough prick. The test came back negative, in case you're wondering. Zach was feeling better the next day and is now completely recovered.

Curing AIDS?

This week a little girl who appears to have been 'cured' of HIV made a lot of news around the world. If you haven't had a chance, check out the story at NPR here. She's only the second human in the world to enjoy the title 'Cured of HIV.' I like that the last one, The Berlin Patient, was a rich old white dude and this one is young, likely of a low socio-economic class considering her mom's behavior, and who knows what race. Maybe God is balancing out his favors.

But what does this actually mean for normal people? It means little but it should be appreciated for what it is: an extraordinary occurrence that shows us how little we know about diseases. It's not a far leap from there to being optimistic that if we know so little there is still so much to learn and so much opportunity for what we learn to completely change the way we treat people living with HIV.

I am incredibly skeptical about this natural experiment ever being replicated on a large scale. Afterall, her mother first infected her with HIV without knowing herself she was positive (rare in the USA) and then stopped giving the infant the ARVs that were sustaining her life (incredibly shitty parenting). These sorts of things do happen naturally but can we identify those situations? Manufacturing that kind of situation is out of the question.

Anyway, the Berlin Patient still appears to be cured of HIV so he and this baby do offer a lot of hope. I just doubt that either of them actually holds the key to the cure. Though I clearly hope to be dead wrong. And I hope they end up being friends, which sounds like fodder for an awesome documentary or book.

Dogblogging: Hoarding Continues

In the latest installment of my series of pictures of Bay hoarding things in his bed, I present to you: Bay and the Dirty Kitchen Rug. This thing is filthy and Zach just can't keep him away from it. So gross to find it's been dragged into our bedroom yet again.

Living in the Matrix

One thing I've come to hate about living in America is that to me it feels like living in a bubble. A soft, comfortable bubble which I adore but a bubble none the less. The simple truth is that life in America is not actually life on Earth. No one else lives the way we do. In fact, 90% of the world doesn't even live *close* to the way we live and yet we go about our daily lives feeling like we're just one of the crew here on Earth. Thinking about how different life is everywhere else is mind boggling. Living in America is like choosing to live in The Matrix. I can understand why most of us want to do it - I want to do it soon! - but remember how you're not actually living on the Earth that everyone else is experiencing or else you're shitting yourself every day. America is not real life on this planet.

To that end, this giant format-busting map from The Red Cross illustrates how Americans live in a false reality where they think Hurricane Sandy was the biggest thing to hit this year. 99% of you never even had the CHANCE to hear about these other occurrences because your normal news outlets didn't cover them. How incredibly odd to not even have access to the truth.

But yes, I'm still planning to come home, drink bubble tea, enjoy electricity, public parks, and festivals. I do love America anyway.

Changing the Game

One cool thing about working in Malawi is that I get to see close-up some game changing initiatives. Malawi's government, despite it's many flaws, is flexible and willing to ditch the status quo when it comes to attempting to improve health outcomes. This even earned us a shout out in Bill Clinton's speech at 2012's International AIDS Society Conference in Washington, DC.

The most material change in policy (for me and my job) has been the implementation of Option B+. Here in Malawi all pregnant women are initiated on ART, no matter how close to developing AIDS they may be. If you're pregnant then you're on treatment - for the rest of your life. In other countries you must wait to be very close to developing AIDS before starting treatment (how close depends on which country you live in; you won't be surprised to know that you will start treatment in the US much more quickly than in other countries). Clearly there are drawbacks and benefits and I personally believe that the evidence supports Option B+. And I'm proud of Malawi for being the first to roll out a really ambitious policy.

Malawi made the NPR blog yesterday. It does a good job of explaining the policy for people who don't care about the details but who still want to understand something that affects so many people in sub-Saharan Africa. That is available here, or see text below.

There's great enthusiasm among some global health leaders about a bold – some say radical — strategy to prevent pregnant women from transmitting HIV to their newborns.

But skeptics worry that the approach, dubbed Option B+, will pit pregnant women with HIV against others infected with the virus, diverting resources from the broader struggle against the pandemic.
The goal of Option B+ is to make serious inroads in reducing a stubborn and heart-breaking problem. Every year about 300,000 babies in sub-Saharan Africa are born with HIV.

The new strategy aims to put every pregnant woman with HIV on triple-drug treatment and keep her on it for the rest of her life — even if the virus has not yet damaged her immune system to the point where she needs medications to preserve her own health.

Universal treatment of HIV-positive pregnant women avoids the need to do expensive and often hard-to-access testing of a woman's level of CD4 immune cells to determine if she's sick enough to need long-term antiretroviral drugs.


The name Option B+ distinguishes the strategy from two earlier approaches, called A and B, which have failed so far to eliminate mother-to-child transmission of HIV in most-affected countries. Those other options either reserve triple-drug treatment for pregnant women with severely compromised immune systems or provide it only temporarily around the time of childbirth to those whose immunity is still relatively robust.

A report, published Thursday by scientists at the Centers for Disease Control and Prevention, finds that when Malawi, a small country in southeast Africa, made a big push to implement Option B+, the payoff was impressive: a sevenfold increase in the number of pregnant and breast-feeding women starting anti-HIV treatment in only a year.

"I think this is actually a big deal," CDC director Dr. Thomas Frieden tells Shots. He says the results not only demonstrate that it's possible to implement Option B+ across an entire country, "but that it makes a huge difference. The data are really remarkable."
In the space of about a year, Malawi trained 5,000 health care workers to give Option B+. It doubled clinics offering triple-drug treatment and went from having less than 1,300 pregnant women on HIV treatment to nearly 11,000.

Frieden estimates Option B+ prevented 7,000 infants from getting HIV from their mothers in its first year of operation.

"I think Option B+ is absolutely crucial," Frieden says, "because it gets to people who account for 60 percent of new HIV infections – women of childbearing age."

He predicts Option B+ will have ripple effects that benefit families and communities by sharply reducing transmission of HIV from women to their uninfected partners.

But not everyone is convinced. Among them is Dr. Hoosen Coovadia, a leading South African HIV specialist, who chaired the International AIDS Conference in 2000, which helped focus the world's attention on the pandemic's staggering toll in Africa.

Coovadia tells Shots that he had "a gut reaction" against Option B+ last July "because of the way it was presented" at the International AIDS Conference in Washington, D.C.

"It looked like everyone had been tutored to say this was a great thing," he says. "Hillary Clinton mentioned it in her speech. Almost everyone spoke about B+ as though it was going to change the direction of the AIDS epidemic. But it didn't look to me that there had been adequate consultation. This was a pet program of the U.S. government."

After the Washington conference, Coovadia says he and his colleagues debated the strategy back in South Africa. Recently he coauthored a sharply worded commentary in The Lancet calling Option B+ "extreme."

"The strong push for countries to switch to B+ is premature," they write. "A switch now would be dangerous, ignoring severe ethical, safety, feasibility and economic concerns."
The CDC's report on Option B+ in Malawi this week "is not a convincing argument that B+ is worth all the potential problems," Coovadia says.

South Africa, he says, has been able to lower the rate of mother-to-child HIV transmission from 33 percent to less than 3 percent by treating pregnant women with simpler, cheaper regimens and reserving triple-drug treatment for those who need it.

One big concern is that Option B+ will create tensions in households and communities when it becomes known that pregnant women with HIV are preferentially getting triple-drug therapy whatever their immune status, while other infected people with deteriorating health may not.
"South Africais already a fractious community," Coovadia says. "If it got out that of two women with the same CD4 count, one was treated and the other was not, the scope for tensions would be great."
Frieden's response to that: "Why should being pregnant get you to the front of the line? The answer to that, I think, is first, that it's more likely to get the baby protected ... It also saves the lives of the mother, the child, the family and it stops the spread of HIV."

And the critics? "Frankly, I think they're mistaken," Frieden says.

Coovadia calls for more study of Option B+ before implementing it aggressively. More data will be forthcoming. Rwanda and Haiti have already adopted the strategy, and seven other sub-Saharan countries are actively implementing it or preparing to.

Brokenness

*From mid-December to mid-January my folks visited. Upon their return home, each is writing a post (or more?!) about some part of the experience. Here is my Pop.

 I am using this collection of letters as a noun.  I am not sure that it is actually a word.  Perhaps Zach can ask his Brit friends.  They may know something about the language.  To lend a bit of legitimacy to my comments, I (his father) and Carol (his wonderful mother ) spent a month in Malawi during December and January.  We visited Malawi, Zambia, and Zimbabwe with Zachary and Serena. I even sneaked into another central African republic but I am not revealing the name because it might bring about an international uproar.

Brokenness can be defined as seemingly constant, and certainly irritating, phenomena of everything in the society in some degree of disrepair.  Nothing is spared.  Bathrooms, automobiles, houses, roads, the electricity, etc.  You name it.  Because so many things are manufactured in Western countries it is often difficult, if not impossible, to fix them.  Zachary's car is a good example.  It seems to suffer from constant irritating problems.  There are funny noises here and there and idiosyncratic behaviors such as unplanned horn blowing!  It is a Honda so it ought to be well-made - but the irregularities continue.  Of course this may be due to the fact that it is Zach's car.  Ask him about the car he had in college. 

Although these kind of problems seem ubiquitous there is actually a hopeful side to the issue.  It is that there is an ingenious cadre of "fixers" who have sprung up the deal with the problems.  As we were blissfully motoring across Zambia a suspicious noise showed up in the front, right wheel of the car.  Of course we were in the middle of nowhere.  We debated whether to continue on in hopes of finding some kind of help or turning around and retracing our path.  Of course nobody likes the latter alternative.  Serena then suggested that we should continue on because if the town ahead is big enough to appear on the map it will have somebody who works on noises like ours.  So we continued on. When we arrived at the town we went to the only gas station and explained our situation.  They directed us across the street to a dirt lot filled with automobiles in various conditions and several fellows milling around among the derelict cars.  So that is where we went.  To shorten the story, the fellow took the wheel off, identified the problem, and fixed it!  Additionally, the cost was very modest and we were able to meet and interact with the local automobile mechanic and his friends, including the local teacher.

I suspect that the phenomena I have described is one residual effect of colonialism.  If there had been no colonial influence it is likely that the trappings of western society would only now be emerging in much of Africa.  But modernity has a constant presence.  The problem is that when the colonial powers left Africa there was a sudden and severe lack of expertise.   Hopefully that is being reversed.  In the meantime, if you visit Africa be prepared for the first contraption you encounter to be in some state of disrepair.  Don't let that stop you, however.  There is so much that is interesting and beautiful to justify the trip.

Dog Blogging: The Joy of Water Bottles

 I know we've mentioned a few times that Bay loves to chew on things. He has chewed more than one of my under things, as well as some socks and shoes. We give him bones and chew toys to entertain him but recently he discovered something he likes even more than those: water bottles. We try to minimize the use of disposable water bottles but we still end up with hundreds in the house. Bay has begun hoarding them in his bed, chewing loudly on them and chasing them around the room when he accidentally shoots them out from between his jaws. It's ridiculously loud and we've had to take them away more than once when he decided to enjoy them at 5am. Still, we're trying to let him have this small pleasure.

What Did You Do This Weekend?

Weekends here are fabulous. I love turning off the alarm on my phone and not having to leave Zach alone with annoying little Bay all day. The weather is constantly pleasant and the sheets my big sister mailed me are oh-so-soft and perfect for sleeping in on a Saturday morning.

On Friday night we ate delicious home-made Chinese food with a friend who is a VSO volunteer who Zach plays soccer with. (Zach is finally back to playing soccer after 3 months on the mend after that unfortunate ankle sprain.) On Saturday Zach played soccer while I had a leisurely lunch with some coworkers and friends at one of the nicer restaurants in town. My lamb burger was great - but it cost US$10. Eish. Then I got a manicure (Also $10) and went to the market to buy cloth to have a dress made. Zach and I spent last night and this morning working on his resume and thinking about the next steps after we finish in Malawi in July. Tonight we're headed to the birthday party of another friend, the only pediatric cardiologist in the country, at a nice Italian restaurant. Sprinkled throughout the weekend are the sounds of Zach laughing out loud. Very loud. He's reading 'Spud' but some South African Afrikaans writer and appears to be loving it.

You would not believe the difference between being a Peace Corps Volunteer and living in the capital city with your boyfriend, your dog, and your car. Life is bougie.

Dog Blogging: All Curled Up

Must be more comfortable than it looks.

Serena and Chimango Are Not Impressed

 Here's me, listening to one of the Health Surveillance Assistants tell me why they have only sent in 15% of their expected number of DNA PCR tests in 2012. And below is my co-mentor, Chimango, listening to why that team will never be able to reach their target. We are not impressed.

To be honest, I don't think we spent most of our time in the field last week making these faces but when I scrolled through the pictures from the week I noticed we definitely spent too much time making them.

Usually the people we met in the health facilities were eager to improve and quick learners. They discussed amongst themselves strategies for improving the number of tests they collect and the number of HIV exposed infants identified. Often Chimango and I felt sort of unnecessary. But, as you can see, sometimes we were a little skeptical.

At any rate, I'm back in the office tomorrow to assess whether mentoring went smoothly. In a few months we'll see whether it had the intended effect on the early infant diagnoses of HIV exposed children in Malawi.

Dogblogging: Action Shots

 Our dog has an incredible amount of energy. He gets regular walks from Zachary but he still gets so worked up that we've had to come up with ways to help him get some of that energy out. Otherwise he jumps, runs in circles around the living room, bounds over the couches, knocks things off tables with his tail and does one particularly amazing move in which he jumps sideways onto the wall and kicks himself off of it.

So we've come up with something not terribly clever that does the trick none the less. We stand out in front of the house and take turns calling his name, resulting in him running between us as fast as he possibly can until he's fit once more to be inside of the house. Look at his grace and form. And also, note that we are sunbathing in the 75 degree weather in February because even though I've already mentioned that, it's worth repeating. Come visit and we'll go lay on the lake shore and drink iced tea!

Awesome Plants: Part 4 (?)

Guys. Look at this amazing plant that I saw while hiking a few weeks ago. It's camouflaged!

Also this yellow flower and this orange flower were bright spots in a field of green. I know I've said it many times but the flowers here and unbelievable - hundred of shapes and colors everywhere. Also that beautiful honeysuckle/jasmine smell is back in backyard and once again floats in through our windows at night. It's amazing! I am not looking forward to the return of the dry season and the death of many of the tall green plants that have sprung up everywhere (though it will be nice to have dry clothes again).

Work. (!)

Most of you know that I never talk about work on the blog. First, work is depressing. There are a hundred things every day that make me shake my head, cry, think about buying a ticket out of here. Zach becomes irate at many of the stories he hears from my colleagues (not super helpful but at least he's in solidarity). Second, putting stories about people at work on the internet is SKETCHY. That crap gets you fired!

But how much can I write about flowers and dogs? Well surprisingly a lot. But today I'm going to write about work! Sort of.

I work with an incredibly dedicated group of people. Both in the Malawi government and at CHAI, I am impressed by the extra hours put into work and the thought that goes into efficiency and effectiveness. I focus on early infant diagnosis of HIV (what is that? Maybe the topic of another blog post). This week I've been out in the field with some of those incredibly dedicated people, visiting health facilities that have a high volume of patients but a low volume of submitted EID tests. We go there to have a conversation and find out how we can make things easier for that facility and urge them to improve. Usually it comes down to some inspiring speeches and, when that fails, some veiled threats about accountability and the Ministry's computer that is omniscient and "knows when you guys are failing!" And a promise of some Fanta next time we come if they've improved never hurts.

There's a million steps in this mentoring process and for me, most of them began two weeks ago. It's a short time to deal with the logistics for visiting 52 health facilities but we just have one more day to go and then I'll declare success! Up there is my fabulous group of mentors who we sent out across the country last Sunday. Send us your good juju from America cause we're trying to save babies here and we can use all the good juju we can get.

Dogblogging: Ashamed to be Bathing

Bay hates his weekly massage with warm water and soft shampoo. Not sure why, but the shame and dread is palpable every time he's subjected to it.

British People.

One thing about living abroad is that you end up getting to know a lot about other cultures. Duh. But not just the culture you live in - you also end up hanging out with expats from other Western countries who have really odd hobbies and pastimes. We spend a fair amount of time with our British and Irish friends and last weekend they invited us to have Pims and play croquet. Pims is, apparently, a type of posh alcohol that is mixed with lemonade and drank by rich people. To me it just tasted like alcohol.

That's Zach's homemade quiche in the foreground, by the way. Anyway, after we drank some liquor out of wine glasses we played croquet. It turns out there's a lot more to it than meets the eye, though I think I'll stick to miniature golf in the future. At any rate, Zach and I were honored to be the only American attendees and enjoyed an afternoon of trying out our fake British accents and being the butt of jokes about gun ownership and mass shootings (which is pretty typical when hanging out with Brits).

So classy right now

Small Emergencies

I mentioned in a past blog that Bay jumped through a window. In fact, he did it again a few days later when chasing a moth. Luckily the only damage done was to his paw (and to the window, of course). Why would he jump through a window? He was alone and getting worked up and he probably didn't even realize it was there. Lame. It ended up being relatively easy to fix the window but we were worried that the cut would require stitches. Of course, Bay wouldn't stay still long enough to assess it. We rushed home from a bar after receiving a panicked call from our roommate to find this:

Ewwww. He had spread blood throughout the kitchen and was still bouncing around like he hadn't just risked his life to get into the living room. The only way to keep him still was to continuously feed him peanut butter while tightly tying his bandage. Here's how he looked subdued:

He didn't end up needing any stitches, thank goodness.

Dogblogging: Lovely in Yellow

The handkerchief makes him appear more obedient and tame, don't you think?

Keeping Busy

Hello, hello! I apologize for the silence on the blog for the past few weeks. I've been extraordinarily busy at work and Zach seems to have lost his inspiration. Hopefully it comes back soon. In the meantime I'll update you all on the mundane happenings of life in Malawi.

Two weeks ago we went hiking at Nkhoma mountain, which is a large rock mass about 45 minutes south of Lilongwe in a cute little town with an old mission. We went with our friend David, a pediatrician with Baylor, and Amanda, who works in public health for a nonprofit related to Baylor. Most of you saw the pictures on my or Zach's facebook page so I won't put up many. We had a lovely day though we ended up heading straight up a mountain without a trail to help us (I think we got lost). On the way back to town we also walked by some fishermen and their packs of dogs, who didn't take very kindly to Bay. We made it out alive though and after a coke at the local market (where we also purchased a very special gift for Eric Griffith) we headed back to Lilongwe. That was 2 weeks ago, which means you still have some more mundane weekend updated headed your way.

Dogblogging: Gardening

Now that Bay doesn't run away from the garden he spends a lot of time sitting around watching us plant things. I think he thinks its super boring and is missing the days of hunting for bones in the neighbors' yards.

Small Hiccups

Last week we had 4 small hiccups in our lives. Well, 5, if you count the time I smacked into the curb and busted a hole in our muffler but Zach already told you about that and got it fixed. In chronological order:

1. It started raining inside our house. We woke up on a Monday morning to a flooded room due to a burst pipe in our ceiling. Here's Zach cleaning up the damage. Happy ending: a plumber came to fix the pipe the same day.

2. Bay caught a chicken and mauled it. We had to pay 500 kwacha to the man who owned the chicken, though the chicken didn't actually die. I suppose Bay just enjoys the chase but I find this to be disturbing and gross and awful. He is far from the first dog to chase a chicken and be unlucky enough to catch it but still, ew.

3. Bay jumped through our window, shattering the glass and cutting his paw. ! He dripped blood all over the kitchen floor before our roomie cut up a sheet and tied it tightly around his leg. What a total idiot. Another happy ending: we replaced the glass today and Bay seems totally fine, though he keeps breaking the gash open and bleeding on my hands. He's also chewed through two screen in the past three days. He's really on a roll this week.

4. Our dear friend and employee Paul appears to be stealing money. This is a super tricky one since we don't want to fire him without any proof and leave him without a way to support his family. But the truth is that if he IS the one stealing money then he's stolen the equivalent of the rest of his year's salary and he'll be just fine if he gets fired. How this is resolved will depend on Jonathan's advice and wisdom, so stay tuned.

Also this morning our shower broke. I guess that makes 6 hiccups?

A Warm and Sunny February

One thing that is better about Malawi than I ever expected is the weather. December and January in some African countries are oppressive months, marked by 100 degree days. In Swaziland I couldn't be inside of my house between the hours of 9am and 4pm because the low tin roof made me feel like I was being cooked alive. I would lay outside under a large tree, reading and sweating. Even baths couldn't cool me down and even at night it was so warm that you would sweat even when you weren't moving. I spent every night of both years laying directly in front of a fan (ok, there was actually one night in June where I had to sleep in a fleece jacket when it dropped into the 40s).

But January in Malawi is totally different. We had one week of straight rain, which meant that our clothes began smelling mildewy and the wicker furniture in our room gave off an odor redolent of hamster shavings (wet sawdust, you know). That wasn't very pleasant but it was still mild weather and being from Oregon, it didn't seem so terrible. And for the past week we've been in the low 80s, with no humidity and some of the most beautiful clouds you've ever seen. We spent today lounging under the tree in our backyard and playing cards at an outside table at our favorite cafe, dressed in shorts and a t-shirt and enjoying iced tea. The weather couldn't be nicer.

Here's Zach planting the leek seeds sent to us in a package by my lovely friend Margaret. Great pastime for a sunny day!

Good luck to those of you battling the rain and snow in the Northern hemisphere!

Purchasing Produce

*From mid-December to mid-January my folks visited. Upon their return home, each is writing a post (or more?!) about some part of the experience. Here is another from my Mom.

We bought most of our fresh produce from roadside vendors or the open markets.  We bought lots of tomatoes, eggplant, onions and green peppers.  We also got wild mushrooms (they were full of sand), green beans, apples, oranges, green onions, cilantro, zucchini, potatoes, garlic, and leeks. Zachary even splurged and bought asparagus for our homemade Christmas dinner (roast chicken, bread stuffing with sage from La Grande, sweet potato soufflé).

It was common to see a vendor with a small quantity of bananas set up along the street or carrying them in a basket on her head or pushing them in a cart.  Zach’s strategy was to hand them a 100 kwacha bill (about 30 cents) as though we knew what that would buy and just see how many bananas would be handed over—usually about 6!  However, with almost everything else there was a required negotiation about the price. 

Mango barrage!

 It was always easier to get something if there was only one seller but it was amazing how a gang would appear if they detected that a sales might be in the offing. Stopping to buy something could create a mob scene.  Mangoes were ripe and available everywhere when we first arrived.  At one stop about 15 children descended on Dale, all offering large quantities of mangoes, each assuring that his mangoes were the best.  Dale finally made his purchase from one shy little girl.  We never knew if she had to share her money with all those bigger, louder children.     Toward the end of our stay, pineapples became available.  Zachary and I were out in the rain when I decided I would really like pineapple before we left Malawi.  So he asked one of the banana sellers what a pineapple should cost.  She told him 300 kwacha.  He then went to the pineapple vendor who told him 700.  They finally settled on 350 (about a dollar).  It was a very tasty pineapple.

Mosquitoes!

Per request: How are the mosquitoes?

Answer: I dunno... because there aren't many. In a wonderful turn of events, it turns out the wet season does not equate to loads and loads and mozzies (as they are known here). We were set to start taking malaria prophylaxis once the rains started, but because the biters never came, we didn't take the pills. That doesn't mean we are tearing down the mosquito netting (that's Bay's prime goal in life), but we do even know ex-pats who sleep without. To be sure, malaria is a problem, but nothing like what you see on infomercial pitches.*

*Maybe as a result of the good work of those groups who fund the infomercials!

Autoshop Liveblogging!!!!

Meh, not really. I'm sitting in the back seat of our jacked-up car that the guys are trying to fix. Over the weekend Serena had a... what shall we call it... conversation with the curb. The car almost had enough clearance to avoid any trouble, but unfortunately not the case. The exhaust was nicked as well as the plastic engine casing that protects the underside from water and grime.

An interesting difference between mechanics in the States and here: They have zero parts. At home mechanics have basic things that are commonly needed--filters, fluids, belts, hoses, etc--but here they have nothing. That means they take off the part, walk or take a minibus to an autoparts store (that is invariably out of stock), and return. The process takes hours. Making matters worse, it's generally known that you should stay with your car while it is at the shop for fear having pieces removed or swapped out. So, here I am, doing something I've grown accustomed to: waiting.

Dog Blogging: At the Kitchen Table

This is a position I keep finding Zach and Bay in. Zach leaves a little room behind him in his chair while eating dinner and Bay squishes in behind him. I suppose it's probably because Zach gives him tidbits of food, though we like to think it's just because he likes hanging out with us. He'll sit there for 5 minutes until he gets bored and moves on to hunting for things to hoard in his bed.

In other news, Bay is wearing a shock collar. He's been learning the terrible habit of running away from our yard that needs to be addressed for him to be safe. A shock collar seems pretty inhumane and sick but we DID shock ourselves first and it's really just surprising, rather than painful. The good news is that it's working! If you look closely you can tell he chewed the thing up and we had to wrap it in duct tape to salvage it. Really can't blame him for that.