More from the Field: a Community-Centered Approach

Also posted at: http://scoutbanana.org/health-in-africa/from-the-field-a-community-centered-approach-3/
In the field of global health, community-centered models are increasingly popular. Such models have sought to counter the traditional Western aid "do as we say" approaches to development and health, suggesting that people within affected developing world communities are valuable resources towards improving their own well-being. This may seem like such a commonsensical notion, but 24 years ago when organizations like Paul Farmer's Partners in Health emerged on the scene, the idea of using community health workers (CHWs) was unpopular in mainstream health and development work. Even today, as my experience in Malawi has revealed, there are tensions between traditional and Western responses, between accepting international aid (which often comes with conditions) or struggling without assistance, between relying on the more than 200 NGOs to attend to the well-being and success of the nation or building internal capacity to reduce foreign dependency...

Yesterday, after a field visit to a government-run district hospital in a rural community just 60 kilometers out of the capital of Lilongwe, many of these issues were brought to the forefront of my mind as I observed the process for hiring CHWs. There were six candidates for two slots, and with training just three weeks around the corner, the odds were in favor of a very productive day. We arrived early, thirty minutes before we were scheduled to start, but after more than an hour, we were still missing some of the interview panelists. When they all arrived, I was struck by the size of the panel. In addition to the Regional Manager and myself as an observer, there were two HR people from the facility, two facility nurses, and a government official from the labor bureau, all of whom insisted on being a part of the interview process. (I later noticed that in addition to the snacks and drinks provided, we all received a "lunch stipend" for our involvement - a cultural expectation, I was later informed, that may have contributed to the unusually large involvement).

What should have been an easy though tedious process - as I expected - was actually a challenging one. The CHW requirement of being an HIV-positive mother with a young child who has disclosed her status was met by only one candidate; a male applicant even showed up. It was hard to watch the others turned away - some with primary school education, one with a high school diploma - hopeful that they could take a job that pays so little as a means of supporting their families and their life. But it was great to see that the one eligible candidate - a 31 year old woman - was a model example: she was a young mother, still married (which is not always common when a husband knows the wife's status), who had overcome the fear of stigma so as to share her status with her entire village. She was educated through primary school, articulated herself well throughout the interview, and passed the written portion of the interview with flying colors; the only mistake she made was in writing 2011 as 20011, which reminded me of the numeracy challenges among the CHWs we will train. She was confident that she could share her experiences with other women living positively and looked forward to using her new income to buy more nutritious food for her family.

Before we left for the day, she was formally offered a position and a plan was hatched by the panelists for an additional candidate search. As I thought of the process - the late start, the emphasis on snacks and drinks during the interview, the expected lunch stipends for the numerous panelists and travel vouchers for applicants, and attracting more unqualified than qualified candidates - I realized that what I regarded as unnecessary inefficiencies and expenses were considered culturally acceptable, and in some ways culturally-expected. In fact, my organization provided fewer perks than most, which could also have contributed to the low applicant turnout.

And so I am left struck and perplexed by the challenges of merging different cultures for the best outcome in global health. I cannot purport that my experience was typical - in fact, the Regional Manager suggested new challenges have emerged this year - but my on-the-ground observations will be valuable as we continue to improve the program here. My field visit revealed that the global community is making positive strides through the use of culturally-acceptable approaches and an emphasis on community inclusion; however, there is still much more work to be done. We have to learn to blend the NGO and government sectors for long-term sustainable, nation-driven improvements. We have to learn to continually adapt Western models in different local contexts, and perhaps strive for more ideas to emerge from within these local contexts. And we - who come from the "outside" but with a passion and desire to work in under-served areas - have to learn to understand, respect, and in some ways challenge the myriad of cultures we will continually find ourselves in on the journey to improving health and well-being worldwide.

The panel discusses the interview porcess.

The front of the hospital.

Outside the hospital.

Some market stands in the town.

Lunch on the side of the road
(deep fried beef/goat meat and chips).

My Favorite Things About Malawi

From reading my blog thus far, you might get the impression that I'm having a terrible time here! "Luggage problems," "lanaguage barriers," "challenges in the field," and the list could go on. But truthfully, if I really reflect on my three weeks in this new environment, such an impression is only one-sided. There are so many things special to this place that little snags here and there sometimes prevent me from recalling and relating.

And so, in the spirit of sharing some of the positives, I've compiled my David Letterman-inspired "Top 10" list of favorite things about Malawi, so far:

10.    The Malawian-bottled beer is called "Kuche Kuche" (prounounced awfully similar to - yes, you guessed it - "coochie coochie")

9.      A really filling lunch of starch, meat, starch, more starch, and veggies costs less than US$2, which is a far cry from the $9 salads in Boston...

8.      I have a lot of time for reading, personal reflection, exploring new hobbies like yoga (I can almost touch my toes), getting creative in the kitchen, and keeping in touch with all my favorite people back home (which, for those of you who know me, is a HUGE accomplishment).

I have time to make this...

into this...

And then this!

 7.      My organization provides transportation for me to and from work everyday! No 7 am 15 passenger vans-turned-public transport for me!

6.       I am in the midst of a political change.  The July 20 protests revealed questionable government  tactics, and combined with food and fuel shortages, prompted the removal of the Hunger Project Award to Malawi's president and brought attention to the country. The civil society-initiated August 17 protests have been postponed for at least one month, but tensions are still high and politics are still on everyone's tongue. This may not be Egypt but it's exciting to see that Malawians may be finding their voice and that changes are being made.

5.       I have the opportunity to learn a new language: Chichewa. I can now say 6 things...

4.      Weight gain is considered "looking healthy," which is perfect considering all of the bread, fried food, and nsima I've been eating.

3.       My apartment is very comfortable! I have a big sitting room perfect for entertaining, two balconies, and for those of you who have also experienced the 4 person/1 bathroom housing debacle, I have my own bathroom!!


2.       I get free drinks at the bar, even when I'm clearly there with someone else.

Reunion with a former classmate and some other interns at my
favorite local spot.

  And my favorite thing about being in Malawi?! Drumroll please...

1.        I have the opportunity to meet amazing people - locals and expats alike - who are doing amazing things to improve their communities. From Peace Corps Volunteers and Staff who have warmly adopted me as their own....

New friends on my first night out in Malawi.

to other fellows who willingly listen to my endless chatter...

to co-workers who provide me with insight on their cultures...

to the women community health workers that teach me so much...

Community health works plus management team at the
monthly coordinator's meeting.

Malawi is not home yet but hopefully it will be soon.

From the Field: the Power of "M&E"

Also posted at: http://scoutbanana.org/health-in-africa/from-the-field-the-power-of-me/

When asked what my favorite part of being in Malawi is thus far, I can answer in a heartbeat: being in the field! Although I only understand six phrases in the national language of Chichewa, the experience of interacting with real people making real things happen in their communities is inspiring. We live in a world where we're taught that intelligence is in a university degree, but anyone who has interacted with these community health workers knows that is simply not true.

Recently, I had the chance to attend a site coordinators meeting. Twelve talented female community health workers (CHWs) who have been overseeing CHW involvement at several health facilities came together for a day of training, discussion, and fellowship. After opening with a prayer and reviewing the induction of new health workers, we focused on one of the most crucial components of the organization's work: M&E.

Now, perhaps you've heard "M&E" is the buzzword of the year. "M" stands for monitoring, or measuring what a program is doing. "E" stands for evaluation, or measuring the impact of the project. The idea behind the loaded phrase "monitoring and evaluation" is that any project should be periodically and systematically examined to ensure that it is accomplishing its goals and to understand its long-term impact. It is easy to propose, for example, that training community health workers will prevent HIV. But monitoring and evaluating such a project encourages us to keep track of the project: how many people are we training? What effect is the training having? Is the knowledge translating into action? What impact does our project have on its overall goal of decreasing HIV incidence over time? In the words of a former professor, monitoring answers "Am I doing the right things?" while evaluation looks at "Am I doing the right things?"

I know it may sound like unnecessary technical jargon, but M&E is so valuable because it can drastically improve the way we approach health worldwide. Instead of just pouring resources into a random project that "sounds good," utilizing both monitoring and evaluation strategies can encourage us to critically think about how we approach these projects and how we can improve them so as to help the people we seek to serve. Of course, with any methodology come additional challenges: how do we encourage the collection of quantitative AND qualitative data? How can we begin to measure nebulous concepts such as "empowerment" and "community participation?" And these are some of the issues that I hope to contribute to over the course of the year.

Perhaps what was most exciting about the field visit was watching the commitment and engagement of the 12 women present. They were quick to identify differences between the old and newly-introduced M&E tools; they successfully summarized and tabulated required data for the past week. The workshop was not without questions or challenges, but these women who are "living positively" were eager and committed to enhancing their skills so as to improve their advisory roles. They provided hope that contrary to so many existing models – where an outsider is deemed more capable of tabulating data and measuring indicators and where HIV infection is considered a death sentence – women from these communities can be trained and utilized as valuable resources towards improving the health of themselves and those around them.

Outside the training venue.

Preparing to start the training.

The National Trainer and Regional Manager prepare for
today's meeting.

The National Trainer intently listens to issues brough up
by the coordinators.

Two site coordinators evaluate the new M&E tools while
enjoying snacks.

Coordinators examining new tools.

Coordinators listening as another colleauge speaks, as one
carries her baby on her back.

One site coordinator completes the new Tally Sheet by
summarizing client information from the week.

The National Trainer double checks the coordinators' work
to ensure comprehension.

A team of amazing women!

"The Danger of a Single Story"

As many of you know, this past week was particularly challenging for me. Feelings of uncertainty and discomfort reverberated in my head until I feared they cloud my entire experience. I had identified that there was a problem - I was not happy! - and knew it was time for a change; the question was "how?"

After completing my morning bout of yoga (a new routine toward finding my "inner peace"), and laughing about my sleepless night due to all of the noise in my surroundings, I was reminded of a Ted Talk given by Chimanda Adiche Ngoze. A Nigerian novelist and short story writer, Ngoze's presentation craftily described "the danger of a single story," the consequences of taking one presentation of a nation, a city, a peoples as law without considering that it is only one story. Ngoze talked about her childhood of reading British novels, of "white and blue-eyed" characters who "played in the snow" and "ate apples," and then recreating those scenes in her own short stories, not realizing that literature could depict people like her. The danger of a single story. Ngoze also described her experience when, at the age of 19, she came to an American university to study. "My roommate was shocked by me," she describes, "She asked where I had learned to speak English so well, and was confused when I said that Nigeria happened to have English as its official language. She asked if she could listen to what she called my 'tribal music,' and was consequently disappointed when I produced my tape of Mariah Carey." The danger of a single story. My interrupted sleep erected this concept, probably because it - too - was an unexpected take on the "the danger of a single story." My visions of a peaceful, quiet Malawi isolated from the real world were shattered as a 5 am prayer was broadcast from the neighboring Islamic center and my neighbor's goats sprung to life and began their day 2 hours before I began mine. The danger of a single story.

It is this very concept that challenged me to reexamine my own experiences here thus far, while also learning from the experience of others. Two volunteers I met candidly shared that their Malawi experience at the 6 month and 1 year marks were similar to mine, with constant feelings of disrespect and a need to cling to their "American" identity (never mind their African-American realities). Their stories of Lilongwe and village life implanted in my mind that things here aren't going to get better, and that I may not like the person I become, but I can learn to change how I respond to situations and to live in the moment.

But just days later, I met to two volunteers whose two month stint in Malawi had been quite different. They encouraged me to "try to be open" and suggested that perhaps my deficiency in this was why car rides often involved tens of minutes in Chichewa conversations in which I cannot participate. Their friends, they shared, often tried to include them in conversations in English, so it must have been my fault or insensitivity that those around me did not frequently do the same. In their opinion, the situation here in Lilongwe would get better as months passed; I just needed to be patient.

The danger of a single story.

My realization is that a single story, or even a single experience, should remain as just that: a single, instantaneous occurrence. I've been cognizant of drawing parallels over multiple days, weaving understanding and theories from several stories. But my daily life also consists of single characters who will continually present only one story. Perhaps my housemate, for example, is not the typification of a Malawian male, and thus the challenges and comforts of interacting with him should not be projected onto the whole population. Perhaps my organization, as another example, is just that - a single organization - and can't be viewed as the "Bible" of NGO work in Malawi or the developing world.

On the other hand, although Ngoze didn't emphasis this, perhaps there is a lot one can learn from a single story. My organization is just one of hundreds in the world, and yet the lessons I take from my time here can enrich me no matter where I end up. Similarly, it's the memories from my last 7 roommates that have contributed to my current housing transition. And the interactions that I have with my housemate may help me understand other aspects of people here in Malawi, preempting unforeseen disappointment or frustration that cultural differences could encourage over the course of the year.

"The problem with stereotypes," Ngoze acknowledges, "is not that they aren't true but that they are incomplete." Moreover, she concludes by emphasizing "That when we reject a single story, when we realize that there is never a single story about any place, we regain a sense of paradise. "

I wonder if we can ever regain a sense of paradise. It's true that a single story is incomplete, a microcosm of a greater picture. But it is also doesn't minimize are own experiences, the stories that we haven't just heard but have been one of the characters inside of. Perhaps the message I take is that everyone has a different story, and there is value to be found in this fact. Some we may share parts of with others, as well as the character roles we assumed within that story; some we may completely disagree on. The best thing I can do is not only accept that there is never a single story but to work toward being okay with the differences.

First Day in the Field!

After exactly a week of orientation, today was my first day in the field. Lectures on PMTCT, the organization we're working for, and monitoring and evaluation (M&E) were brought together as my partner Arthur and I accompanied staff members on two site visits in Lilongwe District.

Our first stop was the Area 25 Health Center, one of the many government health facilities located throughout Malawi. Although not large by Western standards, the outpatient facility provides many services through its under 5, maternity, postnatal (after pregnancy), antenatal (ANC, during pregnancy), antiretroviral treatment (ART), family planing, and outpatient departments/wards. Area 25 H.C. is a high volume facility facing the same challenges as many hospitals here: drug stock-outs and, relevant to our project, HIV test kit stock-outs. As space is a challenge, our organization houses its own activities in a UNICEF-donated tent on the grounds of the facility. 

Area 25 H.C. has six community health workers (CHWs) whose daily tasks are numerous. Each day, they provide a relevant health talk (often at the ANC) when other organizations are not giving one, conduct group pre-test counseling inside the tent, walk the mother over to the HIV testing and counseling (HTC) center, and provide 1-1 counseling based on HIV test results with the woman and, when possible, her partner. They facilitate support group sessions once a week, discussing a relevant issue suggested by the women and also serving a nutritious (and educational) hot meal. The CHWs also interact with return client mothers who are coming in for a check-up or receiving their medications. 

 M & E Coordinator outside the health clinic

Our second stop, Chitedze Health Center, was almost opposite to Area 25 H.C. A densely-populated space was replaced with a low-volume site, requiring only two CHWs for our program. Nested within the government's agricultural headquarters, Chitedze H.C. provided a small room for our program. The CHW's tasks are quite similar, although they expressed that there is very strong collaboration with the health facility's medical staff. 

On the way to Chitedza

At both sites, I had the chance to ask several questions to really get a feel from the women what their experiences working in the field are. As my Chichewa has not yet progressed, Delia - Regional Manager - translated that some of the challenges faced include: retention of women after HIV testing (due to long waiting times), disbelief of HIV status resulting in refusal to return to the facility and get proper medical attention, and getting monthly PMTCT data from the health facility as required for documentation purposes by our organization. 

What surprised me most in asking about the challenges was that none of the CHWs complained about the task of collecting data. These women are required to document their daily activities on several tools, including an education notebook, a general registry (Antenatal/Postnatal notebook), and a support group notebook. Moreover, they have to translate this information to a logbook, individual daily tally sheet, and a site-specific daily/monthly tally sheet. While the information is very useful from  an M&E perspective (thus, making my job a lot easier!), there are often problems and inconsistencies in implementation. Instead of describing these notebooks as tedious or arduous, Madaritso, site coordinator at Chitedze, actually suggested that they have been helpful in continually monitoring her site's success. It has even encouraged charting progress on a monthly graph. 

Charts documenting the program's progress at Chitedze Health Clinic

When asked why she became a CHW, Grace, a second-year mentor at Area 25 H.C., echoed the sentiments of the other employees, responding that she successfully completed a PMTCT program and wanted to help others. Singere, the site coordinator, emphatically described that by encouraging other HIV-positive mothers, she is able to encourage herself. My morning in the field (which included playing with a little girl named Jennifer) was the highlight of my time here thus far, and a reminder of why I chose this path. These women CHWs and the mothers they assist are not just women living with HIV, they are women "living positively."  

Area 49, which we passed along the way

Computers and Politics

I was inspired by a co-fellow's blog today to outwardly reflect on similarities and differences between the U.S. and my new home of Malawi, and two things immediately came to mind: computers and politics. (Perhaps my laptop woes biased my thoughts on the former, while media coverage of both Malawi and the U.S. encouraged the latter). But personal biases aside, I see computers and politics as somehow related. We want both to work in an orderly fashion, to stay within the norms of a system. We want to know in advance the effects of "pushing a button," producing no surprises. And, as I discovered this past weekend when my digital heart wouldn't come to life, we are distressed - engulfed - when one stops functioning as planned because our whole lives revolve around them. Computers and politics are synonymous when they work as we desire...

The reality, of course, is not so cut and dry. Much to my chagrin, computers do not always work as desired. And neither do politics. Take Malawi, for example. My initial arrival was postponed a few days due to the deaths of 18 (or 19, depending on your source) Malawians in an unexpectedly violent protest situation. "Malawi has caught wind of the Arab uprise," analysts have been suggesting (never mind that it's a predominantly Christian country). "Failed coup attempt," one Malawian newspaper wrote. But if you dig a little deeper, talk to some of the people on the ground during the protests, these suggestions (at least at present) are absurd. It seems that no matter where you are, exaggeration is shared!

The protest, I was informed, was organized several months ago by Malawian civil society, designed to express solidarity in the people's disappointment with progress (or lack there of). It was supposed to be a peaceful undertaking, consistent with Malawi's calm history. It was not a "blitz attack" on the current administration, nor was it designed to overthrow the government, as some media sources may lead you to believe but was actually shared in advance with the government and relevant people. To summarize what I was told, problems started in the week leading up to the protest, as tensions arose between both sides. Just hours before the event, the government was approved for an injunction, causing the protest to now be illegal. When individuals wearing their protest colors appeared and were told to go home, anger erupted and physical displays of this manifested. Tires were burned and stores were looted, although interestingly, many of these robberies were targeted at establishments assumed to be related or beneficiaries of the government. The police became involved in a forceful manner, easily identifying protesters by their colors, and needless to say, the results were devastating.

From those that I have interacted with, the picture is not just of a protest but of a deeper political problem. Malawians are disappointed, frustrated, angry, and discouraged, as presidential promises are broken and national improvements are non-existent. One Malawian shared that current president Bingu wa Mutharika was of average means upon assuming the presidency seven years ago, he's now among an elite club of Africa's richest men. And although there could and should be excitement as candidates arise for the 2014 election, The Nation (Malawi's most reliable newspaper, I was told) reported yesterday that President Mutharika's party - the Democratic Progressive Party, or DPP - has endorsed Mutharika's brother to be his successor. We've seen that in history, family successors can be publicly supported, as the Bush family legacy in the U.S. illustrates. But on a continent whose legacy has all too often demonstrated otherwise, yesterday's news article worried me.

Although the sentiments that "those Africans are at it again" could easily come to mind, it was less than 24 hours ago that the U.S. averted an unprecedented crisis of its own. A country as "developed" and "advanced" as the U.S. was caught up in partisan politics to the point where the not only did the "nation" as a political and financial entity suffer, so did we the people. It's embarrassing that it took so long to come to an agreement on raising the debt ceiling, demonstrating that too many of our policymakers' commitments to improving the nation operate on a different definition if who that "nation" includes. It is difficult for me to comprehend - for example - one's professed commitment to lowering debt but not supporting tax increases, as has been successful in the history not only of the U.S. but other countries as well. And, on the other hand, a true commitment to lowering debt rapidly would have to consider cutting spending; to avoid this would be inefficient. A democracy has to be built on compromise, lest we settle for the tyranny of the majority (or at least of those in power).

Politics (and non-functioning computers) are tricky no matter where you are. And in both the U.S., as campaigning goes into full effect, and in Malawi, where it's rumored that the July 20 protests were just a warm-up, I am concerned. I am worried that both of these events signify not just one glitch, but something bigger. In the U.S., perhaps an even uglier divide in partisan politics. In Malawi, possibly more aggressive displays of dissatisfaction. And in both, a lack of progressively realizing rights which all humans are entitled to and that governments are required to protect.  Lucky for me, my computer was fixed this morning after tinkering around with a few parts. If only the political situation in my two current "homes" could be fixed as easily...

Ready to Roll but No Where to Go: on the first few days in Lilongwe

I am not in love with Malawi yet. No, it's not the accommodation. I can't say I've been enjoying the luxury afforded to me at Sunbird Capital hotel since my first evening in the city, but I am living quite comfortably by anyone's standards! And no, it's not the air pollution or the red dirt-cladden feet that result from my leisurely strolls. Cleaning, roaming the town, dancing around an empty apartment, and a defunct laptop have colored my time here thus far. My welcome to the "warm heart of Africa" proved to be lukewarm, as constant technology failures only magnified the loneliness and isolation I felt on Day 3 of time here in Malawi. But perhaps I'm getting a bit ahead of myself...

I went into work at 9:30 am Thursday (decided that "jet lag" was my excuse for avoiding the 7:30 am start) and enjoyed the first two presentations of my month+ orientation. I was so impressed that Ellen, the country manager for my organization, had our orientation mapped out for us, and even more impressed to hear the progress that Malawi has made in regards to HIV responses since my thesis research (which I completed just two months ago, mind you). Ellen shared with me and my fellowship partner (and flat mate) Arthur about Malawi's approach to prevention of mother to child HIV transmission (pmtct), as well as more about the organization that we are now working for. In response to a question I posed about other actors in the realm of pmtct, I was saddened - though not entirely surprised - that the others involved in this include: Baylor School of Medicine (focused on pediatric treatment), Johns Hopkins (focused on early infant diagnosis), and Elizabeth Glaser Foundation (which trains ministry of health workers and works through UNiversity if North Carolina). Notice any commonalities?

As Arthur headed to the field to assist a consultant with an evaluation, I remained in the office, finishing my first serving of nsima (solid maize porridge or a corn-made fufu, for my Naija people) and beef stew. It is quite astonishing how much people are expected to eat in one sitting...and in the middle of the day! (Good thing that Friday's are half days). My failed attempts to connect with current fellows for the weekend contributed to a rather uneventful weekend, but I tried to make the most of it and get some much needed rest.

Nsima, beef stew, and greens - to go!

While a normal person would have slept, I (with my jet lag and determination) spent the evening scrubbing my room and bathroom, emptying my suitcases, and making my brand new bed. My repose was unfortunately brief, so I started Saturday morning right where I left off, sweeping, mopping, organizing my room, and rearranging our cushion-less furniture. My entertainment plan had a hiccup when my computer stopped working, and so after some encouragement from my parents, I attempted to walk around the "town" a bit and grab a beer.

Kitchen...in progress.

Bedroom.

Eating pizza in the living room (cushions haven't arrived for the furniture yet).

My bathroom.

Lilongwe is Malawi's most populous city, but it seems that it's development surpassed it's planning. I walked for a few hours around different neighborhoods of this spread out city (task 1: accomplished) and while I found several grocery stores, I didn't find one bar (task 2:epic fail)! I did, however, stumble upon the end of a Christian hip hop album launch, and although I made a few friends, I think that the word "statutory" would apply, should I decide to actually keep in touch with my first Malawian non-work contacts. I ate the only food I had - some leftover nsima and a unique take on the typical Nigerian stew that I prepared earlier today after knifing open a can of tomatoes -and read through half of one of two hardcopy books I brought. Feeling inspired by the "rager" across the hall (which I was not invited to, nor did I seem welcome when I tried to find a "discrete" way to get invited), and still with no luck in finding a new buddy in Malawi, I decided to check out a local bar near my place. It seemed just a 2 min walk on my taxi ride earlier today, but as I discovered when accompanied by "Sandrassa," my non-English speaking gate security, it's nearly a 10 min walk along a very dark path (and, of course, it was not open). To make matters worse, while I desperately hoped someone- a Malawi based fellow who had my number from a mass email I sent out, or my parents, or anyone - would call, the only communication that kept coming through were the 200 text messages (no exaggeration!) that "Airtel Malawi" kindly kept sending...So yes, pathetic as it sounds, the night ended for me after midnight when the neighbor's rager died down and with an undesirable little critter scurrying across my room ...

Malawi sparks creativity in me...

The weekend did get better, as Sunday involved interacting with people my age! There was an informal breakfast with outgoing fellows on their way to Uganda, and I met a few of Arthur's close friends, one of whom took us to a few local clubs to watch the finale of "Big Brother Africa" (and to try "kuche kuche," my first Malawian beer)! I miss my family, friends, other fellows, and little bits and pieces of the conveniences of American life (particularly, overcoming boredom and not being confined to the middle of nowhere with no phone credit, transportation, or Chichewa skills), but I'm trying really hard to maintain a positive attitude because it will get better. In addition to meeting the other fellows, I think the highlight of my weekend was finding my approximate location on the Bradt Malawi travel guide map!

Malawian beer. Now I'm happy.

Lessons learned: 1) dress older so I attract people of legal age. 2) Figure out how to describe where I live so that when the one taxi driver I know isn't working, I'm not stranded. 3) call Airtel and beg friends to text; I only want 200 texts if they come from friends or secret lovers (just kidding about the latter!) 4) regain a sense of independence!