Monday, April 13, 2009

Second of three(?) parent posts

Wasn't gonna bother to post this, but I guess someone is still reading. Here's what my mom thought about Malawi.


Billy asked Bill and me to write some notes of our thoughts about Malawi, as he was too busy when he first arrived to make blog entries about an outsider’s first impressions. So, here are my thoughts after a very few days in the country. A couple of days in Blantyre, one of Malawi’s largest cities, and two forays to clinic sites with the Project Peanut Butter staff. Obviously, that hardly makes me a Malawi expert, so you’ll have to take thse observations with a grain of salt …

It’s 6 a.m. as I write these words and Blantyre has come alive. I’ve been listening to the horns tootle and engines roar by on the road nearby. I’ve seen the scene for the past two days and I can envision what is happening outside in the city and countryside.
The streets are fairly teeming with people walking or cycling to work. Malawi is among the poorest countries in the world and few of its people own automobiles. Some people ride in crammed white mini buses, but most people do all their daily traveling on foot. No matter what the size, condition or location of the road, it is sure to have a constant stream of people walking along it. I have never seen so many people on foot. It’s not like the crowds you see at rush hour in the city. It is a steady stream of people who must walk miles in each direction, often in bare feet or worn flip flops, to attend to their daily business. Women have babies tied comfortably on their backs, cradled in colorful chitenjes. They balance amazing configurations of bundles on their heads. And they walk and walk without complaint.
Many vendors move their goods to their little stalls by bicycle. I’ve seen a vendor with four newly made side chairs strapped to his bike. Bundles of wood, charcoal, sugar cane – you see all kinds of things balancing on the back of bicycles, extending far to either side, like a tightrope walker’s pole.
Cars careen through the streets at speeds higher than seems advisable. As the driver approaches pedestrians or cyclists, or zooms past a slower moving car, they tootle their horn. As Billy says, car horns are used “conversationally” in Malawi. Not “get the hell out of my way” like we do in the States, but more “hey, I’m coming up on your right.” Everyone has nerves of steel, for the cars pass within inches of people on foot and bicycle and no one flinches a bit.
There are stores in Blantyre but there are also hundreds of vendors. Each has a minuscule stall – maybe four to six feet wide – from which they sell their wares. The more successful vendors have stalls made of cinderblock with a corrugated metal roof. Most of the stands are built of sticks. Not planks of wood but sticks about an inch in diameter, seemingly lashed together, often listing to one side, looking as if a wee bit too much pressure in any direction would send the whole thing toppling over. Row after row of these stands are set up on muddy clay fields to form the markets for the poor of Malawi.
While the business center of Blantyre is paved, its neighborhoods are likewise built upon rocky, clay streets. The road surface is riddled with deep crevices and boulder-like rocks. Driving on these streets is jarring to both vehicle and passenger. This is true in fairly affluent areas as well as in working class neighborhoods. In the mornings we drove to pick up one of the nurses near her home. She and Billy liked to joke that her street was the worst in Malawi – but one of its side streets looked far worse, more akin to a rock climbing route than anything that a wheeled vehicle should ever traverse. It was startling to see that a fair number of the pedestrians wore business attire – suits, nice dresses, shirt and tie – as they trudged down the muddy, rocky streets to go to work. It must take concerted effort to keep their appearance so crisp and clean when their daily commute is so messy.
Another ubiquitous feature of Blantyre neighborhoods is high walls. In richer neighborhoods, the walls are thick and topped with barbed wire, razor wire or jagged shards of glass. Labor is absurdly cheap in Malawi, so every walled home has a staff of “guards” who open and close the gate for cars of the owner or visitors. As you drive down the street in an affluent neighborhood, it’s as if you’re passing through a bumpy canal, as you are surrounded by high cement walls on both sides of the road.
Poor neighborhoods have their share of walls, too, albeit homemade ones of tall sticks that are lashed together. Coming from the open suburbs of Southern Maryland, where even open fences are rare, it felt like the whole city has a fortress mentality.
It’s easy to understand, though, the need for theft deterrence. The income gap between the haves and the have nots is enormous. By upper middle class American standards, the homes of the “haves” seemed fairly modest. No enormous kitchens with steel appliances and marble countertops. Furniture and walls looked a little worn. But the homes are of a size that would feel comfortable to most Americans. They have electricity, running water and fully functional bathrooms.
In contrast, the poorer neighborhoods are populated with houses that are tiny squares – ten or twelve feet on a side. Probably no running water or electricity in most of them. It’s hard to imagine how a family can survive, much less thrive, in such a confined space.
In the city, begging is fairly common, especially begging from the azungu (white man). In the city, as soon as you step out of your car, you are accosted by someone with his (in my limited experience, the beggars were usually male) hands cupped together at his chest. “Hungry, mama. Hungry.” The staff at Project Peanut Butter made a joint decision not to give alms to any beggars. They felt it warps the economy if able bodied adults – and children who should be in school – learn that the most profitable use of their time is to beg. It was difficult to say no, knowing that we are wealthy beyond the imaginings of these people; but we did abide by the rules that the PPB team have set for themselves.
In the countryside, you see Malawi’s peasant farms struggling against incredible obstacles. There is absolutely no farm equipment. When you see a farmer hoeing the fields, she (usually it is a woman) is doing it by hand, with a homemade hoe. I’m told that Kamuzu Banda, who was the dictator of Malawi for 30 years, in a misguided effort to protect small farmers outlawed heavy farm equipment.
Less than 5% of Malawi’s arable land is irrigated, so there is only one growing season – and that one is vulnerable to the weather. Either too much rain or too little will doom the single harvest for a whole year. Most rural communities lack both paved roads and any sort of motorized transport, so farmers cannot move their own crops to market for sale. They are beholden to the middle man, who can pay low prices to farmers who must unload their crops before they go bad.
So much is broken in Malawi that it’s hard to imagine how to fix it. The infrastructure that supports a robust economy is completely absent – paved roads, public transport, irrigation, a good public health system, a broad electrical grid, industry to provide employment … all lacking. Project Peanut Butter’s Malawian staff says the current president, Bingu wa Mutharika, and his administration have made strides in paving roads and fighting corruption. In the current election, there is much discussion about improving food security for the country. The old ruling party proposes giving fertilizer to every farmer. The current administration proposes investing in irrigation, a more far-sighted solution.
According to Wikipedia, Malawi has made measurable progress in reducing poverty in the last 10 or 15 years. It’s hard for me to imagine what conditions must have been like in the late 80’s if that is the case.I think Billy’s concerns about the dependency that comes from begging can also apply on a national level. This is part of the argument that Dambisa Moyo makes in Dead Aid. I haven’t read her book – only heard about it last night – but I did some research and found some reputable experts* who think she doesn’t really support her argument that foreign aid is what is holding Africa back and should be eliminated in a few years. However, I do think that it’s really important for individuals and countries to be given the tools to eventually stand on their own economically.
So next year I think I’d like to give my contributors a choice of two ways to assist Malawi. Project Peanut Butter or an organization that is dedicated to fostering long term economic growth in the country. I’m thinking of supporting a microlending organization, maybe like http://www.microloanfoundation.org/ which has been set up specifically to help small entrepreneurs in Malawi. They make small loans and require the borrower to take training in setting up and running a little business. They don’t just hand out money; they help to ensure the borrower will be successful. I haven’t really decided yet … just starting to research alternatives.
As Billy mentioned, when he asked us to write, the text just kept flowing … I’ve been about writing a book on my observations. I will send him my Project Peanut Butter notes later. I’ll just say I was really touched by this trip. I am so glad we had the opportunity to visit … to see Malawi and PPB and Billy in action.* Here are two critiques of Moyo’s arguments:http://blogs.cgdev.org/globaldevelopment/2009/03/dambisa-moyo-discovers-key-to-ending-poverty.phphttp://zambian-economist.blogspot.com/2009/03/dead-aid-by-dambisa-moyo-review.html

Sunday, April 5, 2009

First of three(?) parent posts.

Here's what my Dad thought of Malawi. Thought that giving you a first impression of Malawi I was never able to crank out, and an other perspective at how things are could be nice. Completely unedited by me, by the way. Mom is apparently writing an entire book on her five days in Malawi, but thats neither here nor there. Here I give the floor to my father...

Hello from the third world (well, a week late):

Billy asked me to record my impressions of the 5 days I spent in Blantyre Malawi. I am having a hard time writing a cohesive story line. There is too much detail to do this justice, plus I need time to sort out all I have seen. I will not be giving a traditional entry but a list of the different thoughts and impression I have formed. This may be a bit scattered.

Keep in mind I have been here for only 5 days and I am in no way any sort of expert. I don’t want to offend or misinform. I am sure I have confused a few facts or formed a few misconceptions about this place. So please treat this as a collection of random thoughts bouncing around in my scattered head.

A LITTLE BACKGROUND: Billy (our 18 year old son) is spending 9 months volunteering for Project Peanut Butter in Blantyre, Malawi, Africa. For those who don’t know, PPB is a research project run out of the Washington University/St. Louis Nutrition Project. I am not a hundred percent clear on all the players and organizational structure, but their overall goal is to develop better ways of treating malnutrition in the third world. So they are examining all aspects of malnutrition from the different contributions and causes to the different ways to treat. Malawi is one of the poorest countries in the world. Thus it is a perfect place to work on malnutrition problems.

Billy is technically a volunteer. He is one of 3 to 8 students/ researchers/ nurses/ doctors/ med students living and working for PPB in Blantyre. People come and go through out the year. From last September to this May, there were three long term members, Jay, Eleanor and Billy. Heidi, Amanda, Adam, Dr. and Ms. Manari (among others) would come and go through out the year. Billy started off helping out where he can, loading trucks, driving, passing out peanut butter, running errands and generally playing with the kids. In the last 6 months he has taken on more and more responsibility. Now he is part of the stool study team. They track a number of twins, examine kids, taking stool samples and preparing the sample for cryogenic storage. He also wrote (or help write) an ACCESS data base to assist in managing and analyzing the medical data.

ABOUT MALAWI: You have no idea how lucky you are. If you can read this, (have access to the internet) you are a very privileged person. We went to villages that don’t have running water, electricity or sewers. Places filled with grass roofs, goats, chickens, mud brick walls. For the most part everyone seems happy. If this is all they know, heaven can be an extra plastic trash bag.

HOUSING(middle class): Malawi has two somewhat large cities: Lilongwe (the capital) and Blantyre. Billy is staying in a city called Blantyre, population of several hundred thousand. He is staying in a compound with a fence, guards and dogs. The compound is owned by an Indian business man who lives there and rents out some of the extra apartments or houses. The PPB team has three of these houses/apartments. Each has a kitchen, bedrooms and a bath. There is a maid and cook who comes each day. This is not unusual for the middle class. Most live in a walled compound. Theft is a problem, guards are required. But I never felt unsafe or threatened. PPB was robbed this passed fall. The guards were over powered and they got away with some appliances and $1200 in cash. I am guessing, out of the half million of people in Blantyre, a few thousand can afford to live this way.

HOUSING(city folks): For two of the days of our visit, Ann and I helped out at one of the PPB clinics. Ann, Billy and I along with a driver (named Vegas) started out our day by driving to a nurse’s home (Jean) to pick her up. She lived in a less than glorious part of town. Homes were in varied conditions. Some were somewhat nice, some were very rundown. But what struck me, all were very small. I would guess less than 20x 20 ft and within 30 ft of each other. I saw electrical poles, but not all were wired. I saw water pumps here so I am guessing they don’t have running water. All the houses were right on top of each other, I don’t know what they do for sewage. I saw no evidence of public water/sewer. I suspect most in the city live this way.

HOUSING(the bush) In the country most live in a mud brick hut with grass roofs. I was not invited inside, but I am guessing they were about 20 x 20 ft single room homes with grass roofs. All were set within a corn fields. I expect every flat piece of ground is used to grow something. They are all subsistence farmers.

ROADS: On Monday, We woke at 4:30. Ate breakfast and were on the road by 5AM. We picked up the nurse (Jean) at her home. She lived down a dirt road so bad that a billy goat would have problems. After picking her up we drove about 1 hour down some pave highway. Turned off onto a dirt road and drove another hour. 4 wheel drive is a must in this country. There is no way to get to the villages unless you have 4 wheel drive. Billy slept most of the way. How, I don’t know.

Some of the major roads in the city are paved, some of the highways between the cities are paved. But the vast majority of all roads are dirt. Most of the dirt roads I saw haven’t been grated in years. Even the paved roads are laced with pot holes. No exaggeration, they make Pennsylvania roads look good.

ABOUT HIS ROOM MATES: Jay, Eleanor and Amanda, They are very nice people. While most med students are working hard to get their degree and start earning the big bucks, these three are willing to take time off, delay the education, to make this sacrifice. These are special people. Also they seemed to have taken a liking to Billy and helped him grow through this. Also he really looks up to Jay and Eleanor. I can see why. I look up to them too.

ABOUT THEIR DAY: Each day the team wakes sometime between 4:30 and 5. Eat Breakfast, leave about 5:00 to 5:30. Pick up a nurse and drive 2 hours to some remote village and set up a make shift clinic. Women and their babies walk for miles to get to the clinic. Once the mothers assembled they start by singing traditional Chichewa songs. The words are changed to convey some public health message or improved parenting skills. Then the kids are weighted, measured, poked and tested. They are given the Chiponde based on their weight and sent on there way. This lasts until 1 to 3 pm. They pack up, drive 2 hours back to Blantyre. Then clean out the trucks, repack for tomorrow, eat dinner, enter the day’s data, collapse in bed. Repeat the next day at a different village.

LABOR COSTS: For all you that have a garage, you most likely have a garage door opener. You know when you drive up to the house and need to open the garage door without getting out of the car? You press the button on the clicker hanging off the car’s visor, Yes? Well those in Malawi that have homes, they hire people to open and close the gate to the yard. For the compound where Billy is staying, the landlord hired a family to live in a small building by the gate to open and close the when cars come and go. I believe they also clean and maybe work within the house. The landlord also has guards walking around the compound at night along with gardeners and others working about the place. When I say guards, I am not talking of someone in uniform with a gun. I am talking about some guy in very dirty street clothes with a whistle. From what I am told he is not a rich man, no fancy cars, and the house could use a good coat of paint. It just that unskilled labor is so cheap.

TRANSPORTATION: In Malawi there is no public transportation (or at least none I saw). To get around they mostly walk. It is scary how far they walk, rain or shine. During rush hour, the streets are crowded with people. Even in the rural areas.

The other mode of public transportation is the privately owned mini-bus taxi. Take thousands of very broken down mini vans, place behind the wheels all the deranged mad men and nut cases you can find, fill them with twice the number of passengers design by the manufacturer; now you have a commuter bus transportation system. These mini buses start beeping their horns starting about 5 AM looking for customers. Sounds like Morse code being practiced. Each day they drive from villages to the city and back again. Malawi must not have any form of insane asylums. If you are nuts, crazy or a general menace to society, they make you a taxi driver.

BEGGING AND CLASS STRUCTURE: I saw this for my own eyes. There are three types of people in Malawi: Black Africans( the mass poor), Indians(business class), and Whites(rich). Just because you are white you have money. At the market, there are two sets of prices; white people prices and everyone prices. Every time a white person walks by the beggars come out of the wood work. Boy they know how to look pitiful. Should you give to the beggars? Every fiber of your body wants to empty your pockets to help these people. However, this quick fix and just encourages more begging. People will keep there kids out of school because they can make money begging. I don’t know what the right answer is. Watch “Slum dog Millionaire” some time.

The first time Billy and I were walking through Blantyre I was taken back by how pushy the beggars and vendors are. I was also surprise on how Billy responded to these people. He seemed rude on the verge of being mean. I was taken back. I didn’t think I raised my child to act this way. When Ann and I confronted him about this, he explained his actions this way… He and his two room mates had many discussions on this topic. To encourage kids to stay in school, be fair to all people and to discourage people from relying on begging; it was decided that they will not give outright to beggars. Only give them money if they provide some needed service and agree to the service (before hand). You pay them the going Malawi rate. This “Ed Koch” response is a hard standard to meet. Before you go out, you need to put on a “game face” to face the crowds. Do not look around, be clear on what you want and don’t want. Not rude, but forceful. And don’t give in to constant pestering. You want to encourage economic growth not dependency. Again, I don’t know what the right answer is.

MODESTY: In the city, fashion is pretty much similar to anywhere here. More men seem to wear suites to work more, even if they live in a slum. In the rural country side, things are very different. Men wear shirt and pants, no surprise. For women, it seems that the thighs are the sexy part of the female and should be covered up. All women wear a “Chitenje”. This is a 6x3 ft cloth that women wear as a skirt, wrap or carry a baby or two. Ann and the two female med students had to wear them while out in the rural villages, otherwise the woman would point, giggle and possibility be offended.

Now, if their baby cried or even fuss a little, the woman would instantly whip out a breast or two and feed the child, anywhere and at anytime, in front of me or anyone. I felt I was in a La Leche League convention.

BALANCE: I can juggle. I spent a summer in college learning how. I still juggle from time to time to relax. Over the years I have learned a few tricks and have seen some impressive juggling by professionals. They can’t hold a candle to the women in Malawi. I saw women balance a huge sacks of potatoes (25 lb at least) on their heads, kid strapped to her back, carrying things in both arms, walking down the road, for miles, turning to look at us as we drive by. I’m talking about balancing something on their heads without touching it! Walking miles! Carrying other stuff! Circuses will never be the same for me.

PARENTING: The mothers in the treat program get an allotment of PPB food/medicine at each visit to the clinic. Sometime the mother or father will sell the food or eat it themselves or share it with other children. How could you do this? What kind a parents are these people?

Then I hear that some of these women (Mothers, Grandmothers, Aunts and sometimes Fathers) would walk up to 10 to 15 km, one way, to get to the clinic. Each week. One mother walked from Mozambique crossing a major river by row boat. WOW

LIFE AND DEATH IN THE THIRD WORLD: Here I am very conflicted. Death is so pervasive; They fight this by having more babies. For the two days I helped giving out Chiponde, I estimate that at least half of the mothers with a sick child were months pregnant. Most were holding the hands of at least one other child. It seems mothers only gets only a few months between pregnancies. They don’t have enough food to eat, so they make more babies. When is the family too Big? I don’t get it.

Then I hear the Pope visited Angola and made statements about condom use. Ugh. Someone needs to rethink this life, death and reproduction stuff.

PICTURES: The rural villagers loved having their picture taken. Ann and I would take their picture and show them the image on the camera’s LCD screen. Adults and kids love seeing themselves.

A FEW PHRASES I CAME ACROSS:

Azungu – White people, Little boys would see us and call out this phrase in surprise and often wave. Like seeing a fire truck going by. I was a novelty.

Zikomo Kwambili - thank you very much, said with a little curtsy.

ADITUDE: These are very friendly people. While driving back to Blantyre, Ann and I asked the driver, Vegas, if he could stop to allow us to take a picture of a Mud brick hut. The nurse (Jean) told the driver to stop, Jean got out and walked into the yard of a two or three hut village. Jean called out and found the owner. After some discussion in a language I was clueless, the family sat with us and chatted for a few minutes while we took pictures. They were very nice.

We are just coming out of the “hungry season”. The peak of the Hungry Season (worst time) is right before the harvest. Everything is green and growing but you can’t eat it yet. Despite all the deprivations they endure, they can still be friendly and happy. How do they do this? I get so grumpy when I am hungry.

TRAVEL: Africa was never on our radar for potential travel places. Billy’s working for PPB was the only reason I went to Malawi. Originally I was not looking forward to this part of our trip. While I was there, I found it different than I expected. There were times I was so glad to be there and other times I wanted to run to any 1 to 2 star hotel, just to take a bath. But in the end I am glad I went.

SAYING GOODBY: Last summer I spent 6 weeks trying to talk Billy out of working in Malawi. I didn’t think this was a good idea and I didn’t think he was ready. Most of all I was afraid that he might fail somehow and it would really discourage him from taking on any future major endeavors. After seeming him work and operate I am no longer worry about his future. I was WRONG and Ann was RIGHT!

I am so proud of what Billy is doing this year and I look forward to his return.

Medium Bill

Tuesday, March 31, 2009

Need to mention this

Nothing big, just heard an interesting story. One of the mom's coming to chiponde clinic has a problem. 

Her husband is stealing all of her baby's chiponde....

(Oh well, regrettable but it's nothing all that unusual. But wait, there's more?) 

Her husband bought her from her parents to be his wife, probably when she wasn't that old...

(That's the first time I've ever heard of that kinda practice, but I'm not all that suprised...)

He bought another woman as well...

(OK...Polygamy isn't uncommon here but he had to buy both his wives...what kind of a loser is he...?)

She is afraid to hide the chiponde, because her husband might find out, become enraged, and beat her, for trying to feed her kid...So he is a misogynistic polygamist wife beater who has no problem starving his kids...

([Apologies folks but this has been removed for the sake of the little kiddies due to extensive profanity and violent imagery])

Anyway, just figured I'd share that with you.

Oh and I'm doing fine. Also, my parents came to Malawi a couple weeks ago and I'm gonna post something they've written on what its like here. Assuming they ever finish it anyway...

See you in a month and a week.

Sunday, March 15, 2009

Not feeling a big post today...

Yeah I don't feel like writing a lot. I don't have a purpose to writing this, no reactions I'm trying to elicit or info to convey, just letting you know I'm alive.

George was replaced by one of the smartest drivers I've ever met. His English is better than mine. He is completely comfortable with his job. I felt like dead weight when I was teaching him, because he knew his job perfectly by the end of day two, and I had to observe for four days. Its too good to be true.

Stool study is running like it should. Nothing to say there.

A photographer came and left. His pictures were great and he took some really good videos. I'm looking forward to seeing what he produces.

I'm currently in a super posh South African casino. Quite the contrast. I feel so detached from all the people coming to spend massive amounts of money. But anyway first time in six months I'm getting some real vacation. Vacation where I don't even have to think about work. Quite relaxing.

Well, not much else to say. Seeya.

Mr Bill

P.S.

Remember those two terrible twins I talked about? The ones that elicited a stronger response than I had expected? Here's what happened. One twin lost 1.5 Kg's in the two weeks before we sent him to the hospital. He died twelve days later. The other twin, the one that lost 1 Kg survived, and is now recovering. Just figured I'd finish the story.

P.S.S.

In total I think 15 children have died in my study by now. Don't worry about me, I'm used to it. And hell, the main clinics treat so many children you can bet that they see a lot. One time I asked and Jay said he had news of three in one day. As ironic as it sounds, that's life.

Thursday, February 12, 2009

Yet another death.

The new driver, I think I named him Gerald, died yesterday. I'll revert to his real name now, George. He has been very sick for as long as I have known him. Last monday he came to work even though he was terribly sick. He couldn't even drive back home. He was told to go to the hospital, but for whatever reason, he did not go. And then he died.

Welcome to Africa.

Sunday, February 1, 2009

A better blog.

Ok this is Joy's blog, a much better, much more articulate, much more literary, and much more well researched blog. Everyone who reads my blog should read his as well, as there is some quality info on Malawi there.  And please leave some feedback on his blog would ya?


Oh and I guess I can start calling him Jay now, as his name is clearly there in his blog.

Monday, January 26, 2009

A day in the life...

I'm making a second rapid post because I don't think the vague references I've been making to how things are here is going to work without a real example.

I got to Makhwila today and found out that cholera is in the lower shire. There's only one case confirmed so far but considering that its a pandemic a relatively short distance away that isn't much comfort. For those of you that don't know, cholera is a particularly severe and lethal kind of diarrhea. It is caused by a bacteria, and causes all liquid in your body to be expelled from your butt in what is referred to as "rice water stool." Those who have it lose liters and liters of water each day, and if you don't get as much water as you lose, you will die. The possibility of getting this disease scares the crap out of me. Anyway, I didn't eat until we left and when we did I scrubbed my hands more than Lady Macbeth to make sure I got everything off them. 

Today was a typical day, nothing extremely unusual happened. Keep that in mind.

To get away from the (possible) cholera patients nearby, we crowded into a cramped hot room. There were 12 of our 14 scheduled kids stooling, and one of the two healthy kids turned out to be malnourished, so make that 13. Plus we enrolled three new kids, so make that 16. Which is 32 stools to do. Not counting a couple others we needed so make that 36. Busy busy busy. Plus we had to buccal smear, which took more time. All in all, it ran well, busy, hot, tiring, and long. in most respects a manageable day. As always there was a few fat, very healthy babies from families that are probably fairly well off. (By Malawian standards at least)

The not-so-good things, but nonetheless not unusual things were as follows. We had one mom who didn't come for the umpteenth time, and we kicked her out of the program. We have had a lot of those. One person Victor went to fetch was found to be in mourning. One of the twins had died two days ago, and was just buried yesterday. The mom was in no condition to go. As soon as she is able, we will try to have her come for a few more visits, and then we will discharge her. This serves both to get some more data to wrap up the set, and to give the mom a little extra (in the way of incentives) to get through the mourning. We have had far too many of these kids. I'm not sure if I will recognize the remaining twin when she comes back, but the names sounded familiar. Also there were two twins on chiponde today who did terribly over the last two weeks. Both lost a quarter and a fifth of their weights, respectively, and one of them is not eating. Their heads resembled raisins in the way the skin was stretched across their heads and the veins were popping out. The worse of the two had a terrible diaper rash, and both looked like skeletons. We sent both to the Nutritional Rehabilitation Unit, or NRU, were they will be observed and made sure to eat properly. I have a fifty-fifty bet that I will never see one of them, and a twenty-five - seventy-five bet that I never see either. Its not that I don't want them to recover, but when you've seen so many you can kinda gauge how likely it is for the children to survive. 

Not meant to depress or scare anybody, I just felt like I hadn't gotten it across well yet. 

A day in the life of a volunteer in Malawi.

TTYL

---He who is tired of the cute babies dying.