Malawi

ok- so its my birthday today- It started at 2:00 am with a wake up call and then about 2 minutes later I answered the phone and it was a lovely voice singing happy birthday to me- it was my good friend Joan. she is the study coordinator, research nurse in Cape Town- I first met her in 2002. I have now worked with her for 5 years and we have taught together in cape town south Africa twice, Washington DC, Durban South Africa, and earlier this week in Uganda- we are currently en route to Zambia where we will teach together again. We have developed a relationship over time as we do roughly the same job on different continents- only she does so much more than I ever could as far as studies go. She has 400 patients on the TB study we first started working on back in 2002, whereas I get a bit stressed if I have 8 patients on a meningitis vaccine trial! She also has 4 kids and works full time. She is an amazing woman and freind. So...back to my birthday- in order to get to Zambia from Kampala, Uganda- you have to wake at 2:00 AM, drive 45 minutes to Entebbe, Uganda, wait in a very slow line to check into the plane. they had no computer so the attendant had a scratch piece of paper where she had hand written all the seats- you ask for a seat (an aisle) and she looks at her scratch paper and crosses off your seat (taken). you then fly to Nairobi kenya- you must wait in several lines prior to getting on the plane ( at this point since 2 am I have waited in 6 lines) then you are on the flight to Lusaka...however- there is one stop before you get to Lusaka...Lilongwe, Malawi. So any of you who know me well know I have wanted to go to Malawi for a long time. Mark’s father was born there and he has family still there-here is one project they created: http://www.kindleorphanoutreach.org/index.html

So here we are on the runway in Lilongwe Malawi - its my birthday and I cant get out of the plane (will post picture from window!) So, the irony in this trip is that there are two places in Africa I would very much like to visit- Malawi and Ethiopia- I will spend time in each country but only from the plane or the airport. So, Joan just walked across the acr and gave me some Amarula for my birthday. She remembers that I always bought this while in South Africa so she got me some on the plane (Duty free!)

So..I wanted to blog about this- me being in Malawi- while I was actually in Malawi from the plane...because at least i can say I have been to Malawi- on my 39th birthday. On to Lusaka. To sleep maybe?

Uganda

I am in Uganda- we are training a site to implement a study that will look at two HIv treatment regimens in children from 6 months to 3 years old. Its been an amazing 2 days as you can imagine. I have not seen much of Uganda having been in Kampala only and since I have been teaching the whole time- but what I have seen is beautiful. The more I see of this continent the more I WANT to see. I leave in a few hours for zambia and will fly out through the countries of my baby boys birth, Ethiopia. I was not able to stay on there unfortunately but will be back.

I was able to see some of the pediatric clinics here in kampala as well as the pediatric ward - or hospital. the clinic space that is funded by the research studies is really pretty nice compared to some paces I have seen in other places- but the ward was overcrowded with antiquated tools and low staffed- everyone was so friendly and incredibly bright! But the nurses make so little they cant afford to work there and so the care is not what it should be. I saw children suffering and parents by their sides in most cases...who were also suffering because it is so hard to have a child who is sick. Anyone who has taken their child to the emergency room or has had their child hospitalized knows this. its heart wrenching when there is only so much you can do. the children were so beautiful- I can't even begin to describe them.

what I found so interesting was that while walking through the medical complex there was a place for Johns Hopkins and a new clinic being built by Baylor and an oncology clinic funded by another entity and so many many different places funded by NGOs, research institutions, educational institutions and governements...its seemed so incongruous. And the word of the day was "Sustainability" the example was a lab machine donated for Tcells and they said the funds to run it would only last 3 years and then what? these patients do not have money to sustain the machine or ability to obtain the materials to run the assays long term...an incredible lab funded by Pfizer- for 3 years - and then what...I was saying how amazing it would be to have a new pediatric ward and they were saying- yes but how will we keep it staffed without any nurses since they are so underpaid they leave the country to fill spaces in south Africa to fill the spaces by those nurses who have gone to Saudi Arabia...and then it came up how our dear president is using Ugandan Soldiers to fight our war in Iraq. It was all a bit incredulous and then you thought about the faces of the children and the mothers. Photos I cannot post here due to privacy. i will post what I can when i return to the O.S. Next stop Zambia...same 2 day training.