Posted by: rhoban | March 2, 2009

Day 1 – Malawi

There’s little covering the ground when you look out of the plane as you fly over southern Malawi. African soil is a distinctive rust-brown, green ribbons mark rivulets and streams and, at the end of dry season, it’s pretty dusty looking.

Blantyre sits on a series of hills in the middle of a plain surrounded by mountains. It’s the largest city in Malawi, but it’s still the kind of place where passengers climb down stairs onto the hot tarmac and walk across to a low building to go through customs, immigration and collect their bags, all in one small room – sweating all the way.

The roads into town are skinny, one way in either direction, and they’re not very good. The edges of roads crumble and there’s no sidewalk. As a matter of fact, there’s no right of way on the sides of the roads, so everyone uses the roads: pedestrians, bicycles, herdsmen, kids playing, trucks, cars… the poor infrastructure is only the first clue as to Malawi’s poverty.

One of the many coffin shops that line the main road into Blantyre, Malawi’s largest city.

One of the many coffin shops that line the main road into Blantyre, Malawi’s largest city.

Some stats

Malawi bears some grim statistics – it’s one of the world’s 10 poorest countries, and it’s one of the most densely populated in Africa. Many African countries have teeming cities, filled with refugees from the country. Malawi doesn’t. Instead, 85% of the population lives on the land, using simple tools to scratch out a living from soil that’s been farmed for millennia. In 2005, the rains didn’t come, and there was a lot of hunger.

This certainly isn’t a place that gets the press that a place like Ethiopia does when it goes hungry. It’s a small knife of land piercing the southeastern portion of Africa, the tail end of the Great Rift Valley. There’s little tourist traffic, no natural resources to speak of. The best known feature is a huge, long fresh water lake that’s the third biggest in Africa. Malawians call it Lake Malawi, and the country is named for it, but on many Western maps the lake is listed by its colonial name: Lake Nyasa.

Health statistics are the numbers that really bring a reader to a standstill. In 2004, infant mortality stood at 76 infants per 1000 live births and an additional 133 out of every thousand children die before the age of 5. By way of comparison, in North Carolina, infant mortality is 8.5 children per 1000 live births.

Maternal mortality for Malawian women stands at a shocking 984 per 100,000 women. That means that fully 17 percent of all women who died, did so because of maternity-related causes. At last count, in 1999, maternal mortality in North Carolina was around 12 per 100,000.

As of 2008, between 11 and 17 percent of adults in Malawi were HIV positive – that varies depending on where in the country you live – urban rates are higher, rural lower. Anti-retroviral medications to treat AIDS only appeared in about 2005, so some people have experienced the miraculous recoveries that fill media stories about ARVs. Nonetheless, shops that manufacture coffins and grave markers are a common sight along the main roads.  Eric Hodge and I talk a little bit about this in a discussion that kicks off the series.

Another coffin shop located right across the street on the main road leading from the north into Blantyre

Another coffin shop located right across the street on the main road leading from the north into Blantyre

These realities are why I decided to visit Malawi – combined with the fact that a handful of North Carolinians have been working here with some very dedicated Malawians to try to change some of those numbers. They’ve had some success. I also wanted to come here precisely because Malawi isn’t Ethiopia… or Kenya… or Nigeria. At first blush, it’s not an ‘important’ place to the US strategically or in terms of trade or even culture. Few people in the US have ever heard of this country, except that Madonna adopted a Malawian boy whose mother died of AIDS.

But I wanted to tell these stories because some of the successes taking place here are model projects, and because the research happening here is providing clues about how to treat a number of diseases. And the North Carolina folks who work here – they’re not self-aggrandizing, but they certainly deserve some attention.

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