Posted by: rhoban | March 12, 2009

Day 11 – from Zambia, back to Malawi

Back on the road after a few days’ rest…

You can find all the stories in the series here:

Traveling in Africa takes a long time. To travel reliably, I’ve been told one has to go through Johannesburg and then onto Malawi. Luckily, the plane from Jo’burg to Lilongwe goes every day. That differed from when I went to Blantyre. That flight only goes on Wednesdays and Saturdays.

In the Johannesburg airport, I rushed to get to the gate.  I had left the restricted area in order to mail a letter at the post office in the airport, buy some minutes for my cell phone and then made my way to the gate.  It was a maze of people and counters.  My ticket said gate 24,  but the board said gate 1, located waaaay at one end of the airport, down a long corridor.

So, I made my way to gate 1.  There were about 30 people sitting there, chatting, but there were no airline personnel.  We waited… and waited.  Perhaps we were too patient – we all sat there past the time when we were supposed to board.

Finally someone got up and walked about 500 feet to the nearest board.  It now said gate 24 – all the way at the other end of the airport.  We all gathered our stuff and started hustling our ways to the other gate – a good 7-10 minute walk (there was one man who relied on a cane and he was having trouble keeping up).

Once at the gate, airline personnel were unperturbed that we’d been sent the wrong way.

Back in Malawi

I finally arrived in Lilongwe in the afternoon, flying in with Dr Mina Hosseinipour, an American infectious disease doctor who trained at UNC-Chapel Hill.  She’s been at the UNC Project for 7 years, pretty much since the time she finished residency. She gave me the background on the project. Tidziwe_mother

OK. Perhaps I’d missed this in my previous conversations with people at UNC… Perhaps they’re used to the size of their project.  They said it was ‘big,’ and being familiar with international NGO projects, I reckoned that ‘big’ meant several dozen employees.

Boy, was I off-base!!

On the plane, Dr Mina informed me that the project has 320 employees – the vast majority of them Malawians.  I had to have her repeat this fact… she drew me an organization chart.

But even with this preparation, I had no idea of the scope and scale of what I’d find.  I threw out the plans I’d had for stories and started from scratch.

UNC Project

The UNC Project isn’t just one project, it’s many things… research, patient care, foreign relations, education.

Custom-made ceramic tiles greet visitors to the Tidziwe Center

Custom-made ceramic tiles greet visitors to the Tidziwe Center

Tidziwe (pronounced: tid-ZEE-way) Center is located on the grounds of the Kamuzu Central Hospital (KCH) in the northern part of Lilongwe.  In 2003, UNC built a two-storey building to house research facilities that include administrative offices (everyone shares an office, except the director), a state of the art lab, and clinical rooms for patient exams.

If Tidziwe were it, that would be something special, but it’s not.  The next building over from Tidziwe is the Lighthouse, a program for patients with HIV/ AIDS.  Currently Lighthouse follows some 8000 patients with HIV.

Some of the people are participants in research, all of them receive anti-retroviral medications.  There’s no quid pro quo… patients don’t have to participate in research in order to receive drugs.  But many do. Lighthouse is one of the two largest programs for patients with HIV/ AIDS in the country, and has become a model for the care of Malawians with HIV, and a center for research into better ways to deliver service to patients who are often very, very sick.

UNC clinicians who do research work at Tidziwe spend at least 20 percent of their time doing patient care at Lighthouse. Tidziwe_steth

Staff employed by the UNC Project also run an clinic for sexually transmitted infections at Kamuzu Central Hospital.  This clinic has daily clinical hours, conducts research and does outreach in the community to encourage testing for HIV.  Most of the employees are Malawian, the STI clinic is headed up by Gift Kamanga, who was a Fogarty Fellow sponsored by UNC.

As if these activities weren’t enough, the UNC project crew (fewer than ten  expatriates, and more than 300 Malawian staff) are involved in research about:
– a malaria vaccine trial
– research to determine the right combination of HIV and TB drugs for patients diagnosed with both diseases
– research to determine better ways to notify partners of people diagnosed with HIV
– methods of creating informed consent that work for people who are illiterate and semi-literate
– research to compile data on trauma in Malawi

… and, of course, all kinds of research about HIV/AIDS, from drug research to finding the best combinations of drugs, prevention trials, and on and on and on.

I’ll be filling people in on more details in coming days.  Tomorrow morning’s story will look at services aimed at curbing the spread of HIV/ AIDS.

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