Thursday, April 26, 2012

World Malaria Day!

It happened! I wrote about it and posted pictures to http://stompoutmalaria-mozambique.tumblr.com/post/21790205979/world-malaria-day check them out!

Monday, April 23, 2012

Looking Forward to World Malaria Day!

On Wednesday visit http://stompoutmalaria.org/country-by-country/mozambique/ to read tweets in real time from PCVs commemorating World Malaria Day across Mozambique!
Wednesday, April 25th is World Malaria Day and the President’s Malaria Initiative (PMI) and the National Malaria Control Program (PNCM) will hold the national recognition ceremony in Cumbana village, in the district of Jangamo, Inhambane province. Activities will begin at 6:30am at the Cumbana health center with a March in honor of World Malaria Day. Ceremonial placing of flowers and singing of the Mozambican National Anthem will follow. To kick off the day’s activities, spectators will be invited to participate in an activity testing their knowledge about malaria transmission, symptoms, treatment, and prevention. Following this, national and international partners in the fight against malaria in Mozambique will be invited to speak briefly about their efforts. Festivities throughout the day will include songs and skits about malaria from local groups and a soccer tournament. Expected attendees include the First Lady of Mozambique, the Minister of Health, the Governor of Inhambane province, and representatives from PNCM, PMI, USAID, as well as many more partner organizations.

23/04/12

The power has been out at home since about 6pm last night. Last night I played guitar and wrote in my journal by candlelight…I don’t think it gets more Peace Corps than that! This morning I really needed to bathe but we still had no electricity which meant so way to heat the water for my bath. But being the resourceful PCV I am, I remembered that the Peace Corps office has a generator, so I brought my large basin and a plastic cup to bathe at work! On the way I passed a woman who we buy bread from and who I pass each day going to and from the office. “Why do you need that basin at work?” she asked. Embarrassed, I sputtered a reply about needing to bathe.

Sunday, April 22, 2012

22/04/12

It seems like anytime a chapa drives past me here the conductor sticks his head out the window and yells “Maputo?” at me. Regardless of whether I am on my morning jog, enjoying a snack, or just strolling down the street, it’s unfathomable to them that a white person would actually want to be on the streets of Namaacha, surely she got lost en route to Maputo. This would happen in Inharrime too. On most days I just wave my finger “no” at them…on some days I yell back “do I LOOK like I’m going to Maputo?!” This morning it happened again. I just shrugged my arms like “what are you thinking?” and gave them a bad look. But then one of the men standing in a group talking between the chapa and me yelled back to the chapa conductor “no she doesn’t want to go to Maputo, she’s going to church!” I laughed and thanked him because he was absolutely correct.

Stomping Out Malaria in Chongoene!

Friday and Saturday I spent up in Chongoene, in Gaza province visiting Michelle, the PCV there. Michelle had organized an “inter-group exchange” for her JUNTOS (Jovens Unidos no Trabalho para Oportunidades e Sucesso—Youths United in the Work for Opportunities and Successes) group and another PCV’s group. Michelle’s JUNTOS group’s primary activity so, in light of World Malaria Day coming up on April 25th, they decided to focus their skits on malaria. Check out http://stompoutmalaria-mozambique.tumblr.com/ for my write up about the very successful two day inter-group exchange and see pictures of the kids performing their skits! How will YOU Stomp Out Malaria in 2012?

BAMM 2012: HIV and Malaria Co-infection

A source of one of the biggest obstacles I have faced so far this year as Malaria Activities Coordinator is the incredibly high HIV rate. The latest reported HIV prevalence rate for Mozambique was 11.5%, and some districts in the country still report rates in the mid-twenties (while other districts have very low rates). As crude as it sounds, HIV is definitely one of the “sexiest” and most glamorous topics in public health right now—there is so much money and attention given to the subject. PEPFAR (President’s Emergency Plan For AIDS Relief—comes the US Government) is all over Mozambique, whether it’s directly funding events, projects, and activities, or indirectly doing the same thing by funding partner organizations. All of the Health sector Peace Corps Volunteers are funded through PEPFAR, which means that they should be primarily HIV-prevention workers. Money talks. Since so much funding is in HIV prevention, the same amount of focus is on HIV prevention. During Peace Corps’ Pre-Service training it seems like every session can be tied back to HIV prevention. But PCVs in Mozambique only receive two hours of Pre-Service Training on the subject of malaria. All of the PCV youth projects (REDES, the coed youth group JUNTOS, Science Fair, English Theater, and Future Business Leaders) are funded by PEPFAR, so they must have HIV components. So far this year I have experienced resistance to malaria projects because the organizations are “supposed” to focus on HIV, since this is where their money comes from. HIV/AIDS is clearly a debilitating problem in Mozambique and deserves extensive attention and prevention efforts, but not at the expense of other life-threatening diseases, especially malaria, which is actually the number one killer in Mozambique (though this statistic itself is a little tricky because nobody actually dies from AIDS, but from the other diseases that capitalize the body’s weakened immune system. Malaria being one of these opportunistic diseases). The irony though, is that a high HIV rate should make diseases like malaria MORE of a priority. As scary as HIV and malaria are individually (two of the most fascinating and “clever” diseases I have ever learned about), together they are far more dangerous and deadly. Pregnant women and children under 5 are targeted in malaria prevention campaigns as being most at risk, as they have lower immunity than the general population. HIV (which stands for Human Immunodeficiency Virus) positive people fit into this category as well. Let me attempt to explain some of the terrifying effects of HIV/malaria co-infection. HIV positive people have the Human Immunodeficiency Virus in their bodily fluids. The amount of virus (called the “viral load”) varies: it is high immediately after infection, drops for a while (months or years) before beginning to climb again (this is when the person begins to show signs of AIDS). The level of the viral load (quantity of little viruses in a drop of, say, semen) impacts the probability that HIV will be transmitted, given an exposure (unprotected sex, breastfeeding, sharing a needle/knife). The malaria parasite raises the viral load in an HIV positive person, which in turn raises the probability that this person will transmit the virus to someone else, be it a sexual partner or their baby. Repeated bouts of malaria seem to lead to faster progression into AIDS (HIV is the virus that attacks the immune system. It can remain dormant in the person’s body for months or years, during which time the person is HIV positive, but does not have AIDS yet. Once a person’s CD4 cells—immune system fighting cells—dip below a certain level, this person’s immune system is severely compromised and this person is considered to have AIDS). Also, as I said before, AIDS (Acquired Immunodeficiency Syndrome) doesn’t kill you, it is a state of compromised immunity and being more vulnerable to diseases like malaria, which ultimately kill you. HIV infection makes a person more susceptible to malaria and more likely to have severe malaria or die from malaria. In summary: malaria makes HIV worse and HIV makes malaria worse. Because of this, I hope that organizations here in Mozambique will come to realize that malaria is not LESS of a priority because of our huge HIV problem, but MORE of a priority because of it.

Monday, April 16, 2012

BAMM 2012

One of my PCV colleagues Jordan Rief recently wrote a Blog About Malaria that was featured on http://www.malariapolicycenter.org/! Read this incredibly moving account of how malaria impacts everyone's lives here in Africa. Jordan is another third year extendee like I am and you can read more about her experiences at www.jordanrief.com

Saturday, April 14, 2012

Stomping Out Malaria in Africa


Check out what PCVs are doing in Mozambique:
stompoutmalaria-mozambique.tumblr.com

and across Africa:
stompoutmalaria.tumblr.com
www.stompoutmalaria.org

to Stomp Out Malaria! And read PCVs blog posts about their experiences with malaria:
http://stompoutmalaria.org/blog-about-malaria-month/

Friday, April 13, 2012

Every Child Deserves a 5th Birthday


Malaria is the leading cause of death in children under 5 years old in Mozambique. Pregnant women (who, for some reason, lose their acquired immunity to malaria during pregnancy) can be infected with malaria parasites without ever showing symptoms. The malaria parasite hides in the placenta and can cause premature birth, low birthweight, and anemia in the baby. Children under 5 years old are also extremely susceptible to malaria, since they haven’t been able to build up immunity yet, and thus have a higher malaria mortality rate, as compared to the general population (malaria accounts for 42% of deaths in children under 5 years old, and 29% in the general population, which is actually still quite significant).
But the sad part about all of these statistics is that malaria is easily preventable and, when contracted, generally treatable. Malaria can be prevented through use of Long Life Insecticide-treated Nets (LLINs), yet only 7% of pregnant women and children under 5 in Mozambique use one regularly. All pregnant women in Mozambique are recommended to receive Intermittent Preventative Treatment (IPT) during pregnancy to prevent malaria infection in the mother and the fetus, yet only 33% of pregnant women in Mozambique receive the recommended two doses. Rapid diagnosis and treatment of malaria is the best way to prevent death, yet only 4% of children under 5 years old in Mozambique received ACT (malaria drugs) within 24 hours of onset of malaria symptoms.
PCVs in Mozambique and across Africa are working hard to promote use of bed nets, two visits to prenatal clinics to receive IPT, and rapid diagnosis and treatment of malaria—three ways to help children across Africa live to see their 5th birthday.
Every child deserves a 5th birthday, regardless of where they are born.

How will you Stomp Out Malaria in 2012?

13/04/12

Happy belated birthday to my baby brother Buck who, in a completely puzzling turn of events, is suddenly no longer a baby.
On a sad note, Anna and I returned from our Easter weekend away to find Shenzi, our new puppy, dead. It appears as though he just died in his sleep. But it’s sad and frustrating because now we are doubting just how well the man we are PAYING to take care of our house and dogs is really doing these things. He didn’t even call to tell us, which is either an extremely strange move on his house, or demonstrates that he hadn’t been to our house in the day or so before we returned, even though we are paying him to sleep there each night. Shenzi was the runt and fairly sickly, he had a skin disease that we were going to take him in to get treated for as soon as he was old enough, so it’s possible that there is nothing that could have been done. But a phone call giving us a heads up would have been good. He was a nice little puppy.
Other than the sad homecoming it was a very nice Easter weekend, spent up in Inharrime with the girls and the sisters. I got to spend my favorite holiday at one of my favorite places on earth and many wonderful hours with girls climbing all over me. I also got to see and catch up with a number of PCVs up in that area. At one point Irmã Dolorinda, the head sister in Inharrime, told me: “You know this is your home right? You are always welcome here and will always have a place here, even if you have to sleep under my bed!”

Saturday, April 7, 2012

BAMM 2012


Mozambique PCV Mac Segar drew and submitted this for a "Stomping Out Malaria in Africa" logo contest. Although it didn't win, I think it encapsulates the reality of malaria in Africa. Considering that 89% of 1 million annual deaths from malaria occur in Africa, picturing malaria sucking the blood and life out of Africa is frighteningly accurate.

Thursday, April 5, 2012

BAMM 2012: not-so-fun-facts


Malaria is the second leading cause of death from infectious diseases in Africa, after HIV/AIDS

Wednesday, April 4, 2012

BAMM: Blog About Malaria Month!


World Malaria Day is coming up on April 25th!

30/03/12

On my way home from the office today I ran into the approximately 7 year old child of the guy who takes care of our house and dogs when we are gone. “Let’s walk with our big sister!” he announced to his other friends on their way home from school. So we walked back together, two of them holding my hands.
I was on the street a few days ago when a man walked by. I greeted him and then he stopped and said “hey, don’t we pray together?” He does indeed go to the same church as I do, and he proceeded to chat to me a while about the work he does. Between encounters like these, the kids around the neighborhood who are learning our names, and the girls in church who sit with or on me and hang all over me afterwards, it finally feels like we are beginning to become a part of the community of Namaacha.

29/03/12

This morning Anna and I went for a run as our morning workout. At one point a police car driving toward us starting to pull over, right into where we were about to run. As a matter of pride I don’t give in to the cars that think it’s funny to try to run me off the road, so I held my ground. The car wasn’t able to pull over as much as it wanted, but they stopped from hitting me by about 6 inches. In Mozambique there seems to be a very strong direct correlation between the size of a man’s belly and his status in society. So just then a moderately important man began to get out of the back seat of the car. I saw it coming so put out my arm to block the door he opened into me, hitting me. “Hey! Watch out!” he yelled at me, annoyed. I turned and yelled back a string of expletives about how he should be the one watching out. He was shocked. I am sure this was one of the first times he has ever been yelled at by a woman, especially one so young.
Shenzi, the new puppy, is settling in well. He is miraculously somewhat housebroken already which is fantastic—if the door is open he will always go outside to relieve himself. Amendoim—the other dog—is a little wary/scared of him. We think that maybe he isn’t aware that Shenzi is a dog, because he isn’t territorial or anything, but mostly just keeps his distance.
I got home today and found a livid Anna in our house. She told me that when she got home she found two kids up in the tree inside our yard just out of reach of the dog’s lead, taunting him. When they saw her they ran away and the handful of people around the front of our gate somehow couldn’t come up with the names of the two kids. She was livid because she knew that everyone knew who the kids were, but were refusing to help her. I went back outside to chat with the neighbors. At first I was told that nobody knew who the kids were. I explained how incredibly disrespectful it is for kids to enter our yard without permission (which it IS in Mozambican culture) and how I needed to talk to these kids’ parents. After chatting for a few more minutes, I was able to discover a couple kids who did know who these kids had been. Turns out one of them lives directly next door to us. (Interesting that nobody was able to come up with her name before.) This girl was one of the older ones and leaders of the neighborhood gang of kids, so I thought maybe there was a misunderstanding and it wasn’t her, but either way I knew she could tell me something, so I went to her yard. As soon as she saw me, she ran and hid in her house. So much for thinking she was innocent. I explained to her mother that other kids had seen her in my tree today taunting the dog and I explained that we always let them come in and gather guava fruits from the trees when we are there, but to enter our yard without permission was completely unacceptable. She called out repeatedly to her daughter, but the girl refused to come out. I mentioned that I thought it was her shame that prevented her from coming out. The mother apologized and said she would have a talk with her daughter. Later I saw the girl’s best friend who I know is very hardworking and responsible. I explained to her that she needs to show her friend how to be a responsible and good person—she can’t allow her friend to act like that. The culture of shaming is generally quite effective here.

Monday, April 2, 2012

27/03/12

This morning at 1am I got a text from a woman who works for Peace Corps. Because phone service is so bad in our house, I more often than not don’t service, and so then when it returns, I will receive a flurry of text messages. This text read that I should call her immediately or check my email. As a PCV, you tend to get really nervous when you get a strange text like this at a strange hour, and your heart skips a beat when we get a call from an unknown number at a strange hour. I tried to get on my email on my phone and was able to see my inbox—the only email I thought might pertain was from my mother with my brother’s name as the subject line. My stomach knotted, had something happened to my brother? I tried to open it, but then I lost my phone service again. Finally a moment of clarity broke through my half-asleep panic, so I checked to see what time the text message had been sent. It has been sent at 3pm the previous afternoon (yes, I apparently hadn’t had phone service for the 10 hours since then). I calmed down. This wasn’t an emergency, I simply had something time-sensitive in my inbox (and she probably knew that PCVs sometimes don’t check their email for days).
There is a woman named Ofelia who has worked with REDES (Rapariga em Desenvolvimento, Educação e Saúde—Girls in Development, Education and Health) for a number of years as a successful group coordinator. She has emailed Anna a few times asking her if she knew of any job or study opportunities she could pursue. She emailed me recently asking the same thing. This is one of the great frustrations here in Mozambique—there are simply no opportunities for the extremely hardworking and deserving people we know. There are few jobs and it is difficult to get into a university unless one knows the right people or has a lot of money. The students we taught the past two years had neither. I forwarded her email to the Mozambican women who work for Peace Corps and asked if they knew of anything, because I personally had nothing to offer her. A few of them had responded with suggestions, but nothing too concrete.
When I got to the office I finally was able to read the email from the woman who had texted me (also one of the women I had forwarded Ofelia’s email to). She had contacted people at the U.S. Embassy on our behalf, and they had told her about Fulbright and Humphrey scholarship opportunities—the deadlines for which had already passed, but when she told them about this girl they agreed to extend the deadline to this Friday. Which explained the urgent text. I forwarded the information and applications to Ofelia and called her immediately to make sure she saw them and completed them as soon as possible. Cross your fingers!

Shenzi ensures that every last noodle of spaghetti gets eaten

25/03/12

Friday night we celebrated another PCV’s birthday with her out on the town in Maputo. It’s fun to occasionally get dressed up and go out like that. But very very occasionally—a Peace Corps allowance doesn’t cover many nights like that. At the end of the night we got a ride home with a Mozambican friend and his friend was in the car as well. He turned around and was chatting to us and asked our names. When Anna told him hers he said “oh were you in Namaacha? I did your dreds, remember?” And yes, in fact, when Anna got her hair put into dreds almost 2.5 years ago, it was this guy who did it!
At mass today the same little girl came over to sit on my lap again, this time bringing a friend with her. Last week I had asked her if she knew how to give the money for the offering and she nodded at me, so I handed her my money. But apparently she didn’t understand (and who knows if she even speaks much Portuguese) because she walked over and offered the money to her mother. Her mother was quite confused as to where her daughter had gotten so much money, but one of the girls from the orphanage who was sitting with us went over and explained and took the little one up to the front to put the money in the basket. This morning I asked her if she understood this time and she nodded confidently, so I gave her and her friend money to offer for me. As she made her way up to the front (which is just a disorderly mob every week because there is no concept of lines here), she proudly showed off her money to everyone she could with a huge grin on her face.
After mass it is customary for everyone to hang out in front of the church for a long time socializing, so in my attempt to before more a part of the community of Namaacha I did this. Though admittedly I socialized mostly with people under the age of 12—girls from the orphanage. One of them pointed out a white girl about my age who I had seen around town a few times, so I went over and introduced myself. She is Ecuadorian and volunteering for the sisters here, so we made plans to hang out sometime. One of the girls hanging all over us grabbed our hands and put them together, asking “why are you this color and she is this color?” She is fairly pale and I just came off a weekend at the beach. I laughed and asked why her hand was lighter than her friend’s. I think a couple of the girls were genuinely surprised, I don’t think they had ever realized that “white” people might come in different shades of pale.