New and Old, Same and Different

I usually pride myself on my adaptability, especially when traveling, but maybe now that I’m working on this project over so long it seems like it takes a little more energy to go with the flow. Of course reminding myself that it’s been an entire 13 months since my last visit makes things more comfortable. My life back in the states sure doesn’t look the same since last time I made this trip.

To organize what would otherwise be a random smattering of updates, here’s what’s inevitably changed, and what’s stayed the same:


Malawian Kwacha


The currency here has taken a dive since my trip. I thought that meant good news—that what’s left of the money i left in USD would be worth even more now than it was before! But it turns out the funds were all exchanged at once. Ouch. So even though the money has been well managed I’ll be needing to leave some extra behind to complete the 18 months of surveillance we originally planned for.

Clinician Buy-In
One of my two main supporters in the clinic no longer works at MWC. Another doctor has jump started a new, awesome initiative providing support for the teenage mothers they see in the maternity ward (another change that i’m super excited to share in more detail later!).

I’m going to be testing the waters in the next weeks to see what kind of room there is left to take action in response to the data we see from the surveillance (cases include a couple of teenage mothers but not many).

Office Location
The old research office is the new and improved laboratory for the clinic. We’re jus around the corner in a  space that feels about the same—it might even be a bit bigger.


Attention on Home / TBA Births

One of the research assistants delivered an impressive proposal for an initiative to work with Traditional Birth Attendants in the area and retrain them as advocates for safe deliveries at a facility with skilled assistance. I was considering this as a potential intervention to explore, so I’m glad to see someone else was thinking in the same direction.

Again, though, I am wary of moving forward with a comprehensive reaction to the surveillance before we’ve really completed the data collection, looked at the results as a whole and evaluated our efforts. I guess I can’t be surprised that everyone is moving at twice my pace, since they’re here working all day every day. Sometimes being strategic just takes a bit more time, and it can be difficult to wait if you already see where you can have a very positive impact.

meeting prep is better when you’re prepared enough to know they don’t have a color printer, so you’ve bought markers to make it work.

Life at the Guest House
I’m back to sleeping in the same room, enjoying the same food cooked by Freddie, playing with Afshan’s kitty and sitting by a fire almost nightly. It’s still cold like last time and I’m unprepared for it like last time.

Navigating Needs
There are so many good things to put time and money into. Good people trying to go to school, interventions designed to fill obvious needs in the community, existing efforts and interest expressed by the CLI or MWC leadership… I’m putting on my collaboration cap and trying to see how I can align my existing work with the initiatives MWC is already committed to, but I hope we aren’t doing too much shoe-horning just to make that work. Every project brings a dozen new needs to the surface and it’s hard when you know you can’t do it all.

Tomorrow I meet with clinic leadership to see just how that alignment might work. Wish me luck!


Technical Difficulties

I have updates! But they are typed up on my computer which hasn’t had access to the Internet for about 27 hours now. 💀

Permissions on my laptop are so locked down I can’t even change the time zone let alone my wifi settings.

I sent a cry for help to Ohio State’s IT Service Desk but I have no idea whether they’ll be able to help me.

Please send your wifi healing feelings!

UPDATE: that was fast! About 3 hours after posting this I was back in action. The power of vibes-err-prayer-err-desperate endless rebooting.