Mumbo Island

Hello! The past month or so since I last wrote has been pretty hectic. The power has been going out almost everyday but at least its cooler at night. The GeneXpert arrived so the TB and malnutrition project started. This study is insane. Right now I'm mostly helping to enroll kids for the 2.5 days per week I work on the study. This entails finding possible participants, giving the study spiel, having the interpretor consent the parents, scouring the illegible passbooks and charts to take a history, and interviewing the parents. As an aside, we recently had one family that immigrated from the DRC and I attempted (and sort  succeeded) to conduct the whole process in French.

Most parents are very willing to have their kids join the study (I think 99% of the Nutritional Rehabilitation Unit - NRU - have our green sheets stapled to their charts). At first, parents were reluctant because of the tube we stick down the child's nose to suck out the sputum but we've since reworked how we talk about the induced sputum process. Many people associate NG tubes (the ones you stick down the nose usually to feed a kid who won't eat) with death since those who have them are really really sick, and our sputum sucker was sort of like that. We enroll kids who have severe malnutrition characterized by one or more of the following: weight for height < 3 standard deviations per WHO guidelines, a MUAC < 11.5 cm, and/or bilateral edema (swelling of the feet, legs, and/or head). There are 3 types of kids we see - those with marasmus (wasting), kwashiorkor (swelling), or both. The malnourished kids are really sick and a good chunk of the ones enrolled in the study have died while in the hospital.

In general, the pediatric wards are incredibly crazy right now. The wards that we recruit from are jam packed with kids and their parents. Most of the children admitted seem to be under 5 yrs.  Then there is the treatment room and it's pretty clear that if a kid spends some quality time there it's not a good sign. The wards smell and I swear every time I leave to come home, I have a layer of grime on my skin. I really enjoy the excitement of the wards, but I also find it pretty stressful and I'm very happy spending half of my week in the outpatient (and air conditioned!) Baylor clinic.

We stayed in these permanent tent structures (this one is mine).

One good thing about the rains are the "green season specials." A lot of different lodges and destinations in Malawi and elsewhere are having discounted packages since the rains are unpredictable (or predictably everyday) and occupancy is down. This past weekend, I went with 3 of my housemates to Mumbo Island, about a 30 minute boat ride from Cape Maclear. This place was AWESOME. The island is within the national park, so the beach, sand, and water were totally pristine. The food was also great and we were the only ones on the island the night we stayed there. I snorkeled some, checked out the cichlids, and got to test out my underwater camera case.

cichlids!

more cichlids.

View of the Lake from my tent

Come to Malawi!!