Malawi Project posts displayed by category

President's Q&A

President’s Q&A

The next Q&A session with President Jay A. Perman is July 28 from 11 to noon in the School of Nursing auditorium.

This session will feature a continuation of the discussion about race in Baltimore.

Join Dr. Perman as he answers questions from students, staff, and faculty. If you have a specific question you would like to ask but never had the opportunity, or if you would just like to know more about what’s happening around campus, please join us.

The President’s Q&A will be available for viewing on Apple devices via a live video stream provided by Twitter’s Periscope app. To view the program, follow @UMBNews on Twitter and download the free app from iTunes.

  
The ElmABAE, Clinical Care, Collaboration, Contests, For B'more, Global & Community Engagement, Malawi Project, People, UMB News, University LifeJuly 10, 20150 comments
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Malawi Project Group

Final Thoughts From Malawi

The Malawi 2014 project in-country participation draws to a close tomorrow as we head back to the U.S. Our reflections identify major accomplishments from our research and educational initiatives and the identification of opportunities for the sustainability of the project outcomes.

Implications of the Research Project

We completed the dual IRB-approved research study with a full data set on 28 clients with stroke and various types of spinal cord dysfunction. Our data is rich with information – both quantitative and qualitative data – that will enhance the bigger picture of client participation in their home and community environments after discharge from the Kachere Rehabilitation Centre.

The Kachere staff shared their thoughts with us on the implications of the research project. We offered some ideas on ways to follow through with current clients to extend the value of their rehab interventions and in consideration of future client planning.

Interprofessional Team Success

As the team leader, I am immensely pleased with the obviously positive Malawian staff and administrative response to our project, educational initiatives, and other efforts to meet their requests and needs, even with limited preparations.

The warmth, caring, and people-centered orientation exhibited by the staff is definitely a part of the warm culture in Malawi and their willingness to help each other.

I am particularly proud of the interprofessional team of faculty and students who initially met in April 2014 and developed a strong, collegial, interactive, and effective relationship over the next four months.

This team not only provided the academic component to the project but on a personal level, enabled successful implementation of many of the project processes. The apparent outcome will help to write a new future for the clients from the Kachere rehabilitation program.

Final Thoughts

Nicole White (Nikki), social work student: The culture of care-giving in this community is infinite. I will never forget the warmth I felt in the presence of such a high level of devotion and willpower. I hope I can embody that strength and that one day the Malawian care mentality will be a culture of humanity, not just a culture of “the warm heart of Africa.”

E. Shannon Walters (Shannon) nursing student: My global health experience in Malawi has made me realize that my moral obligations cannot be defined by individuals to whom I have an obligation and individuals to whom I do not. As a nurse, my obligation will be to provide the best care I can to individuals regardless of race, socioeconomic status, religion, geographic location, or cultural beliefs. The people of Malawi will be the shadow that follows me into my professional life, reminding me of my moral obligation to the human race.

Megan Warres, physical therapy student: When we went to the village and blew bubbles, it was the first time the children had seen them. The children’s reactions were beautiful to watch. First, they seemed intrigued but puzzled. Then, understanding dawned on them, and they became delighted with their new-found discovery. This trip has brought so many new ideas into my life – and with each, a mix of curiosity, some confusion, and joy. Thank you to Malawi for blowing bubbles at me!

Zikomo, Kachere Staff and Malawi!
The UMB team

Photo above (from left to right): The University of Maryland Malawi Project research team is Shannon Walters, Leslie Glickman, Nikki White, Laurie Neely, Aku, Megan Warres, and George Chimatiro.

  
Leslie GlickmanClinical Care, Collaboration, Education, Global & Community Engagement, Malawi Project, People, Research, UMB News, University LifeJuly 25, 20140 comments
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Bwemba for Sale

Adventures in Eating

As we wrap up our last day of data collection, we’ve all been feeling a bit reflective and nostalgic. Some of our favorite memories and cultural experiences here have been associated with food. So, readers, we’d like to share some memorable food moments we’ve had in Malawi.

Nsima

The staple food here is nsima, a thickened corn porridge made from the staple food product, maize. Meals here are considered incomplete without nsima. It’s eaten with hands – no utensils required! Since it doesn’t have a strong taste, we’ve found nsima to be an excellent vessel for other foods such as stewed red beans and beef.

Sugar Cane

Another food adventure was sugar cane. Initially, we bought a piece because its shape made a convenient physical therapy (PT) training tool. However, the cook here showed us how to eat it and we decided that after using the sugar cane for PT, it would make a good snack. The cook was easily able to peel the sugar cane with her teeth. Alas, we weren’t as skilled – after a few feeble attempts with our teeth, we decided a pocket knife might be an easier way for us to peel the sugar cane. Chewing the inside of the sugar cane released a flavor similar to the raw sugar you can sometimes find at restaurants. Delicious!

Bwemba

Bwemba

Bwemba

Bwemba is another fun Malawian food. It’s a fruit sold at the markets in clumps that look kind of like hairy brown fingers. The inside is also brown, but less hairy. Although the appearance isn’t particularly promising, the fruit is quite tasty and certainly unique – a sour, almost warhead-like taste.

Nali Peri-Peri Hot Sauce

Our favorite condiment is Nali Peri-Peri hot sauce made with Birds-eye Chili’s. The sauce comes in several flavors including garlic hot sauce, hot hot sauce (it is, indeed, very hot), and curry hot sauce. The “hot” hot sauce, ubiquitous here as ketchup is in the U.S., is a great way to kick up the food we’ve been eating.

We’re excited to see what food and other adventures come our way in the next few days before we leave!

  
Megan WarresClinical Care, Collaboration, Education, Malawi Project, People, Research, UMB News, University LifeJuly 23, 20140 comments
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Hospital Beds in Malawi

Malawi Project Team Tours Health Facilities

Nurses have a great responsibility when addressing global health issues. They must distinguish the global connection between the origins and outcomes of illness, disease, and the jagged distribution of health care and health disparities.

Nursing’s Influence on Global Health

The chaos theory of the butterfly effect can be seen in health care – a small change in one place can result in large differences in another. The health, or lack of, in one country can be felt in many.

As our world becomes smaller, and our borders become more easily accessible, health care needs to be addressed on a global level with nurses at the forefront of the global health movement. Nurses can contribute to global health by influencing policies and laws that endorse health care equality and by participating in research that is relevant to global health.

Health Disparities in Underdeveloped Countries

Here in Blantyre, our interprofessional team has had the opportunity to tour two very different health facilities – the Kachere Rehabilitation Centre (the host of our research project) and the Beit CURE International Hospital. These facilities, just 500 feet apart, are a perfect example of health disparities in underdeveloped countries such as Malawi.

Kachere is a 40-bed facility that serves over 16 million people in Malawi and relies heavily on government funding. Recent financial cuts threaten major service reductions in order to continue operating. For example, the patient wards are not wired for electricity and they no longer offer any home care or community follow-up. The patient rooms sleep eight to 16 people at one time, with beds placed end to end. The equipment in the physical therapy department is not state-of-the-art but the physiotherapists make do with what they have and offer the best patient center care that they are capable of given their resources.

CURE International is a 501(c)(3) nonprofit organization with the philosophy that “adults pay a fee so that the children can walk free.” Any adult that is admitted to the facility pays as a private patient and has a private room. These funds are used to provide free surgical orthopedic interventions to children. The additional funds needed to run and maintain CURE are received from international donations. The hospital has a 72-bed capacity and the patient wards are more spacious and well lit. The therapy department has state-of-the-art equipment.

Access to Care

While at CURE, Shannon had the opportunity to speak with the charge nurse. Shannon asked, “What would you change if you could?” The charge nurse was very quick to let Shannon know that their facility is the only of its kind that treats children with conditions such as clubfoot, bowed legs, cleft lips, untreated burns, and osteomyelitis in the country and they do not charge a fee.

But, the one thing she would change is access to the hospital – families travel long distances to get to CURE and transportation is very expensive. Most families delay coming in due to the financial and family hardship created when traveling to CURE.

In the nurse’s perfect world all children would have direct access to CURE so that treatment could be started immediately. She spoke of patients arriving with osteomyelitis (infection of the bone) and hydrocephalus (“water on the brain”) that had gone untreated for so long that by the time they arrived at CURE they required radical treatment to save their lives.

During these tours, our team truly realized how greatly the quality of the facility depends on the almighty dollar. However, quality care also comes from the heart and we have been privileged to see that.

by Shannon Walters and Nikki White

Photo above: Hospital beds at Kachere Rehabilitation Centre

  
Shannon WaltersClinical Care, Collaboration, Education, Global & Community Engagement, Malawi Project, People, UMB NewsJuly 22, 20140 comments
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House in Blantyre, Malawi

Redefining Rural in Malawi

July 11, 2014

Today marks the end of our week of data collection for the community reintegration of discharged clients from Kachere Rehabilitation Centre, Malawi – our pilot interprofessional sustainability project.

Our team was able to observe a total of 17 homes throughout the Blantyre, Malawi area this week. Next week, we’ll continue with home visits.

About Visiting Client Homes

Some of the homes that we’ve visited are in remote locations. Interestingly, even the most remote homes, which require traveling down narrow dirt roads for several kilometers only to meet long, rocky footpaths to get to the home, are considered “urban” because they’re still in the Blantyre area.

According to our partners at Kachere, we have yet to see a “rural” village, which has totally blown away our team’s concept of urban vs. rural.

Getting Around in Blantyre

If it was not for the 4×4 vehicle, and our daredevil driver, who can expertly maneuver any terrain, we’re not sure we would make it to all of the homes. This makes us think about the families we’ve met with who don’t have transportation resources, such as cars or bicycles.

If our vehicle had a difficult time traversing this terrain, how do these families travel to the market or clinic to meet their basic needs?

The amount of time needed to complete daily tasks here is astounding; tasks require so much strength, patience, and perseverance. We wonder if these virtues are inherent in the Malawian culture or learned over time?

Family Roles and Independence

We’re in awe of the way these family and community systems seem to work like clockwork. Children of young ages are confident in their family roles and are quite independent. This independence is a refreshing change from the majority of families we know at home who coddle and “overprotect” their children and give them very little responsibility.

It’s a very different lifestyle, and one that we believe we could learn from. We hope to instill a similar level of independence and resilience in our own families and look forward to learning more while we have the chance.

by Shannon Walters and Nikki White

  
Shannon WaltersClinical Care, Collaboration, Education, Global & Community Engagement, Malawi Project, People, University LifeJuly 15, 20140 comments
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Elephants in Malawi

UMB Team Arrives in Malawi

July 7, 2014

The team from the University of Maryland, Baltimore (UMB) has arrived in Blantyre, Malawi.

An Interprofessional Team

We’re an interprofessional group doing a pilot study of the reintegration of clients into the community that have been discharged from the Kachere Rehabilitation Centre in Blantyre.

We are: Leslie Glickman, PT, PhD, assistant professor, School of Medicine; Laurie Neely, PT, DPT, instructor, School of Medicine; and students Megan Warres (physical therapy), Nikki White (social work), and Shannon Walters (nursing).

Malawi Project Team

From left: Leslie Glickman, Nikki White, Megan Warrens, Shannon Walters

The Kachere Rehabilitation Centre is a 40-bed facility; the only facility in Malawi equipped to provide intensive rehabilitation to people who have neurologic deficits.

During our time here, we’ll be working closely with the Kachere Rehabilitation Centre and the University of Malawi, College of Medicine to determine how successful clients are reintegrating back into their community and homes.

We’ll make several home visits to discharged clients to collect qualitative and quantitative data. Ultimately, the hope is the data we collect will help the Kachere rehabilitation team with clients in the future.

The Warm Heart of Africa

Today was our first day of data collection in the community. We were able to complete five home visits within Blantyre. Malawi is known as the “warm heart of Africa” and today we found out why.

In each home we visited, the residents greeted us with appreciation and kindness. Every client was eager to share his or her story. We were able to see clients in varying stages of recovery. Some have returned to their pre-injury responsibilities, while others haven’t been able to return to work because of the residual effects of their injuries and accessibility challenges.

We’re excited about our contribution to this society. Tomorrow we continue our work!

Check back for more posts from Shannon Walters coming soon!

  
Shannon WaltersClinical Care, Collaboration, Education, Global & Community Engagement, Malawi Project, People, Research, UMB NewsJuly 8, 20140 comments
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Malawi Travel Diary

June 13, 2013

Hi friends and family,

You are receiving this email while I’m abroad this summer. It’s a lot easier than blogging because I’m not sure that my Internet connection will be strong enough for that. Thank you so much for all of the kind words, messages, phone calls, texts, and email send-offs that I’ve received!

I depart this afternoon (BWI => ATL => JNB => BLZ) – of course, I spent most of the day yesterday doing last-minute packing and errands. Before I head out, I wanted to give an overview of what I’m working on this summer.

I’m traveling to Malawi from June 13 – July 28 with the University of Maryland, Baltimore (UMB) Global Health Interprofessional Council. Each summer, they select one student from each of the professional schools (medicine, dentistry, pharmacy, law, social work, nursing, and physical therapy) to go with some of the faculty on the council. This is the fourth year that UMB is traveling to Malawi. I’ll be spending the first 10 days at the University of Malawi’s law school. They have a legal clinic for HIV+ clients, and we’ll be sharing our experiences with UMB’s well-established HIV+ legal clinic. The goal is to build a relationship with the University of Malawi and to continue collaborating with them well after the trip ends.

I’ll be spending the remainder of the six weeks in rural villages in the Chikhwawa district, doing community mapping. That’s a social work activity that helps identify what resources are used by communities. We hope to get an idea of how the community members feel about their health resources and figure out what we can do to improve the situation, specifically regarding malaria treatment and prevention.

You can follow what we’re doing on Facebook and read more about the Council and previous trips here.

After our program in Malawi is over, I’ll be traveling to Ethiopia for three weeks (July 28 – Aug. 17) to volunteer with the Vermont Oxford Network, an international neonatal quality improvement organization. I’ll be in the Tikur Anbessa NICU, the first Neonatal Intensive Care Unit in Ethiopia.

Again, thank you so much for supporting me as I embark on my longest trip outside of the U.S.! I get back on Aug. 18, just in time to start school again on Aug. 20.

Best,
Sheila

Malawi, trees

June 17, 2013

Hi everyone,

The first few days of the trip have been great. We were delayed in both BWI and Atlanta, but luckily got to Malawi with all of our bags intact (though a few of our locks/suitcase belts did go missing…). The overnight stay in Johannesburg was great – the hotel was beautiful. Plus, I got to eat Roganjosh for dinner at the airport – this was probably my last meal of Indian food for quite a while.

We’ve been spending the past few days settling in/doing touristy things. We went to a dance show on Saturday and a tea plantation on Sunday. It’s been a very relaxing trip so far since we don’t start our actual work until tomorrow morning. The weather has been great so far, in the 50s-70s. Blantyre reminds me a bit of Honduras in terms of the climate and the architecture. The house where we’re staying is really pretty, and we’re fortunate to have a great cook, too. We haven’t tried any local food yet, which I’m really excited to try.

We figured out that I’m the youngest of the group (the dental student is 25 and everyone else is in their 30s), as well as the one who has the longest time in school left (everyone else is either finishing their second or third year of their professional degree). Still, everyone in the group is supportive of each other. It’s been really interesting to learn more about people’s backgrounds, travel experiences, and lives in general.

Tomorrow we start our collaboration with the University of Malawi Law School, which will last until next Tuesday. I’m excited to meet the students and to get to work!

MalawiBannerJune 28, 2013

Hi everyone,

I’ve been having a really interesting time in Malawi thus far.

For about a week, we were working with the University of Malawi Chancellor College Law School in Blantyre (where we are situated) and Zomba (a city about an hour away, where their campus is). Both University of Maryland and University of Malawi have legal clinics that address the needs of their HIV+ clients, including discrimination and other psychosocial issues. We were able to visit their clinic and hear from the community workers there. We also had a series of presentations from our student group about the medical information about HIV (what the virus is, diagnosis, treatment) and the demographics of the populations it affects in the U.S. The University of Malawi also had speakers share about diagnosis, treatment, and psychosocial issues regarding HIV in Malawi. We wrapped up the conversations with a few case studies.

During the week, we also got to visit the High Court in Blantyre as well as Kuchewa, the mountain that overlooks Zomba; the law students were able to accompany us for most of our trips. They were extremely bright and inquisitive, and it was really fun to get to know them. Over the next few weeks, we will try to figure out how to continue this collaboration. Some options we are looking into are exchanges, funding, or online discussion forums.

Last weekend, I went back to the tea plantation, but this time we got a tour of their coffee plants and learned how they harvest the beans to make coffee.

Yesterday was our first day in Mfera, a village in the Chikhwawa district, which is about an hour outside Blantyre. Before we got to Chikhwawa, everyone was warning us that it would be hot, and they were not lying. It’s still not that bad since it’s winter, but it’s definitely a lot hotter in Mfera than in Blantyre – probably in the 70s/80s. The village health center is what you would expect for a low-resource clinic – inconsistent water supply and electricity, small rooms, etc. – but overall the health workers are doing a great job catering to their patients as best as they can. We spent the past two days getting situated in the clinic, but our real work starts on Monday. Next week, we’ll start community mapping with the villagers to learn what resources they have nearby and what spots in their areas they frequent most often. We’ll be in Mfera for a total of two weeks.

It seems like things are pretty busy in the U.S as well – I know SCOTUS has been coming out with some big decisions! And there have been a few shockers in Wimbledon as well. Thanks for everyone who sent me updates about their lives over the past few days – it’s really comforting to come back to our house in Blantyre and have emails from you.

Lake in MalawiJuly 5, 2013

Hi everyone,

Happy belated 4th of July! Today marks the halfway point of my stay in Malawi. This week has been wonderful, since we finally got to start our work in Mfera. I was working with a group of six children, ages 11 to 16, on community mapping and seasonal and daily calendars. The first activity involves having the students map out all of the resources available in their communities, so that we better understand how their community works and what spots in the village are important to the children. On Wednesday, we got together with the all-women’s group (five women who have children under the age of 5) and the all-men’s group (two community health workers and three schoolteachers). It was great to hear from all three of the groups and to see that they appreciated learning about each other’s priorities in the village. The adults were very proud of what the children accomplished, and every group commented that they learned a lot more about their peers and their workloads.

Women in Mfera work really hard, doing chores almost all day, whereas the men have shorter days and more down time. Once we shared this information with everyone, the whole group came to the consensus that the women should be served lunch first, instead of the men, since their days are more grueling. It’s a small step toward gender equality, but progress nonetheless!

I’ve spent the past two days figuring out the students’ daily calendars. The translator’s English isn’t perfect, so we’re never totally sure if our questions are being understood properly, but we were happy to hear that our students attend primary school regularly when it is in session, except for during the rainy season (December to January), where they help their parents harvest crops. The kids are finally starting to get comfortable with us, and we had a lot of fun hanging out with them today. Next week, we will share our results with the other groups.

Last weekend, I hiked Mt. Michiru, one of the three mountains surrounding Blantyre. This weekend, five of us are taking a trip to Lake Malawi from Saturday to Monday. It’s the most biodiverse lake in Africa and one of the largest lakes in the continent. Tomorrow is Malawi’s Independence Day, which is why we have Monday off.

Elephants on safari

Elephants on safari

July 17, 2013

Hi everyone,

I hear it’s been getting incredibly hot for all of you in Baltimore – I hope everyone’s finding a way to stay cool! The weather here has been getting colder each day, but it’s still in the 60s/70s, so I really can’t complain.

Last weekend we traveled to Cape Maclear, which is one of the spots around Lake Malawi. We stayed at the Gecko Lounge, which was absolutely beautiful. It was an incredibly relaxing weekend and I even got a little tan! Yay. We went snorkeling in the lake, which was incredible, but since the lake also has Schistosomiasis we have to take medication six weeks after we get back (no big deal though, students swim in the lake every year and everyone’s turned out fine).

Last week was our last week of working in Mfera. I spent Tuesday working with the men’s group on their needs assessment. They told us that it was the first time that anyone had ever asked them how they would want to improve their community and get more resources. On Wednesday and Thursday, the men’s, women’s, and children’s groups came together to share their daily schedules, seasonal calendars, and needs assessments. It was interesting how some of the needs of the community were similar (more bikes for transportation, a functioning ambulance, more textbooks for students), despite how different their daily calendars and activities are.

We are hoping to take the information we gathered and report back to a newly established partnership, called the UMB (University of Maryland Baltimore) Foundation. The foundation recently raised $4,000 to build a new roof over the maternity ward over the health clinic because it is leaky and during rainy season they have to shut down most of the health clinic because all of the rooms flood. As it is, the maternity ward is three beds without sheets in one room attended by one nurse. Learning about all of the needs of the community was pretty overwhelming because there is so much to be done, but it’s great to know that our work is going toward a sustainable partnership. We plan on having the community contribute at least 25 percent of the cost for each of the initiatives – cost can be interpreted as cooking food for the builders, volunteering time to build the project, etc. We also are looking to start a Peace Corps Partnership with the health clinic, since there is a Peace Corps Volunteer in Mfera with whom we have been working.

This week, we have been focusing on creating our report that we will present to the community on Thursday. We want to share our results and the community members’ hard work with the participants, village chiefs, traditional authorities (one step above the village chief), district health officers, and other members of the community. We’ve been in Blantyre writing the report, preparing our presentation, and getting the gifts for the participants together.

Hippos!

Hippos!

Last weekend, I went to Liwonde National Park for a safari. It was unbelievable – we saw elephants, hippos, crocodiles, warthogs, waterbucks, impalas, mongooses, baboons, and lots of different types of birds, including egrets, herons, and a fish eagle. We even got to see baby hippos, baby elephants, baby baboons, and a baby crocodile! We stayed at Mvuu Lodge (which means Hippo in Chichewa), which was unfenced, so we could see a bunch of the wildlife right from our front porch. Seriously, it was phenomenal.

Thanks for keeping me updated on everything that’s going on back home. I miss all of you and I hope that you’re doing well.

 

Dancers

Community celebration with traditional dancers

July 27, 2013

Hi everyone,

This will be the last email I send from Malawi! I’m not sure if I’ve mentioned this yet, but everyone in Malawi calls it “the warm heart of Africa,” The majority of the group leaves tomorrow morning, and Sam (the PT student who is my closest friend here) and I both leave on Sunday at 3 p.m. Sam and I are on the same flight to Addis Ababa, but Sam’s final destination is Kenya.

Our community celebration in Mfera last Thursday went great! We had performances by the traditional dancers of the village as well as the Gulis. I’m not sure exactly how to describe the Gulis – they are a dance group that is chosen secretly so no one in the village knows exactly who they are.  The community seemed really happy with the celebration we planned, and we discussed future projects with the village so that our project will ultimately be sustainable.

We’ve been writing our final report to be submitted to the UMB Global Health Interprofessional Council and Dr. Perman, UMB’s president. It has been quite a challenging process to write a 50-page paper with seven authors, each with his or her own distinctive voice and opinions. We finally put the finishing touches on the report today, which was a relief! Overall, this trip has been a really great learning experience that expanded my interests in global health, even though it’s been frustrating at times to deal with some of the group dynamics. I’ve really enjoyed meeting the law students at Chancellor College and the members of the Mfera community.

My next email I send will be from Addis Ababa, Ethiopia, where I’ll be volunteering with the Vermont Oxford Network in the NICU in the Tikur Anbessa Hospital. I’m so excited for this project – I’ve missed spending time in a hospital setting and seeing patients.

Sheila

  
Sheila RazdanCollaboration, Malawi Project, People, University LifeSeptember 23, 20130 comments
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