A Happy Arrival ...

I arrived in Blantyre, Malawi yesterday afternoon. 

Blessed am I.  My bags arrived as well.  

Two members of the Project Peanut Butter team greeted me at the airport.  Great to find their familiar faces in a massive crowd.

Outside of one very unhappy, very loud, screaming baby who shared his feeling with nearby travelers for ten hours on a flight from London, my last venture into the "friendly skies" was kinder and gentler than my first series of flights to Malawi.  

Apparently, the airport security staff read a typed note I left in both of my checked-in bags that expressed my respect for their job (yes, I poured it on), described the contents of my luggage,  and pleaded for careful engagement in re-closing my bags.  After their search and non seizure of my belongings, they took time on this occasion to reseal my duffel bags with tight, magic, little plastic bands.  Grateful was I.    

Yesterday afternoon, when I arrived, the weather was hot, muggy, and a bit windy.  

Later, small touches of rain flowed.    

Dinner and early discussions about this documentary production went well.  

Some of the children we started tracking about four to five weeks ago are experiencing great improvements in their health.  Other children remain in an uncertain state.  A group of additional kids will be tough to re-connect with.  We will try to follow up on all of the cases we started with over the next two weeks.   

This next eight days will be especially intense.   I will be in rural clinic settings Monday through Friday and then in a remote village for most of Saturday through Monday.  Then, more clinical work will continue.

If all goes well, we will  generate documentary footage that allows a viewer to move much closer to the daily life and intimate experience of a poor family in a rural setting - a deeper effort to touch the "face of hunger."   

Right now, I feel pretty good on the health and energy meter.   

I just woke up from a big, big night of sleep.   

My body is still operating on a shifted time clock that is off by about twelve hours.  Thus, I tell myself it is "Ok" to be a bit of a "whack-o". 

As I awoke this morning, I felt thankful for much, including the large, well worn, white mosquito net swirling above my head.  Yes, the familiar buzzing sound of mosquitos lingered from the night.

Ah, Malawi!        

Back To Africa ...

I leave in an hour for the airport.

My flights cover two nights and two days.

First, I fly from San Francisco to London. Then, after a four or five hour delay, I fly from London to Johannesburg, South Africa. After a morning in this fine airport, I fly from Johannesburg on to Blantyre, Malawi.

Great fun.

If all goes well, I will be in Blantyre, the hub of Project Peanut Butter's work, at about noon on Saturday.

The heat of southern Africa will greet me.

The "wonder" and sense of discovery associated with travel in a far away land and my continued hope for this documentary project will continue.

I am grateful to take additional steps.

During my first three week trip, I produced roughly thirty hours of footage (about a thousand High Definition video "clips") and hundreds of still images.

I spent a major portion of my time in San Francisco through the last three weeks reviewing, organizing, and editing this colorful material.

There is much to be encouraged with. I found many little gems and "touching moments" from the medical nutrition project and daily life in the central and southern region of Malawi.

On this next trip, I will follow up with twenty two children and their mothers (or alternative caretaker), who were interviewed during my first trip to Malawi.

I am working to document the transformational change in the children's health through RUTF treatment. 

If all goes well, I plan to spend several days living within a rural village and visiting the homes of clients that Project Peanut Butter serves.  These experiences will bring me closer to "the face of hunger" and the power of this therapeutic approach to heal malnutrition.

My days will be full. During some evenings, I may have the chance to update this blog. If so, I will offer updates from my journey.

Thanks for joining this expedition, steps into a world that teaches and challenges me in wonderful and difficult ways.

All my best wishes to each of you.

The Questions We Ponder ...

Since my return from Malawi to San Francisco three weeks ago, many of you shared colorful and expressive emotions about Project Peanut Butter.  

You posed insightful, powerful questions.

At the heart of a number of discussions were/are central issues : the deep and relentless scale of human need in Africa, the fragile capacity of the earth to support an ever expanding population, and the true sustainability of a small, lightly funded, innovative nutrition program in a rural area where there is extreme poverty and limited capacity to grow food.  

Some of you ask: 

How can programs such as Project Peanut Butter truly solve the pressing, difficult, long-term challenges these children and these mothers face?   

Even if the children are out of a nutritional crisis, what type of life will these children experience in the future?

Is it really worth investing in this type of an initiative?

You wonder out loud : 

Does it make sense to save children from hunger when they return home each day to extreme poverty?

Of course, some questions you partially pose are more difficult for us to talk about.  

Is malnutrition one of the natural ways the earth controls population?  

In the long run, is it better for the more established global community, those with more resources, more power, and more capacity to affect change, to allow certain tragedies to happen?  

What is the price we should pay to save a life, especially a life in poverty?  

After all, some of you argue, maybe there shouldn't be so many people in Malawi.

It's fascinating to open ourselves to different perspectives.  

Some of you feel strongly that every child, no matter where he or she is born, regardless of what level of poverty he or she lives with, presents a life worth saving and supporting.  

This community of believers tends to see connection between all humanity, tends to feel empathy for all children, even children from vastly different cultures and dramatically different economic circumstances, and tends to want to take action when there is perceived inequity, injustice, tragedy, or crisis in the world.  

This community tends to be idealistic, often impacted by emotion and hope.  

This community yearns for solutions that hold promise, solutions that are effective and sustainable, even when problems are overwhelming, complex, and chronic.   

This community tends to feel blessed by life circumstances and tends to believe that our place of birth, character of family experience, access to education, and access to material wealth may be more like a giant lottery than a tightly controlled, personally-earned path.  

I can see strong reinforcements for this way of thinking.  The earth's climate, oceans, food supply, air, wildlife, population impact, and other organic systems are tightly connected and linked throughout the world. In today's age, one man's simple daily action touches the lives of men in distant lands for many days to come.   Clearly, much of our life experience is out of our control.  From what I can tell, few of us had much say in the choice of where we are born.  And, as far as I know, re-incarnation possibilities aside, we don't "choose" our parents, the home we are born into, or many of our childhood experiences.  

There are, of course, other points of view.  

Some perspectives shared bring a very, very different orientation to the problem of hunger and food security.  Although it is difficult to express these types of ideas directly, I sense some of us hold deep seeded emotions that keep us away from emotionally or intellectually investing in these types of global issues.

To start with, deep inside, we may feel Africa's problems are Africa's problems.  

Clearly, Africa's problems are big and long-standing.  

With all the news reports of violence and self-interested dictators across Africa, it is easy to view Africa as dark, corrupt, and unyielding in need.  

When we sit in this community of thinkers, we may point out hard facts.  

We can talk about Africa's brutal history and the movement of millions and millions of people into geographic areas that are not able to sustain growth.  We can speak about squandered resources and wasted foreign aid.    We can argue that the earth cannot possibly support an ever-expanding and increasingly demanding population of poor, uneducated people.  We can focus on the need to control birth rates in poor and less developed regions.     

There are reasonable emotions and much truth within these perspectives.  

When we see Africa through this lens, we tend to feel detached.  

When we approach Africa's problems in this way, we tend to position sustained poverty and food shortages as unfortunate, uncontrollable forces.  

This line of reasoning leads us to conclude that, given the earth's limited resources and massive population growth, famine and food insecurity are normal, unstoppable processes.  

"If a child or an adult dies from lack of food, perhaps this is meant to be."  

When we are conscious or unconsciously in this camp, "survival of the fittest and wealthiest" is the path of reason we softly, almost silently, argue.

We may not be politically correct, but when we feel this way, we sense we are right.  We feel justified in non-action.

There is also a third community.

Many of us are not sure what we believe.  Sometimes, we don't have the "bandwidth" to engage.  

It is common for most of us to have a full plate of responsibilities and worries and hopes and challenges without thinking about kids living in poverty in a far off place like Malawi.  

There are plenty of important issues to address in our own country, our own state, our own city, and our own homes!

Our hearts and heads may be overloaded.   

The whole discussion around food, hunger, and RUTF therapy for children in extreme poverty may feel too complex, too uncomfortable.  Our eyes may glaze over when these topics come forward.  

As I ponder these different points of view, I find myself thinking about what it might be like to be a mother or father and work tirelessly for years and years and still fail to find a way to feed my young child and his/her siblings.  I can't imagine the experience of watching my son or daughter "waste" away or swell in pain with edema.  

I think about how different my life would be if I were born as a young child in a family that lived with extreme poverty. 

Would I overcome these challenges?   

I don't know the answer to this question.   I know my path would be very, very difficult.  It helps me to try to feel empathy and hope.   

We are all learning and growing - trying to find our way along this bumpy path.  

I certainly struggle to find satisfying answers to many of life's great questions.  

How we feed and provide access to clean water for the most needy among us sits high on the list of global challenges.  Roughly 2 Billion people live on less than $2 a day.  About half these individuals live on less than $1 a day.

More and more, as my life evolves, I sit and run and wobble in the : "We are all connected and share a responsibility to support and care for each other" community.  My sense is that each of us "makes a difference" with our actions, both intimate and international, as we interact with each other and the earth and choose our values and investments.  

Sometimes, those with little in material terms can transform their world through the power of simple kindness and compassion.  Several friends come to mind.  Their hearts just glow with care for the world and those in need.  

I believe just "being present" can be a tremendous gift.  Most of us find it difficult to get out of our own world of yearning and pushing and driving to connect in a meaningful way with others. 

My time in Africa allows me to pause and reflect on my own path.  When I experience the intimacy and success of Project Peanut Butter's work, I walk away without a sense of admiration and inspiration.  

In many ways, I remain an idealist.

The short history of Ready To Use Foods (RUTFs) presents a compelling story. 

 A small group of passionate, dedicated people with innovative, low cost tools and a firm commitment to change the world in the only way they know how - by supporting and transforming the life of one child, one family, at a time - pushed through obstacles and early failures and created a transformational approach to support children in nutritional crisis. 

There is something quite captivating within this path.  

 

One Child At A Time ...

In the video posted above, Jay, a talented medical student who co-manages Project Peanut Butter's clinical sites during his year long commitment in Malawi, moves through the later stages of a typical assessment of a child's nutritional health.

I should note, this child's weight and other basic health indicators were assessed earlier.

A height scale is on the bench before Jay.  

The man on the opposite side of the bench from Jay is a "HSA," a government paid Health Surveillance Assessor.  The HSAs are stationed in rural areas throughout the districts where the Project is engaged.  They serve as informal partners with the Project and provide a link to many of the villages and other remote communities.

A combination of measurements that include weight to height ratios, age, and other calculations allow Jay to determine if this child's health and life are truly at risk.   

The Project uses international standards for malnutrition and a substantial base of additional research data to qualify and track each child's health.  

Many of the children brought to the clinic are tested and not qualified for treatment - they are reasonably healthy and nutritionally stable.  These children are often hungry and sometimes have other medical complications, but they are not in crisis. They are sent home with their caretakers without additional food.  The mother's and other caretaker's major gain is a positive assurance that their children are not at immediate risk for severe malnutrition.  The mothers and other caretakers for these children are often encouraged by the doctors and other members of the Project staff to come back to the clinic in a month for further assessments.  

The Project is clear about core values - there is a tight focus of Project resources on children who are in desperate need, children who are moderately or severely malnourished.  The Project makes a commitment to serve of these vulnerable children free of charge.  At the clinics, no children are turned away.   

This, I believe, leads to the relative calm for the entire community of mothers.  There is a sense of trust that if their children need immediate support, food and other Project resources will be available.   

It is my understanding that the most critical period for children in terms of nutrition is the period between the end of breast feeding and an age of about three years old.  A child's development and lifetime health, size, mobility, and intellectual capacity are all significantly impacted if adequate nutrition is not in place during this time frame. 

As Jay states in this short footage, the child featured in this video clip has "Severe Acute Malnutrition" and evidence of "Wasting."  This child's statistics indicate a crisis.  

Without treatment this child is not likely to survive.  

As the video evolves, Jay gathers critical information and enrolls this child in the Project's highly successful, intensive, nutritional program which utilizes "RUTFs," or Ready To Use Therapeutic Foods, a dense paste of peanuts, milk powder, vegetable oil, sugar, and vitamins and minerals called "Chiponde" in Malawi.

Fortunately, the child in this video footage is highly likely to recover in a short period of four to eight weeks and sustain a very positive level of health through the early years of his life.

Each day, Monday through Friday, Jay and El, the other medical student engaged with the Project, work with a team of nurses, HSAs, and additional Project staff to assess the health of a hundred to six hundred children.  They return to each site every week to two weeks. 

In many cases, extreme poverty, domestic issues, and health complications lead to periods of the year when a large number of families have little to no food.  

In some situations, a child's nutritional requirements and overall health status are complicated by exposure to Malaria, TB, HIV, and other factors.

The flow of a day long clinic during the most challenging times of the year is quite mesmerizing and exhausting - singing, clapping, long lines, measurement after measurement, endless crying children, and big, big heat. 

I remain inspired and humbled by the work this team completes.  

The Power Of Song ...

In Malawi, song has a long history and a powerful memory.  

Women sing together.  They sing alone.

The program I work with, Project Peanut Butter, incorporates this legacy and cultural connection within each day's clinical work.

Early in the morning, around 7:15 AM, when Project nurses and doctors arrive at a site in rural communities within southern Malawi, there is a common shuffle to unload the simple measuring equipment and food from trucks and complete an informational exchange, an update meeting, with the local Health Surveillance Assessors (HSAs).  

Each of these government health care workers are responsible for basic health screening, vaccinations, and support in a small cluster of villages within a district or region.  

The nurses and doctors learn about the events of the last week to two weeks - the time period since the previous clinic.  They are briefed on emerging health issues and other developments within the community. 

Typically, several hundred mothers and children are already gathered under a nearby tree or a small building awaiting services and nutritional support.  They sit quietly in small groups anticipating the flow of the clinic.

Then, as an introduction to the day and culturally sensitive educational tool, a nurse gathers the attention of the entire group and begins a rhythmic presentation, a flow of information about nutrition, family planning, hygiene, a range of health issues, and use of "Chiponde" (the legendary paste made of peanuts, vegetable oil, milk powder, sugar, vitamins, and minerals).  

This portion of the day begins with a speech and quickly evolves to laughter, clapping, and shared singing.  Everyone joins in.

The sound of hundreds of mothers' voices, brought together from villages across a large region by a common hope, chanting, playfully laughing, and singing together is quite moving.

This video clip presents a moment these mothers share.  

If you close your eyes and listen closely, it almost sounds like they are singing:   

"I love ... I love Obama."   

Well, not quite.  Our new President  is, however, quite popular in Africa!

  

Daily Life ...

Thought you might enjoy a quick, visual splash of daily life near a rural Malawi village.

The lush, green scenery in this video is present for just a few months each year during the rainy season when a single crop, mostly corn, is grown.

Mid day, the dirt paths near many of the villages in southern Malawi are full of men, women, and young children in colorful cloth moving every which way, engaged in play and the driving motion of rural commerce.

As you may note, most of the men and women are without shoes. Yet, they tend to move gracefully and quickly on well worn, often rocky paths.

Bicycles are common. Cars and trucks remain a special sighting.

Most schools serve a large area containing many villages. Classrooms are typically an empty, rectangular room with mats on the floor and an old chalk board near the front wall. Pencils and paper are a luxury. Air conditioning or heating are alien discussions. Teachers are respected, yet underpaid and overworked.

In the fields, a day laborer may be paid less than a dollar a day. Work is hard to find.

Many families live on a single harvest from a small piece of land. On special occasions, they sell some of their corn and other home grown vegetables to generate enough money to buy vegetable oil, soap, salt and other household treasures.

Women and young girls often carry large, heavy loads on their heads. Balance is a "learned and expected talent" at a very young age.

It is typical for an entire family to live in a small, one room home with a mud, brick, or concrete floor.

Electricity is rarely available. Water and firewood are gathered each day.

During "Hunger Season," for most families, only one or two light meals of "Nsima" (sometimes stated as: "Nshima") are generally possible. This is the staple for much of southern Africa.

There is deep poverty throughout this region. Yet, there is a strong sense of community. In my short experience, it was rare to see an individual who appeared lost, lonely, or forgotten.

It is interesting to reflect on modern cities with vast resources, millions of residents, and much intensity.

In large cities and suburbs, we are capable of creating attractive material wealth, joy and laughter, and a sense of closeness. We are also capable of developing tremendous inequity, a feeling of isolation, and human emotions that don't seem to exist in a rural space such as southern Malawi. In countries such as the United States, we have much in commercial terms and broad access to technology and other resources, yet we sometimes struggle to connect with each other in positive, meaningful ways. Many of us do not know our neighbors.

There is no question that the rural communities of Malawi have deep and challenging problems to contend with. These communities also have tremendous strengths. The poor farmers and their families who reside in these villages tend to maintain a richness of spirit, a depth of culture, and a strong sense of resiliency and inter-dependency. They share much together.

There are lessons for all of us to hold, reflections to ponder.

Publish Post

Can It Be ...

The road continued to wind left then right, then left and right again, as we climbed further and further up the long hill near Blantyre, Malawi.  

After each rotation of the wiper, a new pattern of small raindrops appeared on the thick, foggy, windshield glass before me.

We were returning from a day of clinical work in a rural area in the far south.

I turned to Dr. Mark Manary, the founder of Project Peanut Butter and an international nutritional expert, and started through a series of my questions about the state of global nutrition and the efficacy of the scientific tools we have to measure vitamin and other deficiencies in our bodies.

There are many expensive tests available to assess our blood and tissue.  I wondered out loud: Are these tests accurate?  What should we all be conscious about with regard to our diet and the support of our immune system?  What is most needed to support doctors and patients with our allopathic (western) medicine practices in the United States and the rest of the world?  What are the most pressing issues for international nutrition?  Are there simple solutions?

A colorful conversation evolved.

I sensed Mark's perspective on many of these issues is deep and broadly informed.  I tried to grab highlights, a portion of his rich response.  

Mark will likely write a series of books at some point!

One of the many ideas Mark shared fascinated me.

Apparently, one third to one half of all the people on our planet are deficient in iron at this time.  Wow.  

How might we solve this issue?  

Clearly, the foods required to address this are typically expensive and often scarce in poor and remote parts of the world.  

Mark said there is a simple and elegant solution.  

Here's his recipe ...

Each person in need of iron might acquire or be given one common iron nail.  

Then, this nail might be placed in a cup of clean, drinkable water and allowed to sit for a few weeks to initiate rust.  

After the nail is exhibiting a full state of rust, the proud owner can drink the iron fortified water and refill the cup with new water. 

Once the cycle is in process, the water may be consumed and refilled each day.

Mark said, in this way, appropriate levels of iron at a remarkably low price and accessible form may be achieved.  

As long as we avoid drinking the rusty nail with the water, all should be well!

Emotions That Linger ...

Many colorful memories linger from my time in Malawi.  

The faces and sound of children in stress, the visual flow of curving lines of hundreds of mothers seeking support, bumpy, dusty roads, the stunning beauty of Malawi's countryside, and the warm spirit of many people I met throughout my trip stand out.

Over and over, when I reflect on Project Peanut Butter, I think of the compassion, commitment, and empathy held by the Jay and El, two medical students engaged in the management of the Project's clinical sites, and the ongoing work of Dr. Sandige and Dr. Manary, the two senior doctors within the clinical program.

On a typical day during this intense stretch of Malawi's "Hunger Season," Jay and El each review health indications for three to five hundred children and enroll thirty to sixty kids who are in nutritional crisis immediately in a food supplementation program.  They are up at about 4:30 AM and work non stop from about 5:15 AM through mid to late afternoon with a group of nurses and drivers and HSAs (Heath Surveillance Assessors) in remote settings without a break.  

They often sustain their bodies on a touch of water and a quick snatch of bread.  

Then, in the midst of the late afternoon heat, when most of us would roll over, close our eyes, and yell "Uncle," Jay and El pile a group of  very sick children and caretakers with special needs into their vehicles and provide critical shuttle service to the nearest rural hospital.  Many of these children are in dire shape with complications from Malaria, TB, HIV, other infections, and malnutrition.  

In the image above, Jay is getting ready to take seventeen people in his car to the nearest hospital, which is about thirty kilometers from the clinic - a distance that proves very difficult for almost clients who rely on foot transportation.   

When this work is complete, El and Jay drive back to their lodging in Blantyre, a trip that often take an hour and a half to two hours.  When the cars break down or the weather turns ugly, this trip can be much longer.  One day last week, a river swelled from rain and prevented travel home for several additional hours for two of the Project teams.  

When Jay and El return to their lodging, they eat a quick dinner and begin the work of managing case files, supporting research, and re-packing cars for the next morning.  

These are long, tiring days.

In my three weeks of experience, their attitude was universally positive, engaged, and hopeful. 

I am not sure where this type of compassion, empathy, and energy comes from.  

It is inspiring.  

Little Blessings ...

Last night, after about thirty six hours of wandering in airports and experience with the joy of confined, international airplane travel, my feet "touched down" in San Francisco.

It's funny how one craves little moments, blessings often beyond one's reach during travel in less developed regions such as rural southern Africa.

The feel of an ice cube in your mouth.

The joy of uninterrupted sleep in a big bed without a tightly fitting mosquito net.

The taste of fresh, crisp, uncooked vegetables.

The feel of cool, misty fog.

The sound of friend's and family member's voices.

I am back home.

Piles of mail, a bit of sleep deprivation, and a big "to do" list are now with me, but it's all good.

I will spend the next three weeks engaged in four primary projects and a bit of resettling.

My work with the TV Series, Travels To The Edge, continues.

Consulting work with PBS EDCAR, an on-line initiative for teachers, and Worldlink Foundation's education and broadcast media initiatives resumes.

I start the process of editing and logging over twenty hours of video material and hundreds of still images from my recent work with Project Peanut Butter. We have four goals in mind, each requiring much further development. There's a small video story on Project Peanut Butter, an exploration of a new media-rich "channel" on YouTube, a advocacy and fundraising kit for Dr. Manary and his team, and the start of a larger documentary project on the transformational power of Ready To Use Therapeutic Foods (RUTFs).

If all goes well, I depart again for Africa on February 26th.

We are working to document the transition and outcomes for children who complete Project Peanut Butter programs. Ideally, we can show children at the point of crisis and the same children after therapy. My first trip to Malawi provided much insight and learning.

The journey continues.

A Memorable Moment ...

Jay is an incredibly committed, compassionate member of the health care team here is Malawi. 

He is a third year medical student.  He put his formal education on hold and gave up a year of his life to come and serve these rural communities.

This image above presents his typical mode of engagement.  For hours and hours, he speaks with mothers, grandmothers, and other caretakers who fear for their children's health.  Each day, he reviews case histories and nutritional assessments for hundreds of young children.

A few days ago, I watched Jay work, documenting the interaction with a video camera.

I remember a unique moment when Jay lifted a bright eyed, four-year-old Malawian girl up to the bench in front of him.

The young girl smiled and turned from the embrace of her mother to face her unknown, white doctor.  She was calm.    Her faded, slightly torn, silk blue dress with a tiny white collar reflected the bright light from the morning sun.

Jay reviewed bits of information on the young girl's medical card and then assessed her weight, arm circumference, and height measurements.  

He checked the charts for normal growth and body mass.

He checked for edema (swelling) and other signs of malnutrition.  

He checked her eyes to look for iron deficiency. 

She was thin, but she did not seem to be in nutritional crisis.

After a pause, Jay raised his voice and expressed his positive assessment: 

"Alibwino,"  all is well!

Then, the girl's mother spoke.  She shared a new concern.  

She told Jay her child's genitals were very swollen and inflamed.  

Jay asked permission to examine the young girl in the midst of of the public courtyard.  

Hundreds of other mothers and screaming children waited patiently in long, winding lines through the surrounding area.

Without hesitation, the young girl's mother expressed consent.  

Public displays of breasts and other "private" areas one's anatomy are omnipresent here in Malawi.  Underwear is optional.  

Jay asked the girl to stand on the bench.  He lifted the bottom edge of her dress to determine what the mother's concerns might be.  As the girl's dress slid over her hips, it was clear the medical situation was much different than anticipated.

The "swelling" and "inflammation" of concern turned out to be a normal part of the male anatomy.

Apparently, this mother was not sure what to expect as her child grew older.  

She did not have other male children.  She was uncertain what normal development might look like.  

She told Jay she did not have enough money to afford boy's clothes.  

A simple solution evolved for this family.  Clearly, an old, available, slightly tattered dress provided basic coverage.  None of the African women nearby seemed surprised or concerned with this choice.  One of the other doctors on our team told me these situations are common. 

When faced with extreme poverty, African women work with whatever is possible.  

After the shock of the gender discovery was over, Jay worked with a translator and encouraged the mother to take three important medical steps.  

One, he asked her to continue to feed the child with as balanced a diet as she can afford.  

Two, he asked her to return to the nutritional clinic in a month for further testing.   

Then, he smiled.  

He recommended she trade the old blue dress for different clothes that are "good for boys." 

The boy's mother offered a bit of laughter and her thanks.   Then, she held her son's hand and walked off toward her village.

Makes one think about the resiliency of the human spirit, the power of education, and the challenges with deep poverty.

  

Two Dreams To Care For ...

Moments like this fill each day - the joy and "curse" of twins in Africa. 

I was moved by the intensity, intimacy, and care of this moment.  

This caring mother is Annie Mankhumula.  

Her twins, Yamikan and Thokozan, are thirteen months old.  

Annie's chest tells a story.  

These young children are grasping for all they can attain.  There is little Annie can offer.

Fortunately, both children "graduated" from a therapeutic nutritional program this morning.  

With the help of "Chiponde" (the magic peanut paste), Thokozan grew 500 grams and Yamikan grew 550 grams in the last two weeks.  

They are now out of the immediate crisis in terms of their nutritional health.  

Much like most of the other children in the program, their father works as a farmer.  

Right now, he is far away from home in the North of Malawi struggling to earn a living.

Apparently, there is no work anywhere near his village that will allow him to earn a salary with his skills.  

Annie has five living children - three under ten.  Annie had two other children, but they both died before they were five years old from malaria.  This is a common story in Malawi. 

The family lives in a small home with a thatch roof.  

Three times a day, Annie and her other children go to gather water from a rustic well near their village.  

Like many women in Africa, Asia, and South America, her days are filled with caring for children, caring for the house, preparing food, gathering water and firewood, and tending the small family farm.  

Her face is calm and strong.  One senses the impact of many tiring days. 

* * * 

Yesterday, while driving to a site early in the morning, we saw a sign on the side of the road that said: "Men At Work."  

I turned to the nurses in our vehicle, pointed to the road sign, and shared my thought: "Sometimes."  

I paused and added: We should make a new sign that says: "Women At Work ... Always."  

Great laughter and a long discussion about the role women play in much of the less developed world evolved.  

At this time, many large non profit organizations and development initiatives are focusing on empowering women in poor countries to address poverty and improve economic stability.  

Micro loan and other stimulus programs have demonstrated tremendous outcomes by extending support beyond men in rural and and urban communities to embrace women.    

Perhaps, the next century will bring dramatic change.  Old patterns have a way of resisting modification.

As I prepare to head back to San Francisco (I leave Africa later today), the faces and spirit of countless mothers and grandmothers who care for their children here in southern, rural Malawi will linger with me.  Their dedication and sense of hope is quite moving.

My current plan is to be in San Francisco for most of the next three and a half weeks.

If all goes well, I will return to Malawi at the end of February to continue my work on this short documentary material.  We are planning to "shoot" a continuation of several "case studies" to show the full transition from the start of the program through completion for at least a half dozen children. 

As the some of the video material evolves, I will share additional thoughts.

Thanks for joining my journey.