Lumen In Action

Homeward Bound ...

2009-03-14T08:35:00.000-07:00

I write from a small cafe in Johannesburg airport.

If all goes well, my feet will touch soil in San Francisco tomorrow (Sunday) afternoon.

My second trip to Malawi left many colorful impressions.

Emotions tugged and pulled.

Sleep lost and sometimes found.

Intensity, warmth, openness, exploration, uncertainty, inspiration, fear, hope, encouragement, sadness, yearning, creativity, disappointment, and trust were all part of my journey.

My professional capabilities were stretched.

Rich experiences and memories linger.

Thank each of you for sharing this journey with me.

I am grateful for your engagement, your encouragement, and your insight as I find my way.

Simple moments bring much into our lives.

Often, my challenge is to be "present" and open enough to recognize and hold these gifts.

This is certainly true with intense travel and documentary work.

The little boy in this picture reminds me of this opportunity.

I want to bottle his joy and excitement!

May his smile and playful energy add a touch of brightness to your day.

Best wishes to all.

Let The Good Times Roll ...

2009-03-14T07:44:00.000-07:00

When you need to brake quickly, you wish for tight, firm control of your finely tuned rig.

Yes, this African cyclist is ready, willing, and able.

Why bother with expensive brake levers and a complex mechanical system used by many bike owners when you can have finger tip power?

My buddy, hand and body shown in the picture above, pulls hard on the wire around his thumb and hopes for the best when he needs to stop.

He often travels long distances on the rough trails and uneven dirt roads of southern Malawi.

One sees large quantities of cargo - wood, pumpkins, sugar cane, flour, tobacco, bricks, people of all sizes - transported on older, "customized" bikes such as this machine.

These two wheeled bicycles provide inexpensive mobility, a freedom we tend in America to associate with a car.

Large weight loads and harsh conditions take quite a toll on both the rider and bike.

It is quite common to see shacks converted into bike repair shops on the side of major dirt roads.

The "mechanics" at these shops proudly display a collection of old tires, mechanical pumps, and beat up wrenches and other tools.

Purchasing a vehicle is generally an unimaginable "stretch" for almost all rural families.

Thus, bike ownership is golden.

For forty to a hundred dollars, a semi-rolling rig with an old saddle and heavy metal tubes may be purchased. As you can imagine, bikes are used for years and years and years.

Pedals and a functional chain are optional. Gears are very rare.

As I reflect on my time in Malawi, I touch visual memories with bikes in a central role ...

Families of three or four people riding together with five or more bags of goods they plan to sell at the market.

Women with their babies tied to their backs and one hand on the steering wheel while their personal possessions are held tightly in their other hand.

Young male riders swerving down a dusty path with three or four giant 75 Kg sacks tied to the back of their bikes.

An elderly man walking along side his old, partially broken bike with thick piles of wood fastened to every imaginable piece of the frame.

One way or another, bikes continue to roll and wobble forward along bumpy paths and roads within Malawi's countryside.

Each day, as we traveled through the countryside, my eyes spread wide and laughter came forward from my gut as I witnessed Malawi's version of a cycling parade.

Sapuleni's Story ...

2009-03-13T07:41:00.000-07:00

On Thursday last week, I met Sapuleni.

She came with her youngest son to a roadside clinic near "Chipolonga" where our team provides nutritional assessments and, if needed, "Chiponde."

Unfortunately, her son is quite sick with severe acute malnutrition (SAM).

At the clinic, Sapuleni received advice and a bundle of Ready-to-Use-Therapeutic-Food.

Fortunately, with proper treatment, her son his likely to recover.

Before Sapuleni left the clinic, we had a chance to speak.

Her spirit and warm energy stood out in the crowd of mothers that morning.

I asked her if she would allow me to visit her at her home.

Then, I explained my goal.

Through an interpreter, I told her I am working on a documentary project to support children who are hungry, children who live within families that need food and medical attention. I told her I am taking pictures to communicate how clinics such as the roadside program she attended impact family's lives in Malawi.

I tried to explain that I want to better understand the reality of daily experience in a rural village - to touch the world she knows each and every day in an intimate way.

I asked her if she would allow me to bring my camera and sit with her and her family for a day or more during the weekend.

She smiled and let out a light laugh.

Yes, she must have thought, "here is a crazy azungu (white person)."

The notion of her daily life holding interest to someone from a far away place must have been both unusual and surprising. What could she possibly share?

I told her she didn't need to change or alter anything in her day. I spoke about authenticity and my desire to see her experience first hand in an unfiltered way.

After a short pause, she nodded her head and accepted my request.

As Sapuleni walked off in the morning light with her son on her back, I felt encouraged.

I planned to drive three hours early Saturday morning to meet with the chief of her village and then come to her house.

I did not know much about her family or her village, "Kwilasya," yet Sapuleni seemed to express much that I am drawn to with my photography work. She seemed strong, thoughtful, and expressive in her spirit.

In our first conversation, she shared a raw outline of the circumstances that led her to her son's health crisis.

She is very poor.

She has many children.

She has no food.

She has little opportunity for work.

All common challenges in rural Malawi.

I worked with one of the student doctors, a nurse, and a government health worker (a "HSA") to plan our visit.

After driving to her village from Blantyre, we picked up the local health care worker and drove to the chief's home. The chief was not available, but his wife provided permission for us to walk about a half mile on a small path through several fields of corn to visit Sapuleni's house.

By the end of our first three or four hours together, Sapuleni's life unfolded in bolder, more difficult, and more moving ways than I could have predicted.

I left our time together, torn up, moved, hopeful, challenged, worried, and inspired.

Here is a bit of Sapuleni's life story ...

* * *

At this time, Sapuleni does not know her age. This is common for many individuals who live in rural areas of Malawi.

It turns out, she has a very large family - nine children.

Here's the kicker. She is now a single, divorced Mother.

Her previous husband is a fisherman.

When they married, Sapuleni's parents provided the newlywed couple a small piece of sandy dirt to build a home and start a "garden" (think corn).

Sapuleni came from a Muslim family. Her husband came from a Christian family.

As you might guess, these types of mixed faith marriages are tough in any rural community, especially southern Malawi.

To support unity, she converted to Christianity at the time of her wedding.

Sapuleni and her husband built a one room house out of bricks and mud. For about seventeen years, they lived together in this small home and worked their way through tough times with bits of corn, fish, and vegetables as the primary source of food in their diet.

Sapuleni told me that "Hunger season," the period from about November through March, is always tough.

Unfortunately, when Sapuleni was pregnant with her ninth child, she became very sick. She had to go to the closest hospital, which is about ten kilometers from her home. There, she received medical care for about a month.

Since her family has no car or bicycle, communication with her husband and children was difficult during the time she was in the hospital.

After, she gave birth to her child, she returned home and found a surprise. She discovered her husband was sleeping with another woman while she was sick and away from the village.

This led to a series of heated conflicts.

Ultimately, Sapuleni asked her husband to make a choice - faithful marriage or divorce.

He chose divorce.

Suddenly, Sapuleni found herself alone with nine children, no education, no profession, no source of income, and few assets outside of a minor collection of old pots and pans.

To complicate matters, one of her children developed mental health issues.

The marriage separation took place about one year ago. Her husband left their home and ceased all communication and support.

Sapuleni's children are now 18, 17, 16, 15, 13, 9, twins at 6, and 1 year nine months old.

Her days involve constant motion and commitments of care.

Two to three times a day, she must walk about a half hour to get water from a bore hole with a manual pump. This, as you may guess, is not the purest of water sources. She pours several gallons of well water into a large yellow plastic can and returns home.

Her family's diet consists mostly of corn flour and boiled water. Sometimes, Sapuleni can sell bits of corn from her garden or find work in her neighbor's gardens to raise money and afford a bit of small fish and vegetables such as pumpkins.

Her previous husband he has not provided support of any kind. He still lives in the "hood," but his commitment to his first family, Sapuleni and all nine children, vanished completely when he left about a year ago.

The full family is now Sapuleni's sole responsibility.

To support her children, Sapuleni works in the only way she knows how to earn money - she provides manual labor in neighbor's homes and gardens.

Generally, she is paid 30 to 40 Kwacha (twenty to twenty five cents) per day for about eight hours of work.

Imagine this compensation as a means to support nine children. What a challenge.

On Sapuleni's best days, she makes about 100 Kwacha (sixty six cents).

With a day's wages, she can sometimes purchase one or two cups of milled corn flour for "Nsima," the primary source of food for her family.

Sapuleni has no brothers and no sisters. Her father passed away years ago. Her mother, who is about sixty years old, lives nearby in a small mud hut with a thatch roof.

So, there is no extended family to offer support.

Sapuleni's older children split their time between work and school.

They too make meager wages for simple manual labor.

As you may guess, it is difficult for Sapuleni to support her children in school.

Much like many other regions of Africa, Asia, and South America, there are requirements for uniforms and other fees in Malawi's public schools.

In some local classrooms there are over one hundred students - quite a student to teacher ratio.

Almost all teachers in rural Malawi are poorly paid and overworked. As a result, these professionals are sometimes far from sympathetic toward children who cannot meet basic requirements.

It is difficult to keep the poorest of the poor in school.

Quite often, Sapuleni's oldest son is thrown out of classes because he has no funds for simple class fees and no uniform. The fact that he needs to leave school early to work on many weekdays creates further challenges. Yet, Sapuleni continues to push hard for his education for all of her children. She believes this is essential for their future. Her oldest child, who is eighteen years old, currently attends second grade. He had to drop out and then re-enter school during the last year.

Poverty has a way of cycling deeper and deeper.

Sapuleni cannot afford fertilizer. She was not able to get a government voucher. So, her corn crop from the small plot of land around her house is weak and fragile.

I asked Sapuleni what her current feelings are about a large family.

She spoke about her love for her husband and all of her children and the evolving flow of life. She mentioned her experience with family planning. Through her years as a child and young adult, she never had any education in this area or understanding of this concept.

She wanted to be part of a large family.

She did not anticipate life would be so hard.

In Malawi, a large family is generally a source of wealth, blessing, and pride.

Unfortunately, the rest of her village is not in a position to offer support.

Each year, Sapuleni needs more and more food to support her growing children.

Through all her experience, even the rough moments, Sapuleni continues to have faith in God. She spoke about her beliefs and her hope that all will evolve in a positive way.

In may respects, Sapuleni's heart is tied to her children.

When she spoke about her dreams, her words were focused on their future.

Education is her main goal.

She described the importance of each child learning to read - a skill she never developed. At this point in time, only one of her children can read and write.

She spoke about the possibility of her children gaining employment. She yearns for this.

In a full year, Sapuleni's income is often only $30 to $50. Think about this. Her annual income is roughly equivalent to the cost of one dinner for one person at a restaurant in the United States.

Sapuleni allowed me to sit and witness her daily life. I encouraged her to act as though I was not present.

I filmed her making corn stew, cooking tiny fish, gathering corn, feeding her family, cleaning her house, and interacting with her children.

When I entered her home in the middle of the day, it was dark. Two small windows provided the only light. Within the brick walls, I found a barren slab of mud that serves as Sapuleni's floor, a few extra pieces of clothing, an old, broken, plastic radio that was dusty and tied with a cord, a few worn pots, several mosquito nets used as a shelf and a hammock, a wooden board that looked much like a old, abandoned door, and a small swarm of unidentified flying insects.

Outside of one worn, wooden chair, Sapuleni has no furniture of any kind. There is no bed and no kitchen in her home - she cooks outside on a small wooden fire in a thatch hut.

My experience with Sapuleni at her home provided an intimate "brush" with poverty.

She graciously provided an opportunity for me to see how she lived and how she cared for nine children with little material resources.

Sapuleni's life is truly tough. Yet, through our time together, Sapuleni expressed warmth, hope, and a sense of resiliency.

I never sensed any remote sense of blame toward others. Nor did I ever feel she held onto the experience of a "victim." She seemed calm and "present."

She seems to work her way through each day, one day at a time.

It is hard for me to imagine the uncertainty she must live with.

It is fortunate her faith is so strong.

As we left our time with Sapuleni our little team of travelers provided several gifts, bundles of beans, corn flour, sugar, and soap - all cherished and graciously accepted.

As we drove down a long dirt path near her village, many questions flowed through my heart and head.

How might we transform Sapuleni's family's trajectory?

I searched for a way to uplift her experience and create some form of sustainable income.

Is there a way to use a "micro loan," a gift, an investment in inventory or equipment to allow her and her family to transcend current circumstances? How might we allow her to grow more food or produce greater income?

I wondered if there are creative and cost effective solutions that can impact her entire village.

Ideas flowed.

We could purchase a hundred small "chicks" for about fifty dollars. But, how would she feed and protect these little birds? Between the wild dogs and other predators as well as a village of hungry people, it is unlikely this idea can work as well as planned.

We could create a maize mill in her village. This would be valued, but expensive and inefficient given the small number of families nearby.

Fertilizer? Even a single bag would make an extreme difference.

Cloth for hand made products? She would need to learn to sew. Who would her customers be? How would her goods make it to market? Wouldn't this continue her cycle of depency on poorly paid hourly labor?

We might provide funds for inventory to start a small vegetable stand on the main path near her village. Would any food and funding support just be consumed?

We don't have a solution yet, but we are trying to find a promising path that Sapuleni wishes to pursue. We want to drive our engagement from her needs and aspirations. We may involve the chief of her village in this pursuit.

A charismatic and engaged nurse, Rosemarie, who came with me to the village for my visit was moved by Sapuleni's story. She is serving as a local "bridge."

We raised a small amount of money. We plan to explore a range of alternatives. There is a bit of hope.

Sapuleni's story is the story of thousands of mothers in Malawi.

There are no easy solutions to the experience of extreme poverty and hunger.

I recognize that sustainable change for Sapuleni's family is just a "drop in the bucket" for this country's and this continent's needs.

Yet, I don't know where else to start. So often, when we wish to impact large human issues, it requires starting at an intimate level. In many cases, we can not get "there," to a new future, unless we build up the broken pieces of our existing, fragile foundation.

We can toss food and other short-term resources into this crisis. And, we may be able to create powerful healing - much like the outcomes of Project Peanut Butter. At the same time, it seems essential to enable truly sustainable change that comes from within Sapuleni's own home and community.

I am not at all sure how to achieve this. I can see problems with so, so many alternatives.

Almost all of the forty to fifty families who live near Sapuleni share her poverty and food shortage. Working through logistics and potential curruption, cultural challenges, training issue, potential jealousy and equity issues from other village members and related parties, and other concners will all play a part in determining if any support for Sapuleni can be successful in the long term.

Clearly, positive, long-term solutions for this community may involve a combination of many changes - micro loans, small businesses, improved farming and crop yields, more accessible and more effective education, infrastructure investments, technology, and improved family planning are all needed.

It is fascinating to reflect on what people who live in extreme poverty say when you ask a simple question :

"What change will bring the most benefit to your life?"

The four answers I hear most often here in Malawi are: roads, education, fertilizer, and employment.

Ok. There are few individuals who go straight for the"gusto." They simply answer "money."

Yes. Wealth, happiness, and prosperity are defined and achieved in many ways.

Despite Sapuleni's lack of material resources, she has many valuable assets.

My hope?

That the future brings brighter days to her doorstep.

Fish Tales ...

2009-03-12T10:30:00.001-07:00

A story from Africa's creative spirit ...

A number of lakes and large rivers exist in Malawi.

Many people travel long distances by foot, bicycle, car, or minibus (a type of cheap, shared taxi) to pursue fish - a luxury and desired source of protein.

Nets and lines are used.

Let's just say the "bait" may be unique and colorful.

Sometimes, a quantity of fresh fish are caught and gathered in a bucket or basket.

The big challenge?

How can one get pounds of raw seafood home in the middle of day with high African heat and long distances to travel?

I am told fresh fish will spoil in just a few hours in Malawi if the fish are bundled up in a car or carried in a basket or bucket. The heat and muggy air will prevail.

Some of you may suggest an ice box as a solution.

Great idea. The only problem? Ice is rare and expensive to generate.

We need a quick, simple, low cost solution, a solution that does not require planning and equipment.

A ways back in time, an African somewhere on this vast continent discovered an elegant alternative to the modern ice box.

This solution involves a vehicle of some kind.

The slightly wealthier traveler, the fisherman with enough "coin" to jump in a mini-bus or the good fortune to be successful as a hitch hiker, may strap his/her "catch" to the mirror outside of the vehicle with a rope through the gill and mouth of each fish.

Then, when the vehicle moves along the dirt and paved roads, moisture from the fresh fish evaporates. And, due to the magic of physics, this evaporation causes cooling.

The faster the speed, the faster the evaporation and the greater the "cooling effect."

In this way, fish can be left, without ice or other sources of preservation, for hours in the deep heat of the day as the vehicle drives from an area near the lakes and rivers to the fisherman's home.

Yes, this approach also creates nutritional benefits - the addition of essential vitamins CO2 and road grit. Fortified fish.

When the fisherman arrives home, the need to scale, clean, and boil or fry the fish is immediate.

I am told, when consumed, "roadside preserved fish" maintains a new and slightly "altered" flavor.

It is clear the hygiene around this process may involve a certain degree of compromise. Yet, the fish make it home without spoiling. Clever.

As they say, "Necessity is the mother and father and grandparent of innovation!"

Ester's Path ...

2009-03-10T10:56:00.000-07:00

Just before we met, Olive Menyani and her daughter, Ester, walked three hours in morning darkness to arrive at a nutritional clinic in the village of "Mbiza."

Ester is now ten months old.

Unfortunately, her health is compromised by a number of illnesses.

To complicate her life further, like so many families in this area of Malawi, there is little food currently available within her home.

In this case, Chiponde is positively impacting Ester's condition. Yet, she has a rough path ahead.

The hope is to help Ester get through the next month and into the "harvest season." With food and medical support, the Project Peanut Butter team hopes Ester will recover and grow toward normal height and weight.

When I look at this image, it reminds me of my experience on that morning.

There is something in Ester's eyes that held my attention, tore at my heart.

Perhaps, it is vulnerability, a fragile sense of trust, a sense of openness, or the feeling hope that only a young child can express in such pure form.

Soles That Travel Well ...

2009-03-10T10:54:00.000-07:00

Bare feet and long, rock filled trails dominate rural Malawi.

Now, imagine if you spent the first thirty five years of your life walking without shoes on hot, uneven dirt.

You too might develop toes that spread widely and travel boldly.

This mother's youngest child is enrolled in Project Peanut Butter's nutrition program.

This image was produced as she paused on her long walk back to her village.

As I looked through my lens, I wondered about the many stories attached to the soles of her well-worn feet.

These ten toes look as though they "evolved" in form and function, through many colorful experiences, through many years!

Chief Waisoni Injesi ...

2009-03-09T12:56:00.000-07:00

We met on a hot Sunday afternoon.

I came to ask Chief Waisoni Injesi for permission to allow me into his village.

As an "Azungu" (white person), it is not appropriate for me to arrive unannounced in a remote African community ... especially with strange equipment and lots of intimate questions.

First, there were formal introductions and meet-the-chief protocol - I learned to shake a chief's hand with reverence, bow from the waist, and ensure my head is lower than the "mighty" chief's head. Ok. I am embellishing a touch.

I came with a local health care worker and a nurse who works in our program. This provided a link to the Chief's world and a means for me to communicate in the chief's language. We sat for about an hour in conversation.

Chief Waisoni Injesi is quite skilled at nodding and prodding and responding.

There were many "Mmmmms" and "Ohooooos."

It took about thirty minutes for me to feel confident that we were on a positive track.

This picture was taken at the end of our time together.

The chief sits in this portrait with one of his wives. That's his daughter and grandchild in the background.

For me, the chief's face and eyes reflect a sense of thoughtful calmness.

He spoke about the way he leads - apparently, he handles crisis and joy with a sense of consistent, stable, strong emotional perspective.

He said he does not receive gifts or any form of taxes and other forced payments from the families in his village.

Chief Injesi is responsible for forty five households near his home.

He became chief for this community thirty six years ago.

He does not know his age.

Turns out, he has two wives. Each wife lives in a different home.

From what I can tell, the chief shuttles back in forth between each wife to ensure diplomacy and balanced leadership is available across his village. Smile.

Through his eyes, despite the progress in many areas of Malawi, it is much more difficult to live today than it was when he first became chief.

There are more people to feed with the same amount of land. This chief's land is sandy and less fertile than many other areas of Malawi.

Of great importance, over the last several years, the chief has not been able to procure government vouchers for discounted fertilizer.

He said that this is the single most important goal he has at this time - to gain access to modern fertilizer.

Chief Waisoni Injesi said almost all of his village is starving during this year's "hunger season."

Even his own family desperately needs food - one of his own children is using "Chiponde."

This chief never went to school. He said that some children in his village are able to attend school. Other children are not able to go to school because their families have no funds for uniforms and other supplies and/or the children are needed to work in the home and in the fields.

A few years back, the chief tried to establish a community garden, a source of mutual support. He hoped to diminish the village food insecurity. Unfortunately, this did not work. Crops never grew effectively. In this case, much like the many existing gardens of corn and tobacco near village homes, fertilizer was too expensive to afford.

Despite all the challenges in chief Injesi's village, he was open, positive, and warm.

He laughed very hard when I gave him my camera to take pictures of his family. His hand shook and his face became very serious as he attempted to work this modern gadget.

He laughed again with great enthusiasm when I started to play with the three dozen children who gathered just outside the chief's gate while we, the "Azungus" (white people), were working through our introduction and request.

In the end, we were granted the chief's full permission to work within his village.

I spent most of a day with an inspirational, single mom named "Sapuleni," who has nine children.

The chief knew her situation and wished her well.

Beauty And The Mud Hut ...

2009-03-09T12:53:00.000-07:00

At times, the vivid colors of African fabric and the expressive curves and of an African woman's body seem eternal, especially in warm afternoon light.

I meet this woman, Margret Chitsulo, a few days ago at her home.

She has four children, two boys and two girls.

She and her husband, who works as a fisherman at a nearby lake, are quite poor.

At this time of year, her family is often without food for days at a time. When resources allow, she feeds her children bits of corn, millet, rice, and fish.

Yet, her spirit is bright.

She did not go to school. Her mother and father did not go to school. She is pushing hard for her children to complete a basic education. Her greatest wish is to see her children complete school and start into jobs far from the village where she lives. She wants her kids to have a life much different than her life, a life without so much hunger and struggle.

She spent about an hour sharing the details of her home and the activities of her "everyday" afternoon.

Tribal Medicine Rattles And Rocks ...

2009-03-09T12:50:00.000-07:00

Around noon, in the full heat of the day, I met Fanny Chikopa and her youngest child, Mphatso, in a small village near Chickweo.

Fanny has four children.

Each day, her husband walks for several hours to a nearby lake and works as a fisherman. When all goes well, he catches "chambo" and "matemba."

Unfortunately, at the end of the day his nets are often empty.

To help support the family, Fanny tends a small garden of corn and pumpkins near her brick and mud home.

During hunger season, like so many other families in their village, Fanny has little food to feed her children.

Fanny spoke about the challenge of making it through January, February, and March each year.

Poverty and hunger are not a new experience for Fanny. She has five brothers and four sisters. Quite typical for Malawi. Her parents and her siblings live in the same village.

You may note the charm on Mphatso's neck.

There is a story behind this piece of powerful jewelry.

A tribal "healer" made this necklace for Mhpatso to overcome sickness at a young age.

When Mphatso was eight months old, he was very sick. His eyes were infected and he struggled to maintain general health.

At first, Fanny took her son to the local, rural hospital. Unfortunately, after weeks of treatment, he did not get well with traditional, western, "allopathic" medicine.

So, Fanny took Mphatso to see a tribal doctor to gather a "second opinion."

The local traditional "healer" assessed Mphatso's illness and informed Fanny that "the bones in her son's head were not united." The "healer" then told Fanny that Mphatso's head would grow large if he was not treated with special herbs.

Fanny paid a fee of 50 Kwacha (33 cents) and the "healer" mixed a special potion of herbs.

The "healer" then wrapped the herbs in cloth and tied thread around the "medicine" - the necklace shown in the picture.

Mphatso has been wearing this "medicine" for four months.

Fanny said that Mphatso has ten more months of treatment to finish his therapy.

Apparently, ever since the necklace was put in place, Mphatso's eyes improved and his health changed dramatically.

Fanny is convinced that the traditional medicine led to Mphatso's recovery.

Who knows? From my vantage point, this may be true.

Faith and momentum in one's beliefs are powerful tools.

In a few months, Mhpatso, which translates as "gift" in english, will walk about in a colorful, difficult world.

Harvest will bring plenty of corn and vegetables for the early months of the Spring and Summer, yet the annual hunger cycle and challenges associated with extreme poverty will likely continue.

Mphatso's early path has been touched by both the old and the new.

Yet, his future is filled with uncertainty.

How Malawi will change? My guess? Slowly.

How will his village evolve? It depends. Roads and infrastructure can transform a region in a few years, but the resources to create these changes are not readily available. The tribal chiefs I met with indicated it is harder now than it was years ago for families across the region.

Will there be a solution to food shortages and extreme poverty that is sustainable and effective? This is complex. No one has a viable and proven path at this time.

It may take several generations before electricity and clean water are widely available near Mphatso's home.

One thing is clear. Mphatso needs both traditional and modern faith, a deeper education than his parents and grand parents, and new opportunities to thrive.

Chief Mphatso Mati Mati ...

2009-03-09T12:46:00.000-07:00

Chief Mphatso Mati Mati, which means "Gift Tomato" in English, agreed to meet with me a few days ago.

You may note his regal "flip flops."

Yes. He recognized I am a very, very important visitor.

Chief Mphatso Mati Mati leads 1,600 families in a area near "Chipolonga."

As an "Azungo," I sought his permission to visit three families within a nearby village.

The blue bag near his feet is the "offering" I brought for our meeting - beans, soap, corn flour, and sugar.

After a long introduction and explanation of our work by the nurse and translator who traveled with me, the chief and I held a warm conversation.

It turns out, Chief Mphatso has been "chief" for fifteen years.

He was appointed at age twenty one years old to his current role by the village community. Apparently, he had the "right stuff."

Despite options to expand his marriage options, the chief has just one wife and seven children.

He spoke about how he leads. He uses old school tools such as messengers and town hall meetings to communicate with his constituency. He spoke about poverty and conflict. He spoke about crops and harvest.

The thatch structure on the left side of the image above is his own drying hut for tobacco. Few individuals in Malawi smoke, but tobacco is known as a sturdy crop that produces cash.

The brick and mud structure behind him is his home.

Fortunately, he knew about Chiponde.

During our conversation, he reflected on the ongoing work the non profit group I am associated with completed over the last few years. He assessed our small caravan. He listened and asked a few hard questions.

Then, with a nod and a light smile, he granted me access to his village.

Off we went ...

In The Early Morning Light ...

2009-03-06T13:07:00.000-08:00

As mentioned in earlier posts, each weekday during "Hunger Season," which stretches from November through April each year in Malawi, hundreds of mothers and children from dozens of rural villages in central and southern Malawi gather in the early morning light to attend a once a week, or in some areas, every-other-week nutrition clinic.

By 6:00 AM, informal lines and small discussion clusters form as mothers and children await the arrival of the Project's team of nurses, student doctors, and volunteers.

Despite what may be a long, long walk, often in the dark, typically with bare feet across uneven, rocky trails and rough dirt paths, young, middle age, and older women come together with a common emotion - hope.

The rich emotions in the eyes and faces of many mothers linger in my memory.

There is strength and purpose in their spirit.

They often express a sense of quiet kindness, an openness, and a depth of patience that generally eludes our daily experience in "more developed" regions of world.

Calm Within The Storm ...

2009-03-06T13:05:00.000-08:00

I remember the feel of this moment.

Hundreds of mothers gathered early at a "Chickweo," a rural clinic site to receive testing and consultation for their children.

Rain fell softly in the courtyard. Children were crying. The village was just lifting into the full motion of the day. Yet, the scene felt calm almost surreal.

I slipped between two tightly packed lines of Moms and faced toward the front of the colorful procession to produce this picture, a memory from this busy day.

You may note the health cards on the dirt which are used to mark each mother's place in line.

One mother did not have a card. Her spot is marked with a rock.

Bare feet, umbrellas, loose cloth bags, and brightly colored cloth ("Chitenjes"), fill my view.

Patience And Hope ...

2009-03-06T13:03:00.000-08:00

This image was produced a few days ago at Chickweo, a small village about three hours from Blantyre, the home base for Project Peanut Butter.

For several years, Project Peanut Butter served this site once every two weeks.

Yes. If we had an "audio" button, and you hit "play," you would hear dozens of children screaming and crying at high volume. The atmosphere can feel quite frenetic.

Yet, there is a simple flow and a natural calmness at this clinic.

Mothers and other caretakers seem to exhibit great patience, perhaps this skill is nurtured by their everyday life experience. Long lines, long walks, bad weather, and unpredictable health and economic circumstances may bring a certain calm to one's path.

The medial team's commitment to serve every mother and every child "in need" with an assessment and to provide every qualified child (a child in crisis) with RUTF (Ready To Use Food) may also contribute to the character of this site and other sites.

It may take two to six hours for a mother and child to receive care and, if appropriate, to receive therapeutic food, but everyone is served.

Moms wait patiently with a sense of hope. They wait without a sense of scarcity that enters other moments in their lives.

Reaching Toward Harvest ...

2009-03-06T13:01:00.000-08:00

In the image above, a young girl sits on a pile of freshly picked "maize" (corn).

Her brothers and sisters are gathered around her - everyone is involved in pulling the kernels from the husk of the corn and celebrating the start of an early harvest.

At this time of the year, corn is just starting to finish the critical growing season.

After the kernels are pulled from the husk, the corn is dried.

Then, the dried corn is taken to a corn mill.

After the family pays a fee based on the weight of the corn, the kernels are turned into flour.

Much like many other regions of the world, such as central and south America, one can hear local corn mills grinding hundreds of kilograms of flour early in the morning.

The corn flour is then used as the center piece of most meals.

In southern Africa, typically, twice a day, this corn flour is mixed with water and vegetables to create Nsima (corn stew).

A quick side note ...

In areas such as central and south America, corn flour is used for tortillas and other traditional foods. With beans and rice, this often produces a nutritionally rich and balanced diet.

In America, we use corn in a central role as well. Most of our cows and chickens are fed corn. Corn flour is used in a tremendous variety of foods. Corn oil is used to fry foods and as an additive in many products. The feature role for corn in America is even larger. We also use corn syrup as one of the dominant ways to sweeten our food and our omnipresent processed beverages. When you drink a Coke or a Pepsi, you are drinking processed corn.

Our diet, unfortunately, is not typically so "balanced" or nutritious. Thus, many medical professionals and policy makers argue we produce a escalating crisis with diabetes, heart, and other illnesses.

We tell ourselves, we are "sophisticated" and modern, yet we continue to pursue some unhealthy paths with vigor! The power of our commercial engine is strong.

Back to Malawi ...

Each year, this country moves through a common cycle.

During most months, the weather is hot and the ground is dry and parched.

From November through about March or April, the country receives rain. Some years, there is a great quantity of rain and water for crops. Other years, there is drought.

Over 80% of the population survives as subsistence farmers.

By far, corn is the dominant crop.

Tobacco and a range of vegetables fill in the agricultural mix.

Fertilizer is of tremendous importance. Without this rich addition to the dry soil, many "gardens" produce a tiny yield. Thus, farmers throughout the country seek access to this resource.

I am told a single 50 Kg bag of fertilizer, if used sparingly, will provide support for a garden that is roughly two hectors in size. As a geeky side note, a hector is about 2.5 acres or roughly 108,000 square feet.

The government provides subsidized packages to a portion of the poor population - a 50 KG bag of high quality fertilizer that sells for 10,000 Kwacha in a store (about $60) is sold by the government to individuals with a "voucher" for 800 Kwacha (just over $5). Big advantage. Big opportunity for discriminatory practices and for corruption. As one would guess, vouchers are difficult to get, even for very poor families in desperate need of help.

In the villages, families control the use of land that is passed down from one generation to the next generation. I am told a village chief may provide additional land to a needy family.

In the countryside, almost every bit of visible land is used to produce corn. When the soil is weak and parched, the corn grows to a small height. These plants are often light green or yellow and brown. When the soil is enriched with fertilizer and there is a healthy amount of rain, the corn grows much taller, sometimes to eight or ten feet, and holds a rich, dark green color.

When we drive into the countryside it is quite common to see on "garden" with very robust corn then a garden a few hundred yards away with fragile, lightly leafed, dry, and poor growing corn. One family has access to fertilizer. The other family is trying to grow corn without support.

There is an entire art to the number and type of seeds used in the fields at the start of the growing season.

While the single crop of corn is growing, many families run out of food from the harvest in the previous year. This is the source of the "hunger season."

Thus, there is a strange contrast. One sees lush, green vegetation throughout the country during December, January, February, and March, yet there are massive food shortages.

During these critical and stressful months, everyone is waiting for the corn to grow to its fullness.

The baby in the picture lives in Mbeza, a small, poor village in southern Malawi.

She is sitting on her family's first production of corn for this year.

For her family, relief from the experience of hunger is in sight. Most other families throughout the central and southern regions of Malawi have not started the harvest yet. Hunger is still in full "swing."

Merchant Of Light ...

2009-03-06T13:00:00.000-08:00

Just after the sun dropped beyond the horizon, our four wheel drive vehicle rolled slowly down a hill on a rocky path toward a small village named "Namindangi."

We stopped near a group of wooden shacks and small concrete structures.

Dozens of children ran from their homes to gather near the side of our dusty car.

Along the dirt path to our left, several older women wearing colorful clothing presented neatly organized piles of green, white, and orange pumpkins and bright red tomatoes for sale.

For just a few precious dollars, a visitor could purchase tens of pounds of food.

Further ahead, in an open area near the center of the village, a merchant named "Casim" called for our attention.

Here, we found a source of light.

"Casim," at thirty-three-years old, is a colorful salesman of "paraffin." He packages his beloved "paraffin" in small plastic sleeves and sells "bundles" of product in two different sizes.

Small bundles are 10 Kwacha (6 cents). Large bundles are 20 Kwacha (12 cents).

What are these carefully displayed packages of "paraffin" for?

None of the homes in the village have electricity.

So, basic utilities such as lights and refrigerators are not an option.

When the sun goes down, the village is very dark. Often, wood burning fires produce the only light.

Many homes are made of thick mud walls without windows.

If villagers can afford the luxury, small candles and rustic paraffin lamps are sometimes used as a source of light just before bed.

In countries such as the United States, we assume power and light should be available at all times. Take our power away for an hour or two and we move into a frenetic, confused, emotionally charged, demanding state. We are outraged.

In a rural areas within Africa and other regions of the world, access to electricity and light are special gifts.

For "Casim," the need for light offers an attractive business opportunity. The money he makes selling paraffin complements his only other source of income - a major endorsement deal with Nike. Note the proud display of the globally omnipresent "swoosh." Smile.

A Fashion Statement : Malawi Style ...

2009-03-06T12:57:00.000-08:00

Women in the rural areas often have little in terms of material resources, yet they find a way to present beauty and individuality through a hundred small personal touches each day.

Even little children in torn rags evoke this impression.

Babies are dressed and wrapped in cloth that often matches with a mother's outfit. Even the young children seem able to clap in unison with melodic chants and songs. Five and six year old girls sing with voices that are light, elevated, "in tune."

If one looks beyond poverty and stress of daily life, one finds warmth and richness.

As a photographer and filmmaker, I am often swept away with the color, motion, and sense of beauty African women and children bring to life.

If I wish to create deep laughter among a large group of African moms, I just need to provide a few steps of bouncy motion while they are in the midst of a morning celebration.

Fortunately, my camera is focused away from my own pale, sweaty, fashion statements and my not-so-finely-tuned capacity to sing and dance. I can use some consultation!

Shared Spirit ...

2009-03-06T12:55:00.000-08:00

The swirl of motion and color continues ...

An Albino's Journey ...

2009-03-06T12:52:00.000-08:00

Last week, I met a young boy, Ikra Jailos, the "albino" child shown in the picture above.

Beatrice, Ikra's mother, is shown in the background.

Ikra is squinting due to his extreme discomfort with bright sunlight - a common experience for an "albino."

Ikra's father is also black.

Try to imagine Ikra's life experience both today and in the future.

He is now two years eight months old.

As he grows older, he will face the world surrounded by brothers and sisters, extended family members, and a village full of families who hold a common and powerful difference - the color of their skin.

It's one thing to be a white child in a white family in a black world or a black child in a black family in a white world.

Imagine being a white skinned child in a black family in a poor black village in rural Malawi.

How will Ikra be treated?

His skin tone will make it very difficult. His peers and family spend almost all of their waking hours in the hot, African sun. There are many challenging cultural stigmas and spiritual beliefs around Albino's in Africa. Different tribes view this skin condition in very different ways

Stories exist from Tanzania and other areas of tribal healers ascribing special powers to an albino's body parts. This, of course, can lead to bad outcomes.

In Malawi, Ikra is likely to feel a sense of separation and discrimination that few of us can fathom.

Perhaps, an African American in a white neighborhood with racist tendencies in America may feel some of the same emotions. I want to believe that our community in the United States has moved well past this, but I recognize our fear and our ability to inflict silent and visible pain continues. As a global community, we are not great at seeing past the color of another person's skin, especially when this individual's skin color is different than our own. It is hard to be conscious of all the ways we discriminate, the emotion and history we attach to our view of skin color.

In this case, Ikra has the same parents as his brothers an sisters, yet he is vastly "different." I want to believe he can be accepted and embraced as fully as his siblings, but I know this is difficult.

When I met Ikra, I was reminded of a conversation with a good friend about ten years ago. We were in the midst of idealistic pondering. I asked him how he would change the world if he had just one wish. He said he would create a new condition for all human beings. He proposed that on January 1st of each new year, each of us agree to wake up with randomly modified skin color and, if we were not married, accept the possibility of a shift in sexual orientation.

This one change in our lives, he argued, would not transform any aspect of our personality or our inner spirit, but it would radically impact predujuce and the pain of discrimination. Wow. This would, I admit, be powerful medicine.

Until we are able to feel empathy, to walk in another man's shoes (or skin), it is hard to come together as a global, national, or local community. We tend to act as though we are radically different, unlike each other. Yet, in many ways, at the core, we all seem to share more than we differ.

Ikra faces a tough path.

Unfortunately, in addition to his skin tone and the other complications of being born as an "albino," Ikra's family is very poor.

As a result, Ikra's parents has little food to feed their children.

Yes. Poverty and malnutrition are color blind.

A month and a half before this picture was taken, Ikra exhibited the symptoms of severe acute malnutrition. He was in the midst of crisis. Without treatment, he was likely to die.

Fortunately, he is recovering on a promising path. Over the last six weeks, through the use of "Chiponde," Ikra gained close to four pounds.

Now, Ikra's footsteps into the world continue.

I hope for the best.

Belly Signals ...

2009-03-06T12:48:00.000-08:00

In rural areas of Malawi and other regions of the world with extreme poverty, children often exhibit swollen and extended areas of their body that stand in strong contrast to their lack of access to food and thin body frame.

This young girl presents a typical case. Her name is Violet White.

She is two years and eight months old.

As you can see, her ribs are visible. Yet, she holds many signs of malnutrition and her mid section is quite full and puffy.

She receives treatment at a temporary health care site named "Chamba."

I met Violet under a large mango tree near several tables and bench that are used as a outdoor medical office.

Nurses and two doctors from Project Peanut Butter arrive once a week at the same time, on the same day of the week to offer support.

Village health care workers from ten to fifteen miles away are paid a stipend to encourage children in crisis to travel to this location. These village health care workers (HSAs) maintain active contact in almost all villages across the country side.

During "Hunger Season," hundreds of mothers and children walk for hours with their young children to attend each clinic.

For the last three months, Violet's mother, Magret, received "Chiponde" to use as medicine for Violet's moderate malnutrition.

Fortunately, Violet appears to be recovering, but her progress is slow.

In this case, Violet's stomach area appears to be swollen by a number of health factors.

Parasites may be part of the story. In many rural villages, clean water is a challenge. Food is often stored in less than ideal circumstances. As you might guess, broad education about health and hygene is still a "work in progress."

For Violet, a recent severe case of Malaria may have caused the spleen and other organs to swell, which extends the stomach and groin.

Sometimes, when a child's body is very weak, their muscles lose the capacity to tightly hold the organs within the chest and stomach area. One of the doctors feels Violet may suffer from this challenge as well.

In a few weeks to a month, the annual harvest will take place throughout Malawi. This will be a promising transition for Violet. Food will suddenly be more prevalent.

With further medical care, improved nutrition, and good fortune, her health holds promise.

From my short time with her, I sensed both sadness and hope. It is encouraging to imagine her as an energetic and vibrant little girl.

This is a future to wish for.

Only In Africa ...

2009-03-03T13:01:00.001-08:00

The slightly broken, wooden structure in the foreground of this picture is an old door.

This door had a second life, a history that is difficult to fathom. It was used as a bed, a bed with a special purpose.

This picture was taken yesterday near a rural health clinic in southern Malawi. The nearest hospital is about ten miles away. Few families have any form of transportation outside of their bare feet. A few families own bicycles. Occasionally, a car drives by on the nearby dirt road. Food is scarce. Poverty is extreme.

Unfortunately, in this part of the world, health issues are serious and systemic.

Right now, in addition to Malaria, TB, and HIV, there is a major outbreak of Cholera in nearby villages.

Cholera, as you may know, is a nasty infection.

Many people with Cholera die in several days from dehydration.

Rural health care workers use this old door as a bed for Cholera patients.

You may note the hole in the middle of the wooden structure.

This hole is positioned in an appropriate place for the patient, an African solution to the need to measure all of the fluids that are lost with massive, constant diarrhea.

Through every hour during the heart of the infection, rural health care workers attempt to provide an equal amount of fluid back into a Cholera patient's body as the amount of fluid the patient loses through diarrhea through an IV (assuming a needle and appropriate fluids are available).

Imagine laying on this hard, wooden door in a dark, isolated building. Not a comfortable thought.

The building in the background currently houses Cholera patients. This small building is "off limits" to anyone outside of cholera patients and a small group of village health care staff.

These government workers are paid about $50 a month to serve the rural areas. They have light training in vaccinations and basic health issues.

Despite all of the challenges with modern medicine, it's moments like these that make one grateful for both the quality and availability health care in many regions of the world.

In Africa, you make the very best out of what you have.

Impressions That Linger ...

2009-03-03T12:58:00.000-08:00

Each night as I fall asleep, a tapestry of young faces and moving expressions flow through my thoughts.

Here are a few visual moments from today's clinic.

Joy, uncertainty, hope, pain, and calmness are all found in the eyes of children in crisis.

Despite their deep hunger, these kids hold a special gift - their mother's love.

A Flow Of Color, A Lasting Embrace ...

2009-03-03T12:54:00.000-08:00

One of the many memories I hold from my time in Malawi is a strong, positive impression of young children comforted by the embrace of their mother or older sister.

It is rare to see a young child under the age of three who is not tightly bound and supported with human touch.

There is great power in this cultural norm.

In this region of the world, kids must feel a deep and lasting sense of intimacy and connection that is quite different than a child's experience in cultures where children are more often separated from their mother and spend many more hours without this closeness.

In this picture, you see a mother and three children moving in typical form - one child on Mom's back, one child in older sister's arms.

Young girls learn early in life to partner with their mothers.

Two African Scorpions And A Bucket Of Rain ...

2009-03-03T10:40:00.000-08:00

Monday was crazy, long, wild, colorful, memorable.

Up at 4:30 AM. Quick breakfast and early morning organization. Left for "Nkhate Market," a rural clinic in Southern Malawi, about 5:30 AM.

It started to rain about 7:00 AM. By 8:30 AM, it was pouring. Then, it poured some more.

Light brown, clay-like, dirt roads turned to soft, dark mud.

Water began to pool up everywhere.

We moved the clinic from an outdoor area under a large tree to a small concrete and brick structure that serves as classroom part of the week and a health clinic part of the week.

Our normal location is currently being used as a cholera isolation area. Not a comfortable "zone" for us to work in.

In the first several hours of our clinic, about four hundred mothers came to "present" their children.

The image above was produced in the mid-section of the morning.

As you can see, women are packed into a small, dark room.

It is very, very muggy, hot, and uncomfortable inside.

Babies are wrapped on women's backs or held tightly by the hand as mothers push to move forward in line.

Breasts are exposed everywhere to support infant feeding.

Many mothers left home early in the morning.

Some mothers walked for over four hours to arrive at this location.

Hundreds of children cry continually.

Some women sing and chat with their friends.

Every mother seeks attention and an assurance that their child is safe.

The doctors and nurses work continuously for five to seven hours.

Hunger Season is now in full form.

Unfortunately, many of the children who arrived at this clinic were extremely thin and "wasted" or swollen with edema.

In most cases, there is absolutely no food in a mother's home. The mothers of these sick children are doing the best they can.

Twice, we had to stop the clinic suddenly.

Both times, a large, dark red, African scorpion appeared on the wall above the doctor's head.

Not a nice surprise.

We were told these frightening creatures are quite poisonous.

One was about eight inches long and the other was about ten inches long. Each scorpion had about forty black legs moving in rapid fire.

I am not sure how the scorpions grew so big or learned to move so fast. Perhaps, they had a secret supply of "Chiponde" hidden somewhere near the roof.

Each time a scorpion appeared, one of the male staff members removed his right shoe and had a rather violent conversation with our intruder. That was that. Not pretty.

At the end of a long clinic, I began a series of follow up interviews with three children I met during my first trip to Malawi. Rough.

One child encountered a bad case of cerebral malaria and lost weight during the first two weeks after the "Chiponde" treatment began. This child's health is now greatly improved, but the arc of his therapy with "Chiponde" will take longer than a typical case.

A second child recovered from edema and severe malnutrition and gained about a kilogram of weight since my last visit, but now suffers from what the doctor believes to be TB. He had a cough that sounded terrible. His father is TB positive.

The third child encountered a severe bout of diarrhea from some type of infection a few days after starting "Chiponde" treatment. Here too, there was great improvement, but the path was bumpy.

We spent about three hours attempting to locate one of these children in his village. One must get comfortable with patience in Africa.

We traveled to the hospital. We drove all over the country-side.

As we left to travel home, the fog rolled in. Very thick. Very damp.

After all the rain, several river crossings were almost beyond our reach.

We returned to our apartment around 7:30PM.

The medical students and other project staff had several hours of additional work to prepare for the next day.

I went off to download and archive images and video from the day, reformat my storage drives, and recharge my video and still camera batteries.

I scarfed a plate of rice and beans and took a quick shower.

Late night. Early wake up call the next day.

This trip is just starting to roll.

The Little Kitchen That Whispers and Roars ...

2009-03-01T12:11:00.001-08:00

What's with the bunny suits?

All in the service of ensuring clean, high quality food production, Malawi style!

Many of you ask :

Where does the nutritional paste, Malawi's magic "Chiponde," a rich mixture of roasted peanuts, milk powder, vegetable oil, sugar, vitamins, and minerals, come from?

About five years ago, after experimenting with the European production of "Chiponde" (also known as "Plumpy Nut"), Project Peanut Butter's team created a small, local plant within Blantyre, Malawi.

USAID donated a major portion of the equipment.

A portion of an old shoe factory was leased and converted to serve as a new manufacturing plant.

A talented plant manager from Malawi was recruited.

About eighteen staff were hired.

A new stage of Project Peanut Butter began.

Today, most raw materials for "Chiponde" are sourced right in Malawi.

High quality milk powder, vitamins, and minerals are the only components of "Chiponde" sourced from Europe.

In all fourteen clinics where Project Peanut Butter's nurses, doctors, and other staff work, "Chiponde" is provided free to all qualified clients. Qualification is based on international standards for Severe and Moderate Malnutrition.

For outside corporate customers, such as Doctors Without Borders, The Clinton Foundation, UNESCO, and other charities and government organizations, the entire plant runs on a "cost recovery" basis. The only charge for "Chiponde" is the actual cost of manufacture.

To keep costs very low, Project Peanut Butter's team strives to achieve donations of quality ingredients from international partners. Many organizations provide support. For example, WFP (The World Food Program) provides milk powder from Europe.

As a result of the plant's efficiency, local labor, and donated ingredients, a full four to eight week treatment for malnourished child costs between $20 and $25 for "Chiponde."

Right now, the plant produces about two tons of "Chiponde" a day. This translates into about 500 tons of product a year. Yes, that's a lot of peanuts!

As a result of food shortages across the world and the increasing success and broad use of this therapeutic approach, demand for "Chiponde" (and "Plumpy Nut") is growing rapidly.

Over the next six months, Project Peanut Butter will expand the Malawi plant to provide roughly three times the current capacity - up to six tons a day.

During the hunger season, which runs from about December through early April, the plant often operates at "full throttle." Night shifts are common.

The biggest manufacturing challenges come from the realities of Africa.

Sometimes, there is no electricity for days at a time. Sometimes, suppliers run out of critical raw ingredients. Bottling materials may be scarce. Inventory management requires much forward planning.

Each bottle of "Chiponde" is made with a commitment to eliminate water from the final mixture. This ensures there is no capacity, no fluid support for bacteria. Thus, "Chiponde" maintains a shelf life of roughly nine to fourteen months.

A new packing machine with high-tech foil containers will be installed in the next year to push this shelf life to nearly eighteen months.

You may have noted the different colored caps on the bottles in the second image above.

For Project Peanut Butter's own clinical sites, bottles are sanitized and reused over and over again. Thus, the rainbow of tops and scuffed labels on the bottles in this particular manufacturing "run." All part of an environment friendly path!

For major customers, such as Doctors Without Borders, the plant uses shiny new bottles with crisp red lettering.

Each finished bottle of "Chiponde" contains about 1,200 calories of food and a broad spectrum of vitamins and minerals.

Dr. Manary, the founder of Project Peanut Butter, refers to this product as an "atomic" food, designed to replenish a long-term deficit in a child's nutritional history.

A young child with severe acute malnutrition will use roughly a bottle a day as therapy to heal from edema or "wasting."

As mentioned in earlier "posts," this approach allows a mother to avoid a hospital stay and return home where she can care for her other children and maintain her regular daily routine.

Fortunately, this therapy is generating successful outcomes 90% to 95% of the time.

A Union Of A Different Sort ...

2009-03-01T00:12:00.000-08:00

Yesterday, at the airport in Johannesburg, just before my flight to Blyantyre, I made a new friend, John Obongo Mwafulirwa.

John spent his life growing up and working in Malawi.

He is a proud father of four children. This is "wealth" in Malawi, to have a big, healthy family.

He spent his career in construction in Blantyre and other small cities. He now serves as the General Secretary of Malawi's Building Construction Civil Engineering and Allied Workers Union.

Flying to Johannesburg, where we met, was a big, big venture for John. He had just completed a conference with union leaders from other countries all over Africa. No surprise, the primary theme of this meeting was "how to enhance wages for union workers."

Within a few seconds of introducing myself, John reached out his hand to share an embrace. Throughout our conversation, he expressed laughter and a sense of warm positive, openness. This is quite common here in southern Africa.

I had many questions. John had much to share.

It turns out, John represents about 8,000 workers in labor negotiations with government and private businesses. He also manages training and education for this community of construction workers.

We spoke about the reality of unions in Malawi - how hard it is to protect worker's rights and ensure "decent, living wages" when there are millions and millions of people waiting for employment of any kind, at any price.

Eighty five percent of the work force survives through simple, subsistence farming.

In Malawi, there is no formal pension system (a small number of private businesses offer very limited retirement support), there is no social security from the government, and there is no unemployment insurance or training available for almost all unemployed workers from any source. Bank accounts are primarily in place for a small portion of the population - relatively wealthy individuals who live in the cities.

If you don't have work, you are on your own - survive or perish is the fundamental value.

John smiled broadly and laughed out loud when I told him about some of the benefits many U.S. corporations and the U.S. government provide.

Then, we spoke about wages.

In Malawi, John's union pushed hard through may years for government sponsored commitments to hold wages at a minimum level.

He feels his union achieved powerful milestones.

The current law?

An employer in Malawi is required to pay at least 129 "Kwacha" for an eight hour day of work.

Here's a dose of Malawian reality. This government mandated daily wage translates to about eighty five cents in US currency (150 Kwacha equals about $1 U.S.)!

Of course, many employers who wish to establish loyalty and a stable staff pay much more, sometimes up to 200 or 250 Kwacha a day.

This elevates pay up to roughly $1.30 to $1.65 for an eight hour day - a good salary here in Malawi.

To become a successful, well employed construction worker, one might attend technical school for three to four years, work as an apprentice for several years, and then go on to make full construction wages when employed as a professional member of the union.

Imagine working in the hot sun all day, five days a week, fifty weeks a year for about $300 in annual pay - a tough haul.

You may wonder how the union supports its own operation.

Each union member pays 1% of their salary in union fees.

It would be interesting to contemplate that level of contribution as a policy for America's unions.

It was great to hear John's perspective on the future.

He is encouraged and hopeful - a reminder that joy and happiness have more to do with expectation and perspective than individual life circumstances.

A Happy Arrival ...

2009-02-28T23:38:00.000-08:00

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 ...

2009-02-26T14:22:00.000-08:00

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 ...

2009-02-18T12:07:00.000-08:00

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 ...

2009-02-13T18:12:00.000-08:00

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 ...

2009-02-11T08:37:00.000-08:00

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 ...

2009-02-09T12:01:00.000-08:00

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 ...

2009-02-09T08:39:00.000-08:00

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 ...

2009-02-08T15:59:00.000-08:00

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 ...

2009-02-06T09:18:00.000-08:00

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 ...

2009-02-03T21:42:00.000-08:00

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 ...

2009-02-03T08:26:00.000-08:00

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.

Curiosity, Mud Balls, And The Power Of Play ...

2009-01-31T07:37:00.002-08:00

My new friend in the top image is working hard to re-design Malawi's health certificates - a simple task filled with discovery. Yes. Those forms are confusing.

My buddy in the bottom image is finding joy in an evolving match of mud ball.

There seems to be an international rule.

Kids find a way to transcend challenges each day.

I know the sound of hundreds of hungry children crying will remain with me for some time.

The sound of African children laughing and playing will linger as well

When I see a child rolling an old, rusty bicycle wheel simply for the pleasure of watching the hoop bounce through the countryside, or a young Malawian boy smiling as he samples fresh, hot, roasted corn that has been cooked over a dented, steel car rim filled with burning wood, or a group of kids kicking a tattered, dirt colored ball toward a wooden post that serves as a goal on a field that is converted in their hearts to a great soccer stadium, I think of the power we all hold in our minds.

I am reminded of the old adage: "One man's junk is another man's treasure."

This seems to apply both to physical goods and emotional experiences.

I think about the perspective and expectation we bring to our day.

It is easy to get lost in our reach for what we don't have.

If we allow it, kids with little to no material wealth, yet a joyful, open spirit shake our world.

Kwashiorkor ...

2009-01-31T03:50:00.000-08:00

The image above reflects a child in a state of nutritional crisis - in this case, "Kwashiorkor."

Before this trip, I had never seen a child's skin stretched and swollen like this. It is quite incredible to see the body's response to food disruption.

A portion of the children who experience a substantial nutrient deficit for a sustained period of months develop this type of painful "edema."

The impression (dent) shown in the child's right foot remained visible for several minutes after Dr. Manary, the Founder and Director of Project Peanut Butter, pressed his thumb against the skin on the child's foot and held this pressure for about five seconds.

Fortunately, this child's condition, "Kwashiorkor," may be relieved in less than a week with a nutrient rich diet of "Chiponde."

Several of the children at yesterday's clinic were not able to walk because their feet, ankles, and shins hurt so much.

At this point in medical history, scientists and doctors do not know why some children develop this condition and other children grow very, very thin and lose lean muscle and other body tissue. This is a mystery that has been debated for decades.

Dr. Manary is conducting a series of research projects to better understand and prevent these conditions. He has a team with a Malawi born nurse, a U.S. doctor, and a volunteer collecting stool samples from hundreds of twins in Southern Malawi. This medical team transports liquid nitrogen in the back of a four-wheel to one local village after another to immediately freeze the "specimens." Through this process, Dr. Manary hopes to determine if certain flora or other "gut" conditions influence symptoms and conditions associated with severe acute malnutrition. Each of the twins in the test are provided with special nutritional support.

It is incredible to watch this type of intensive research and treatment occur in a remote, isolated, and poor region of the world.

The Tales Of Our Lives ...

2009-01-30T12:30:00.000-08:00

I met Abott Jackson in a small village near a clinic this week.

He has lived fifty five rich, full years.

Through his eyes the landscape and cultural flow of Malawi has shifted and evolved.

For over thirty years, one powerful leader ruled this country.

Today, a new form of democracy is being tested.

Slowly, roads are built. Health care takes little steps forward. Industry and the hope of employment calls from the increasingly sprawling cities.

The sense of "community" Abbot has known for so long is stretched and stretched. Phones, TVs, and other tools have made the world smaller, more connected.

Yet, all around Abbot, farming still dominates the flow of life - tobacco, corn, and other crops are grown in one short rainy and semi-fertile season.

For most of the year, the countryside is brown, barren, and dry.

Life can be a struggle.

Abbot's face and eyes reflect much.

There is a joy, a strength, and a sense of reflection that captured my imagination.

Walking, Wishing, Praying For Food ...

2009-01-30T10:18:00.001-08:00

At each village clinic this week, the number of children and caretakers seeking food and medical support escalated substantially.

Today, the team screened about six hundred children at two sites.

At times, the scene was quite frenetic.

I can't imagine walking for two hours and then waiting with hundreds of other women and screaming children for two to five hours for a chance to see a young doctor to gain possible admission to a program that provides free magic food that may save my child's life.

I remain in awe of the determination and spirit these women demonstrate.

One must learn patience and gain comfort with flexibility in rural Africa.

I am reminded of a phrase uttered all over the world.

"Yes. It is possible. God willing."

Rarely, a day flows as expected.

Surprises are the norm - some pleasant, some not-so-pleasant.

Fortunately, many of the kids who arrive at the clinics remain outside nutritional crisis.

Yesterday and today, doctors and nurses associated with the project I am working with "enrolled" about a hundred severe and moderately malnourished children in their monitored, home-based, therapeutic feeding programs.

Enough nutritionally rich food ("Chiponde") is provided to feed each enrolled child through a week to two weeks, until he/she returns for testing.

I am told most of the children "enrolled" will die if they do not receive immediate help.

Right now, Malawi is deep in the stretch of "Hunger Season."

Many mothers I interview share stories of extreme poverty, a complete lack of resources, no food, and many mouths to feed.

It is common for children to get just one or possibly just two small meals a day. Often, all children receive are small amounts of corn (nsima) and other vegetables.

The still images above were taken in between my documentary efforts with a video camera. I am very challenged to communicate the emotion and character attached to this critical work.

Each day, I am stretched in many ways - emotionally, creatively, technically, and physically. My experience, however, is nothing compared to the struggle all around me.

At many moments each day, I see and feel a sense of desperation and hope in the sea of mothers who come together with a common goal - an embrace of compassion.

Yesterday, a blind woman with no husband and two young children came to one of our clinics.

Despite her physical handicap, she supports her small family on a tiny farm. She told stories of tending her crops by feeling her way through the fields with her sensitive hands. Her daughter led her to the clinic to seek extra food.

One cannot help but reflect on the blessings we experience each and every day.

In The Midst Of The Wave ...

2009-01-29T11:56:00.000-08:00

Each day, after singing together and listening to health lectures, woman, children, and other caretakers line up to gain a doctor's assessment and, if they qualify, special nutritional support.

The children are weighed. Their height is assessed. A review of their health condition is completed.

The process is quite amazing to watch - hundred and hundreds of kids moving along a well worn path.

Fortunately, the great majority of the children in the lines are hungry, but reasonably healthy. The children who are not in crisis do not qualify for the "Chiponde" therapy. Despite a long walk from their home, often several hours on dusty paths, and hours of waiting, this is "good news."

In the midst of each wave of women, children, and colorful African cloth, one finds little moments of magic.

This morning, this young child caught my attention.

I love the embrace of her siblings foot and the sense of "Africa" reflected in the procession.

They Come Seeking Help ...

2009-01-29T10:57:00.000-08:00

The pictures above show a few of the thousands of children who come each week for screening and support.

In the first image, Heidi, one of the program's senior doctors, is working with a young child who experienced "wasting." The child's name is "Kondwani." She was born on June 30th of 2007. She ways just 5.3 Kg. This child has "severe acute malnutrition." With four to eight weeks of "Chiponde" (peanut paste, milk powder, vitamins, vegetable oil, minerals, and sugar), children in this type of condition have very high odds for survival. It is remarkable to watch children with little energy, limp, and somewhat lifeless re-acquire a bit of their "light" when they first taste the magic, nutritionally dense paste.

In the second image, a grandmother is holding a fourteen month old orphan named Amina. As is true for close to 1,000,000 children in Malawi, Amina's parents died from HIV. At this point, Amina is quite small for her age and height. She too has severe acute malnutrition.

The third image portrays "Jirane." She is three years old. The man in the picture is her twenty three year old brother. Her mother passed away last year. Her father is working in northern Malawi far, far from home. There are six children in the family. The two older siblings, a brother and sister take care of the other four children. Unfortunately, at this time, they have no food. You may note the incredible swelling on "Jirane's" legs. This is "Edima." When a child experiences a prolonged period of malnutrition, their ankles, head, legs, and arms may swell. In many cases, the swelling is so strong that the skin becomes shiny and sometimes breaks open. Fortunately, this condition may be corrected relatively quickly with nutritionally dense foods. In one to two weeks, with Chiponde therapy a child's Edema may be gone. Then, the child is left with loose skin for a short while. The clinical team feels hopeful that Jirane will fully recover.

The last image reflects the state a maln0urished child may move toward - little energy, upset, uncomfortable, eyes somewhat lifeless. This child was able to eat and start on nutritional therapy.

All of these kids are vulnerable. They don't have access to more than one or two light meals a day - typically mushed corn that is still left from last years harvest.

On many weeks, the clinical team screens one to two thousand children. As we move farther and farther into the "hunger season," more and more children and mothers or other caretakers appear in long winding lines at the daily clinics. Chiponde and other nutritional support is provided free to all children who appear to be in crisis - qualified as moderate to severely malnourished.

Taxi A Go Go ...

2009-01-29T08:04:00.001-08:00

Throughout Southern Malawi, bikes are quite common.

When we drive on the dirt roads, bikes and riders continually swerve into the dirt ruts and paths along the main open space to allow the vehicle to pass.

If one arrives in a congested area where building and pavement exists, dozens of bike taxis stand ready for passengers. Standard fees are twenty five to fifty "Kwachas", fifteen to thirty three cents.

This "driver" and his loyal friends worked me hard to sell time on that coveted rear seat.

with

Yesterday, on the way home from our clinic, we stopped in this same village. I figured it might be worth hiring a bike taxi to roll me through the small outpost with my video camera up on my shoulder - sort of culturally appropriate "dolly." Humor evolved. I hired a large guy with a shiny bike and a well padded passenger seat. The price? About a dollar for a long ride in the late afternoon sun.

As soon as we started, I knew my ride would be an adventure. The bike I rented had wheels of the "not so round" vintage. We swerved left, right, left, right, left right and bounced up and down. I remember my efforts to point the video camera in a somewhat straight manner and laugh. All part of the journey.

Imagine ...

2009-01-29T07:33:00.000-08:00

One of the villages where we work is about thirty kilometers from the nearest road. At this time of the year, it is wicked hot with short afternoon rainstorms and flash floods. Within this village, much like many of the small communities in rural Malawi, life revolves around subsistence farming.

Many families have a small plot of land. Their entire year's food supply depends on one crop of corn. The big rains came in November and December. Right now, the corn is growing near it's mid to full height. Harvest in about four to six weeks.

Most of the families in this village are currently our or nearly out of food.

Generally, they live in small, one room structures with dirt or concrete floors. Fires are used to cook - inside and outside their home. Often, cloth thrown over the floor is used as a bed. It is unusual for an individual to have more than one or two sets of clothes. Shoes are a luxury. Days are long. Women work incredibly hard. Water is often several kilometers away Firewood and food are challenges each meal.

Illness is common. TB, HIV, Malaria, colds, coughs, and infections of other kinds seem to be daily partners for so, so many of the children and adults we work with.

Last week, there were several cases of Cholera in this child's village. A tent with an informal barrier to visitors was established near the tiny health center.

My impression is that the community drives forward with each day. There is no expectation that life will be radically different tomorrow. Despite the hardships, one finds a deep sense of community and the type of joy and curiosity children display all over the world. Culture and customs are strong.

If you allow yourself to be touched, your heart is stretched. One feels the deep sense of the many blessings so many of us experience, the unconscious benefits we hold each day in most of the world.

Poverty is rough. Solutions to many of these issues are complex. Yet, there are bright moments. In areas such as malnutrition, there are major breakthroughs and a sense of progress.

I constantly feel humbled and encouraged by the experience of watching the doctors and nurses I am traveling with complete each day's clinic. They are tireless, hopeful, and committed.

Even after screening and supporting three to five hundred children in a five to six hour period, they engage further outreach. We often transport three to six children to the hospital at the end of a long, exhausting day.

In Malawi, the caretaker and the child check in to the hospital together. Often, a mother sleeps under the bed of the child. The nutritional recovery units are packed. Kids may need to stay for a week to several weeks to recover from crisis. The great news is that with support and dense nutritional food supplements such as "Chiponde" (the food developed by the doctor I am working with, Dr. Manary), most children survive and move on to stable health.

The Precious Bond ...

2009-01-27T13:27:00.000-08:00

Over and over, I am struck by the intimacy and bond between African mother and child.

Kids are wrapped and carried throughout the day - establishing a powerful connection. They are rarely outside the embrace of their caretaker.

One often sees rows of mothers, each with a child or two children wrapped on their back, walking along dirt roads and small winding paths, gathering wood, water, and food.

They seem to be in constant motion.

Six to twelve year old girls often walk beside their mothers and carry an infant on their backs if their mother has twins or two young children at the same time.

Many children in Malawi are breast fed until they are two to three years old. The kids seem to develop the capacity to "self serve" whenever hunger strikes.

This, fortunately, provides vital protein to many children who might develop malnutrition if they ate only crushed corn, pumpkin seeds, and other common, indigenous foods.

Many of the children treated by the nutrition program I am working with experienced disruptions in this supply of breast milk.

Often, their mother has become sick, their father has died and the left the family with no resources, or some other event has disrupted the normal flow of their home.

In rural Malawi, many families live on a thin edge.

Joy Is Where We Find It ...

2009-01-27T12:59:00.000-08:00

Yesterday, just before we started work at the clinic, it rained lightly. Our second vehicle with equipment, the primary doctor, nurses, and other staff was still in transit. A large crowd of women gathered under a large tree near the open space we work in.

I left my video equipment in the truck and took the opportunity to wander for a few moments near Chikadza Village.

A charismatic young boy, Marizan (ten years old), and his younger sister, Namiziya (eight years old), offered a warm welcome. Their father has a small plot of corn nearby. The survive on little. Yet, they seem "present" and filled with hope.

In just a few moments, we shared laughter and a sense of shared discovery.

I couldn't help but feel their strong bond of closeness.

I admired their sense of play.

They stayed near my side for several hours observing the flow of the clinic and my efforts at documentary work.

I remember their captivating smiles and the bright light in their eyes. There is magic in our lives if we can hold this sense of "wonder."

A Path To Health Services ...

2009-01-26T18:36:00.001-08:00

Near many rural villages where the nutritional project works, Malawi's government provides basic health services. In Malawi, there is a health care worker, a "Health Screening Assessor," in most large communities. The "HSA" provides support and medication for illnesses such as malaria, HIV, and TB. In addition, these government workers serve as the central government's training arm for hygiene and handle births and other daily life needs for the surrounding villages. They are paid about $10 to $12 a week - a relatively good salary in rural Malawi.

Health care support for the entire population is provided free of charge.

When a child or an adult needs to see a para professional, he or she often travels five to ten kilometers by bike or foot and then waits for a half to a full day to get help.

The picture above was taken at a busy health clinic - a small brick sided room with a flat roof and an adjacent waiting area filled with stone benches. The woman with the white cap has waited most of the day. She is now near the front of a long swirling line of roughly two hundred people. I sat and watched this procession for some time. I was drawn to this quiet woman. She seemed to possess a sense of reflection and peace.

RUTFs - Medical Relief In Action

2009-01-23T06:31:00.000-08:00

My first week in southern Malawi flew by. Little sleep. Much heat. Immersion.

Monday through Friday, we completed five intense, day-long sessions in remote villages - "hot spots" for poverty and hunger.

I watched and reflected as small teams of nurses, doctors, and health screening assessors (HSAs) tested several thousand children for health and nutrution issues.

My ability to reflect these experiences in the words of this post is limited. One's heart and head are challenged. Each child seems to have a powerful story.

In Malawi during Winter months, "Hunger Season" unfolds.

For most families, life is dependent on a single, annual, twelve to fourteen week growing season, and a precious crop of corn.

Roughly 80% of the population of thirteen million people survives as "subsistence" farmers.

Harvest is typically in April.

The size of each year's crop determnes the difficulty the family will have eating through the entire year.

In the Summer, a child in Malawi may eat three times a day.

By October, a child may eat just two times a day.

By February and March, a child may not eat every day.

For some children, malnutrition becomes a crisis. Without intervention, their lives are at risk.

When farming yields are low, the country suffers greatly. As a result, each year's growing and harvest season is watched closely. Fertilizer and seeds are subsidized by the government.

As one might guess, politics, curruption, and beauracracy influence the distribution of many cricial resources.

Last year's crop was not robust.

As a result, at this time in the year's cycle, many families in rural areas are running out of food. The impact of poverty and limited resources for government assistance are evident.

At the end of each day last week, a doctor noted the rapidly expanding group of families in desperate need of support.

On Friday alone, we screened about six hundred children and added about sixty children to the enrollment of kids under treatment for moderate and severe malnutrition.

The drug of choice?

"Chiponde" which is comprised of peanuts, oil, milk powder, sugar, viamins, and minerals. These ingredients are mixed into a paste served to children three to five times a day within their home environment. The "Chiponde" is free to all children who need this support.

Fortunately, outcomes when a child receives treatment with "Chiponde" (Ready To Use Therapeutic Foods provided by Project Peanut Butter) are quite remarkable.

Through the last six to seven years, 85% to 95% of the children treated with Chiponde have recovered and remained stable. I watched repeatedly as strikingly thin children and their caretakers began this therapy.

Each day is filled with a series of critical commitments for this medical relief project. Our days start at about 4 AM and finish at about 10PM. The team eats breakfast at home before departure and then does not break for a meal until mid afternoon.

Monday through Friday, around 5 AM, three to four teams pack large boxes of food and simple assessment tools into a group of old four-wheel-drive vehicles and depart from the city of Blantyre toward the countryside in Southern Malawi.

Each vehicle rolls through the dark streets, hugging the left side of the road (a British legacy), headlights tossed up and down by the uneven surface of the road.

At this time of the year, low clouds and fog typically cover gently rolling landscapes in the early morning. The sun and heat slowly rise. By mid morning, I am often dripping with sweat.

After we leave the apartments where the doctors stay, we stop to pick up a team of nurses and drivers. Then, we complete an hour to two hours of travel on paved and dirt roads. The sounds of industry, commuters rushing to work, and city life fade.

Vehicle problems are common. In the last six days, we experienced smoky brakes, a flat tire, a broken differential, problems with the starters, and a series of unexpected challenges with simple movements along muddy roads. This is Africa. One cannot expect travel to roll forward as planned on a regular basis.

Project Peanut Butter works in the same locations on the same days each week - a consistent rotation.

In the countryside, on the day of a specific "clinic," women, older children, and other caretakers walk for hours, some up to fifteen to twenty kilometers, with young infants to arrive at the start of each session.

By the time a Project Peanut Butter team arrives at each site, it is about 7:30 AM.

Long, winding lines of caretakers, often thin, young mothers, each holding one to three hungry, screaming children, await the start of the clinical session.

Mothers come searching for community interaction, support, assessment, relief, reassurance, and hope.

Fortunately, many children, despite the poverty and other challenges faced by their family, are not in need of emergency relief. These kids are screened and encouraged by the health team to continue to check in.

Other children are in a state of crisis. These kids desperately need help - they may be "wasting" (very, very thin) or exhibit "edema" (swelling).

When the Project Peanut Butter teams arrive at each site, the nurses lead the women in discussion of health topics.

Next, there are a series of songs, educational in nature with local melodies and much improvization. The harmony, clapping, and sense of unified engagement is powerful, uplifting. If I close my eyes, I can almost forget the sense of urgency and concern all about me. The mothers and other caretakers seem to enjoy the transformational spirit of this ritual.

Then, the doctors and nurses break into pods with scales, height, and other measuring tools. The rush begins.

Hundreds of women pack into lines leading to each "station." The Project Peanut Butter Team works with the local Health Sceening Assessors to weigh, measure, interview, and review the status of each child's nutritional status.

Primary indicators for health assessment and nutrional crisis are height to weight ratios and lean body mass indexes. International standards, two and three deviations off of a bell curve, are used to determine if a child is in need of immediate medical intervention.

Global figures indicate roughly 4% of all children internationally die before they reach five years of age. In Malawi, the figure is close to 18%.

I am told nearly half of all child deaths across the world have a direct relationship to nutrition.

If a child has moderate malnutrion the odds of death go up 400% (four times as likely).

If a child has severe acute malnutrion, the odds of death go up 800% (eight times more likely for the child to die before five yers old).

Project Peanut Butter provides highly nutritionally dense foods for children with these desperate needs. The therapy lasts six to eight weeks.

Throughout this last week, I was inspired and, at times, overwhelmed by the intensity and spirit of this work.

All four of the doctors working with the team are incredible - inspirational skills, commitment, and drive.

I go to sleep reflecting on many moments. I ponder difficult questions that often hold no clear answers.

Is there another mammal sleeping in my room?

Is that buzzing sound inside or outside my mosquito net?

What exactly is the "Hair Fertilizer" sold by the local store?

Then, there are the more serious ponderings ...

What is the true cause of hunger? There are many opinions about this.

Are there long-term solutions to extreme poverty? Simply attaining clean water and adequate food are a huge reach for several billion people on our planet.

What if I lived in a country where the average annual wage hovered around fifty dollars? Many of Malawi's citizens work for $1 to$2 a day. Many other members of the population have no income of any kind - they survive on small plots of land. If I were born into these circumstances, how would I respond to the struggle of each day?

I think of our health care system. We certainly have challenges, but in the U.S., we are blessed with an abundance of resources. The ratio of doctors to citizens is roughly 700 to 100,000. We spend huge levels of professional staff to support our well-being. Can I imagine living in a country where there are just two doctors per 100,000 citizens (Malawi's status), a country where Malaria and Malnutrition are the leading causes of death, a country where health care is free, but access to services is hugely difficult. What if I had to walk for two to three hours to see a lightly trained nurse? What if the closest hospital was a hundred kilometers from my mud hut and my only form of transportation was my own two feet?

What if close to 15% of the U.S. population was HIV positive? Would we view this crisis differently?

Despite deep poverty and difficult daily life challenges, joy and laughter and a deep sense of community can still be found all around me.

Material wealth and professional status are not driving these outcomes.

How do people find happiness when life circumstances are so rough? What do they rely on?

Two days ago, I met a grandmother who works with twenty other generous and compassionate volunteers to support about two hundred orphans. What life stories!

The grandmothers, or in local terminology, the "go gos", work in very low paying jobs (often $1 to $2 a day) to earn enough money to pay for food for the hundreds of children they care for.

Where does this motivation and sacrifice come from? Africa remains a place where "extended family" and kind embrace remain in force.

Fighting to survive has a way of clarifying one's priorities. Expectations drive so much of our emotion.

My documentary work is going well. I am highly challenged to produce video and still images that reflect the power and importance of this work. We are making progress.

My health and energy are holding up. My spirit remains engaged and hopeful.

There are many opportunities for me to learn and try to contribute.

The group I am working with is generous and full of vibrancy.

A Quick Splash Of South Africa

2009-01-16T11:59:00.000-08:00

Landed a few hours ago in "Jo-burg", South Africa.

Tired. Happy. Encouraged.

It is warm, muggy, almost sticky. We are in the midst of an African Summer.

My luggage arrived. I was quite relieved to see both bags in the customs area. One bag was once again opened by a security staff somewhere during transit, but repacked. Thank you.

My cab driver and I had a flat tire during the ride to the airport in New York. Pulled off a delicate cab-switch near the midtown tunnel in New York City. Slush and cold all about. Lots of conversation. Opted out of the opportunity to "spend a few moments waiting for the tire to be changed on the side of the road." Something about an international flight schedule that compelled me to continue my steps toward the airport. Fortunately, my first driver rolled with my suggestions. Switching cabs on the way to the airport an bypassing a large fare is a little like attempting to switch from dating one sister to another. Delicate.

At first, our flight take off schedule looked good. Then, as we increased the thrust on the engines, we experienced a "frozen valve" within some part of the plane's navigation system. The captain spoke about "safety first." His caution my have been lifted by the US Air crash an hour earlier from a New York airport. We sat on the tarmac for two hours. Lots of cramped, grumpy passengers. The hero was some guy in a giant black, puffy jacket who runs a big machine that produces hot air. I pondered his job title. "Director of ... " I suppose every organization needs one of these professionals.

Met some interesting people during the flight.

Travel seems to open up a world of new relationships.

A kind woman from Nigeria working on a mission assignment. We spoke about the power of community and her work with women across the world.

A geo-physicist from Mali. We spoke about plate tectonics, the evolution of "truth" in science, his first experience with research - a four month trip in the Sahara, and his mother's travel to the U.S. which included a broken hip. All part of the journey.

A couple from Manchester, England. They are on a three month "walk-about" and shared their thoughts about trekking and exploring in different regions of the world. They just returned from three days at a incredible international music festival in the dunes near Timbuk2 and a trip through the Dogan and other regions of Mali. Some day!

A twelve-year old girl from "Jo-burg" who went to the U.S. by herself to visit with her mother. Her Mom is going to school at NYU. We spoke about her trip and her aspirations. She had a charm and spark in her spirit that was quite memorable. In her mind, America remains a huge, open, confusing, powerful source of opportunity.

Our plane stopped in Dakar, Senegal to gather some gas and a few passengers. The sunrise over the Atlantic was stunning. I will try to post an image I took from my plane seat sometime soon.

If all goes well, I will be in Malawi tomorrow.

Tonight, I met up with Mardi, one of the passionate managers of the non-profit I am working with. She just arrived from St. Louis. At home, she is a community nurse. Her care and love for the people in Africa is quite inspirational.

Project Peanut Butter was born about fourteen years ago when Mardi and her husband, Mark, came to Malawi to provide medical support. It took about eight years for the program to begin to show transformational outcomes.

Mardi's energy is contagious.

...

Thanks to all who have written and commented on this rambling blog. Much appreciated.

Off to sleep.

A Child's Wisdom: The Power Of The Moment

2009-01-15T08:59:00.000-08:00

I just returned from a walk through the streets of the Chelsea District.

The streets are covered with a light sprinkle of snow. It is quiet.

A cold wind, the type that makes one's ears sting, blows forth.

After a bit of searching, I found some new clothing to replace the lost items.

Then, I returned to my good friend's loft to seek warmth and prepare for my trip to South Africa.

My buddy, Little Campbell, shown here at the top of this "posting," let me know that life is full of opportunities to choose a perspective.

He wanted me to recognize the opportunity to play in his "hood." After all, this should be a priority. No?

When I told Little Campbell about my difficulties with the airline and the problems with the baggage handlers, he paused and reminded me that "Yesterday is history." I told him that I was concerned about the work I need to do in Africa and the equipment I may have lost. He said "Tomorrow is a mystery."

Then, he looked up from his important work of discovery. He paused and said: "You know Jeff. I just focus on the moment, right now, right here. I can't remember what happened a day ago. It's not important. I don't need to be concerned about the days ahead. It all seems to work out. Now, let's focus on what's important. Look at all my cool toys! Play with me!"

I ponder how my perspective shifts through each day. I know I can benefit form absorbing more of Little Campbell's teaching.

Laughter And Empathy ...

2009-01-15T05:44:00.000-08:00

I just went through the duffel bag that experienced "travel difficulties" yesterday with TSA, the national travel police.

So far, confirmed missing inventory includes my precious bag of clean socks and underwear, a pair of pants, and a few other items.

If any of you are traveling through New York in the next few weeks and you wander through JFK Airport, please be on the lookout for nicely folded blue and white boxers, a few pairs of "tighteee-white-ees," and a group of tame white, brown, and black socks.

At this point, these fine articles of clothing are unsupervised. They may run off to far corners of the airport. Please use caution if you attempt to capture these items. I recommend you call the authorities if you have a "sighting."

If you wish to laugh, imagine the moment you discover your underwear is spread all through JFK airport. The good news? The event occurred at the start of my trip. My underwear was clean, folded, and ready for the parade. I put my best effort "out there."

The morning is rushing by. I need a shower ... and a quick shopping trip to find replacement clothing in New York City.

Travel Bumps And Luggage Bruises

2009-01-14T19:22:00.000-08:00

Ah, New York City!

It's quite cold tonight. Snow and wind projected. Tomorrow, weather professionals expect temperatures at seventeen degrees below freezing.

With good fortune, my flight to South Africa will still depart.

My trip from SF was mostly good.

A little bump was tossed on the road when I arrived in JFK airport to test my travel spirit.

When our plane landed, I gathered my carry-on bag and walked through the crowded airport to the baggage claim arena. I stood waiting for my duffel bags for some time. After about twenty minutes, I started to become restless.

Then, "it" happened. My world became a bit less calm.

A sharp, firm voice came forward from the loud speaker above my head.

My heart beat quicker. My thoughts started to race.

"If Jeff Davis is in the baggage area, please come to the airline office immediately."

Why was the airline paging me?

I checked to make sure I still had my wallet.

Perhaps, my luggage missed the flight.

I hoped the message did not concern an emergency with family and friends.

As I arrived in the airline office, I noted a dark skinned, unshaved man in a bright red vest with a large, clear plastic bag in his hands.

He stretched out his right arm, held the bag up in the light, and asked me if the contents were mine.

Turns out, he had found my malaria medicine on one of JFK's conveyer belts.

My name was on the pill canister. Thus, the ominous message from the airline office.

On one level, I was grateful. It was kind for this professional to make such an effort to try to connect a stranger with a little canister of greenish pills.

On another level, I felt a sense of fear. The malaria medicine was positioned at the bottom of one of my bags when I left the airline counter in San Francisco.

What happened to the rest of my belongings?

I had visions of my duffel bag ripping apart in the conveyor belts system and my gear separating into independent piles for wild rides all through the airport. Not a pleasant thought.

I acknowledged my ownership, held the bag, thanked the kind gentleman, and went back to the baggage area.

I stood in silence. I wasn't sure what to feel. I figured all I could do is wait.

In about five minutes, my first duffel bag arrived. The straps were wide open. The zipper was wide open. One of my shirts was draped over the top of the bag. A small equipment sack was hanging out.

As I looked at my open luggage, I recognized a standard, printed note from TSA, our beloved national security force.

Apparently, a TSA staff member had opened my bag in San Francisco, rummaged through the contents and thrown the bag back on the conveyer belt for the airplane. It was clear that carefully replacing the contents in the duffel bag and closing the zipper and re-fastening the clips to hold the bag shut was way, way too much trouble.

Big bummer.

At this point, one of the airline staff members saw my bag, threw up her hands, and said "sorry, we have no control of TSA."

My first emotions were not constructive, certainly not remotely compassionate.

I so, so wanted to have a "conversation" with the TSA staffer who went through my luggage.

In the end, I believe I found all, or almost all, of my gear. I lucked out. I may have lost a shirt and some other clothing as well as other small items, but I think I am "good to go" with regard to equipment.

I wish I knew what set off TSA's concern.

One culprit stands out. All four boxes of pencils, which I packed as gifts for children in Malawi, were torn open. Perhaps, the United States government has concerns about exporting lead and wood. These are, after all, very dangerous.

On the cab ride into the City, I tried to tell myself 'it's just stuff." Deep breath. Let it go.

There. I am ready to roll with the day tomorrow!

In Search Of ...

2009-01-11T12:03:00.000-08:00

The closet searching, duffel bag stuffing, documenting, list reviewing, equipment testing, packing, and padding continues.

Much to do before "lift off" with this documentary project on RUTFs and Project Peanut Butter.

In three days, I depart for New York City where I will spend a day with several friends and my rambunctious, wonderful one-year-old Godson.

The next afternoon, I fly on to Johannesburg, South Africa where I stay one night. From there, I travel on a short flight to Blantyre, the second largest city in Malawi. If all goes well, travel in Southern and Central portions of the country begin the next day.

Even with strict packing guidelines, I anticipate the need for a strong "ooompa looompa" to help carry my bags to the airport.

It's frightening to look at the expanding pile of batteries, chargers, cables, and other gear that is needed to keep my bigger pile of equipment working.

A comedy can be written about this part of the journey.

Yes. It's true. I have just a marginal idea how to use most of this "stuff."

I tell myself to have faith, let this process unfold, smile often, and be prepared to laugh with my many stumbles. I know I will have moments of uncertainty and humor. This is learning "real time."

I do wonder ...

Can I stop the action all around me and ask for a "lifeline" (call a friend) if I get into difficulty while attempting to produce footage?

Where do I sign up for a free set of "do overs"?

What exactly are the words for "please don't panic" in Malawi-ese?

The next three weeks will be an adventure - new steps into the unknown.

A New Year : New Dreams To Chase

2009-01-06T11:26:00.000-08:00

Happy New Year! 2009 is now in full motion.

My professional time is split between public television (PBS) and film projects and an ongoing engagement with documentary photography.

On January 14th, I leave for Malawi, Africa to start an exciting media campaign and fund raising project with an innovative, non-profit named: "Project Peanut Butter."

You can visit PPB's web site at: www.projectpeanutbutter.org

Here's a link to information about this country: Malawi

I will be traveling with Dr. Mark Manary, a legendary pediatric doctor with a specialty in child nutrition, through villages in Central and Southern Malawi for two and half weeks.

Our goal is to support awareness, advocacy, and fundraising for Project Peanut Butter through a series of short documentary films and other media initiatives.

Project Peanut Butter has developed a transformative approach that addresses Severe Acute Malnutrition (SAM) with Ready to Use Therapeutic Foods (RUTFs).

Crushed nuts, vegetable oil, milk powder, vitamins, minerals, and sugar are mixed into a paste and delivered in small containers to families in crisis.

Through foundation support and private donations, these therapeutic food products are provided at no cost these children and families.

This is a story of hope, care, and the power of persistence.

For many years, the survival rate for children near starvation (children diagnosed with Severe Acute Malnutrition) in Malawi was roughly 25%. Several years ago, the infant mortality rate in the country hovered around 23%.

Today, there is a national health care program with stunning outcomes. About 95% of the children who receive Ready to Use Therapeutic Foods (RUTFs) survive and go on to a state of stable health. The infant mortality rate (the percentage of children who die before age five) has dropped close to six percentage points, with roughly half of this improvement attributed to RUTFs.

Project Peanut Butter has been transformational.

In 2007, the United Nations adopted RUTFs and Dr. Manary's community based approach to support children with severe nutritional needs as the global standard.

Still photography and HD Video camera in tow, I pursue a great learning adventure as I explore ways I can support this important cause.