Update from Chipoka, Malawi Africa

CHIPOKA, Malawi, Africa — Rebecca Severinsen, a high school student from Augusta has arrived in Chipoka, Malawi, Africa.

After spending two weeks in Florida for training, Rebecca arrived at her designated site.

She said boot camp was difficult, but she loved it!

She now gets to use her newly aquired skills to build two-kitchen, four-bathroom facilities at two orphanages.

On July 7, she was headed to the Wellman Rescue Unit, which is a small orphanage that houses AIDS orphans.

Before this Wellman Unit was built, the site was used as a bathroom for the community.

The site has been cleaned and the children and facilitators have planted a garden and have made a fish pond.

The pond has several fish and the children have been able to eat fresh fish.

The corn field, however, has been under attack by the monkeys, and the monkeys have already eaten half of what the orphanage had planted.

They have also planted potatoes and they are hoping that will yeild a good harvest so they will have plenty of potatoes to eat.

Rebecca and her team will be in Chipoka for a couple of weeks building the facilities needed to help make the orphanage a more suitable place.

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Therapy could save thousands of babies

Hopkins study halves passage of HIV from mother to child in milk

A new treatment for infants of HIV-positive mothers could prevent hundreds of thousands of infections a year in the developing world, according to a report in today's New England Journal of Medicine.

The study by researchers at the Johns Hopkins Bloomberg School of Public Health tested whether an extended regimen of anti-AIDS drugs could protect infants from becoming infected by their mothers' breast milk.

The treatment cut transmission of HIV from mothers to infants by 50 percent.

"This is a landmark study," said Charles van der Horst, an AIDS researcher at the University of North Carolina. "The treatment had an extraordinary effect."

Every year, 500,000 babies are infected with HIV by their mothers. Half of those infections occur through breastfeeding. In the West, infants of HIV-positive mothers are almost always fed formula, and, in part because of this practice, rates of mother-to-child transmission have dropped to less than 1 percent.

But in the developing world, this approach is untenable. Many families can't afford formula, and even if they can, they often lack access to clean water.

"Breast milk is nutritionally very convenient," said Dr. Taha Taha, a Johns Hopkins epidemiologist and lead author of the study.

Many studies have shown that breastfeeding increases overall infant survival rates, even when the mother has HIV. Breast milk increases immune function and reduces the severity of diarrhea and pneumonia, two major killers of infants in poor countries.

"Breastfeeding is essential for at least the first six months, even in HIV-positive mothers," said UNC's van der Horst.

In recent years, researchers have tested a variety of methods to minimize the risk of HIV transmission through breast milk. Before that, he said, researchers largely ignored the issue.

"It's a unique problem for resource-poor countries because HIV-positive mothers don't breastfeed in the West," he said.

In the developing world, most infants of HIV-positive mothers currently receive one dose of nevirapine, an anti-HIV medicine, soon after birth.

The new study, which took place in Malawi, extended that regimen. The researchers divided 3,016 breastfeeding infants into three groups: In one group babies got a single dose of nevirapine; in another they got nevirapine for 14 weeks; the third got nevirapine and zidovudine, another antiretroviral drug, for 14 weeks.

In the latter two groups, HIV rates dropped by half. In addition, infants showed no ill effects from the longer drug treatments.

HIV is a significant problem in Malawi, one of the world's poorest countries. Sixteen percent of its 12 million inhabitants are HIV-positive. The country also has a high child mortality rate: One of every five children dies before the age of 5. In this context, experts say, breastfeeding is crucial.

The researchers said the study provided strong evidence for the longer treatment regimen.

"The study has a big sample size, so the data is really strong," said pediatrician Mary Glenn Fowler, a Johns Hopkins HIV researcher in Kampala, Uganda, and a co-author of the study.

Taha said researchers and public health officials are devising plans to roll out the new treatment in Malawi and elsewhere. Taha is working with the Malawian government and is part of a World Health Organization panel dealing with the issue.

In much of sub-Saharan Africa, the cost of nevirapine and zidovudine is subsidized by international aid, including the U.S. government's $15 billion AIDS program, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. As a result, poor countries such as Malawi might end up not paying much to extend treatment to all infants of HIV-positive mothers.

The treatment itself is simple: Using a dropper, mothers give their babies the medicine in a syrup.

Even so, setting up widespread programs, particularly on a continent that remains largely rural, will be difficult. "The cost is not the major barrier," Taha said. "The logistical barriers will be key."

Dr. Brooks Jackson, an AIDS expert at the Bloomberg School of Public Health, agreed that implementing the treatment would be difficult. Jackson, who was not involved in the study, noted that 30 percent of pregnant HIV-positive women in Africa still do not get a dose of nevirapine during labor. That therapy was proved nine years ago to reduce HIV transmission by half.

Scientists are testing other treatments to further reduce mother-to-child transmission of AIDS. Taha and Jackson are now planning a trial in several African countries in which infants take antiretroviral drugs for six months or longer.

In Malawi, van der Horst is examining whether giving anti-HIV medicine to nursing mothers with the disease can reduce transmission.

"In the U.S., we've largely stopped mother-to-child transmission," said van der Horst. "We can do the same in the developing world."

Muzungu in Malawi

Dalhousie science student Emily Stewart is a volunteer in Malawi with Engineers Without Borders.

“Malawi … I think I’ve heard of that. Didn’t, like, Madonna adopt a baby from there or something?”

Dal student Emily Stewart admits to not knowing much about Malawi when she first heard that’s where she’d be going as a volunteer with Engineers Without Borders Canada. But since May, the 19-year-old from White Rock, B.C. has been gaining an intimate understanding of the impoverished country which is nestled between Mozambique, Tanzania and Zambia in southern Africa.

So far, her experience has been eye-opening and exhausting. She’s been wrapping her tongue around the Chichewa language, rebuffing marriage proposals and bathing in four cups of warm water. There have been bouts of explosive diarrhea and unexplainable tears. Plus, she’s had to get used to being the centre of attention almost all the time.

PHOTO ESSAY: 'The air smells alive'

“That’s the toughest thing,” she writes in an email to Dalnews, “The respect and privilege I get as a muzungu (white person/foreigner) is not something I feel I deserve in the least.”

But at the same time, she’s never learned so much, from how to adapt to a new diet and living conditions to communicating using a Chichewa phrase book, lots of hand gestures and plenty of good humor. Everything is markedly different from her life as a Dalhousie science student. Until now, one of the biggest challenges she’s had to face is deciding what to focus on in her second year: microbiology and immunology or economics?

Engineers Without Borders, by the way, isn’t limited to engineering students. Volunteers come from different academic disciplines, including international development studies, science, environmental studies, theatre. EWB volunteers are currently working in four countries: Burkina Faso, Malawi, Zambia and Ghana. Some, like Ms. Stewart, are on four-month junior fellowship placements while others are on long-term overseas placements ranging from one to three years. Many Canadian universities have chapters of EWB, including Dalhousie.

She done things she never could have imagined. Despite being a vegetarian, she’s sampled offal (“rhymes with ‘awful’”), a deep fried assortment of goat heart, liver, stomach, and large intestines. And, early on in her stay, she was enlisted by a blind midwife to deliver a baby.

“I entered the dark hut and was immediately struck with a metallic odour I couldn’t quite put my finger on,” she recounts on her blog (http://emily-in-malawi.blogspot.com/.) “Amayi gave me a pair of XL plastic gloves and told me to close my eyes. ‘So you be blind like me,’ she explained. Closing my eyes didn't make much difference as the hut was almost pitch dark in the middle of the afternoon. But I closed my eyes, and let Amayi take over. She took my hand and my finger and placed it somewhere as I heard a quiet moan. ‘That is head of the baby,’ she told me in her limited English as the tip of my finger poked an indescribable surface.

“I was in such shock that the next 20 minutes passed by without much thought. The birth was surprisingly muted and happened very fast (unlike how movies make them out to be); the woman giving birth (named Melissiana) was silent except for an occasional quiet groan. But the most shocking part came after, when I realized I had delivered the baby myself. Amayi had simply stood at the head of the bed, supporting the woman’s head in her arms, while I stayed at the other end and pulled the curly-haired baby out.”

As a volunteer with Engineers Without Borders, Ms. Stewart works with Concern Universal, a non-governmental organization that works to alleviate poverty in rural communities. Specifically, she’s been monitoring and evaluating how the organization's water and sanitation projects are working—whether disease prevalence has been decreasing because of better hand washing and covers that keep shallow wells from becoming nesting grounds for mosquitoes.

There is usually a technical component to the projects EWB volunteers work on. In Burkino Faso and Ghana, for example, volunteers are refining what’s called a “multifunctional platform.” It’s basically a diesel engine mounted on a steel chassis that powers a variety of end-use equipment such as grinding mills, de-huskers, battery chargers and water pumps. The idea is to help women with many of the tasks they do by hand: pounding cassava, grating gari and grinding grains.

Ms. Stewart’s work with EWB will continue when she returns to Canada: “My goal is to learn as much as I can about poverty and development ... Whether it’s learning to be more critical about development initiatives, or simply promoting development among family, friends, community and government, I'm going to share my experience.”

Malawi at a glance

A Malawian woman carries wood she has collected for fuel.

Malawi, a landlocked country in southern Africa, is among the world's poorest countries. Of its more than 12 million people the vast majority live in rural communities, with only 16 per cent living in urban areas such as the cities of Lilongwe and Blantyre.

The remainder live in rural areas where the population density is one of Africa's highest—six times that of neighbouring Zambia. This, coupled with rapid population growth and erosion due to deforestation, is applying severe pressure to the agricultural industry which employs the vast majority of the population.

Malawi's economy is based largely on agriculture, which accounts for more than 90 per cent of its export earnings and 45 per cent of gross domestic product (GDP). Malawi has some of the most fertile land in the region and almost 70 per cent of agricultural produce comes from small-scale farmers. However, land distribution is heavily unequal, with more than 40 per cent of smallholder households cultivating less than 0.5 hectares.

Access to water and sanitation is also unequal, with an estimated 57 per cent of the rural population with access to safe water in comparison to 90 per cent of the urban population. Access to sanitation is considerably lower with only 15 to 30 per cent of the rural population having access to a latrine.

As a result water-related diseases, including cholera and typhoid, are common; a problem exacerbated by the rapid spread of HIV/AIDS. Almost half of the population is under 15 years old and many of these are orphans.

Malawi Parliament member pays tribute to those who helped realize a dream

GRAND RAPIDS -- Clement Chiwaya has brought a medical clinic, schools and fresh drinking water to his impoverished African homeland. But when it came time to thank his West Michigan supporters, he could not hold back the tears.

"Look at all of you great people, people that have touched my heart and helped me get closer to my God," the 2002 Aquinas College graduate told about 50 people at the campus chapel Wednesday night.

In a special Mass led by retired Bishop Robert Rose, Chiwaya paid emotional tribute to the people who helped him since he came to Grand Rapids 10 years ago with $500 and a dream to attend college.

Supported by crutches, the polio survivor said he is reminded of West Michigan whenever he helps the people of Malawi, where he is a member of Parliament and oversees ambitious development projects.

"I want to thank each and every one of you for being so kind to me, for being so kind to the people of Malawi," Chiwaya said.

The chapel crowd included many who have helped Chiwaya realize his dreams. Robert Woodrick, former president of D&W Food Centers, wrote the first check to help fund his Aquinas tuition.

"Not only is he an example for Africa, he's an example for all leaders," Woodrick said. "He has immense integrity."

Lori Knapp, of Rockford, president of the Warm Hearts Foundation, helped Chiwaya build two schools and drill 186 wells serving the 250,000 people in his district.

"I always knew, from the moment I met him, that he would do important things," Knapp said.

With funding from the Malawi Connection, a local nonprofit, Chiwaya has built a medical clinic, a skills training center and provided AIDS education. The married father of a 4-year-old daughter, Chiwaya, 37, also advocates for orphans and people with disabilities.

He now is looking for computers and wants to build a media resource center and two hostels for those using the training center. A nonprofit bank has shown interest in providing micro-loans for small businesses.

"We've had 10 wonderful, miraculous years, and we're going to go 10 more and beyond," said James Rademaker, president of the Malawi Connection.

Chiwaya returns to Malawi on Saturday, but made sure to give thanks before he left the place that gave his vision wings.

"Looking back at what we've achieved, I don't regret that decision I made to come over here," he said. "It is a miracle."

Bicycles collected for Malawi community

A group of youth will be collecting bicycles Saturday to help support an African community.

Instead of giving a hand out to residents of Zomba, Malawi, Africycle provides the community with used bicycles. Most of the bicycles are refurbished by local youths and sold back to the community.

"The profits made go to support the orphanage and the school there," said Michael VanDerHerberg, a member of the group. "It's not a hand out, but really it's recycling bikes and keeping them out of the landfill and creating economic sustainability."

Some of the bikes are repaired locally, but VanDerHerberg said most are repaired in Malawi.

As well as collecting bikes, Van- DerHerberg and six friends will embark on a bike tour around Ontario to raise money for Africycle.

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Bikes wanted

What:Bike collection

When:Saturday 9 a. m. to 3 p. m. Where:Third Space Church at Knox Presbyterian Church at Park and Wolfe streets

Who:Africycle which helps support the community of Zomba, Malawi ( www.africycle.com)