My Introduction to Malawi

It is late afternoon on Sunday, May 27.

Yesterday we flew from Jo’burg to Blantyre, Malawi. We were met at the airport by Irving Hoffman from UNC. Irving has worked in Malawi for 15 years, and is spending the summer here this year.

Malawi is a much different country than South Africa. In contrast to South Africa’s vibrant economy, skyscrapers and expressways — Malawi is one of the world’s 10 poorest countries. The roads are filled with people walking or biking, and they are often carrying huge loads, either on their heads or on the backs of the bicycles. They have sticks, sugar cane, anything that they need to move.

The average annual income in Malawi is around $170, and unemployment is a huge problem. The streets and roadsides are filled with people trying to sell something, anything to make a bit of money.

But with all the economic challenges — the Malawian people smile! Everywhere we are greeted with broad and genuine grins, and it is very welcoming. I am told that Malawi is called “The Warm Heart of Africa,” and it’s easy to see why.

Last night Irving told us about his work here, focused on sexually transmitted diseases, HIV/AIDS, Tb and malaria. About 15 years ago he and Mike Cohen published a paper that made a major contribution to the world’s understanding of how HIV is transmitted. They showed that men with active STDs are much more likely to transmit the virus that causes HIV/AIDS than men without STDs.

UNC has built a major set of research, service and teaching programs in Malawi, and now spends about $12 million per year here. Much of that is in Lilongwe, where we will go on Tuesday.

I asked Irving whether he is hopeful about the future of Malawi — and he paused and told me how committed he is to this work, and how important it is to be here in this very poor country. He then told me of the successes that the programs have had, including a reduction in the HIV prevalence rate over the past several years. Clearly though, this work takes major persistence and real heart.

This morning, I got up early and went to the 7:30am English language service at St. Paul’s Cathedral, a congregation of the Anglican Church of South Malawi. The church was filled with enthusiastic worshippers — and I was one of the two non-blacks there. The experience was really wonderful, especially the a cappella singing led by a men’s trio, using the call and response style.

Later, after brunch, we were introduced to Mick Royle, a friend of Irving’s, who is a native Malawian. He is a well-trained naturalist, and his business is guiding tours of this region. Irving described him as the real “Crocodile Dundee,” and that is very apt. We rode in his Land Rover an hour east of Blantyre, to the tea estates — vast fields of tea bushes. They are pruned to be about three feet high — and at a distance it looks like acres of finely pruned boxwood shrubs. Mick was raised in that region of Malawi, and knows it well. His father worked for the government in the agriculture department.

We went to Mt. Mulanje, and had a picnic beside a beautiful mountain stream. We ate sandwiches and fruit that we bought along the roadside on the way — pineapple, bananas and sugar cane. We took lots of pictures of the vendors, and they loved getting Polaroids of themselves!

On the way back we stopped at a roadside market where they sell wood carved items, mostly made of very fragrant cedar — we got some beautiful small boxes, carved animals and other things.

It has been a long and very pleasant introduction to this beautiful country. We have dinner tonight with colleagues from Johns Hopkins University, with whom we collaborate a great deal, and then tomorrow is to be filled with visiting a number of research, teaching and service sites.

My vision of global health is getting sharpened and made very real — especially through the insights I am getting from the very committed people who work here — Malawians and Americans. And I can see even more why global health is important, not just for UNC researchers, but for the people of North Carolina. What is learned here will be helpful in back home in NC, as we seek to advance health and medicine in North Carolina.

I have not mentioned until now that I am accompanied on this trip by our son, Will Roper, and by his friend, Jessica Epsten. They both start college this August, and this trip is a great way for them to expand their horizons, quite literally. In my upcoming notes, I’ll tell more about what they are doing. Tomorrow, for example, they are spending the day with the Street Kids Project here in Blantyre.

Bill