At Mangochi district hospital I met with the Safe Motherhood Project Coordinator. She explained about one such safe motherhood project in Chilipa zone – a rural area in Mangochi district. This community project took a bottom up, participatory approach involving all members of the community, male and female. The main focus of the project encourages the use of maternal health facilities through increasing knowledge and awareness on Safe Motherhood. Traditional leaders, practitioners and husbands were encouraged to refer all pregnant mothers to deliver at maternal health services. Once Traditional Birth Attendants (TBAs) now act as signposts to health services rather then delivering themselves. The slogan used by TBAs “A Wise Mother will deliver at a Health Facility”. Through sensitization the demand for maternal health services increased thus in order to help with access to these services, bicycle ambulances were supplied. Thus through community mobilisation and participation delivery at health centres increased and the maternal mortality rate of the zone decreased.

A Different Scenario: Giving Birth in the Village

 Visiting a traditional birth attendant at her birthing house in the rural community helped me to fully realise and understand the complexities and dynamics involved.  Dr. Cecilia Nyrienda (ethnobotanist) previously carried out her Masters research for six months with Mrs Kamasuka a TBA in Mwanakhu village, Mulanje, thus she kindly arranged for me to go and visit her. We travelled there by vehicle, which meant turning off the tarmac road before Mulanje town and travelling for 5 or more kilometres long a dirt road. However on our way there we encountered a bridge, which definitely didn’t look stable enough to take a big vehicle so we went on a short detour, weaving our wave between houses. When we finally arrived we were met by smiling faces and lots of warm welcomes by the TBA, her husband and children!

The “birthing house’, a modest mud plastered building with a thatch roof, one room for ‘delivery’ and another for ‘post delivery’. An old frame of a once bicycle ambulance lay propped up against a wall outside, as there were no finances available to carry out the necessary repairs. Beside the birthing house, trees gave shade to family members who waited for their loved ones to be discharged. Another house next door used to act as the maternity ward, but because the TBAs house fell down, it is now temporarily used as the TBAs place of residence. With the heat blazing outside it was nice to enter the cooler, darker house where I was met by two women lying on reed mats, who held their healthy new born babies, accompanied by their guardians. As a visitor I was given the privilege of naming the two new beautiful babies, which I took as a big responsibility! After much consideration I decided on more Malawian names, Madilisto (girl) and Bright (boy), thinking that Irish names might cause complications! Inside the birthing house the atmosphere was very calm and relaxed, even though a woman was in labour next door! When chatting with the women they explained that they preferred to go to the TBA for she was friendly, mature and experienced and also the district hospital was 12km away, which meant finding transport. On market day (twice a week) matola’s (pick up trucks) /mini buses can be found, but on other days travelling remains a challenge. During the ban on TBAs delivering babies, Mrs Kamasuka explained how she felt she was put in an awkward situation as it was impossible to turn away expectant mothers who desperately needed her help.

All first time mothers and twin pregnancies are referred by the TBA to the district hospital, though sometimes with transport and financial problems these mums also give birth with the TBA. Resources for delivery are extremely basic, as the TBA no longer receives any support in the way of resources or equipment, from the hospital or NGOs. The equipment used for delivery: a black polythene sheet on the ground, and plastic sugar packets as gloves! Women bring their own food, blankets and basins for washing.  The birthing centre receives about 15 women a month for delivery. Also the TBA operates anti natal clinics where she determines pregnancy and the stage with her bare hands, skill and knowledge. As the centre receives no medication, mums are encouraged to buy necessary medication such as iron tablets to take during pregnancy.

The TBA explained that while she gained her knowledge of herbalism from her mother, her midwifery skills she gained from observing a “white lady” who was a visiting midwife. Thus the TBAs practice combines the traditional knowledge of her grandmother which that of medical science. As we were about to depart I also noticed a mum being discharged, her details being recorded by the TBAs husband. With the baby rapped up on the mothers back and their luggage strapped on a bicycle, the family walked away into the distance.

After much reading about TBAs it was great to finally be able to meet one and experience the real life situation. The trip raised the issue of ‘choice’ in my head. While some mothers lived far away from the hospital, others by passed the hospital and choose to deliver with the TBA due to social and cultural reasons. Thus the familiar, friendly and culturally sensitive TBA lay juxtaposed with the scientifically trained nurses and midwives at the health centre/hospital. 

Concluding my Trip to Malawi

With my visit to Malawi soon coming to an end I have been busy, finishing my review of literature on safe motherhood. I also gave a short presentation to the staff of CSR and the Sociology Department on my general learning’s and thoughts on existing research that has been carried out and the possible areas and opportunities for further meaningful and collaborative research. Having the opportunity to visit Malawi a second time allowed me to develop a greater understanding of the social and cultural complexities and dynamics of providing ‘appropriate’ and ‘accessible’ maternal health care.

Fast forward, I arrived in Ireland in May Just when summer was approaching and I must commend the CDPC administrator who ensured that I felt comfortable and had all  the assistance that I wanted  to settle down.  During my first week,  I embarked on the analysis of the data set that I had postponed for several months while in Uganda due to the multi tasking that has always characterized my work ethics. I am glad that the time I spent in Ireland enabled me to accomplish this exercise in a record time that would have taken me ages had I done it in Uganda.

For the larger part of my CDPC Fellowship I concentrated on developing two concepts that I had only managed to leave in their preliminary stages for months. This time enabled me to share these ideas with Senior people at the department of Anthropology at NUIM. Its worth noting that with the mentorship that I got, I managed to refine these concepts. I am currently developing them into full grant applications. I submitted one on my return to the Centre for AIDS Research Development Awards programme at the University of California San- Francisco. I am delighted  to note that it was passed during the first review to compete at the next stage.  I have been allocated a mentor to work with at this stage. I am now competing with other junior scientists across the globe that will compete for the final grant.

I am also working on the second concept that I will be submitting for another grant application. The library and online resources that I had access to played a vital role in accomplishing my primary objective from the CDPC Fellowship.

It was also during this time that we also got a chance to attend the  TIDI organized  African Day Conference  at Trinity College Dublin, one of the presenters was  the outgoing executive director of the Uganda Investment Authority  Prof. Maggie Kigozi. It was an important experience for me because for the first time I witnessed Uganda being marketed which isn’t the case when you are in Uganda. The presentation indeed took us through the natural beauty of Uganda’s flora and fauna, the wild life, the culture, the landscape and the people that we often under look. We had time to take a walks along the streets of Dublin and during one of those walks with my Ugandan Colleagues, a curious Ugandan Living in Dublin heard us communicating in our local language that she intercepted us to say hi. We were very humbled and delighted to learn that a stranger along the street could understand the language that we were communicating in.

Another adventure that will take a long to get out of my head is the  attendance of the Obama public rally at College Green. I was so excited to listen live to the man that caused fever across the African continent in 2008 during the presidential campaigns. While time was quickly closing in to our return date, I had another adventure that purposed on understanding Maynooth better. For a bigger part of my fellowship stay I had known Maynooth through the lenses of the campus, the church and the supermarket where we used buy our groceries. But this time round, here I was attempting to visit all the interesting sites around this township. The visit to the National museum of science was particularly interesting as I got to see for the first time  the versions of the very first radio set, telephone set, Batteries, type writer  and it was  a technological journey  that made me  come face to face with  how far civilization has come. My next stop was the Maynooth castle and learning gave me a sneak peak of the History that surrounds this township.

Taking a walk around the NUIM Campus

The topic of safe motherhood definitely is in the public conscience. Coming into Blantyre city I noticed a big billboard saying, “Women shouldn’t die during Pregnancy”. Also in the daily Malawian newspapers there are regular articles related to maternal care in some form or another. One such article noted how the First Lady, ‘Callista Mutharika’ Foundation for Safe Motherhood donated sewing machines and water pumps to a women’s group to aid their development.  Another article by Francis TayanJah-Phiri (The Daily Times 2011) examined the “Role of Culture in Maternal Health”. This article explores in particular the different customs and cultural practices of the Yao tribe of southern Malawi and the Mang’anja tribe (lakeshore dwellers), in relation to maternal health. He refers to key players in the community such as the chief and the traditional birth attendant as ‘cultural custodians’. Through conversations with Yao and Mang’anja community leaders/members the author details how cultural practices and traditions have both positive and negative effects on maternal health. For example: Pregnant women are supposed to wear red beads -“Luchenga” (Yao language) to signify their being between life and death, and thus should be treated with kindness! Other beliefs discourage pregnant women from eating catfish (mlamba) a common and nutritious fish in Malawi. Also the article states that while Mang’anja elders use traditional practices they are also open to incorporating modern maternal health care methods into their culture. This leads to another topic, which I encountered while reviewing literature, Traditional Medical Practice.

Traditional Medicine

In Ntcheu I went to the local market to chat with a herbalist ‘A sing’anga’ (in Chichewa language) who is registered with the Herbalist Association of Malawi (HAM). While I was somewhat familiar with the medicinal qualities of plants such as Eucalyptus or Tea Tree oil and would often use them for the common cold or minor ailment, I was intrigued by the wide range of medicines on display by the herbalist. All parts of the plant (leaves, roots, bark, seeds etc.) are used to treat both physical and social problems. The herbs used though are not cultivated but rather are taken from their natural environment. While the herbalist had medicines for stomach pains or other physical conditions there were also medicines to treat those affected by witchcraft and charms to deal with other social predicaments. Thus his medical practice embraces cultural and spiritual components as well as physical. Kayne 2010 who has written on Traditional Medicine in various countries, states that the key question of Traditional African Medical Care is to discover the underlying cause of illness. “Why is the person ill?”  It maybe due to: a normal stage in development; the person in question has offended his/her ancestors in some way or has been affected by a supernatural force such as witchcraft. Thus illness doesn’t just happen by chance but rather there is an underlying reason why someone becomes ill. Rather then seeing traditional African medicine as an alternative form, Kayne debates that it should be treated as a complementary one, which complements basic western medicine. Thus I began to realise that African medicine is not just herbalism and to fully understand the factors influencing or affecting maternal health I also had to understand the social and cultural context in focus.

  Blantyre City

After visiting Ntcheu and Zomba I went further south to the ‘big bustling city’ of Blantyre, which is the main commercial centre of Malawi. The city dates back to 1876 founded by Henry Henderson as a mission station for the Established Church of Scotland (Bradt 2010). Thus the street names in the city such as Henderson Street or Glyn Jones (former Colonial governor) reflect a historic significance. However Blantyre also has a modern city feel, with multi story buildings, lots of traffic and noise, hotels and restaurants. It has a very large ‘Queen Elizabeth Hospital’ and also a College of Medicine and Kamuzu College Nursing (KCN) which both come under the University of Malawi. KCN named after the former President, Hastings Kamuzu Banda, opened in 1979 as the first Malawian training institute. Prior to this nurses and midwives were trained outside of Malawi. At KCN I met Dr. Angela Chimwaza director of research and postgraduate studies, who directed me to various places where I could find literature on safe motherhood and the use of traditional medicine, such as the College of Medicine library. 

We then drove away from the airport towards the city centre. Enlivened, equally, by both the thrill and apprehension, that one encounters in a new place, I had shirked off the tiredness that comes with a day and a half of little sleep. The bustle of the roads with drivers veering dangerously left and right, in search of space, was enough to keep one’s undivided attention. The wide open spaces that bordered the roads were filled with  people. Many sat around in groups as they talked to each other, in a language inaudible to me, but one that I would soon hope to learn. Others manned makeshift stalls that sold items as varied as fruit, garden clippers, sponges and football jerseys. The dust choked streets were littered terribly and Vincent, thusly prompted, spoke of the problems of urban waste. Vincent was professionally an accountant for twenty years but became a brother a few years ago. He is now involved in empowerment and support groups for people, namely women, living with HIV. The poverty was evident from the great number of beggars that looked for handouts from car to car. The abject poverty of the great number of crippled beggars, some terribly, stood in great contrast to the ‘ultra-modern’ headquarters of telecom companies like Vodacom and Airtel. During the drive I noticed quickly the prominence of the English Premier League in the city. Didier Drogba of Chelsea and Cotes d’Ivoire advertised Samsung air conditioners built for ‘African Conditions’, whilst John O Shea and Berbatov of Man United advertised Airtel coverage. Most men, especially the younger men, I have spoken to so far, all have their teams, with Chelsea, Man United and Liverpool being the most popular. The localisation of the Premier League in Dar es Salaam prompted a re-evaluation of my thoughts on the idea of a global world. This beginning marked my acquaintance with the busy yet relaxed nature of a city and its people, a quality I would come to love about Dar.

Eventually we arrived at Betania House, the nun led accommodation, where I was received warmly by Fr. Mwele. I was provided with a lunch of rice, maize, kidney beans, mutton and spinach, all of which was delicious. I have since grown used to three meals of rice a day. I was then taken for a walk around and through the city centre so as to help me take a bearing on the city. After a long day of news sights, smells, and people I was gracious to finally lie down. The next morning I woke peacefully only to find that I had rather unfortunately been bitten roughly one hundred or so times on each leg. To my dismay I discovered a small hole in my net, seemingly insignificant, that suited perfectly the mosquitos’ dubious intentions.

A bottle of salve and a hearty breakfast of rice and liver later I was set to begin my explorations of the Dar, its University and start the process of attaining my research permit. Three visits later I would, with the help of a kind sociology lecturer named Kamugisha, be able to justify my research. I had to plead the basis of my research to ensure that I did not require the additional medical ethics certificate. The necessity of a permit for clinical trials, which dances to tune of three hundred and fifty dollars, is both ludicrous for social science research and is not too kind to one’s pocket either. Thankfully this additional cost was avoided. With such concerns behind me, and the weekend at hand, I had the pleasure of seeing some local music and sampling a kitimoto plate, thanks to Erasto. Kitimoto, meaning hot seat, is a delicious plate of pork and salad, accompanied by surprisingly tasty salted baked bananas. Chakula hiki kitam sana (This food is very tasty). Off I went then to the beautiful island of Zanzibar for Kiswahili training whilst I waited and wait on my permit. So here I sit on Mtemwe Beach writing this blog and also attempting to translate my research questions, consent forms and information sheets into Swahili. This is a process that is moving polepole (slowly) though is being helped along by the company of a bia baridi (a cold beer).

Generally, my experience with CDPC has been a pleasant one. The accommodation at 47 Carton Square was perfect. The office space at the Department of Anthropology was also quite superb. The library contacts that Tom provided were quite helpful. Apart from the easiness with which I fitted in the official work, it was easy to fit into the daily life in Ireland, because English as a language is widely used here.

The availability of different food varieties has been better than I had anticipated. So, my time during this fellowship has not been disrupted by strange food. With a wide variety of cheap irish potatoes, I realized why they are referred to by that name around the world –they must have originated here. Also, the prices have not been exorbitant as I had anticipated.

One of the first events that I enjoyed was Obama’s address at Trinity College Dublin. I traveled to Dublin together with the other two Ugandans (Eric and Hellen) for the address a bit late to book the front row. So, my colleagues ended up seeing Obama only on the large screens that had been erected for the event. But for me, I pushed on through the huge crowd to a point where I could physically see him. But before getting to my viewing point, the lines heading to the security tents for screening were quite long. And most of the people heading to the security tent for screening were more patient than I expected. I pushed through the crowd, to a point where I could see the man clearly. When he finally appeared together with Michelle, the crowd got extremely excited.

Listening to Obama (Photo by Christopher Tumwine)

Enjoying the sun at the beautiful southern campus at NUIM (Photo by Eric Sseguja)

I am now residing in Zomba, a city further south of Ntcheu and North of Blantyre. Zomba was founded in 1981 as the capital of the British Central Protectorate of the then Nyasaland (Briggs 2010). It still retains a colonial character, with features such as the National Herbarium and Botanic Gardens and Hotel Masongola the oldest building in town and former residence of Sir Harry Johnston (1886). Zomba remained the capital city up until 1975 when Lilongwe became the capital. The city is surrounded by the spectacular beauty of Zomba plaeau and the low-lying lake Chilwa.

While travelling to Zomba, by mini bus (or several as it turned out to be) I started chatting with a man sitting beside me who happened to be working in Zomba hospital. He explained to me about the importance of Traditional Birth Attendants, and how they act as a link between the rural community and medical health services. He also explained how fuel shortages are impacting negatively on health services, for example not enough fuel for ambulances or to transport corpses back to their community to be buried. Also when there is an electrical outage, there is no diesel to run the generator so those on life support machines or operations in progress have to stop resulting in mortalities.

Centre for Social Research, University of Malawi

Here in Zomba I am visiting the Centre for Social Research (CSR), which is a research institution situated within the faculty of Social Science of the University of Malawi. The origins of the research centre date back to 1971 when the senate of Malawi University established the institute of social research. In the initial stages of what is now called the CSR, the main mandate was to appraise, monitor and evaluate UNICEF assisted projects in Malawi. Now the CSR covers research, consultancy, training, outreach and dissemination of research findings, with its four main research areas being:

1. Poverty and sustainable livelihoods,

2. Socio-cultural dimensions of public health,

3. Access to and management of natural resources and

4. Democracy and governance.

The Centre has a documentation/library where I search for articles and reports relating to Safe Motherhood and Traditional Practices. After gathering materials with both a sociological and anthropological focus, I begin to create a review of literature. This review of literature helps to gather a variety of research studies, which explore different theories, perspectives and ideologies on pregnancy, childbirth and both traditional and scientific practices.

Leadership for Environment and Development Programme (LEAD)

While in Zomba I also met with Dr. Cecilia Nyrienda who works with the LEAD programme based at Chancellor College. She has completed her MSc in Biology (Ethnobotany) and a PhD on Medical Plants, thus it was a great opportunity to gain from her vast knowledge and experience in relation to traditional practices and medicines in Malawi. I learned that Mwanamphepo is the Chichewa name given to medicinal plants, which comprise of many different types and varieties that are used for different ailments. Some medicinal plants used in Malawi are often alleged by conventional doctors to be toxic causing complications in pregnancy and birth, but little/no study has been done to access the taxonomy, toxicity and pharmacology of medicinal plants and concoctions. Dr. Nyrienda discussed the need for practical policies which reflect the reality on the ground and which tap into indigenous knowledge and medicine, seeing this resource as an opportunity rather then a threat. 

Here in Kisumu it is hard to see how bad the drought is affecting the country as the people enjoy a warm tropical climate with life-giving rains pouring down during the rainy season. However, there is a strong sense of concern for their neighbours in Somalia and Ethiopia; and of course northern Kenya itself which is home to many Somalian refugees. It is hard to go by a day in the lab without hearing the drought being mentioned. One Somalian student here at Walter Reed mentioned how important aid was to the people of Somalia and that when I return home it would be greatly appreciated to help raise as much funds as possible for those affected by the drought and to encourage others to do so. He stressed that even basic essentials such as clothes and blankets would be accepted with goodwill. He also expressed his gratitude to the Irish people who have donated so much despite the economical crisis. Indeed, in 2011 the amount of emergency funding from Irish Aid to the region of the horn of Africa has totalled €4.4 million to date and further funding for emergency efforts by Irish NGOs and UN agencies in the region has also been provided. Hopefully the support will continue to rise so that all affected can have access to water, food and humanitarian aid.

It has now being reported that people in parts of Uganda, Sudan and Dijibouti may also be affected by the drought and there is growing concern for northern Kenya.

The U.N has declared famine in two areas of war-torn Somalia – Southern Bakool and lower Shabelle (see map below). Reports state that 3,000 people are fleeing each day from Somalia which has suffered 20 years of conflict and civil war.

370,000 Somalis are at an overcrowded camp in the North of Kenya. The refugee camp, Dadaab, is built to hold 90,000 people and is extremely overcrowded.

Fortunately, the Kenyan government has agreed to open a new refugee camp, IFO II, which has a capacity of 80,000. 

After some deferral on my part I finally have the privilege of taking up an exciting opportunity of a CDPC fellowship based in Malawi.  I arrived in Malawi on 17^th July. Malawi is a land locked country in South Eastern Africa with a population of 15.6 million (UN 2010). Under colonial rule Malawi was named Nyasaland, Nyasa meaning lake. It gained independence in 1964. The official language is English, but the National language is Chichewa. 

I had previously visited Malawi as a volunteer with Volunteer Service Overseas (VSO) 2006-2008 at the District Education Office in Ntcheu, so I was excited to come and visit it again. I arrived into Lilongwe airport, Lilongwe being the capital city of Malawi. Descending in the plane the land glistened in the sun with many shades of brown with scattered bushes, unlike the greenness and cloudiness of Ireland! As I travelled in a taxi to my accommodation I asked how Malawi is doing, and the driver replied, ”ok but we have a shortage of fuel, I was a month waiting for fuel”. I stayed a night in the city before proceeding further down south by bus on the main M1 tarmac to Ntcheu district. After an hour the bus was finally full and with a blessing from a pastor we set off on our journey through the rolling landscape.

Malawi is generally a very peaceful country with patient and friendly people, however this week it experienced demonstrations mostly in the main cities Lilongwe, Zomba and Blantyre. The demonstrations claimed to be the biggest in almost thirty years. When chatting to people and asking why they were demonstrating mostly the replies were: because of frustration and demoralisation at the lack of progress on the ground, lack of fuel and lack of foreign currency. Though there appeared to be mixed feelings, some saying that development aid from foreign countries is necessary and vital, while others agreed with the government’s stance supporting more sovereignty. The President Mr Mutharika responded to the protests by saying that violence does not solve anything and is the work of Satan, which God will overcome. On the bus down to Ntcheu, Lucius Banda a popular Malawian singer was played, one of his current songs, encouraging people to be active citizens, stating, “If you don’t want to be criticised, say nothing, do nothing and be nothing”. While many people demonstrated others, especially civil servants, were afraid to in case of negative implications. 

Safe Parenthood and Traditional Birth Attendants

 However even with unsettlement in the air life keeps moving. After a catch up with friends and colleagues in Ntcheu I moved on to Zomba, which was once the capital city of Malawi, to meet with researchers from the Centre of Social Research Malawi. Having just finished my masters in Anthropology and Development, I am eager to put on my anthropological hat once again and commence the main focus of my trip to Malawi, which is to gain a better understanding of the cultural complexities of Safe Motherhood and Traditional Practices. 

Malawi is a mostly rural with only 15% of Malawi’s population regarded as urban (Nove 2011: 2). The Maternal Mortality Rate (MMR) is approximately 510 per 1000 live births 2008 (Nove 2011:3). Therefore Traditional Birth Attendants (TBAs) are used to ensure that someone is available to assist in the labour and birth of the baby when the mother cannot access a health centre due to distance, transport, accessibility, cost and various other reasons, such as when she simply prefers to give birth at home. Bisika in Stronge 2011 states that there are over 5000 TBAs in Malawi, approximately 2000 of which have received training. In 1982 a course for TBAs was rolled out nationally. While there is a lot of respect for TBAs in rural areas, there still appears to be the perception amongst health care professionals that the care they can provide is limited due to a lack of skills, illiteracy/low literacy and old age (Nove Andrea 2011). In 2007 there was a ban placed on TBAs providing maternity care, due to a concern about the quality of care given. However in 2010 the government lifted the ban, instead opting to give them further training.

Visiting former night guard and new baby wrapped in a "chitenje!"

Our trek near the Ngong Hills to collect samples. In the picture is Martin, myself and Michael Kibe (l-r back row) and some of the children we met on the way

We spent a few hours collecting samples, stamping our feet to get rid of ants biting our legs and avoided the herds of buffalo surrounding us. Finally we walked back to town and grabbed some Choma (boiled goat) and goat soup which I wasn’t a big fan of. 

Now that I had my samples I got them classified in the botany department and began work. It was a long process as I would be extracting chemicals from both the roots and shoots of each plant giving 18 different samples. For each sample I used 4 different solvent extraction techniques which gave me a total of 72 test samples. The past few weeks have involved adding solvents to powdered samples, heating to different temperatures, leaving the samples to macerate followed by numerous filtration steps, rotary evaporation of hopefully bioactive compounds, weighing of the test samples and finally reconstituting the samples in a known volume and concentration.  

The work, while long and tedious, was relatively successful except for bacterial contamination of some of my first hot water extracted samples.  These extractions were repeated and this time everything ran relatively smoothly. I’m really getting a feel for the differences in working and undertaking research in a developing country context and some of the challenges that ensue both practically and politically. 

The past few weeks have involved getting all of my samples ready for microbiology work where we will test the antimicrobial activity of extracts from different parts of these African chewing sticks. This week we will be culturing the two strains of anaerobic bacteria we obtained and will test our samples using both agar well diffusion and disc diffusion methods. Once inhibitory activity has been quantified I will then focus on a few samples with the highest antimicrobial activity. With 72 test samples and 2 bacterial strains I wouldn’t have time to study all 144 samples. The few samples I will focus on will be fractionated using a column and different solvents and then, time permitting, I will run thin layer chromatography and also mass spectrometry to help identify the active components. The end result will hopefully identify a couple of inhibitory bioactive agents found in African chewing sticks that may impact on oral hygiene, which is relevant to global health. 

Apart from lab work I’ve managed to travel to Kisumu to see Richael, the other Irish CDPC fellow in Kenya, and take in some of the sites. The journey to Kisumu was an experience on a coach bus hurtling along dirt tracks and overtaking on mountain corners.  Not something for the faint hearted! In Kisumu we looked around markets and took a boat ride out on Lake Victoria which was brilliant. We got fairly close to a group of hippos.  

Hippos poking their heads above the water of Lake Victoria

  Unfortunately I arrived late Friday so I didn’t get to see the KEMRI (Kenya Medical Research Institute) lab Richael works in which she said was really nice and well equipped. However, back in Nairobi I did manage to go up to ILRI (the International Livestock Research Institute) and meet some people and have a look around at the fabulous facilities. 

Halfway through and I really am starting to get a feel for Kenya and Nairobi. I’m looking forward to the final half of my time here.  

The adventure started off getting up at 7 to make sure I got to the airport for 8 o’clock where I met Richael and jetted off to Amsterdam arriving around an hour and a half later. We had around 7 hours to kill so we caught a little bit of Amsterdam before boarding Kenya airways for the 8 hour flight to Nairobi. I sat beside a friendly Ugandan man John who flew to Nairobi a few times a year and he filled me in on the vibrant night life and rich culture of Nairobi. He also mentioned that had been greatly increased in Nairobi and is relatively safe for mzungu. All in all I was excited to see what Nairobi had in store for me.  We touched down the following day at 6am in Nairobi and were met by my supervisor Dr Michael Kibe. I had booked a few nights in the embassy hotel as we were still looking for an affordable room for the 3 months. Driving from the airport to my hotel we saw an outskirt slum Kipila. I could see immense poverty and a village of metal boxes and overcrowding. We proceeded into Nairobi centre and arrived at our hotel located across from a meat market. Even at 7 in the morning the place was packed and we attracted a lot of attention getting out with all our bags. The hotel was basic but clean and comfy. However having a room on the 4^th floor proved quiet the workout with our luggage and no lift. Michael left us to get settled after which myself and Richael explored the surrounding streets picking up local phone and sim card. Soon after Richael headed back to airport and on to Kisumu and I looked around further picked up a modem for my laptop and got some sleep the first two days had been fairly tiring.

Day 3:

Michael picked me up at 10 this morning by which time I was plenty rested and we headed to look at possible accommodation for me for the next 3 months. We took a matatu to westlands just outside Nairobi central close to the university. Matatus are great fun but by god do they drive crazy. We met up with Peter the rental agent and viewed to places. The first was just built but not yet furnished. The second was an en-suite bedroom with a Kenyan family. I took the second because even though I was assured the first house would be furnished fully by the next night I was not taking the risk of sleeping on floor. After negotiating price with ester the “mama” of the house and family I would be staying with Michael showed me around the university introducing me to different people in his department. I also found out the nature of project which would be to isolate bioactive agents from various chewing sticks of the Masaai. The Masaai are a Kenyan tribe which use different roots and shoots from various plants as a form of dental hygiene.  Despite no other dental care their teeth are in very good condition. So I’m going to isolate bioactive compounds from these sticks. I will carry out four different forms of crude extractions using various reagents. I will then test their antimicrobial activity on various bacteria specifically associated with both tooth decay and gum disease. As well as this I will be testing the effect of some samples on glycolysis and bacterial adherence. Michael told me I’d be starting Monday which gives me plenty of time to get lay of the land. 

Day 4:

Today I got up early and got my luggage over to my new house on ceader road. I knew I wouldn’t get lost because just before the turn to the street of my new home was an apartment complex with a sign saying Connaught apartments with a green shamrock on it. I had Kenyan tea with Ester and her family and unpacked. I took a stroll to get the lay of the land and chat to the complex security guard Justice a very appropriate name. For dinner I had a real Kenyan experience. It comprised of ugali (a maize mash), sukuma-wiki (pondweed) and mala (fermented milk with sugar) and some chapati triangular bread) it tasted pretty good. I sat chatting with family for hours as they told me about the different tribes in Kenya and of the troubles surrounding the 2007 general elections. I told them a lot about Ireland I can already tell Kenyan people are very friendly and outgoing.

Day 5:

Today I got a proper tour of Nairobi thanks to the guidance of James Wainaina a fellow CDPC scholar who was over in Maynooth for 3 months the previous year. He took me on an all you can see tour of Nairobi and showed me a completely new side of Nairobi with markets, places to get my camera fixed, cheap food and a dozen other places. We went for a typical Kenyan lunch in upper hill where we picked out the meat (and if you wanted the animal) you wanted cooked. We went for lamb and had some ugali and kitunguu (salad of red onions and tomatoes). As we were leaving I picked up some miwa (sugar cane) from a seller on the road. James started laughing at me as I found it impossible to chew.  We also met up with a few of James’ friends and I got to experience night time in Nairobi and felt a great buzz around town. I then got a matatu home as it was dark and I was told it would be wiser.    

After such a fun packed few days I decided I better do some work so I started researching papers to aid in my introduction and literature review for my thesis. This project is going to be interesting.