On the Road Again...

I’m hanging my arm out the window of the World Camp Land Rover that has certainly seen better days, while peering up at the rocky outcroppings jutting high above the lush grasses and maize rows lining the road.  With Mount Nkhoma looming ahead Baker eases the Rover off the tarmac and onto a washed out track certainly not passable by any vehicle other than a sturdy four-wheel drive.

It has been 4 or maybe even 5 years since Baker and I have been in the field in Malawi at the same time, which is hard to believe after spending so many years working in rural communities around Lilongwe. Today I am reminded of those early trips spending entire days driving the rickety Rovers along scarred roads full of potholes and deep ruts to pay a visit to our World Camp program sites.

Today was no different as we bounced along, swinging the car left then right in an almost futile effort to avoid rocks and ruts along the neglected roadbed leading to Mkhosi Full Primary.  Mkhosi is a small school at the base of Mount Nkhoma and World Camp has been conducting programs here for the past nine years.  Our Rover was met with a handful of curious children and familiar teachers quick to point out their participation in World Camp programs of the past.

World Camp has come along way since Baker and I first brought service intern groups to Nkhoma where we camped outside the school and shared lessons about HIV prevention. We take a few moments to reminisce and then load up and head off to our next program site 20km away.  We slowly climb a long dirt road and Baker gives a recount of a particular rainy season where the Rover slid off the road and ended up on her side half submerged in sticky mud from the constant rains.

We crest the hill and a sweeping expanse opens up and clumps of orange, red and purple wild flowers wave in the wind among vast rows of maize.  We wind our way North towards Matapila Full Primary School, our horizon is framed by a vast escarpment with Nkhoma peaking at us from the East.  As we pull up to the school we haven’t even turned off the Rover’s engine when we spot an anxious teacher making a bee-line for us all smiles and waving.

He presents us with friendly handshakes and then he begins to chuckle and excitedly blurts out my name, “Mr. Jesse”! I am instantly regretful for having forgotten his name, but Mr. Kamponda is quick to point out “that time before when I was at that place, remember”? It turns out that Mr. Kamponda was a teacher at a World Camp partner school we had visited in 2003 and was now Head Teacher for Matapila Full Primary School.  A testament to the expansive reach World Camp’s programs are having around rural districts of Lilongwe.

We review the details of an upcoming World Camp outreach program scheduled for July and then climb back in the Rover, say our goodbyes and drive off into the burning sun towards Lilongwe.

Make sure you visit worldcamp.CO - follow our latest news and projects. World Camp is dedicated to providing simple solutions to the complex problems of poverty and disease in disadvantaged communities and we need your financial support to sustain our work in partner schools.

WC Happenings: Improvements & Gearing Up for Summer!

Hello WC friends, supporters and fans! We hope this Tuesday morning finds you well and celebrating Earth Week in whatever small and wonderful ways you can. Come back on Friday for an informative reflection about environmental conservation in Malawi and the US.

If you haven't had a chance, be sure to check out our new website: http://www.worldcamp.co. We're in the process of fine tuning, so let us know what you think. Or if there's anything else you'd like to see! Post it on your facebook wall, in your gchat status, leave it on your friends notebooks....just be sure and share it with everyone you know!

WC Staff Rachel Dudasik and Jesse Pipes speak to college
students about opportunities to work with World Camp.
Photo credit: Heather Walls

As spring rolls in, so does our relentless push to bring in as many people as we can to the World Camp family. That's right, we're in the middle of recruitment, recruitment, recruitment! We still have a few spots left for both the Outreach Through Education and Youth to Youth summer internships. We've all been hard at work, but did you know that the majority of World Camp service interns hear about us from a former volunteer? That means you! Share your World Camp story with 3 new people a week (on the train, at the gas pump, even happy hour), host an info session on your campus, speak to a class about your experience, post flyers around your workplace. We'll help you do it. Let us know where you are and we'll connect you with other World Camp volunteers/staff or send you brochures/flyers to hand out. We understand the economy's tight and parents worry, so refer great applicants to us and we'll send them our fundraising packet and safety information.

Summer sessions begin the end of May, but World Camp has held a strong presence in Malawi this spring. World Camp founders Jesse Pipes and Baker Henson have spent the past number of weeks in country working with local staff, networking and piloting our new partnership with Baylor International Pediatric AIDS Initiative and Hole in the Wall Camps. Check back next week to hear about the camps and what these two have been up to.

We have some exciting new additions to our core World Camp staff, including local board members in Asheville and a year-round on the ground Country Director in Malawi. We'll officially announce these soon, so be sure to visit again.

Happy Earth Week everyone! Have a great one.

Impact Areas: HIV/AIDS-How Do ARVs Really Work?

Graph Source: http://www.avert.org/universal-access.htm 

Graph Source: http://www.avert.org/universal-access.htm

We hear a LOT about ARVs, but it’s often something we simply refer to when discussing HIV/AIDS treatment. We’ll take this week’s blog post to examine an essential, though sometimes overlooked, question among HIV educators and WC camp participants: How do ARVs actually work?

As most of you know, HIV is a retro-virus that attacks and kills the CD4 cells of a host’s immune system in order to reproduce. ARVs work by slowing, or even reversing, the progress of HIV.  Different ARVs work to do this in different ways. For example, the group of ARVs known as Entry Inhibitors work to block HIV from replicating in the DNA of a host cell.

Antiretroviral drugs (ARVs) are the most common method of treatment for HIV and AIDS. While ARVs cannot cure an infected person, they can significantly lengthen and improve the life of someone with HIV/AIDS. There are currently more than twenty approved ARVs worldwide, although the availability and licensure varies across countries.

Essentially, the goal of ARVs is to reduce and/or slow the replication of HIV in the body and allow the immune system to stabilize and recover.

When to start? There are quite a few factors that determine when an infected person should start taking ARVs. A medical professional must first assess all existing medical conditions (especially hepatitis, TB and pregnancy), current medications (including traditional and herbal), weight, and emotional/psychological readiness. The World Health Organization currently recommends that people living in areas of limited health system capacity and resources (like Malawi) start taking ARVs when their CD4 count drops to 350cells/mm3. In places where medical care is readily available, patients may begin ARV treatment at a much earlier stage of the disease.

Once started, ARVs must be taken every day for life. If the ARVs are not taken daily, the chances of acquired resistance, when the HIV virus becomes resistant to current ARVs, increases. Adherence is a major obstacle in many developing countries (see graph).

A few aspects of one’s life must be taken into account when deciding on the best choice of therapy. Since someone on ARVs must take their medicine at the same time every day, they must have a schedule that allows them to do so. Some drugs have specific food restrictions that must be taken into account. Potential drug interactions and special handling requirements must also be planned for so as to avoid complications.

Combination therapy: taking two or more ARVs at the same time to reduce the chance of resistance and increase strength. Taking three or more ARVs is sometimes called highly active antiretroviral therapy (HAART).

When a patient first begins ARV treatment, the combination of drugs is called first line therapy. If side effects are intolerable or if HIV becomes resistant, there is usually a change of drugs to second line therapy. Normally, second line therapy includes at least three new drugs.

Some possible side effects of ARVs include diarrhea, nausea, vomiting, rash, lipodystrophy (losing or gaining of body fat), appetite loss, central nervous system effects (including dizziness, mood changes, depression, anxiety and paranoia), fatigue, insomnia, weakness, frequent urination, increased thirst, kidney damage, liver damage, pancreas damage, or nerve damage.

So what does all of this mean for Malawi?

• Treatment requirements recently raised CD4 counts (from 230 to 250 in 2010). This is expected to double the number of Malawians eligible for treatment.
• The WHO has switched the ARVs Malawi will distribute. The new ARVs will reduce side effects and prolong the lives of those taking the drugs.

Submitted by: Karen Clark, WC Coordinator

Sources

• Avert.org
• http://www.aidsmeds.com/archive/Integrase_1687.shtml

**If you'd like to submit a post concerning one of 3 Impact Areas-HIV/AIDS, Environmental Issues or Gender Equality-, please email info@worldcampforkids.org or katy@worldcampforkids. Excerpts from current undergrad and grad research papers, discussions from classes, thoughts on articles, etc. are encouraged!**

Impact Areas: Deforestation-An Example of the Intersection of Health & Environment in Malawi

Ariel view of major deforestation in Malawi.
Photo credit: Katie Sacca

Most WC teachers consider the HIV/AIDS and environmental curriculums to be distinctly separate. In fact, when we look at each issue on a deeper level, we see how intrinsically linked they are. We see how they influence each other. There are many other ways in which health and environment impact each other throughout the world. The goal of this blog post is to show just one of the many ways that HIV/AIDS and environmental issues are intertwined in Malawi.


The environmental issues most commonly discussed in Malawi today are deforestation and food security. These are by no means the only environmental problems in Malawi, nor are they necessarily the most pressing. On a broad level, one can easily see how the basic connection between deforestation and food security impacts Malawians. Most Malawians live in rural areas (State Department's 2010 estimate: 90%) and depend on locally-grown and harvested food, often from their own yards (ever wonder why there are so many goats and chickens around?). Deforestation causes erosion and soil degradation, which threaten the land on which subsistence or cash crops are grown. When these crops fail to grow, farmers struggle to make an income and feed their families. 

Deforestation also causes problems related to water quality, often to water sources miles away. Pesticides and waste runoff contaminate natural water sources. This happens because of soil compaction; roots on trees create air pockets which are essential for drainage of surface water; this water is in turn essential for maintaining the natural underground water table. In addition to decreasing water quality, deforestation and subsequent soil erosion/degradation leads to smaller crop yields, the overuse of toxic fertilizers (to make up for poor yield due to erosion), and ultimately, poorer nutrition when families are forced to make do with smaller yields, decreased (or negligent) net profit from cash crops, and less quality/variety in subsistence crops.

A Malawian local carries firewood on the back of his bike.
Photo credit: Katie Sacca

Another major effect of deforestation relates to poverty and infrastructure. Less than 5% of Malawians have access to electricity, leaving around 14 million people dependent on kerosene and open fires for light, heat and cooking fuel. Anyone who has been on a WC homestay in Malawi can attest to the fact that standing in the cooking hut for long periods of time is straight up impossible; dense smoke from cooking fires is a health hazard in and of itself. The massive population increase in recent years is responsible for small-scale deforestation* for this very reason: fuel wood for cooking fires.

So we have now established three threats to health that are directly correlated with deforestation: nutrition and poor water quality due to runoff and soil degradation, and hazards due to cooking fire exposure. The connection between HIV/AIDS and deforestation is a little less obvious so we’ll break it down as we go along.

Deforestation is as much a local problem as a national problem in Malawi. On a very local scale, the more people in an area (lets say a small village), the more the problem will grow. Trees naturally replenish themselves at a very slow rate, so it’s nearly impossible to replace them at the rate they’re being harvested on a small-scale basis. As deforestation intensifies in a localized area, the amount of time it takes to gather the necessary amount of wood to fuel a cooking fire for an average Malawian family increases significantly. Here we get at one of our tenets of HIV/AIDS education: prevention. 

How can deforestation possibly have an effect on HIV/AIDS prevention? Here are a few examples (there are surely more):

• Older children skip school or drop out and spend their day searching for firewood, working to make money to buy firewood, or caring for their siblings while their parents search for firewood (HIV/AIDS effect: these children miss out on critical HIV/AIDS prevention programming in school, one of the only places where children are taught objectively and correctly about HIV/AIDS).
• Single mothers who can’t afford to spend their day searching for fuel may sell their bodies in order to earn money to purchase firewood (HIV/AIDS effect: commercial sex is a risk factor for HIV).
• A pregnant HIV+ mother has to decide between spending her day collecting or buying firewood for her family’s meals and traveling to the health clinic for HIV treatment (HIV/AIDS effect: although ARV treatment for pregnant HIV+ women is free in Malawi, if women can’t make it to the clinic, their newborn is at risk for HIV as well through vertical Mother to Child Transmission).

However seemingly nuanced, many more connections between health and environment in Malawi remain. It's interesting to note that the points made about HIV/AIDS prevention eroding because of deforestation above also apply to food security and nutrition in Malawi. When food security is threatened on a family level, all three of the above examples of HIV/AIDS prevention are also vulnerable. Food security and nutrition are equally as threatening to the general population of Malawi as deforestation is.

So, what next? 

Trees and harvest in Malawi.
Photo credit: Katie Sacca

Despite the grim news of deforestation, Malawi has made significant strides in countering deforestation. One of the most popular ways to respond to widespread deforestation is implementing and promoting family planning, which as many of you know is a prominent section of World Camp’s environmental curriculum (the cup game!).  This week, Malawi will receive a $350 million (K53 billion) grant from the US-based Millennium Challenge Corporation to overhaul its energy network (among other projects). Hopefully, this will lead to improvements in energy infrastructure for Malawi’s rural populations who depend on firewood for survival, not merely industry (mining, industry factory production power shortages have dominated the energy conversation in Malawi in recent months). Stay tuned for more discussion on energy and innovation in Malawi!  



*The nature of deforestation in Malawi is very different from the clear-cutting we’re all used to hearing about in Brazil or the Pacific Northwest. It is small-scale in nature in that deforestation is caused by many individuals hacking down individual trees and eventually patches of vegetation for personal use or small-scale income generating activities (selling firewood), rather than the large scale removal of entire forests (which happens mainly in the south of Malawi on tea and tobacco plantations). 

Sources:

• State.gov Malawi Profile
• Personal correspondence; Kara Greenblatt, independent consultant on Food security and nutrition
• Wines, Michael. "Malawi Is Burning, and Deforestation Erodes Economy." New York Times 1 Nov. 2005.
• Available at: http://www.nytimes.com/2005/11/01/international/africa/01malawi.html
• Nyasa Times Staff. “US completes $350 electricity Grant for Malawi.” Nyasa Times 2 April 2011. Available at: http://www.nyasatimes.com/national/us-completes-350m-electricity-grant-for-malawi.html

Submitted by: Katie Sacca, WC Coordinator


**If you'd like to submit a post concerning one of 3 Impact Areas-HIV/AIDS, Environmental Issues or Gender Equality-, please email info@worldcampforkids.org or katy@worldcampforkids. Excerpts from current undergrad and grad research papers, discussions from classes, thoughts on articles, etc. are encouraged!**