From July through September 2017 I will be in Blantyre, Malawi for the research portion of my fellowship. I wanted to use this blog as a way to keep in touch with and inform people of the goings-on. This is an introductory post about my trip.
Why are you going to Malawi? Why Malawi?
I wanted to utilize time I had in medical training for exposure to international health,. Some of you know I have spent some clinical time in Niger, Kenya/Uganda. Two years ago when I started pulmonary/critical care fellowship, I was encouraged to looked for opportunities to do research in international-related health topic. I talked with various people, looked for mentors, and doors ended up opening with Dr. Homer Twigg. I told Dr. Twigg of my interest in indoor air-pollution after my experience with many young female patients in Kenya: many had right-heart failure from lung disease related to burning crop dust and animal dung for cooking and heating. Dr. Twigg connected me with his contact, Dr. Stephen Gordon in Blantyre, Malawi. And there began a string of emails, skype meetings out of which my project was born.
What is your project that you will you be doing in Malawi?
There is a surging interest in the “microbiome”, or the millions of cells that colonize the human body and outnumber human cells 10:1. They live in dynamic communities in the gut, the lungs, the skin, and they play an active role in regulating normal host-environment interactions as well as provide host defense against infections from pathogens. I will be partnering with my collaborators to investigate whether environmental exposures (like breathing fumes from indoor air pollution) can cause changes to the microbes (bacteria) that colonize different parts of your body such as your skin, your nose, your lungs. The hypothesis was partially generated from a study that was published by my collaborators in Malawi showed that cleaner fuel use for cooking and lighting was inversely related to a bacteria in the lung called Petrobacter. My goal is to recruit 30 subjects and collect their environmental exposures bacterial data (from drinking water, air, soil, burning oil) and then collect their body compartment samples (from lung BAL, nose, skin, stool) and compare the microbes sequenced from these samples using very complicated statistical analysis. I will also look at their immune status in relation to these bacteria to see if there’s a inflammatory correlate between these microbial communities. All these samples will be processed in Malawi.
Who else is going with you and where will you stay?
While I am the only person from Indiana University going, there is a rich research community there composed of other fellows and investigators from UK and US. The lab facilities are established by the Malawi-Liverpool Wellcome Trust, so it was started with UK support. My collaborators are UK as well as Malawi investigators who live in Malawi year round. I will be staying in a house with fellows I met when I went on an introductory visit in February. (see pics below from our hike).
What will the weather be like there? How do you pack for that?
I will be transitioning through two season. It will be the dry season when I go so the days will be high 70’s and nights/mornings low 50’s. But in September, it will be more summer like temperatures right before the beginning of the rainy season. I left some clothes there from my trip in February that are more summer-appropriate. I will carry a 50L backpack with some sweatshirts, long sleeves and jeans. I think the key will be to just do laundry frequently. I’ve learned from these trips that there are truly very few items that are absolutely necessary for survival. I will also bring my hiking gear in anticipation of climbing a few more peaks in Malawi.
What is the country like?
From my 10 days I spent there in February, I see that it is a country filled with wonderful people. The facilities where I will do research is excellent– the caliber can be compared to an American or UK facility. The country is breath-takingly gorgeous. Just journeying up and down the peaks of Mount Mulanje, one word was repeatedly uttered: “Kukongola,” or “Beautiful” in Chiwa, the local language. I hope to show you more pictures and stories as I spend time there.
Below are pictures I took from my journey going up and down 2000m on one of the peaks of Mount Mulanje. Enjoy.