Anne Stoddard
Director, New England Research Institutes, Pelham, MA
Field: Public/Global Health
Host: University of Malawi
Grant Dates: March 18, 2004 - April 6, 2004

In March, 2003, I had the opportunity to develop and teach the introductory biostatistics module in the Master of Public Health (MPH) degree program at the Medical College of Malawi in Blantyre. When I left Malawi last year I never thought I'd be back, but the Fulbright Specialists Program made it possible for me to return to teach the course a second time.

The current class of 25 health professionals will be among the first Malawi trained Public Health professionals in the country. 

Like MPH students at home, the students in the program come from a variety of backgrounds and have diverse abilities in quantitative methods. The program is being designed to take into consideration the specific Public Health training and implementation needs of the country, so customizing the biostatistics course to the students' needs and abilities is important. By incorporating last year's experience I was able to do just that and to include some more relevant examples. In addition, a Malawian counterpart assisted me with teaching, and he will take over responsibility for the course next year. 

Malawi is a beautiful country. I was there at the end of the rainy season so everything was lush and green. I stayed at the home of the director of the MPH program and his wife, high on a tea estate outside Blantyre. We ate passion fruit, pineapple, eggplant, "pumpkin" (like our Hubbard squash), potatoes and more from their garden, supplemented by other produce from the local market. Outside my bedroom window was a rose bed that had been taken over by dahlias.

In contrast to the incomparable beauty is overwhelming poverty. The median annual income is equivalent to about US$700. I was struck again by how little people have. Most people don't have enough to eat and children's growth is stunted from the age of 6 months when breast milk is no longer sufficient to meet their nutritional needs. People walk miles to school or market and carry huge loads on their heads; if they can afford a bicycle, they carry even larger loads. The effects of the HIV/AIDS epidemic, rampant tuberculosis and hyper-endemic malaria are exacerbated by the poverty and limited health care resources. The life expectancy at birth is 37 years, a decrease of about seven years since 1980. Approximately 16% of the adult population is infected with HIV. The MPH program is one way in which Malawi can address its public health needs, increase its health care infrastructure and reduce "brain drain." It is exciting to see this program unfolding and rewarding to be part of the process.

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