African coral tree (Erythrina abyssinica)

The African coral tree (Erythrina abyssinica) are in bloom all over town and beautiful!

Eggs

Eggs in Malawi, although a good source of protein, are often expensive and scarce due to ad hoc backyard farming and expensive production inputs of chicken feed for larger commercial operations. Also, during Malawi's “cold” season, which just ended, eggs can be especially difficult to find.

Traditional beliefs and taboos have historically restricted women and young children in Malawi from eating eggs.

At our house, like most of Malawi, we store eggs at room temperature in a cardboard tray, unrefrigerated and unwashed, and they tend to stay good for two to three weeks.

Odd-sized eggs (like the one in today’s photos) are not uncommon, as there are no computerized sorting lines to filter them out before they reach the customer.

 

Animal husbandry and environmental conditions are associated with cefotaxime-resistant Escherichia coli in yard soil in peri-urban Malawi

One of my students has just published their research on Malawi, so I thought I’d share it here in case anyone is interested. It is also really encouraging to see my student’s research out there and published.

Animal husbandry and environmental conditions are associated with cefotaxime-resistant Escherichia coli in yard soil in peri-urban Malawi

Abstract
Soil is an important reservoir for antimicrobial resistance (AMR) and increasingly recognized as a pathogen transmission pathway, especially for young children. However, drivers of domestic AMR soil contamination in low-income countries remain unidentified. We conducted a cross-sectional study with 237 peri-urban households in southern Malawi to identify household and environmental factors associated with cefotaxime-resistant E. coli in yard soil. Enumerators employed structured surveys and sampled 900 cm2 of yard soil per household. We enumerated cefotaxime-resistant E. coli in soil using IDEXX Quanti-Tray/2000 with Colilert-18 and cefotaxime supplement, and assessed associations with household sanitation, animal ownership and management, child health and antibiotic use, and weather. Among children <5 years, 25–90% played, ate, slept, or crawled on the ground outside. Of 233 soil samples, 69% harbored cefotaxime-resistant E. coli at a mean of 0.90 log10 most probable number (MPN) per dry gram. Compared to households without animals, household soil had approximately 0.50-log lower mean cefotaxime-resistant E. coli concentration if animals were enclosed at night and 0.40-log higher concentration if they were not (p-values<0.05). Mean cefotaxime-resistant E. coli concentrations were approximately 0.90-log lower if soil was dry at the time of collection, 0.70-log lower if the household was in the top wealth quintile (p-values<0.005), and 0.30-log lower if any child in the household used antibiotics in the last four weeks (p-value = 0.05). There were no associations with daytime animal confinement, household sanitation, temperature, and ambient humidity. Findings suggest that animal husbandry and soil moisture had stronger associations with cefotaxime-resistant E. coli in soil compared to sanitation or antibiotic use, underscoring the importance of a One Health approach to AMR that incorporates domestic animals and environmental factors. Given children’s frequent soil contact, our findings also highlight potential AMR acquisition from soilborne pathways. Studies should quantify soilborne AMR exposure and evaluate associations with animal management/enclosure practices.

The full article is here: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006264

United Nations in Nairobi, Kenya

Just getting back home to Mzuzu after an amazing and encouraging week. I was invited to the International Workshop on Wastewater and Environmental Surveillance at Airports and Ports, organized by the United Nations Environment Programme (UNEP) and the United Nations University Institute for Water, Environment and Health (UNU-INWEH). It took place from September 21 to 23, 2026, in Nairobi, Kenya.

The focus was on using wastewater and environmental surveillance at major transport hubs (including airports and both ocean and land borders) as an early warning system for pandemic preparedness, pathogen detection, and tracking resistance or pollution.

I really enjoyed learning about highlighted active wastewater sampling at locations including Jomo Kenyatta International Airport and Rwandan transport streams, and how we could expand our Malawi program.

The United Nations campus in Nairobi was also an amazing experience seeing all the country flags line the major walkway. Here are a few photos from the week.

Malawian citizens must obtain a US visa in Kenya

The United States’ partial suspension of visa issuance for Malawians, with limited exceptions, remains in effect.

But added to that, Malawians intending to travel to the United States must now apply for visas from Kenya after the U.S. State Department discontinued routine local visa services at the U.S. Embassy in the capital city of Lilongwe a few weeks ago.

Malawian applicants must now schedule appointments and process tourist or business visa applications through the regional hub at the U.S. Embassy in Nairobi, Kenya. There is also a refundable bond of up to $15,000 that may be required. Visa issuance for Malawian nationals continues to face partial suspension, meaning applicants can apply and attend interviews, but eligibility for final visa issuance remains strictly limited.

We pray for those Malawians affected by these changes, particularly those whose plans to travel, work, study, or reunite with loved ones in the United States and may now face additional uncertainty and hardship.

Still cool temperatures this September

So far in September, the weather has remained quite cool. September typically marks the start of our hot season south of the equator.  Enjoying a sunny but cool Saturday here today in Mzuzu. 

Delivery photos & thank you to Kennewick First Presbyterian Church in Kennewick, WA

A huge thank you to Kennewick First Presbyterian Church in Kennewick, WA, for the wonderful books donated to our community!

Book distribution continued today as I was able to go to Vyelle Primary School, one of the large government public schools with a very great need for books. Vyelle Primary School has over 2,000 students! Primary school in Malawi is an U.S. equivalent of approximately Kindergarten/Grade 1 through Grade 8. Despite the overcrowded classrooms and lack of resources at this government school, their students did really well in last year’s national exams. They were proud to tell me that (and wanted me to pass on that good news!) and following such good national exam results these new books as the children start the school year will be an additional boost of motivation for the younger students to work hard and do equally well in their national exams. The school Principal received several boxes and she was so grateful! Books are so hard to get in Malawi, these books will really make an impactful difference in the education for the children at this school.

The photos are of me with the Principal, Mrs. Shaba, and two of the teachers. 

The second distribution was at an Early Childhood Development Centre (ECD) that is part of our local Church of Central Africa Presbyterian. And ECD is similar to a Montessori preschool. This was especially a perfect place for some of the preschool books. The preschool books that were included were so cute, and this new CCAP ECD was such a worthy recipient!

If you are also interested in sending even one box of books or organizing a larger-scale book drive in 2026, please don’t hesitate to reach out to us!