Marie-Josèphe Horner, PhD Student Department of Epidemiology
February 24, 2016

Malawi is called the Warm Heart of Africa, and I can see why: its people are kind-hearted and friendly, and although resources are scarce people are generous with what they have. Malawi has a rugged beauty I haven’t seen anywhere else. The wonders of nature unfold as the landscape transforms from the dusty, brown colors of the dry season into a lush jungle and endless maize fields during the rainy season. In many ways, my student life continues on with business as usual while living overseas, with small exceptions. I continue my hobby of marathon training, though now my entourage includes curious neighborhood kids perplexed by the crazy azungu who goes running (‘from what?’, they ask) under the hot African sun. I may have found the best coffee shop in town for proposal writing but I do sometimes miss the grad student vibe of Carrboro’s haunts.

I recall the fateful day I talked to Irving Hoffman about public health projects at UNC-Project Malawi. We traded stories and he began to tell me about a recently arrived oncologist named Satish Gopal, the only medical oncologist in a country of 17 million. Malawi faces an HIV epidemic with 10-11% prevalence, which is reflected in its enormous burden of HIV-associated cancers compared to Western countries. With the increasing availability of effective HIV treatment, the high burden of malignancies is now gaining increasing attention in this part of the world. My dissertation research on trends in HIV-associated cancers has ultimately taken me here to Lilongwe, where I currently live and work as a Fogarty scholar during this academic year.

Since I first started coming to UNC-Project in 2013, there has been enormous momentum in the global oncology research portfolio under Dr. Gopal’s leadership and with support from NIH, the UNC Lineberger Comprehensive Cancer Center and the UNC Division of Infectious Diseases. As a grad student, it is academically stimulating and rewarding to collaborate with a multi-disciplinary team of clinicians, laboratory scientists, biostatisticians and epidemiologists in our Malawi cancer studies. In a short 3 years and apart from research, local cancer advocacy groups have also gained momentum. Cancer awareness is now frequently featured in the local press. In October, the second annual Breast Cancer Awareness Walk drew several hundreds of Malawian supporters in front of Parliament. Former Miss Malawi Blandina Kondowe, herself a breast cancer survivor, has emerged as a highly vocal patient advocate pushing the early detection agenda, and has collaborated with UNC in some of our efforts. Times are definitely changing for cancer in Malawi.

The opportunities offered to me through the UJMT Fogarty Global Health Fellowship and UNC Epidemiology Department have been unsurpassed. Both have provided me with the support to launch a new study in the field from the ground up- implementing the day to day logistics of the project, conducting analyses, and forging new collaborations with Malawian and international investigators. There is much work be done still but I remain optimistic and motivated that the forward momentum of our research will ultimately translate to improving the lives of some of the world’s poorest cancer patients.