Settling In

It’s been while since I’ve written anything sorry! After my hectic New Years celebrations I have kept a low profile and chilled out around Rumphi for the last few weeks. Well that’s not strictly true as last weekend I went to Mzuzu for a friend’s birthday and did a round of pub golf ending up dancing around to electro. But pretty good going for me.

Instead I have been cultivating my garden and having civilised dinner parties! My vegetable patch is looking great and I have harvested my first courgette which was really massive with all the rains! And also I’ve got lots of lettuce and rocket which makes a lovely salad. Yum. The green beans are almost ready and the cucumbers are creeping up the fence too. Soon I’ll have too much veg to eat – I’ll have to set up a stall on the market and start selling it! I have now received some herbs which were hand delivered to me all the way from London strapped to a medical student- thanks to all concerned! So with all this food I’ve been having a number of dinner parties (slightly bad as this is malnutrition season when many Malawian’s starve because of their stores of maize running out). Well I’m occasionally feeding my watchman and 7 months pregnant washerwoman. But I don’t want them to become dependant on a Mzungu otherwise they’ll be in trouble when I leave.

Speaking of my washerwoman, she’s managed not to break anything else of mine thankfully but she has repetitively unplugged my fridge while cleaning and allowed my meat to defrost several times. So big protein load for me. However I have managed to get a wooden structure made which I wrapped some material around and made into a pretty lamp to replace the one she smashed so things are looking up.

The electricity company has been causing me to have grey hairs and also maybe increase my chance of lung cancer from the number of times I have to light my charcoal stove to cook on because of the ridiculous amount of power cuts. Whenever it rains a little the power goes and they never bother to repair the faults properly because the person who gets called to fix it would be upset at losing his job. They also had the cheek to attempt to cut Marianne off, because of a mix up with her bill, after there had been a power cut all day! The president came up to one of the towns near Rumphi to open some new maize silos and there was even a power cut for 2 hours during his speech! He was raging and I think some people lost their jobs.

It’s looking really beautiful now though with the rains- really green and the maize is almost getting so tall I can’t see over it. Hope I don’t get lost.

Building work has begun on the OPD – well actually the demolition has started but not quite the building work- there is no money to pay for a truck and the petrol to collect the bricks and sand. Little bit worrying. I don’t want to pay for everything because it should be a shared project with the hospital and they are more likely to appreciate it if they have paid towards it as well. (That’s what I try and tell them anyway).

Otherwise, I am getting used to the routine of work and everything is becoming ‘normal’ I am unfortunately slowly ceasing to be shocked by what I see. It’s malaria season and there are sooo many sick people especially the children all with Hb’s of <5. Every morning we have a report of the death and the numbers keep increasing. The problem is that it’s difficult to know whether some of the deaths could have been prevented because the documentation in the notes is so poor you can not read through and learn from the mistakes.

Last week we had no plaster to hold cannulaes in or fix dressings so elective theatre cases were stopped until the dutch doctor went to the market to buy some masking tape which we used instead! ‘Just improvise’ is the line I hear so much when there isn’t anything; string instead of staples, torch on phone instead of examining light, washed out antibiotic vials instead of sterile urine bottles You can’t really improvise through when it comes to having no painkillers and no dextrose (sugar) to give someone who’s in liver failure and is unconscious with hypoglycaemia.

The ward does smell a bit nicer now though- the mattresses have been changed and as the old ones were wheeled out there was this horrible stench surrounding them. Patients often just pee through the mattress and a bowl is put beneath the bed to catch the urine as it drips through. Nice.

And last night we had a multiple trauma- a truck overturned and there were loads of people with head injuries and fractures but luckily no deaths. It was complete mayhem! No system is in place to triage the patients and only the orthopaedic clinical officer and DHO turned up- none of the other clinicians! There were lots of nurses though, but they all rushed from the wards leaving nobody on the wards to care for those remaining there. There was absolutely no order to anything, blood everywhere, screaming people and to top it off about 300 locals who’d all come to watch the show as they’d heard the siren go.

Anywho – be thankful you live in a country which has a functioning health system! I hope that 2011 is treating you all well so far and thank you for the Christmas cards that I’m still receiving!

xxx