Interesting families

New birthday years’ resolution: drink less and work harder. Yes the usual decision made after I spent most of the day after my 30^th birthday party trying not to remove the lining of my stomach. It was a good night though. Hum. And I’ve managed not to get drunk since – yey all of 3 weeks! It really does feel like I’ve turned over a new leaf in my 30s.

Working harder? Not sure about that but feels like it because everything takes twice as long to achieve. You want an xray on the weekend? Yes- so you have to call the radiographer to come in to do it which requires a driver to collect him from his home which requires calling the driver on the phone which decides there’s no network for half an hour. By the time the radiographer comes in, wheels the patient to xray, the generator stops working- of course the only electricity company in Malawi decides to turn the power off all day, with no warning, to do some ‘essential’ works on the lines during a fuel crisis.

There are constant battles like this- I needed to transfer a patient with severe facial burns who’s throat was occluding to the central hospital – could I find the key for theatre to get airway equipment? No because the key was hidden in a special place which no one knew where it was. Good luck to the mother who needed a caesarean section. Could I find a driver? No he’d gone AWOL. Was I panicking that I’d have to stick a needle in this patients neck? Yes!! It’s terrible - there are so many children with horrific burns now because we’re entering the cold season and they fall into the fire trying to keep warm. And then there’s the 16 year old who was haemorrhaging out of her bottom but not enough blood products, the neonate with tetanus but no immunoglobulin, the baby with an HB of 2 who we couldn’t get access and no I-O needles!

It’s good to be challenged but it gets extremely frustrating when you can’t treat a patient properly because of lack of resources. I’m not going to go into all the issues that are facing Malawi at the moment as it is a bit risqué for a website but do take a look on the net if you’re not already aware.

Going back to the power failures I had a rather amusing incident (in retrospect) when, just as I received a call to go into the hospital for an emergency, the power went. I was in a hurry and had just cooked some food so wanted to stuff it down first (of course). So I rushed to try and light a candle but in the process I started rubbing my eyes forgetting that I’d been chopping chillis- needless to say I experienced severe burning in my eyes and on my finger from the candle that I hadn’t managed to light successfully. I stumbled to the bathroom and tried to wash the chilli out but all that did was to wash it behind my contact lenses and over my whole face which started stinging too. I chose to ignore the pain and tried to eat dinner but as it was dark the mossis came out and one got me on my foot. I tried to put repellent on but somehow managed to squirt the bottle of white lotion all over myself (I’ll leave it to your vivid imaginations about what it looked like) After trying to scrape it off I eventually tried to eat some food, the plate slipped in my lap and curried vegetables added to the mossi repellent decoration down my trousers (must learn to eat at a table in my old age).  Luckily I couldn’t see the full effect as it was still dark from the power cut however I was a little embarrassed once I finally made it into the hospital which still had fuel this time to run the generator for full lighting. Oh well you can kind of get away with having dirty clothes in Africa. On the up side- I’ve bought a device to heat my water so I can now have a hot bucket shower – yippee!

I’ve also been on the up hill struggle of trying to complete my projects. The emergency room is now almost completed- it has instructions on the walls, bars to stop the burglars getting in and extension leads that sort of work. Just waiting for the benches to be made and it’ll be done! Can’t say the same for the treatment room yet though- having some difficulties procuring bulbs for a theatre lamp as unfortunately Malawi has to import most of it’s medical equipment from South Africa and with another fuel crisis hitting the country transport is tricky.

I met an interesting elderly lady on my ward who is the mother in law to a nurse and mother to one of the drivers. She is one of 3 wives of her 2^nd husband who had a rota to seeing his wives so that none of them felt left out. She said didn’t get jealous but was just happy that he had given her 2 girls and 2 boys because her first husband had only given her 3 boys. Unfortunately though, 3 of her children have died of malaria and 2 of HIV so now she only has 2 surviving. She lives with her fathers’ 3^rd wife who is only 2 years older than her! This woman had 9 children but all of them died of malaria and HIV. Polygamy is very common here and is one of main reasons for the spread of HIV but it was good to hear from the first lady that she wants her son to remain monogamous and thinks that polygamy should be a thing of the past.

Other things that have been happening is that my diabetic clinic is running well and I’ve managed to get the new Japanese volunteer nurse on board to do some educational sessions and also a Malawian clinical officer. So hopefully it will continue to run after I have gone (we can hope).

We also had our VSO drs and nurses peer support which was another opportunity for me to top up the tan by the lake (in between holding the meeting of course). There was a lot to talk about because it is the end of Phase 2 of VSO’s health strategy and they are trying to plan Phase 3 but unfortunately there are funding issues for a variety of reasons which I won’t go into here because again it may be politically contentious.  

And I’ve been out into the field with a brilliant organisation called HAWIP. It was set up initially by a Malawian to assist those working in the hospital with HIV/AIDS but now he has managed to extend it out into the communities to do HIV peer education and testing of school children and donating goats, uniforms and blankets to families suffering with HIV and those in great need. It is currently funded by Egmont the English children’s charity but of course they are always in need of further funding for all their activities. I strongly believe now that the focus needs to be on these preventative activities in order to reduce the burden of communicable diseases and drain on resources that this country has. Approaching the children while they are still young and getting them used to be tested is definitely the way forward. So I went out to present gifts of uniforms, blankets and goats as the ‘guest of honour’  Mzungu to these sufferring children. In one village they had never seen a Mzungu before so they were very afraid. Their school was just a wooden structure with no walls and a thatch roof. The children sat on the dust, had really dirty clothes and no shoes. It was so sad I had to keep my sunglasses on to hide the tears. I gave them some crayons and colouring books and they were so happy.

Anyway, that’s about it for what I’ve been up to over the last month and can you believe - just over a month left in the country! Hopefully I will have time for one more update before I leave!

Hope you are all well at home and enjoying the summer!

Lots of love

Xxx

Oh yes and I ate a bit of a mouse – urghh!