The Lake!

So when they said that the VSO national conference would be at Kande beach I didn’t put my hopes up for anything better than a skank hotel, which was trying to jazz itself up, somewhere in Malawi. In actual fact it was at a beautiful beach resort on the lake shore. This was the first time I’d seen the lake so was in complete awe and excitement at the gorgeous white sands, warm blue water, pretty fishes and bilharzia. Well I don’t seem to have caught it yet but I’ll let you know if I start peeing blood. So you can imagine what ‘conference’ meant to me– swimming, jumping off rocks, topping up the tan (how cold is it in England by the way? ;), drinking a lot of ‘green’ (Carlsberg), playing pool and table footie, drinking more green and dancing on the bar. So, not quite the change in my attitudes and behaviour I was threatening you guys with when I said I’d be living in a developing country for a year. It was a lot of fun though. I met up with the other new volunteers and lots of the old ones and we shared stories, discussed how we were coping and our bowel movements. The docs also had a chance to get together and chat about issues, do presentations about experiences and educational stuff.

Marianne and I decided that we were having such a lovely time that we would stay for an extra night at the expense of travelling back on a Sunday with no vehicle. I’m sure you can all guess, as this is becoming a standard thing for me, what happened – the usual transport disaster! We left bright and early on the Sunday and walked to the road where we then waited. The first thing that came along was a ‘matola’ – ie a truck where everyone just sits in the back, on maize and with goats and chickens, and holds on tight round the bends hoping the thing won’t turn over. Joy. We did enjoy, though, the sunburn and the driver using a ladies bathroom mirror as his wing mirror.

This took us as far as Nakata Bay when we then had to transfer into a minibus- chosen because the corners for the next section really were nail bitingly sharp and we didn’t stand our chances of survival in the matola. So for the next leg of the journey I rested my head on a radio hanging from the roof, with wires dangling everywhere, blaring at maximum volume with 4 other people on a seat made for 2 and sweating quite a lot.

Next stop was Mzuzu, so almost home- only 1 hour away and all we needed to do was get a minibus to Rumphi. Except there were no minibuses, in fact there was very little transport moving at all – it was all standing in a long long queue outside the BP garage with a lot of people twiddling their thumbs. A pretty standard scene in Malawi- no fuel. It costs, per litre, the same amount as England unbelievably because of importing costs, and Malawi has no forex so always struggles to purchase anything from abroad.

So we waited… and waited, ‘yes yes madam a bus is just coming’- yeah right. And then suddenly, a surge of panicked cars racing from one filling station to the other. I think the Malawians were doing a British queuing thing and just following each other without realising that the tanker was actually filling to the other petrol station.  Eventually we managed to pay a taxi a lot of money to get us back to Rumphi just before dark- the trip that took 3 hours to drive there on the first day took 9 hours to get back- not that bad I guess.

To try and get around the costs of high petrol the President opened an ‘inland’ port last week at the southern part of the lake in order to transport goods down the river instead of over the road. The trouble with it are 2 things- first that the port buildings are practically non existent so it can hardly be called a port and the second ‘small’ problem is that Mozambique, the country that the river runs through to get to Malawi has not actually given permission for the waters to be used. Probably should have been sorted out before the decision to open it for ‘use’. So the goods have been sent by road and according to the papers it will only take several years to resolve!

This week I’ve been working on female ward. Pretty hard core. There are loads of patients, they just keep coming. When all the beds are filled they double up and then lie under the beds - like a kind of bunk bed but probably more uncomfortable. And it smells quite bad too- that sort of musty bloody infected miscarriage smell. But there’s some really interesting pathology like Steven- Johnson’s syndrome- her whole body has blistered off, hemiplegia’s in young women, kaposi’s sarcoma of the thighs, sleeping sickness (the parasites look really rank under the microscope), lots of TB and malaria. Unfortunately I had a 21 year old Jehovah’s Witness die of malaria in front of me. Her Hb went down to 2 and she went into heart failure but still refused blood and oxygen.

I have my portable oxygen saturation probe but I’m not sure it’s been very helpful yet- ‘oh dear you’ve got sats of 75%- have we got any oxygen to give? No? oh right’ or if we do manage to acquire the concentrator the patient will refuse it believing that it will speed up death.

I’ve also been very busy trying to apply for some funding from VSO for creating a triage system in the outpatients department. – It’s like our A and E department at home seeing all the new attendances but with no system in place other than a time order one which means that sick patients are often left waiting hours to be seen and when they are there is no where to then treat them. So they are sent to the ward in the hope that a nurse may be free to attend to them before they get  even sicker and die.

The trouble is there is only a very small pot of money and loads of volunteers apply so I probably won’t get the money but I am still hoping to set up a service here anyway but it will be with less resources. Cross my fingers anyway.

You’ll be pleased to know that I’ve made a new friend. The fact that it has 8 legs and looks quite scary is a small point because it also, much to my delight, eats cockroaches!

Hope everyone is good and enjoying the Christmas music which I’m sure is playing in all the shops!