Monday 2nd May 2011-Sunday 22nd May 2011
Lack of internet access in a while means that this blog will be posted at the same time as the previous one, so I’ll try and keep it brief! The last three weeks have been both eventful and uneventful but the non-events have almost been the biggest part.
Before our Easter holiday we had one week where turn-out to CBCC caregiver training was particularly low and we were forced to abandon the session. Unfortunately this trend has continued and despite our visits into villages to promote the scheme there has been no increase in attendance. We have had to accept that the community are not interested in receiving training with no obvious financial or materialistic gain and so the training sessions have come to an end. This is really disappointing because now only three elements remain to the project; Home Based Care Training, NRU antenatal clinics and hospital experience. We really hoped that the CBCC training would work out but part of living in a different community is accepting the differences in opinions and after fighting a losing battle we have accepted defeat. In addition, Paul, our host and co-ordinator of FHECC, has now found a job on the sugar estate and effectively left FHECC. Unfortunately I feel that this will lead to the charity fizzling out in years to come, but for now there are still volunteers working and participating in the community, carrying out worthwhile activities.
On a more positive note we have begun to run the Home Based Care Volunteer Training. There have been three sessions so far, focussing on personal and food hygiene and malaria. Each week on a Tuesday morning there is a healthy turn out of about 23 volunteers from neighbouring villages and what is so encouraging is that they are enthusiastic. We are asked all manner of questions about caring for patients and their families and, though we cannot help them with resources and money, they are really grateful for what they are learning. Focussing on hygiene brought to their attention the importance of washing children when they have an accident and the session on malaria brought many questions too, from “Can mosquitoes transmit HIV?” to “When do you use a mosquito net; when you are sick or when you are not sick?” I am so glad that the volunteers are so eager to learn and will readily ask questions; it shows dedication to their role and genuine care too.
Still, the antenatal clinic has no blood pressure cuff and they are also out of iron tablets; such is medical care in the Lower Shire Valley! What has become apparent in the last few weeks is that the women have started to turn up later. In March and April about 50 mothers-to-be would appear between 8 and 9 in the morning, now they don’t come until about 9.30 and apparently it’s due to the cooler temperatures. It’s not that much cooler-I’m still in vest tops, a skirt and flip flops, but it is noticeably cooler in the mornings before 8.30. With the fall in early morning temperatures mothers in the villages don’t get up as early, and so by the time the morning chores are complete they arrive at NRU later. I can’t say that this makes any significant difference to the clinic, it just starts later and finishes later, but then in Malawi time is not important!
With the CBCC programme falling through a lot more time has been spent at the hospital. Unfortunately despite all the hours I have sat in the labour ward I have seen remarkably few deliveries-why don’t Malawian women give birth in May?! The few that I have seen have been interesting though-there’s been a breech delivery and a twin delivery. I am happy to say that both were successful but what was interesting was that the mother giving birth to twins had no idea, until she was in labour and giving birth, that she was expecting twins. Because the ultrasound machine is almost never used antenatal care is all done on listening and feeling. According to the midwife it is hard to feel two heads or hear two foetal heart rates and when someone has a big bump they normally assume that it’s just a big baby. That’s quite a surprise for the mother! I have become more hands on in the hospital and last week had the chance to be a theatre assistant. I helped the clinician in 5 operations; an abscess drain, 3 hydroceles and the removal of a mass from a lady’s back. It was quite surreal being in a sterile apron and gloves swabbing at blood vessels, cutting stitches and collecting fluids with just me, the clinician and the patient at times!
What I’ve realised recently is that firstly, we have made a strong attempt to make the FHECC project work, but, with the failure of the CBCC plan and Paul finding a job, we need to accept that parts are not working and make the most of the rest of our time here. If that means spending more time at the hospital, gaining personal experience, then so be it-whatever we do will be totally different from anything we would experience in the UK. Also I have realised that although we are not needed at the hospital, we can be helpful. There are theatre assistants who could have been in the operations that I participated in, but as it happened they were particularly busy, rushed and short staffed that day, so my input was of some use. Finally I have realised that the project is not about being essential to the community; if we were needed there would be a reliance on us and when we leave problems would arise (PT have decided not to send vols to Nchalo next year). As it is we are helping to develop small parts of the community in a non-vital way which means that, come August, they will be more than capable of continuing, hopefully with more ideas and having learned a little too. Being in Malawi involves not only learning about the local environment and myself, but also what is important. I think what is important is to give as much as we can, but also to take as much as we can and right now I think we’re doing pretty well at that!
There’s not a lot to report on, food-wise, except that avocadoes are now out of season. This is particularly upsetting because one of our staple meals (guacamole and flatbread) is no longer an option. On the plus side, tangerines are plentiful, though they aren’t orange, but green. I made the mistake of taking a green fruit, thinking it was an orange, peeling it and then proceeded to tuck in to a lemon. Seeing as I ate the lemon on the day that the world was predicted to end it was a pretty minor tragedy compared to what may have happened but I won’t be repeating the experience!
From what I gather, exams are now in full swing and I hope that they go well for everybody. For everybody who has a birthday in May, (there are many of you) Happy Birthday! Things are going well here in Nchalo and I love hearing everyone’s news from home, be it in text form, email, Facebook or the amazing postal service!
Take lots of care and please keep in touch,
All the best,
Catherine
xxx
Thursday, 26 May 2011
Three Weeks of Work, Wildlife and Water
Monday 11th April 2011-Sunday 1st May 2011
Well, it has been a while since I’ve blogged and, as always there are new experiences to report and updates to be made! As I write this blog it is our Half-Way Anniversary in Malawi-we’re 3 ½ months into our project and the time has just flown so far. The project has had some successes and problems in recent weeks but what I have learned is to accept a situation when there’s nothing more that can be done to change it and with this in mind I am excited about the next half of the project.
A couple of weeks ago we held our first CBCC training session with an aim in mind-the focus of the lesson was teaching not by repetition. As I’ve mentioned before, I think, the care-givers tend to shout “A-E-I-O-U” at the children, who shout it back, however they have no idea that A is the first letter of the alphabet, that it is a vowel, that it can be joined with other letters to form words, etc. The first session was successful we felt; about 20 care-givers showed up and by the end they were enthusiastic, had listened to what we had said and were asking us more questions, so we were really pleased. What did go down well was our illustration of how if a message is passed on through repetition and mistakes are made and not corrected the message changes and is wrong. We played Chinese Whispers to show this and the message certainly changed by the end of the line!
Unfortunately, the second training session was less successful-we had a total of 3 people turn up and with an important lesson to teach and 45 minutes left (after we’d waited, optimistic that the no-show was due to Malawian timing!) Never agreed that the session should be postponed. We were disappointed, especially because the day before we’d spent 2 hours on bikes, spreading the word about the session. One of the struggles is that in Malawi, if you go on a training course, you expect to receive something in return, be it money or refreshments. This is strange for us to get used to because in the UK, people pay to go on the course and it works the other way around. We hope that this week will bring more people to the training and I’ll keep you posted!
NRU continues to be busy, especially on Friday mornings when the new mothers come to be registered at the clinic. Unfortunately the BP cuff no longer works so no measurement of blood pressure can be taken and risk of pre-eclampsia cannot be recognised. I don’t know how common a problem it is in Malawi, but it is just another example of African medicine and using the resources that are available to maximise the service that you can provide.
We spent an amazing morning in theatre, watching a very gruesome operation-I won’t go into too much detail! During the operation the patient began to wake up but the anaesthetist was putting another patient to sleep in the other theatre and said that it wasn’t possible for him to come through and attend to the patient undergoing the operation. Thankfully, a nurse came through very shortly afterwards and gave more anaesthetic but when it happened again Edwin, the clinical officer/surgeon, told me to administer the anaesthetic! I know that drawing up anaesthetic into a syringe and then injecting it into a cannula is not anywhere near to actually carrying out clinical work, but it was on opportunity that a 19 year old gap year student would never have been given the chance to do in Scotland. The operation had so many differences to theatre in the UK and both Sophie and I came away deep in thought and amazed too. What was very reassuring was that during the whole procedure we both felt entirely comfortable and at ease watching Edwin’s work. When we first came to Nchalo and spent time at the hospital I would feel queasy from the heat and doubts were forming as to whether or not I would be OK at medical school (even though I have been in theatre many times in Perth) so it was great to come out knowing with more certainty that medicine is what I want to do and also that we are adjusting to the temperature in the Lower Shire Valley. It was an amazing morning and one that has made me very excited for university in September.
Unfortunately, Sophie’s repetitive-strain-injury in both wrists has become very painful, so a trip to a physiotherapist in Blantyre was called for. We decided to see how far we could hitchhike there and ended up in the back of a pick up truck going up the Escarpment Road-please look at the road going from Blantyre to Chikwawa/Nchalo on Google Earth if the resolution is good enough! On the way up, we passed a 16 wheeler drinks lorry that had taken a corner too fast and tumbled off the side, spreading glass Carlsberg, Coca-Cola and Fanta bottles everywhere. The matola ride was an experience that we don’t mind doing around Nchalo or on straight, flat roads, but we have vowed not to go up the hair-pinned, twisting road to Blantyre in any form of open-aired vehicle ever again.
Over the last 3 weeks we have seen a lot of wildlife in Malawi. Firstly, our friend, Tony, took us and his two children to a friend’s crocodile farm. It’s about 12 miles south of us and the crocs are bred and then sold for their skins to dealers who then sell on to the designers in London, Paris, Rome, New York, etc. There were hundreds of them, from 6 inches long to huge fat ones that were 3m long. It was a great chance to see the farm and to touch a baby crocodile but I am still not a fan of snakeskin clothing or accessories!
Over the Easter week we took our first visit to Lake Malawi-beautiful isn’t a good enough word to describe it. We spent time with friends who volunteer by the lake, went to a concert by the Black Missionaries (a brilliant Malawian Reggae band) and at Cape Maclear we went on a boat trip to the nearby island. We snorkelled and saw the famous Lake Malawi fish, had barbequed fish for lunch on the island, watched fish eagles swooping around and then jumped off huge rocks into the clear blue water. It was stunning and at night, when everywhere else is dark, there’s a line of lights on the horizon from the lanterns on the fishing boats out on the lake; it’s easy to see why Livingstone nicknamed it “Lake of Stars”.
On the day of the Royal Wedding, while the UK watched TV, we took a boat safari up and down the Shire in Liwonde National Park and sat 5m away from a 15 year old elephant eating grass by the riverside. It was fantastic and our guide, Jimmy, said that we had a very diverse safari; from elephants to hippos, to crocs, to fish eagles, malachite kingfishers and a whole host of other bird life (the full list is very long). The experience was so special and that, along with a successful curios shopping trip, more than compensated for the sketchy accommodation that we had at Warthog’s Wallow in Liwonde town. We’ve renamed it Cockroach’s Wallow, much more accurate.
Finally, of course, the food instalment! I’ve already mentioned the fish at the Lake that we had and I have said to Sophie many times just how fresh and delicious it was. Sitting on the rocks, in the sun, in Malawi, on my Gap Year, was just great. Before Sophie’s wrists became very sore she made em a birthday cake in a true Malawian style (i.e. no measurements used). It was a lovely coffee cake (our favourite) in the shape of a heart and there were three layers. It went down a treat and was gone very quickly! She also made an incredible, gooey banana cake with some old, black bananas-what a good use of over-ripe fruit! That cake, and the brownies that we baked for the family too, did not last long and I think that our baking skills are much appreciated.
I taught Prudence to make pancakes one Sunday, and was delighted to walk into the kitchen later in the week to find her making them all by herself. I made me feel part of the family and that we have settled in very well. We were so warmly welcomed home on our return from the lake and I am excited about spending the coming weekends in Nchalo, spending quality time with the girls and being a part of the family that have been so good to us. When we came home both Sophie and I were so happy to be back and it felt right!
April has been an interesting month and I’m sure that May with bring more developments and news-this is Malawi after all! I’m having an amazing time, am very happy and thoroughly enjoying the whole experience.
I hope that everyone’s well and that the Easter holidays were good. To everyone with exams; Good Luck! Let me know all the news from home and please keep post coming!
Lots of love and I’ll see you soon,
Catherine
xxx
Well, it has been a while since I’ve blogged and, as always there are new experiences to report and updates to be made! As I write this blog it is our Half-Way Anniversary in Malawi-we’re 3 ½ months into our project and the time has just flown so far. The project has had some successes and problems in recent weeks but what I have learned is to accept a situation when there’s nothing more that can be done to change it and with this in mind I am excited about the next half of the project.
A couple of weeks ago we held our first CBCC training session with an aim in mind-the focus of the lesson was teaching not by repetition. As I’ve mentioned before, I think, the care-givers tend to shout “A-E-I-O-U” at the children, who shout it back, however they have no idea that A is the first letter of the alphabet, that it is a vowel, that it can be joined with other letters to form words, etc. The first session was successful we felt; about 20 care-givers showed up and by the end they were enthusiastic, had listened to what we had said and were asking us more questions, so we were really pleased. What did go down well was our illustration of how if a message is passed on through repetition and mistakes are made and not corrected the message changes and is wrong. We played Chinese Whispers to show this and the message certainly changed by the end of the line!
Unfortunately, the second training session was less successful-we had a total of 3 people turn up and with an important lesson to teach and 45 minutes left (after we’d waited, optimistic that the no-show was due to Malawian timing!) Never agreed that the session should be postponed. We were disappointed, especially because the day before we’d spent 2 hours on bikes, spreading the word about the session. One of the struggles is that in Malawi, if you go on a training course, you expect to receive something in return, be it money or refreshments. This is strange for us to get used to because in the UK, people pay to go on the course and it works the other way around. We hope that this week will bring more people to the training and I’ll keep you posted!
NRU continues to be busy, especially on Friday mornings when the new mothers come to be registered at the clinic. Unfortunately the BP cuff no longer works so no measurement of blood pressure can be taken and risk of pre-eclampsia cannot be recognised. I don’t know how common a problem it is in Malawi, but it is just another example of African medicine and using the resources that are available to maximise the service that you can provide.
We spent an amazing morning in theatre, watching a very gruesome operation-I won’t go into too much detail! During the operation the patient began to wake up but the anaesthetist was putting another patient to sleep in the other theatre and said that it wasn’t possible for him to come through and attend to the patient undergoing the operation. Thankfully, a nurse came through very shortly afterwards and gave more anaesthetic but when it happened again Edwin, the clinical officer/surgeon, told me to administer the anaesthetic! I know that drawing up anaesthetic into a syringe and then injecting it into a cannula is not anywhere near to actually carrying out clinical work, but it was on opportunity that a 19 year old gap year student would never have been given the chance to do in Scotland. The operation had so many differences to theatre in the UK and both Sophie and I came away deep in thought and amazed too. What was very reassuring was that during the whole procedure we both felt entirely comfortable and at ease watching Edwin’s work. When we first came to Nchalo and spent time at the hospital I would feel queasy from the heat and doubts were forming as to whether or not I would be OK at medical school (even though I have been in theatre many times in Perth) so it was great to come out knowing with more certainty that medicine is what I want to do and also that we are adjusting to the temperature in the Lower Shire Valley. It was an amazing morning and one that has made me very excited for university in September.
Unfortunately, Sophie’s repetitive-strain-injury in both wrists has become very painful, so a trip to a physiotherapist in Blantyre was called for. We decided to see how far we could hitchhike there and ended up in the back of a pick up truck going up the Escarpment Road-please look at the road going from Blantyre to Chikwawa/Nchalo on Google Earth if the resolution is good enough! On the way up, we passed a 16 wheeler drinks lorry that had taken a corner too fast and tumbled off the side, spreading glass Carlsberg, Coca-Cola and Fanta bottles everywhere. The matola ride was an experience that we don’t mind doing around Nchalo or on straight, flat roads, but we have vowed not to go up the hair-pinned, twisting road to Blantyre in any form of open-aired vehicle ever again.
Over the last 3 weeks we have seen a lot of wildlife in Malawi. Firstly, our friend, Tony, took us and his two children to a friend’s crocodile farm. It’s about 12 miles south of us and the crocs are bred and then sold for their skins to dealers who then sell on to the designers in London, Paris, Rome, New York, etc. There were hundreds of them, from 6 inches long to huge fat ones that were 3m long. It was a great chance to see the farm and to touch a baby crocodile but I am still not a fan of snakeskin clothing or accessories!
Over the Easter week we took our first visit to Lake Malawi-beautiful isn’t a good enough word to describe it. We spent time with friends who volunteer by the lake, went to a concert by the Black Missionaries (a brilliant Malawian Reggae band) and at Cape Maclear we went on a boat trip to the nearby island. We snorkelled and saw the famous Lake Malawi fish, had barbequed fish for lunch on the island, watched fish eagles swooping around and then jumped off huge rocks into the clear blue water. It was stunning and at night, when everywhere else is dark, there’s a line of lights on the horizon from the lanterns on the fishing boats out on the lake; it’s easy to see why Livingstone nicknamed it “Lake of Stars”.
On the day of the Royal Wedding, while the UK watched TV, we took a boat safari up and down the Shire in Liwonde National Park and sat 5m away from a 15 year old elephant eating grass by the riverside. It was fantastic and our guide, Jimmy, said that we had a very diverse safari; from elephants to hippos, to crocs, to fish eagles, malachite kingfishers and a whole host of other bird life (the full list is very long). The experience was so special and that, along with a successful curios shopping trip, more than compensated for the sketchy accommodation that we had at Warthog’s Wallow in Liwonde town. We’ve renamed it Cockroach’s Wallow, much more accurate.
Finally, of course, the food instalment! I’ve already mentioned the fish at the Lake that we had and I have said to Sophie many times just how fresh and delicious it was. Sitting on the rocks, in the sun, in Malawi, on my Gap Year, was just great. Before Sophie’s wrists became very sore she made em a birthday cake in a true Malawian style (i.e. no measurements used). It was a lovely coffee cake (our favourite) in the shape of a heart and there were three layers. It went down a treat and was gone very quickly! She also made an incredible, gooey banana cake with some old, black bananas-what a good use of over-ripe fruit! That cake, and the brownies that we baked for the family too, did not last long and I think that our baking skills are much appreciated.
I taught Prudence to make pancakes one Sunday, and was delighted to walk into the kitchen later in the week to find her making them all by herself. I made me feel part of the family and that we have settled in very well. We were so warmly welcomed home on our return from the lake and I am excited about spending the coming weekends in Nchalo, spending quality time with the girls and being a part of the family that have been so good to us. When we came home both Sophie and I were so happy to be back and it felt right!
April has been an interesting month and I’m sure that May with bring more developments and news-this is Malawi after all! I’m having an amazing time, am very happy and thoroughly enjoying the whole experience.
I hope that everyone’s well and that the Easter holidays were good. To everyone with exams; Good Luck! Let me know all the news from home and please keep post coming!
Lots of love and I’ll see you soon,
Catherine
xxx
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