Tuesday, May 31, 2016

The Deep End: Zomba Central Hospital

Big day. It’ll be the second day of visiting hospitals, but ZCH is important because: it is here in Zomba and we will be visiting multiple times, making good relationships important, and because it is the main hospital for Zomba, so big things happen here.

We hopped on the bus at 8:30 after a rushed breakfast because Ashley and I tend to sleep in (whoops). The bus dropped us at Zomba Central before taking the education students to their schools. I couldn’t help be a little envious as they pulled away- the kids here have enchanted me the most. They follow us around sometimes and get so bashful and happy when we wave or say muli bwanji. They like to ask us for bottles too because they can sell the glass soda ones and make cars out of the plastic ones. They just smile freely and laugh often, so I knew the education students were in for an amazing day. We made our way to the gate and asked someone for help finding Mr. Chisali, our contact for ZCH. She pointed to a car, and Penny walked over to confirm we were meeting with him. It turned out he had an emergency to attend to at another health center but told us to find Mr. Kamanga. We waited in reception for him, and then he was going to lead us somewhere to talk.
HOWEVER what happened was I met a medical student named Alan from Malawi in reception- he was seeing about working in the hospital. He was so nice and fun to talk to that I dilly dallied  a bit in the office, so that when Ashley (who waited for me <3) and I emerged from the office into the courtyard, Penny and Mr. Kamanga were no where to be seen. We looked at each other in panic and then decided they must have gone to Mr. Kamanga’s office. We asked for directions, and headed in that direction. Now, hospitals in Malawi aren’t all enclosed and multi-story like in the U.S. Each ward or lab or type of office is a different building, connected by covered outdoor walkways. That means they are just massive, sprawling campuses. We were hopelessly lost. We had to ask for directions twice more before finding human resources where Mr. Kamanga works, on the clear opposite side of the hospital.

There we were saved by Mr. Timba. I’ve mentioned our inflatable baby, we carry  it around in the baby pod (infant warmer) for convenience, but it catches a lot of attention. Mr. Timba was instantly in love with the baby and asked it’s name and made all sorts of jokes about if it was a boy or girl, asleep or crying. He was great. We asked if he’d seen Penny, and when he said no, if we could put down our heavy gear (the pod and all the tools we brought as a gift to maintenance). He insisted we put them on his desk, and requested that we put the pod upright so everyone else in the office could see the baby. It seemed to make the whole human resources department so happy. So Ashley and I were back to looking obviously lost wandering around the hospital, now barely able to remember how we’d come. I wished I was as spatially talented as dad, who would have had the whole hospital memorized with a single-walk through. All we could do was laugh at the fact that less than an hour into our visit we were uselessly separated and lost. But back near the courtyard at the front, Mr. Kamanga found us and revealed they had gone into the conference next to the office where we started…oops.

After the misadventure we met with department leads like at Kamuzu. It was great and we got to show our designs and get positive reactions and useful feedback. We arranged to meet the pediatric nurse, Hendrina, at Ward 9 after we followed the lab deputy and assistant deputy through the laboratory. They guided us to the lab and showed us each department. The spaces were small but they had all the equipment they needed to do the analyses and get the job done. Everyone we met seemed to really love their job too. In microbiology, we used the scope to talk more about the mtb device and show them how it works. There we met David. He’s a really young lab tech in training at the university here, though he’s form Mulanji. David had two wonderful things about him: the scarf he was wearing tightly around his neck over his white lab coat, and his super radiant smile. When Ashley complimented his smile he said he hoped it was as bright as mine which just absolutely made my day. He was such a great person and really fun to talk to, he was probably the first person we’ve met in the hospitals so close to our age. Next, the assistant deputy led us to ward 9. But first the poor guy had to take us to Mr. Kamanga’s to get our gear and then to maintenance to give them the tools so we could stop carrying them. In all those errands we learned his name is Hastings and he is recently engaged, and he’s just the nicest ever. He showed his true kindness when we got to ward 9. In the process of asking to see the ward, we showed the nurse at the nurses station the baby pod. After giving her opinions, she said we should ask the mothers. She marched form behind the station over to a bench by the door where 4 mothers all waited with their babies. She spoke to them in Chichewa and soon the whole room changed- those 4 mommies started all speaking, and in a moment every mom in the ward had come over to see the commotion. We were absolutely swarmed by our new focus group, all mothers with adorable babies on their backs in chitenjis. The babies eyed us bashfully while the moms excitedly weighed in and asked questions, some reaching in to touch the pod. Dear Hastings translated some of what they were saying, and we were so happy to get such an enthusiastic response.
Agnes and the mommas


After the commotion died down and we thanked the nurse, Agnes, Hendrina took me into the ward to the malnourishment bay. There were no kids in there though- she said they were in one of the courtyards maybe eating or getting fresh air and that I could come back Friday to see them. I was exhausted already so that was fine with me. Outside ward 9 we showed another mom the pod, and then I asked to take her picture. That started a whole festival of picture taking and selfies and it was the best thing ever.



After that we got lunch. We took a taxi that we later decided was just a guy in a car who saw we wanted to go somewhere and wanted to make money. He took us to tasty bites where we ate and met an Australian family, of which the father owns a business where he comes to Malawi and helps Malawian’s begin and maintain businesses. He had great thoughts on the ethics of aid and development and we exchanged contact information. I also got to talk with them about Sydney which was the best. We called the “taxi” guy to pick us up since he gave us his number, and while we waited a young boy tried to sell us bananas. We said no thanks and crossed the road. Then he came back, and I found out his name is Massa. I told him my name (which here is Lola because it’s easier for Malawians to pronounce). He asked about home, and then he asked for my number. I delicately declined, but he made me laugh so much. His English wasn’t great so talking was difficult but he had the hugest smile the whole time, like life was just so much fun for him. He said he’d seem me again at tasty bites sometime, which sounds great to me.

Back at the hospital Ashley and I just paid a quick visit to maintenance before heading out for the day. It was such a good visit because maintenance is one of the biggest differences between western medicine and here. So here’s the deal:
Organizations in the west donate medical devices to developing countries like Malawi. They are made with parts that aren’t available here however, and no one here is formally trained to use them. So, when these machines break, they are very difficult for maintenance to fix- there isn’t formal education for the maintenance workers, so these hardworking guys just have to FIGURE out how these extremely intricate instruments work; things like oxygen concentrators, blood pressure cuffs, suction machines, and autoclaves. We remarked to them how silly it is that I have a degree in engineering and I haven’t the first idea how to fix anything in that workshop. The director, Mr. Moto, said something great: “That’s the difference between us and the European world: You receive guidance. If you want to learn something, you know where to go to learn it.” We will have the opportunity Friday to work with them and try our hand at fixing some hospital equipment.

The last nuts thing was as we waited for the bus at 3. Mr. Timba came to check on the baby (who we named Hastings after Hastings gave us so much of his day, and he ended up carrying the baby pod for a long time). Penny had the great idea of asking him who I could talk to about shadowing in the operating theatre, a big mission of mine while I’m here. He gave me the number of a doctor from France named Dr. Francis (who he called Dr. France). It felt weird to cold call a surgeon but I didn’t have many options so I just dialed him up there in the parking lot. He answered, I clumsily explained who the heck I am and why I’m here and could I please shadow him. He told me to come tomorrow at half past 7 in the morning. I thanked him and probably sounded completely useless because he warned me: “It isn’t useful for you to come in and out. If you are coming you need to meet the patients before we operate and see how they do afterwards. That is what makes it a useful experience.” I was so intimidated but so happy: this is a man with a solid ethic of care. As a result I will wake up at 5:30 so I can be with him tomorrow and attempt to be less useless. Wish me luck. Sorry there were so few photos today, it is not easy to take them at the hospital because I have to respect the patients's privacy and the work of the providers.

With love and an inflatable baby named Hastings,
Lauren

I am grateful for…
1. Zomba central hospital    2. Wifi and the opportunity to blog    3. Amos the musician
What will I do to make today great?
1. Work on thermistor tech    2. Get more sleep    3. Eat well
Daily affirmation. I am…
Happy
3 Amazing things that happened today…
1. Focus group with the mothers in the pediatrics ward, with Hasting’s help    2. Taking selfies with the women outside pediatrics    3. Calling Dr. Francis and hearing his dedication
How could I have made today even better?

Laugh more

At the top of Zomba

We really did Zomba right for day 1.
We started by going to church. Patti said we could sleep in a bit so we met at breakfast at 8:30. Breakfast is SO GOOD here- Spanish eggs, beans, chips, toast with marmalade, bananas, everything. Before getting there though we were greeted by the ultimate welcoming committee- about 10 monkeys were playing on one of the balconies we pass on the stairs down the mountain to the lodge restaurant. They. Are. Amazing. They are just tiny fuzzy people. They played peek-a-boo with me and have little fingers and toes and love pulling things off of tables and high surfaces. They just played and ran around and absolutely mesmerized me. And they’re here every morning! One seemed to like my necklace because he kept coming right up to me.
the stairs up to our room at Annie's Lodge

It got better at breakfast. The thing about monkeys liking bananas- it is not a joke. They swung down from the roof of the breakfast veranda to snatch bananas off our tables, and then eat them on the railing right in front of us. They are relentless, sneaking up from every direction to try and grab them. Everyone shoos them away and calls them pests. I do to but secretly I bring tons of bananas to the table hoping they will come get them. They are my true love. The monkeys, not the bananas. But the bananas are really good too. Never leave me monkeys.
my friends


Then we went to church. Some street vendors post up outside the lodge because they know people like us stay there, so I got a pine cone necklace on the way to church. It’s classier than it sounds. We walked to the chapel. Girls sit on one side and boys on the other. It was such a great time. It was a Presbyterian service in English, though we were the only white people there. Everyone learns English in elementary school here, which is so nice for us because there are at least 4 languages in Malawi, so Chichewa (which we barely understand anyways) doesn’t always cut it. The hymns were beautiful, sometimes accompanied by a band and sometimes by a really incredible a cappella choir. The pastor was too much also- he had so much energy and called for lots of hallelujahs while he told us about what is says in Deuteronomy 22:6-7, some general things in Numbers, and Malachi 3:10-12, all about not being greedy and discovering the holy portion, and God’s promises about that. There was even some dancing during a hymn, and they invited visitors to participate in the offering, which is done by processing to the front of the church. My favorite part was this song I had never heard before but loved, with the chorus “Bringing in the sheeps, bringing in the sheeps, we will come rejoicing bringing in the sheeps.” Since sheeps and rejoicing are both in my top 5 favorite things ever, I was completely on board.

After church we took a walk around Zomba to get our bearings and scope out the store, called Peoples Mart, as well as another smaller store, and the restaurant Tasty Bites (which is indeed tasty, and for biting). Ashley and I got ice cream though that was risky because milk isn’t pasteurized in Malawi, so it isn’t guaranteed to be safe unless it’s hot. The thing about ice cream is it is milk and it is cold. But we were comforted by the fact that if one of us got sick we’d both be going down together. Spoiler: we were fine. And it was tasty

After eating we stopped at The Wall- a market in an open lot where vendors have gathered and opened stalls. They sell wood carvings and paintings and all the things Americans bring back from Africa. It feels a bit like when people try to sell you purses in New York City until you realize these men are artists-they make these things. If you don’t love a painting they have, they’ll ask you how they can make it what you want, and they’ll paint a new one and simply tell you to come back in 2 days. They sell things their fathers and grandfathers carved. It’s really incredible, and absolutely everything is beautiful. Necklaces, bracelets, paintings, cards, chess boards, every African animal you can think of, masks, boxes, chairs, tables- it’s all there and it is all beautiful. The problem is Africans don’t buy that sort of thing, they live here. So when they see us and can make a safe bet we aren’t from here, they get really excited. They’re all respectful but it is a little difficult to really connect with them because they so want us to love their work and support their business. Luckily it is all really affordable and I have a lot of loved ones so I think I can support each artist in some small way. I’ve learned their names though and really love them all.

We took a shortcut home through the “golf course” which was a pretty field at the foot of the mountain.


Back at the lodge we had to rush to get ready because.. Annie invited us to a party! At her house! We piled in our SWEET bus, joined by the other group of educators: 6 students from UNC Wilmington and their two professors. So together we are 3 universities, 14 students, and 6 professors. Not too shabby. Anyways we got on the bus and were driven up the mountain to Annie’s. We know Annie does pretty well because she owns a lodge in most major cities in Malawi and as I said, she is BeyoncĂ©. Her house is wonderful though, if not just for the view. She has a MASSIVE deck, the size of a ballroom with the most incredible view of the mountains outside Zomba. That is why this place speaks to me, it is a mountain town. They are always around us, curving up out of the earth to hold us. I couldn’t breathe when I saw this view. We all took pictures and talked to each other and Annie’s friends/lodge staff who came up to help her cook for us. We drank sodas (and beer and wine but the soda is way more fun) out of glass bottles and ate bananas. Soon Annie brought out the massive meal and we ate while the sun set. There was some INCREDIBLY spicy sauce with it, and anything that the oil of the sauce touched just engulfed your mouth in flame. I was basically sobbing as I ate when I found this stray kitty. I named him Spicy and he is my friend.


Then, we danced! There is a musician that plays during some meals at the lodge named Amos. I didn’t learn his name until the party at Annie’s, but I had been dying to talk to him because his music is so wonderful, and he knows this song I heard when I was an exchange student in Germany. His is so talented. He played American and Malawian songs while we danced. Our main dancing partner/instructor is a friend we made named Hastings. He is a graduate of the Malawi Polytechnic university and an entrepreneur. He taught us some really, really fresh Malawian dancing. TWO things about all Malawians: they are nice, they can dance. Fact. All of them. After we gave it the old college try, Hastings wanted to learn our dances. A UNC girl went straight for the hokey pokey, so that is what we taught. Then the electric slide. What a strong showing for the dancing of our country. It was such a weird thing to step back and realize “I’m doing the electric slide to ‘listen to your heart’ played by a Malawian in Zomba. How did my life get here?”
the preposterous view from Annie's house

It was so sad to leave Annie’s but on the bus ride back I got to talk to Amos finally. He plays music because his father did. His father died on Amos’s knees and told him he had to keep the music going, so he plays guitar and sings and wants to make a CD and travel to different countries to play. I promised I’d be the first to buy it, he is so so talented.

That night Ashley and Penny and I did a lot of planning in Ashely and my room for Zomba Central hospital the next day. It is intimidating to head back into the hospitals after a weekend of what has felt like vacationing but the work is why we are here and what really makes our hearts grow.

With love and cat diseases,
Lauren

I am grateful for…
1. Monkeys    2. Photographs    3. Annie’s lodge Zomba and it’s mountain
What will I do to make today great?
1. Go to church    2. Ask people their names (doandani?)    3. Laugh freely
 Daily affirmation. I am…
An animal lover
3 Amazing things that happened today…
1. Church in Zomba, and Amos’s grace before dinner   2. Dancing with Hastings on Annie’s porch    3. Pet Spicy the cat and being harassed by monkeys
How could I have made today even better?
Had more courage to talk to Amos sooner



Edit: after reading Ashley’s blog it seems the song mentioned above may in fact be “bringing in the sheaves.” I think I will continue to sing it my way because if everyone is bringing in the sheaves someone needs to take care of the sheeps anyways. Also what the heck is a sheave