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