More Questions than answers

 

I have been in Fatima for 3 weeks now and the questions just keep coming!

 

I am undoubtedly having quite and adventure and my personal growth and to a certain extent my professional development is undeniable what is less certain is the impact my actions are having on those around me.

 

The past two weeks have been spent in the classroom, I have been teaching the year two-student nurses. You couldn’t hope to meet a nicer group of people. They are so eager to learn and are a pleasure to teach (if not a little daunting being faced with 60 students all hanging off what I have to say). However, there are some areas of concern. I have been reading through some of the exam papers that have been set for the students (these are done by the colleges, the final exam being the only one set by the Malawian Nursing and Midwifery Council) there are some blatant mistakes and misinformation. I have to be somewhat judicious with the concerns I raise as upsetting the tutors would be in no-ones interest. I was asked if I would help teach a clinical examination class that was a real eye-opener!! Listening to the tutor inform the students that the apex of the heart could be located at the sternal notch was a little worrying and in that instance I found a way to correct the situation and was ask if I would lead the teaching session, the relief from the tutor when I agreed was palpable! There were three classes before the one I helped with so there are now umpteen students coming out of Trinity college who believe they will locate the apex beat at the sternal notch!!! I wont tell you how they were listening to breath sounds or examining the abdomen!

 

One of the biggest areas VSO don’t prepare you for is the begging. I have found this so distressing. Everyday there are people knocking at the door asking for money. Some of the students have also approached me for funds for various things ranging from their fees (MK57000 that equates to half my monthly allowance!) To money for transport, ‘sisters shoes’, books or simply a bar of soap. You very quickly realize that you can’t help everyone, so how do you choose??? Every story is heart-rending and I have found myself in tears on more than one occasion. I spoke to one of the tutors who told me “Malawi is a nation of beggars, they believe the white man is rich, so why shouldn’t he help, they need to stand on their own” This sounds quite harsh but I am not sure that just giving money is the answer either. Thus my plan is to buy goods (I may need another suitcase to bring home all the gifts I acquire)! I have included a photo of a local man and his family, he made me a fantastic rush mat for the living room and one for my bedroom.

 

I went back to Blantyre last week to catch up with friends, it was the first time we had got together since going to our placements so there was lots to catch up on! Friday night was a party to say good-bye to one of the medics who was heading back to Germany. My hangover the follow day tells me it was a great night!!

Saturday was spent doing the usual Saturday things – shopping! The weekend passed way to quickly, as weekends usually do.

Just found out that uploading photos is not possible here in Fatima. The next time I am in Blantyre I will post as many as I can.

 

 

The road to Trinity

My last week at Queens in Blantyre was full of mixed emotions. I was so excited at at long last being able to get to my placement but also very sad at having to part with some really good friends (get togethers being planned as I type).

This last week found me dotted all around the hospital, I was in the ICU (intensive care), Family Planning and HIV/Aids clinic. I have included some photos, I though the supply of strawberry flavoured condoms was particularly thoughtful of the Malawian government!

Anyway, here I am in Fatima at Trinity college. The journey down here was long and a real adventure. Halfway through the journey the road disappears!! It is a track that Jeremy Clarkson would be proud to test one of his 4×4’s on. I now feel I have a rough idea what being famous is like, everywhere I go people are smiling and waving they are so excited to see a white person.

I arrived with Laura (my housemate) at about 3 pm. the house is lovely, amongst other things we have a fridge a cooker and a small backyard. It was a great feeling to finally be able to unpack. However, I had rather an unexpected reaction when I came across some of the ‘bits and pieces’ I had packed from the boys – tears, and lots of them. 

The next morning it was off to the college to meet everyone and be shown around. At about 10 am I was asked to go out with the students to help with health assessments at a local school. This was to be a week long activity which I was included in and found great fun. The students firstly assess the school premises and then the children. At the end of the week the students, parents and teachers gather for feedback. It was all very impressive.

Evenings seem to pass very quickly, by the time we have had an evening meal it is time to go to bed (normal times don’t apply here, you listen to your body and bed time seems to be between 8 -9pm!!) I was warned about the heat in Fatima but I don’t think anything can prepare you for the temperature or the humidity. I sweat so much it is difficult to keep up the hydration, I feel like I am constantly drinking (water that is). This obviously adds to the exhaustion but even just a week in I am coping much better. I must have spent 80% of the first few days sleeping! The electricity has gone off most evenings this week and we or rather Laura has ended up cooking on our little stove in the backyard. This all seems great fun at the moment and only adds to the adventure (I don’t think Laura feels quite the same, 6 months of it appears to have taken its toll).

I had the weekend here on my own, Laura having gone to a party in Blantyre. The village is so friendly I didn’t have a moment to feel lonely. Saturday night was film night with the students. followed by Sunday morning church (the whole village goes so it seems the right thing to do) in the afternoon the children came round and we all sat and watched an animated disney movie.

I start formal teaching tomorrow, this is obviously going to give me a number of challenges, not least will be the language. Gauging how much has been understood can be difficult as the student often just smile and nod. I think gently does it…..ImageImageImageImageImage

Faith restored!

The view from the chalet

The view from the chalet

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Early morning washing

Early morning washing

The children had made a boat out of a plastic bottle.

The children had made a boat out of a plastic bottle.

Snorkelling on Saturday morning.

Snorkelling on Saturday morning.

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Sunset!

Sunset!

Our chalet

Our chalet

Week 3 at Queens

I started this week feeling rather sorry for myself, I have a flu like virus that means I ache all over and feel like I have swallowed a packet of razor blades. I spend Monday tucked up in bed sipping Lemsip and drifting in and out of sleep.

Tuesday came and I felt I really should try and get to work, to be honest I was slightly less than enthusiastic given my experience last week.  How things can change…. I was on a surgical ward this week and as I arrived it was clear that this ward was very different from the medical ward of the previous week.  The ward oozed calmness and organization. The young ward sister arrived promptly at 7.30 and ‘hand over’ started.  The night staff discussed all the patients, giving name, diagnosis, observations and management plan. They also discussed how each patient had been over night. We then went into the HDU section of the ward. The student nurses were expected to hand over. One of the nurses wasn’t quite sure about her patient or how to hand over. The sister made it clear to her what was expected – it took me back to my student nurse days!!

On this ward observations were done regularly, fluid balance was monitored AND recorded! The patient’s notes were kept in the nurses’ office to ensure some degree of confidentiality. The ward was clean and tidy, the sister ensuring that the area was washed down and beds made every morning. We also helped the guardians care for the patients, all very different from last week. I have felt very reassured that despite the lack of resources good care can be given and the wards can be run efficiently.

Boring nursing/medical bit coming up, sorry!

On the ward we have three patients with oesophageal cancer, I am obviously in my element and have been asked to do some teaching to nurses and student doctors alike. I have also spent time working with the palliative care team. Patients here rarely get offered an oesophagectomy the cancer is usually far too advanced. Oesophageal stenting is an option but only uncovered stents are available so the benefit is short lived. They also seem to dilate, this is very risky in patients with cancer and perforation is not uncommon. Malawi has seen a sharp rise in the incidence of squamous cell oesophageal cancer; it is believed that the preservative used to store the maize may be responsible. Phew, all done!

I am feeling so happy and settled in Malawi, Jo, Vicky and myself have talked about this many times, the three of us feel the same. I think comfortable is the feeling we all have.  The people here are just so friendly and happy; there is certainly no British reserve!! I was chatting to some school children on the way home today, there were obviously some language difficulties and three guys that were sitting on the side of the road just came over and offered their help with the language. That kind of thing is just normal here. When you walk down the road people just smile and say hello to you, it really is lovely!

We are off to the Lake this weekend; we are feeling very excited at the prospect of scuba diving, snorkeling, kayaking and generally lazing around in hammocks drinking cocktails. Watch this space…

Wow, Cape Maclear was amazing. We travelled down Friday afternoon; the journey takes about 4 – 5 hours. It is a long way but the journey is hampered by the condition or the roads, it certainly is not a boring M25 journey. We arrived at sunset and were shown our chalet, this was right on the lake front! We had a veranda plus hammocks OMG pure luxury. On the Saturday we went snorkeling and on the Sunday we decided not to over exert ourselves so just a little swimming and lazing around in the hammocks before the evening entertainment. Monday we went kayaking before heading back home. I have enclosed lots of photos because I cant adequately describe how beautiful it was.