The students are now all on placement, they have been sent to a variety of hospitals around Malawi, including Queens in Blantyre, Zomba and 8 students here at Trinity. I am supervising the group here at Trinity. Supervision involves supporting them with nursing care, ensuring they represent the college in a professional way at all times and supporting their learning needs. 7.30 first morning and all the students arrive on time, we are off to a flying start! Unfortunately, few of the other staff has the same sense of time-keeping and it is not until 7.50 that the last ‘straggler’ wanders in; hardly the best example to be showing the students. A classic case of ‘do as I say, not as I do’! Report starts after Morning Prayer and includes the whole hospital (sounds daunting but there are so few patients it doesn’t take long!) That done and we are off to the ward….. The ward is divided into male and female, which is then further, divided into medical and surgical. Not dissimilar to the UK but there is no division by specialty. The students and I joined the medical officer on the morning ward round. This is where all my experience counts for nothing and I may as well be a student again! Typhoid, malaria, TB, sleeping sickness, sickle cell anaemia to name but a few of the conditions that confronted me. It is pretty clear that I am going to need to spend a considerable amount of time with the books!! Good nursing care however, is good nursing care and that is something I don’t need to consult the books on. I allocated each student 3 patients, I asked him or her to prioritize and then provided total nursing care. They looked totally aghast and said ‘three patients!!! Lizzy that is far too many” By the end of the morning each student had only managed to care for one patient, I am now seriously considering rectal dynamite! One of the highlights of that first day was meeting Steve. Steve is the health care assistant on the ward; he has been there since the ‘year dot’, knows everything and does 90% of the work. I asked him why he did not take a break, his reply “madam, our work involves saving lives, there is no time to rest” Enough said. So why the title “never smile at a crocodile” well, out of the 20 or so patients on the ward that morning, 5 were crocodile attacks. Nsanje district is the poorest in Malawi and the people depend of the Shiri river for many of their everyday needs. Unfortunately for the fishermen and the rice growers this comes at considerable risk to ‘life and limb’. The first man had been fishing in the early morning and had lost his leg and was probably going to lose his arm (what was left of it). The next was a young man who had lost his arm and the ‘croc’ had a little ‘nibble’ at his leg. I asked him how he escaped he told me he bit the crocodile in the eye! I have included a photo of this lovely and very brave young man. We also had rather an amazing lady; she had been close to the waters edge, baby strapped to her back, planting rice when the crocodile attacked. She fought off this crocodile by ‘tucking’ it under her arm, its tail at one point flicked up leaving deep gashes in her back. She escaped with only losing part of her right hand and right breast – her child was completely unharmed!