dreams

The anti-malaria pills that I’m taking (larium or meflaquin) is not given any longer at the public health places in the US because of the many side effects that it can cause. I have taken this one for all of the trips I’ve taken and took it my first year here…(they would only give me 6 months worth the first time though I was coming for a year) and this time they wouldn’t give it at all…said if I went to a private practice I could get it…but I came and found it here from people who had too much and then I could get from the clinics here.
The side effect that I get is very vivid dreams. I sometimes remember them, sometimes I just wake up knowing that I’ve had a strange dream…I have been taking the medication in the morning with breakfast and have had less of the dreams…but occasionally I will forget at breakfast and take it with dinner…that week is sometimes lots of fun.
another: I was going through an airport—don’t know where to…but I had left my shoes at some place behind me…and when I wanted to go back to get them the officials wouldn’t let me go back. And they wouldn’t let me go back and finally they said I could go back if my husband went with me…*problem! I’m not married…but luckily for me there was a guy that I knew in the crowd who offered to go back with me…we just didn’t tell the officials that we weren’t married. I woke up before we found my shoes but I think that if I’d stayed asleep we would have found them.
the latest was chasing goats with james...

escape

Last week had some days where thing were just getting to us…nothing big just everything altogether…every little thing…losing patience…so we decided to go to the lake…Ute, Natasha and I. we left after ward rounds on Saturday morning as Natasha had to see to the wards and went to Senga Bay. Got there in time for lunch…love fish at the lake…then to the CCAP cottages where we stayed—remote from the regular tourist track and right on the lake. That night we watched the clouds come across and it looked like it was pouring at cape maclear (farther south)—beautiful lightning and watching the rain move across the lake. Sunday morning we were well rested and moved from swimming to reading to sleeping…very nice until about 3 when we went for a late fish lunch again. And then back to Nkhoma. A nice time away that refreshed and renewed us for the coming week.

clinic

Back to clinic. We had many patients of course…but two of them came in who had been screened in the villages back in march of last year when they started the epilepsy program at the hospital, they came in for their first visit and never came back…so 11 months later they returned. The first girl looked like she was about 17 (maybe). She came in and sat down. We asked if she’d had any seizures since her last visit (last year) and she said no. asked more questions and she shut down. Wouldn’t answer questions, wouldn’t look at us, nothing. So I was looking more like it wasn’t a case of epilepsy but someone who had come (with her family as they were in the program as well and also haven’t come back) because they heard there was free medication. The doctor and I left the room to see if she would talk to the translator who was a Malawian medical student from Blantyre. When we came back she said it sounded like a relative might be sick but she couldn’t tell and the girl would give a name…we sent her away without medication and instruction to bring back the patient…as she also isn’t really old enough to be a guardian if the patient is really too sick to come.
The second came in and I thought it would be the same case but it was for a smaller child and it was established that she had had a few seizures…though I still don’t get why she didn’t come back for 11 months. She did get more medication—and we’ll see if she comes back on the prescribed day…

real life

Living in a real house on the ground floor means that there are more people knocking on the door either begging or selling things. Living in the cottage and keeping the door closed at the bottom level means that I don’t get very many “visitors” there (anymore). So back to the ground level it felt that every time I turned around there was someone else knocking…when I woke up on Tuesday there were voices outside the door…I couldn’t tell how many people that was but they kept talking and getting louder and louder. I went to answer and four people there selling rounds of rope…they come every week…I bought one round and they were not happy. Later that morning I found out that Rebecca buys all the rope each week (I have no idea what she does with all of it)…but I had made myself understood the lady of the house would be back in two weeks (they weren’t happy obviously as they didn’t come back the next week—while I was still there but are probably coming again now.) then I came home for lunch the same day and there was someone on the front porch begging and about 15 minutes later there was another at the back porch. Gave them some ufa (maize flour) which is their staple and while I felt good about it on one hand I wasn’t giving with a joyful heart…felt pushed and guilted into it and that just doesn’t leave you with a great feeling. I think that they have it pretty well sorted though that Tuesdays are the days for people to come by because I didn’t get too many others while I was there.

market

The market is like exercise for me. I find it so hard to get the motivation to go but I do (usually) enjoy it when I go. And I make it a point to go on Saturdays which is the big day so the time to really go. Getting food that you know is fresh (of course some is so fresh that it doesn’t last very long at all after buying)…and just seeing what is there…you can see what is in season or what is coming into season and you really can’t find what is going out of season. So avocados are coming back…mangos are in but going very soon, okra comes back now…you can always find onions (sizes vary), tomatos, bananas and cabbage…carrots and eggplant (aubergine) occasionally.

And bugs of varying sorts at various times. And it really isn’t too expensive…of course the expense (and even then it is negligible) for me is buying the tchitenji (cloth)…the bright colors and patterns. Almost every time I go to the market I buy another one and if I’m with others who buy them I usually get more than one…I’ve got a whole stack right now—just have to figure out what I want to do with them…suits, skirts, bags, aprons…opportunities are endless in many ways. But what would I really use? Or what would others use or appreciate? and then i think--what's it matter...i like it!

song lyrics

You close the door in front of me, I wait patiently outside. As the minutes tick away, I feel my anger rise. Who’s the object of my rage and who’s not being fair? Is it you for your indifference or me for just standing there?
Sometimes it’s hard to understand when they say that pride’s a sin. Should I go or should I stay on the outside looking in?
Well I didn’t make the grade today and I’m not the only one. But my heart won’t stop hurting or feeling all alone. Maybe we’ll trade places in some not so distant yet I hear your voice a-calling now and I cover up my ears. I dream about you through the day and I toss and turn at night. Well I could brag on the things I’ve done or places that I’ve been, but I’ve never found for on the outside looking in.

“on the outside looking in” Allison Krauss and Union Station—Paper Airplane


i don't quite know why i put this up...where i see myself...if it has to do with me here...or people everywhere...or not at all...but sometimes it feels like it fits

changing

Where is the line of working in a developing country to help them or to help yourself or to help them become more like you? many different things drive me crazy here…from having to greet everyone individually when you walk into a room, to them barely knocking so it is easy to either not hear or ignore, to agreeing with what you say with no intention of doing what was agreed. So I walk in to a room and don’t know everyone and asking the same question over and over and over and answering over and over and over…it just doesn’t seem to stop but can I just walk in and say an overall greeting? I have started doing that but is that changing their culture to suit me? Or will it really not change anything…
The knocking I find even worse…there is a little tap and I just know that (if I hear it) it is probably someone begging or here to sell something that I really don’t need because they come every week to sell rope or mats for the floor or hot pads—and how often do you really go through those things…so I would love to just ignore it…but then my conscience gets the better of me but then I am a bit resentful. And granted sometimes I do buy from them but it is frustrating. And then there are the workers—both the housekeeper and the gardener do the same knock…and if I have music playing (which I often do) I really don’t hear the tap at the door. And I have told them to really knock so that I hear (because them I really do want to talk to or let in or whatever)…but once again is this forcing my culture on them?
And the agreement thing is often a desire to be agreeable…very cultural. They don’t want to disappoint—I guess not realizing that it is much more disappointing to be told something will happen when it (deliberately) won’t. (I was “warned” about this phenomena before coming) but often doesn’t make it any easier to remember or understand.

nguluwe school

Here is a new school that was sponsored by Positive Steps (charity in UK) through Jane and a dutch group who know Mark and Loes who were here for 10 months in 2011. It took quite a bit of doing to get it done. They discussed with Orphan Care and found the village community. Had meetings with the village head and committee…they were given an area and started building…that the foundation dug and had a ground breaking ceremony with lots of speeches and ceremonial brick laying…


and then as things were supposed to get started there was some vandalism to the foundation. After lots of false starts and no communication they found that the chief had given land but the community didn’t want the school there…or something to that effect. It got to the point that they were about to pull out and find somewhere else to build. Gave them another chance with a new location—close to the place where the old school (under a large tree) was located. The community had to build the toilet and the kitchen before they would start the school again as a good faith measure. And there was a timeline that needed to be followed…it did happen. And was to be finished before mark and loes left…but time was getting close and then there was a funeral in the village…so they didn’t get to see for themselves the finished product but here are some pictures…a classroom (above) the kitchen (below)

new house again!!

I’ve moved houses again…for two weeks I’m staying at the morton’s house while they are at a continuing Education for doctors (to keep their licenses valid in America)…now I have access to internet whenever there is power (and network and all is working well). A beautiful yard and a shower! That is really one of the selling points. and this view of the mountain peaks from the back porch area...

at dusk



will maybe put up more but there hasn't been much blue sky lately...and my camera has gone on holiday to the lake...

SLA

There is an agreement called Service Level Agreement. It is between the government and the health services (if I understand correctly). This means that Pediatrics under 5 years of age, Maternity cases, and some of the outpatients are paid for by the government. The patients are supposed to get passes from their nearest health center and then they are to get another slip from here…and…and….and. but the first and second slips at least are supposed to be provided to the centers by the government and they haven’t been. This has been both a problem and a blessing. At the beginning we were getting the slips late and then having to back fill and that is a lot of work that needed to be done somewhat urgently so the hospital could get the money from the government. Now the slips don’t come so we don’t have the extra work of filling them out. Now we only have to put them in the computer…name, village, village head, district, patient number, if they do have a pass, what the diagnosis is, and the cost…many of the diagnosis are the same (peds is usually malaria or pneumonia and maternity is delivery and/or malaria).
I finished the January Pediatrics last week for a bumper month…it is malaria season so there are an extraordinary number of patients…1099 (that is only the number that the gov’t pays for—under 5s) (that’s 35 a day) and the costs came to 3,515,030 Kwacha (~$19,530). And then I finished Maternity with 334 patients at 1,001,180 K (~$5,560).
Each month the government gives K5.6 million to the central area. Nkhoma hospital gets half of that and the rest of the centers split the other half. So the 2.8million K ($15,555) won’t cover this month but we will hopefully make it up with some slower months throughout the year…

no power

Thurs we had power when I woke up and Reinette and I went for a walk. When I got back to the cottage there was no power but that isn’t too surprising…went to school where there was power…that was surprising. When I got back for lunch I checked the main switch (I have been sitting in the dark before when it was only my house and it was the switch that had flipped)…it was on so we should have power. Tried to call Escom (power company) and got through…they said they would send someone and check. But they didn’t…at least I don’t think so. No power all night. I kept trying to call back and couldn’t get through (felt like they were ignoring me). Had other people calling but they couldn’t get through either (so it wasn’t just me). Woke up early Friday and called (5:30) and the guy said yes, he was just talking with Mr. Veitch about that exact problem and they would send someone. I believed him this time. And yet at lunch still nothing…and that night again nothing…and it was raining. So I was told that they were just waiting for the rain to stop…I went to bed. Sometime between 2 and 4 am it was restored to us. So when we woke up early and had power we were so excited! And then Saturday the power went out twice—for all of the area…once in the morning (only over our time for the market) and then in the evening (over dinner of course). But at least it wasn’t just us.

laminating issues

So we had gotten a new laminator sometime before Christmas for the school. I’d been using one from the hospital before that. I had been the only one to use the new one and while I didn’t feel that I needed to be the sole operator I suppose I should have taken more ownership…but it isn’t really mine. Anyway. The two vols we have now are helping in classes and in the afternoons they are doing some of the paperworks things—making new reading books at higher levels, checking that we still have full sets of the older reading books, and making some matching games for the younger classes, and doing the flashcards that I’d been so tired of…I was a little late one day and had no power in the cottage…when we got to school Marlinde tried to tell me about the laminator being broken and I said no no there is just no power…and then I found out that there was…took the machine home as I didn’t have a screwdriver to fit…and had to take the whole thing apart…which I think I did pretty well…got the melted paper out (takes ages and is a bit challenging). Put it back together…also pretty well and it worked for a few days…I was still worried that something would get stuck as not all of the papers would come out flat…and sure enough there is another one stuck now…shame…
*but I fixed again…this time I think for real!!

snowflakes

Friday I thought I would be at school for just a few hours (which always turns into all morning)…but then there was no power to make copies or laminate…and yet I was still able to keep quite busy. (I have figured out since that this is because this term I am only 1 person doing what was done by 3 people last term.) we have 2 dutch helpers at school and they have quite the schedule—arts, PE, reading, activities…with all of the classes. But on Friday one of our teachers was out for a funeral in her family and so Marlinde was there for the morning and Leanne was home sick (not used to Africa yet). So I was left to find an art project for 1st and 2nd grades…I decided on snowflakes—but I didn’t want to call them snowflakes as it is summer here and it never snows…but it was something I could do that didn’t involve copying or special thought and supplies. So I got white paper because after four folds the children’s scissors would not cut through anything thicker. But as I didn’t want them to be snowflakes I told the kids they needed to color the white paper so I didn’t see any white. Didn’t realize that would take up all the time if I let it. so after a while I said put the crayons away even if there is still white…and we folded and cut and I think they turned out well. Good to have them try to follow instructions on folding and following directions…and they were so excited when they opened their flakes…I saw one kid after who showed me the “helmet” they had made…ah imagination!

Education Day

Last Wednesday (Feb 1) was Nkhoma Synod’s Education day. It commemorates the beginning of education in the Nkhoma Synod. I was in church the Sunday before and they announced that it was a Synod holiday…that means that synod schools are not in session. I thought that was interesting…the day remembering the start of schooling is celebrated by no school. But then who am I to turn down a holiday…(well I did go work in the hospital for the morning).
At Bible Study the night before we were talking about it and someone said that the headmaster at William Murray (private boys high school) had said that they were still having classes…well the headmistress at Ebenezer school did not make that announcement…(that is me for the time being).

feelings

So I don’t really find it hard to enjoy my holiday (of course) but when I am back in nkhoma or home wherever that is I find that I like to keep busy. There are times when I can really relax but there are other times when I feel that everyone else is working and I should be too even though I either don’t have things that I have to do or feel that I’m just doing busy work. I’m starting to think it comes from not having a “real” job. Yes, I am helpful. Yes, I am needed. But then again if I’m not there things do go on. This is a good thing but it also gives me the sense of not being needed, spinning my wheels, an extra—nice to have but hey. And it isn’t that I’m not appreciated…but when I decide to take an afternoon off it is ok because everything will get done (just later)…and I don’t have to ask (which I’m glad about).
Last week when Ute and I decided to go up the mountain in the afternoon we went. I had invited Nicole who is also helping Rebecca but she was too busy at the hospital…when I got back she asked me if I had asked Rebecca if I could go…well, no. i don’t work for her—I help her. (this was a time it was great not to be in a real job) And then there are the weekends that I don’t do much…and that is fine but in my head I always have the list of other things that will have to get done soon…but I also suppose that is true no matter what you do. There is always more you can do to help…it is never really enough. Because when you reach the point of enough—there is still more both in you and needed…