Q&A Session

So my friend Eilene (bff4life! since the third grade when I wrote on an assignment that she was my favorite new kid. We have spent many summers at camp sleeping in the same twin bed, every weekend at each other’s houses in grade school, and have managed to stay in touch in our adult life. I am so happy to call her my friend.) has asked me about one million questions about my life now. She may be actually interested or she may not know what to say to her freak friend living in a village in Africa. Either way I have convinced myself that maybe other people actually want to know how I am living now. Since she has covered about everything I thought I would do a Q&A blog with just her questions. Be prepared there are a lot!

Here we are at one of the many times at camp.

What is your house like?

My house is two rooms, one room that is supposed to be a living room and then a bedroom behind it. It has concrete floors, and glass windows. Very basic but works. I also have a yard with my “kitchen” and “bathroom”.

What is your toilet like?

My toilet is a drop hole. It is a pit that has been dug and a building has been constructed over it. In that building is a hole about the size and shape of a brick, that is my toilet.

Do you have electricity or plumbing?

No. I have had a solar panel installed and it allows me to charge my phone, laptop, and camera battery. I am supposed to have lights, but the battery to the solar panel is so bad that they do not work. My battery also makes this terrible noise the whole time it is on so I have to cover it with a blanket. But I am happy being able to charge my stuff. Also when I did have lights for one night it attracted so many bugs. Using a head torch works just fine. There is no plumbing. I have a woman bring me water in buckets every day. I treat one bucket with a lid and a spout for drinking. I use the rest for cooking and cleaning.

Where do you get your food?

Most of my food I can get in town. There are two close by; Balaka and Ntechu. Both have some grocery stores and markets for vegetables. I can also get some small items at little stands in the village or just from people willing to sell from their gardens. When I get more settled I am going to attempt to have my own little garden and some chickens for the eggs.

Do you always boil your water before using it?

Boiling is a lot of work plus takes a lot of wood. So I am using a solution called water guard. When I followed the directions on the package my water tasted like a swimming pool. It made me very grumpy and I barely drank any water. Mary told me to use about half the amount and it would be better. I have done that and it is at least drinkable. I would prefer a filter though, I do not feel like chlorine is really appropriate for drinking.

Where will you get furniture and what will you get?

I have ordered furniture from a local carpenter. I am getting a dresser, cabinet type thing for kitchen things, and a book shelf. I think eventually I will also get a small table, chairs, and a toy box made for the kids.

Where do you sleep?

I have a twin bed and a mattress that was provided for me

How do you use that toilet?

Squatting. I am working on my aim, it is not easy to pee into such a small hole while squatting.

How are you supposed to use it when you are drunk?

I will probably not be drunk here, drinking warm drinks alone does not sound fun. Plus I do not have time with all of the things I need to do, and having a bedtime of about nine. But I am sure it would not be much different, I would still pee all over the damn thing as usual. I think the risk of slipping in it would increase drastically.

How do you keep from tripping and breaking your ankle in it?

That is the only reason it is a good thing the hole is so small. I think it would be very hard to fit my foot in it.

How does a shower room work?

It is just a building with a drain (hopefully) where I am able to take a bucket shower. This way I will not have to stand naked in my yard while a crowd gathers.

What have you learned about the clinic?

I have learned that it is barely running and needs to. The building has been there for ten years and nothing has been done by the government to make it a functioning clinic. This needs to change.

Does it have established staff and equipment?

No and no. There are two non-medically trained volunteers. The main staff member was a traditional birth attendant years ago. The only thing the clinic has is aspirin and Tylenol.

How often is it utilized now?

It is used daily by many people. Due to lack of supplies it seems (from my one hour observation) that it is much like a school nurse office. Everyone comes in with a headache and stomach ache. One man said sometimes his stomach makes funny noises and he has loose stools, after further questioning he revealed this happens after drinking lots of beer. I said, “Well duh, we call it the beer shits. My professional nursing opinion is less beer more water.” Same problems as being the school nurse (just kidding, they would never tell me they drank).

How do the people in the village feel about you?

They seem very excited. It is nice being the only volunteer in a wide radius. They have had previous volunteers in the community but never a medical person. They are very excited about all of the work I want to do. And they are also eager to learn. They are also just fascinated, I am often asked questions about life in America.

Do you know everyone around you?

I am beginning to know quite a few people. Paul is my next door neighbor, he is a teacher at the primary school. Mary’s mother, not sure her name, I call her Agogo (means grandmother in Chichwea) and her brother Davey live close as well. Davey speaks English well and he was the one that invited me to play soccer with them. Mary and her daughters; Linda (9) and Clara (7) also live close. Nobody else speaks English that live close, but I am starting to learn where people live and their names.

What are they like?

Mary is great, she is friendly and I am pretty sure knows every person everywhere we go. She is kind and helpful, and a great mother. Her husband is working in South Africa so she is raising the girls, along with one of her sister’s children alone. Linda is a sweet and smart girl, she is always helpful and understands quite a bit of English, she is always a joy to be around. Clara is a pistol, she is loud, bossy, so loving, and a bit crazy. I learned tonight that she gets in trouble in school and then she will not listen to any punishments. I asked Mary if she ever spanked her, apparently Clara sings and dances to taunt her mother when she tries to spank her. As we were discussing this Clara came running across to my house and threw her arms around Mary and then me. It is hard to stay mad at her. Mary thought her issues were because she had meningitis a few years ago, I laughed and said no, you just have one strong willed kid. Agogo is the sweetest and happiest woman ever. From the first day I have arrived she has come to my door and speaks Chichwea to me, I do not understand a word she says, but it is cute and friendly anyway. Davey seems like a great guy, he is always friendly and helpful. He is also the best soccer player on the team. Paul is very friendly, every time I am outside and see him I know that I will be spending an hour talking with him. He has let me know a lot about the culture and the problems in the school as far as health. Both Paul and Davey are potential running partners as well. Everyone else is extremely friendly. Malawians are just welcoming and happy people. While sitting outside and cooking I hear groups of people walking by always laughing loudly. They are also extremely kind and generous. I never do anything alone here, my bags are carried, my floors swept without me asking for it, and I am offered food every single day.

Do you have a plan for after Africa?

That is a hard one. Until this point I have seen myself returning back to work at Children’s Mercy. Already being in the village I have a hard time thinking I will be leaving a job that involves global health care. I am not sure I could live here forever. But I also know that Africa is now a part of me, and I have a feeling I will pursue a career that allows that to be part of my life. But we will see what opportunities come up.

What type of produce can you get?

Tomatoes, onions, potatoes, carrots, eggplant, zucchini, garlic, green pepper, and green beans.

Does it have to be fairly local stuff?

Yes, I do not believe anything is imported. Everything is grown in gardens here.

What about fruits, meats, bread, milk, and cheese?

I do not like much fruit, but I can get apples when I want them. There are pineapples, bananas, watermelon, strawberries (sometimes) and a few others. Meat, it can be bought in town and I am sure from people in the village, but I do not have a refrigerator, so the easiest thing to do is not eat it. I do eat meat when I go into towns or to lodges for the weekend. I ate meat at every meal at home, I really do not miss it anymore here, I never thought I would say that I could be vegetarian. Bread can be bought in town, I am sure people in the village make it too. I may ask somebody to make me a loaf every week. Milk is pretty much non-existent. There is instant milk powder that I use for cooking. But I have not had a glass of milk in six months. Cheese is only available in large cities. So I also only eat it over the weekends when I am not at home. I was told about an amazing pizza place in Balaka, it was finally a decent pizza. So I think when I need to go into town I will be choosing Balaka over Ntcheu, yes cheese has that much a deciding factor here, they also had mushrooms!!

Do you have a lot of books?

Yeah I brought about 7 with me. I also read some from the library at RIPPLE.

Do you read much there?

I have read 7 books since being here, so more than home but still not a ton. Having my laptop and internet on my phone still gets in the way of reading. Long bus journeys increase the number of books I read though. I once read an entire book in a day, because of a bus journey.

Is there a library?

Yes, it is mainly for kids though. There are a lot of books donated by unicef to help with beginner readers.

What are literacy levels like?

This is hard to tell, I would guess very low. There is not much to read here and I would bet that a lot of people never went to school. Also many may be able to read in Chichwea but there is a lack of material available. Most of the material is available in English.

Do people care about art and pop culture?

There are a lot of talented artists in Malawi, but I think they mainly use their talents to sell things to tourists. I am not sure they really appreciate the art, I could be wrong though. They love music. There is a lot of American music here; 50 cent, Enrique, Rhianna, and many more. They are very quick to know the artist and words to every song. I think if they had access to more pop culture they would be all over it.

Is the toilet in one of your rooms? How do you keep it from smelling?

The toilet is in the back of my yard. It does not smell. I think because only I am using it, the waste is able to decompose rather quickly and it has not been a problem. Unless I just don’t think my shit stinks. Either way it works.

THERE ARE BATS IN IT???

Yes, I looked down one night and a bat was flying below me as I was peeing. A bat also almost hit me in the face while trying to fly at my light.

Can you easily get a rabies shot if a bat bites you in the ass?

I think so. I have been told yes and seen something given at a hospital before. I am not sure it is the best stuff though. I really do not know a lot about rabies. I have done some research, and bats rarely carry rabies, they also have only bitten people usually because they are down from being ill and people think they look harmless and handle them. They are great at flying without hitting things, and I do not think they have it out for me. I am allowing them to live in my house, so they should be grateful and eat all of the mosquitos for me.

Do people stand naked in their yards to bathe?

No. They have grass structures or something built for privacy. Cute babies do sit in their basins naked though.  When I lived on the lake people would be naked bathing, well women would be topless but always have some sort of bottoms on. Boobs are not a big deal here, women constantly have a boob flopped out most of the time there is a kid attached. But their thighs and butts are very risque. Here in the village I have to wear a chintenge (thin colorful cloth) wrapped around my waist over my dresses and skirts.

Does Mary have running water?

No, nobody in probably a 3 mile or more radius has running water. It is more likely that there is electricity, which here there is also not. The clinic that is about 3 miles away does have running water, hopefully ours will too!

What about real medical emergencies?

Well people probably just die. There is no way they can get to the hospital in time, and even if they did, the lack of supplies and technology in this country are insane. Even when the clinic opens this will still be the case. That is why prevention and early intervention are so important. Hopefully with a clinic available and good health education people will become proactive in their well-being.

Is it a small enough place that people know why you are there?

Yes, I am convinced all of Malawi is. People do not have much form of entertainment in the village, therefor anything that changes is exciting. I am confident that most people know my name, profession, where I come from, and where I live. I am sure that by the time I leave I will also be gossiping about my neighbors and be asking tons of questions if any new person comes. And if they are a white person I may just lose my shit!

Are people’s accents hard to understand?

Sometimes, I think they have a hard time understanding me more than I do them. I have been told to speak more slowly. But I have also noticed that here they love to mumble and shorten everything. So when I am greeted in Chichwea I often have to ask them to repeat it so I am sure I give the correct response.

Are you lonely ever?

No, currently I feel very far from lonely. I am always busy and never alone. I was so worried about feeling isolated here, at RIPPLE I was surrounded by other volunteers all the time. As much as I love all of them, I think that was harder for me. I am used to living alone and spending a lot of time alone, although I do not get much of that here. It was also very stupid of me to think that just because I am with people different from me does not mean I cannot develop relationships with the people here. I feel I am doing that. Also working and trying to figure out how to cook and clean without power are busy! I am also lucky to have facebook, imessaging, skype, email, and what’s app on my phone. I feel very connected to everyone. And I am enjoying any alone time I can get.

What are people’s day to day lives like?

For men it depends on if they are working or not. If they do not work they typically do not do much. The women however are busy every single day. They carry water, firewood, cook nsimia (this is a lot of work!), garden, care for animals and children. Running a household here is a lot of work. I am learning it is a bit difficult to manage with work.

What do people do about fires and house fires?

Despite the fact that they build fires everyday they never get out of control. The lack of grass keeps fires from ever traveling into the house.

      Ok, this wraps up the one million questions. If you have any other questions (not sure what else there is to ask) feel free to send them to me. I am more than happy to answer. Also if you made it through all of that, I am impressed, if you got bored feel free to lie to me and say how interesting my life is. I am exhausted and should go to bed. Tomorrow is Thanksgiving! I am going to pass out supplies to HIV positive children’s guardians and then head to the capitol to meet some friends from RIPPLE. Hopefully we can find somewhere serving a Thanksgiving meal. I plan on returning home on Saturday. I am going to spend this weekend hopefully painting my house. I have already decided I will need about a million paint brushes for all of my helpers and some paint thinner for all of the pain they are going to spill on my floors.

                Have a great Thanksgiving! Remember to be thankful for things like indoor plumbing, ice cubes, and most importantly health and access to healthcare.

I'm back!

               I’m back! Sorry for the long hiatus, there have been a lot of changes happening here. I have moved to a new charity and a new part of the country. After several months at RIPPLE I realized it was not the experience I had wanted. It was however an amazing 5 months, I had a great introduction to Malawi and met some people I know will be life-long friends. I am now volunteering under an organization called Consol Homes, it focuses on the care of orphans and vulnerable children. I am living in a remote village on my own, and I am loving it! Some things are not easy, but I am learning to cope.

                I have now been in the village for almost two weeks. It has been quite a crazy two weeks. I arrived to the village on a Friday, while having my solar panels installed I played with the kids all day. I learned where the boreholes were, and attempted to carry my own bucket of water on my head. Yeah let’s just say it was the last time I have done that. I was not about to give up in front of all of the women and children who carry much larger buckets every single day, but I did not hesitate when a woman insisted I give her the bucket. I have now hired a woman (Ester) to bring me buckets of water every day. I am happy I can give her a small income every month and even happier I do not have to do that shit again, it hurts! Saturday was spent moving things into my home, then Sunday I became sick. It first starting with vomiting, since I have a small hole for a toilet I was throwing up in my yard and then kicking dirt over it. I was laughing at how ridiculous it was, after the 5^th time it was not funny anymore. I also felt so hot and weak, I kept trying to cool down by putting my hands and feet into my bucket; it was not working. Then the diarrhea started (sorry for all of the details, I just want you to know how sick I was!). I was losing fluids so fast. I have never felt so sick in my life. Every time I would take a sip of water I would immediately throw up. I no longer had the strength to squat over my toilet or stand to vomit. I just lied on my porch or sat on the ground while vomiting. I had went to get Mary (founder’s sister in law, basically helps me with everything in life) at her home when I started to feel very ill, of course she was not home. While sitting on my porch a group of kids were just starting at me. I asked them to get my neighbor (by asking I mean I pointed to his house and said, “English?” They responded, “yes” so I made a knocking gesture). Paul came out and asked what was wrong, I told him and that I needed help. They went to go find Mary. I lied on my porch and all of my neighbors (none of which speak English) came to help. Mary finally came, I told her that I have never felt so sick and I was afraid I was becoming dehydrated so quickly, being about 15 miles from a hospital and having no transportation I was worried. I asked her if I could go to the hospital. They knew of somebody driving through the village and called him to come pick me up. While lying on the porch waiting, Mary’s mother put blankets down for me, her daughters arranged my things trying to make me feel comfortable, and they were cleaning my house. The truck came very quickly and we were on our way to the hospital. Mary went with me. We got to the hospital the driver would not let me pay him anything, which was so kind, being from one of the poorest countries in the world and knowing I was desperate he could have said any number. I quickly saw a clinical officer, he agreed that I should be tested for malaria (I think he would have agreed with anything I said). Because I am on anti-malarials I have to be tested with a microscope, I cannot use the rapid test. They called the lab technician at home, and said he would come in. Mary went to get me a cold drink, it was all I had wanted, popsicles or ice chips would have brought me to tears I think. The lab technician came and he said, who ordered this? I told him, he said, “I am not testing this, we only do that during business hours.” I said, “Is that not something you could have said over the phone instead of coming in?” I was a bit angry. So we went back to the clinical officer, I said he refused to test me and I will have to wait until tomorrow. I told them I have no way to get home for the night and cannot come back in the morning for testing unless I stay the night. They agreed to admit me and put me on IV fluids per my request.

 I used to say I would rather die than be in a public hospital here in Malawi. This illness gave me a reality check. Not only when you are sick do you want any medical attention, but also what makes me better than anyone else here? These people have welcomed me into their village and everyday lives so openly. They love me and take care of me on a daily basis. This is where any person in my village would have to seek medical care, so why shouldn't I do the same? I felt ashamed for my previous attitude about the situation, so I climbed into my bed next to the other 30 something women in the ward and felt beyond grateful for the caring community I now belong to.

Well the result was not malaria, which I was hoping it was, that way I would have a definitive answer and not have to worry about things like water and food. I am assuming it was contaminated water. I have not treated my water anywhere in Africa so I am not convinced it was the water itself, it may have been a contaminated bottle or bucket. But since I do not want to feel like I am dying again I am sticking with my water guard and have informed my family that a filter water bottle is at the top of my Christmas wish list.

So other than being sick the last couple of weeks have been full of learning my new role and figuring out what work can be done. The main project I have is to get the clinic going. A building was constructed 10 years ago, that is about the extent of what has been done. There are two medical volunteers, they have no official training, and they give out Tylenol. Other than sick people having to walk a long way to get to a clinic, for some up to 6 miles, women also have to walk this far to give birth. In Malawi one in 36 women dies during childbirth or pregnancy, this number can be drastically decreased by a midwife or medically trained professional is present during the birth. So the clinic needs to open and start running! Today I have met with some people about how to make this happen. They were both surprised this clinic existed and is not running. I have been told to write a letter of why it is needed and what I think is important in the clinic (ummm everything! I will have to be realistic though). I have a meeting again on Tuesday to see what can be done. It feels good to at least have somebody give me a job to help get things going. The goal is in 2014 we will have a running clinic and our first baby will be born safely there!

I have also had a meeting with community volunteers. There are three sections of volunteers; early childhood development (they work with preschools), orphans and vulnerable children (not exactly sure what they do), and home based care (visit sick people and children with chronic illness in their home). At this meeting I felt like some great leader giving a speech, every time what I said was translated the room erupted with applause. Then after I was done speaking there was singing and dancing. It was so touching! Then I thought, I guess I better get my ass in gear and get some work done. One thing the volunteers have requested is training sessions. The home based care volunteers have no medical training or background, they seem so open and eager to learn. I asked what topics they would want to cover, they have given me a very long list. On Monday I am doing a training session on malaria. I have invited anyone and everyone to come. I have been told they are going to bring even the chiefs of the villages, they are all so eager to learn. I am excited to see how many people turn up, and turn up on time. I have said I do not wait for people and if you come to a meeting with me it will start on time! This is a very different culture from theirs.

I have also learned many things about the community and the culture within it. They say they have a culture of eating meat, drinking, and having sex. There are many alcoholics in the community and apparently they do not believe HIV/AIDS exists in this community. This suggests the number of people that have been tested is extremely low. I have learned quite a bit about HIV over these past few months. If a person is on ARVs and their viral load is low, it is 92% less likely they will pass the virus onto their partner, this number even suggests so during unprotected sex. So having the virus is really not a dangerous or even that bad of a thing, we have great drugs now! But the idea that it is a fatal disease and passed onto everyone so easily is what makes it so taboo. One of my goals is going to be to talk a lot about this, make it more open and discussed, encourage people to get tested, know their status, and take their ARVs. This will be quite a difficult attitude to change, but I think the more knowledge and facts people have the better!

I am so excited about all of the possibilities in this community. It is nice to be in a place where I feel so needed every day. I also love living right in the community. My house always has people especially kids around, when I pull out my laptop or camera they come in swarms. I attended soccer practice last week; many people came to watch the white girl play with the boys. They loved when I got aggressive. I am excited for all of the new ways I can begin to fit in with my new community. It is already feeling like home.

Month 3

I cannot believe it has been another month. Time is flying! This last month has been a crazy one. I went on a long road trip, celebrated my birthday, spent some time in clinics, and got to work on the village project.

First was the road trip. Mike, James, and I traveled first to Zambia, which was the coolest place I have ever been. I wanted to just stay there forever! We went to South Luangwa National park and camped for two nights at a lodge near the park called Croc Valley. If you ever go to Zambia, you need to stay there! We arrived at the campsite in the dark, so I was unaware of how amazing it really was. I woke up at six very tired, until James announced there were elephants in the river. I sprinted out of the tent. It was amazing to see the sun rising and a heard of elephants in the river. We also watched hippos while eating breakfast and I watched a family of baboons while I took a shower. We went for our first game that night with the most amazing tour guide; Duncan. Duncan is a fearless man and is not concerned for our safety, just concerned about getting us a close to the action as possible. This was evident in the first twenty minutes of the drive. The truck came up to a bunch of other safari trucks, turns out there was a leopard lying next to the tree where it had just killed and impala. All of the trucks has kept a safe distance and so there was a gap very close to the leopard. Guess where our truck went? Oh yes, right next to the wild animal. Apparently Mike and James thought Duncan was making a noise to try to scare the leopard from coming closer to the car. He was not, he was trying to get them to shut the hell up so the leopard did not attack us. It came to the truck and just stared right at us. I was ok with this while it was on Mike's side. But then it came to my side and just stared at me. I was so nervous. I tried to not even look at it so it could not tell how afraid I was. Luckily it ended up just walking away. Duncan later told us he was very nervous when Mike and James were talking. Apparently when nobody talks the animal sees the vehicle as one huge object, it does not notice there are people inside. While talking the animal is able to make out that we are all individuals. Did I mention that this was an open vehicle? Well the rest of the night was amazing as well, we saw lions, warthogs, giraffes, zebras, hippos, crocodiles, elephants, and just about anything else you can think of. After an amazing night I did not think it could get any better. I was so happy.

Then that night I went to bed in our tent and was woken to the sound of very loud footsteps next to my head. I laid as still as possible knowing there were elephants walking within inches of my head. One wrong step and my head would have been a pancake. So I really did not want to startle the elephant. James woke up and decided we needed to see them. He opened the tent door and we watched the elephants tearing the leaves off of all the trees in the camp. Mike was then awoken to an elephant throwing dirt on the side of his tent. It was amazing the see such huge wild animals so close. Finally after watching them for a couple of hours they moved on. We got a couple more hours of sleep and then went out for another game drive. I did not think this one could be nearly as good as the one we went on the night before. I should have know to have faith in Duncan. After driving for a while, Duncan heard the monkeys barking. He immediately said, there must be a leopard. Of course he spotted it running from it seemed like miles away, none of us could even spot it. Didn't matter, Duncan would get us as close to the action as possible. So we were on the move to go see the leopard. When we got close we saw that it had killed a baby monkey. I was so impressed with the leopard knowing that even a few yards away, we were not a threat. At the same time it was very aware of the hyenas that were closing into try to steal the kill. The leopard took off with the monkey and headed up a tree. I felt like I was watching a special on national geographic. I have decided I will not be able to ever go on another safari, my expectations are now far too high.

Next in Zambia we went to Livingstone. In Livingstone we visited Victoria Falls, rode elephants, and went canoeing on the Great Zambezi. Also more reasons why I love Zambia. Of course the elephant ride was my favorite. My elephant's name was Chavuruka. She is a young eight year old, and she acts like it. The whole time the handler kept yelling at Chavuruka while she was distracted and eating everything in sight. At the end we got to sit on our elephant's knee and feed them. Well she got a bit too excited and was basically smacking me in the face with her trunk. I loved my little elephant!

After Zambia there was a lot of driving and me sitting in the back and watching a lot of movies on my laptop attempting to ignore all of the comments made from the two in the front. It was a great trip that was definitely a once in a lifetime experience. I do not know a lot of people who rent a car and drive through five African countries. I could talk about the trip forever but I have something more important to talk about.

As I have mentioned in my previous blogs Mike and I have been working on a village project. We have finished the surveying portion. The first problem that we are going to try to tackle is the lack of mosquito nets. Having nets is one of the easiest ways to prevent malaria. Many people in the village do not have enough nets for their family. Therefor they are affected by malaria several times per year. There is treatment for malaria, but having chronic malaria can cause further issues such as anemia. It also costs the government and other organizations such as U.S. Aid tons of money per year. Families here are often also reluctant to take family members to the hospital at the first sign of illness and cannot afford the transportation to hospitals. Remember the little boy that was dying in Mzuzu, it turned out he had very severe malaria. It is treatable but also without proper treatment and a weakened immune system death often occurs. Some issues we anticipate in providing nets are the people will sell the nets for money, or they will use them for other uses such as fishing nets. We have talked about what we can do to ensure this does not happen. One idea we have is in order to hold people responsible for nets we will charge 200 kwacha per net. A standard net costs about 1200 kwacha (which is about three dollars). We think that by charging a small fee the nets will be cared for and used for the correct purpose. We also think that education is a key factor, in order for a family to have the opportunity to purchase a net they will have to attend an education session. I also think that staying involved with the community and doing frequent checks on the families to ensure they are using their nets will help as well. I am very excited about this project and think that it will go well and make some positive and lasting impact. We also have other plans for the community which I am very excited about. We are tying to focus on one task at a time

In order to buy these nets we will need some support! We are having a meeting on Tuesday morning with people in the community to discuss the plans. We will then get a rough estimate of how many people wish to purchase nets at a discounted price. There are approximately 110 households in the community, the chief has estimated about 50 nets will be needed in the community, I think an average of one per household are needed. This would be around 350 dollars needed to purchase these nets. If you would like to donate to the cause please visit my fundraising page http://www.acharityproject.com/f/PediatricNurse make a donation and put a comment and state that it is for mosquito nets. One net is about 3 dollars, so buying one net could potentially protect a couple of adults or help cover several children. It is amazing how so little money can be used for such a lifesaving cost. Thank you in advance. I know that I have an amazing support system, I could not be more grateful for that. I would not be here if it were not for all of the support I have received along the way.

Month 2

Sorry for the long gap between blogs. I have been busy!

So I have settled in at Mwaya Beach and have found some sort of schedule. Having a full work schedule makes this girl very happy! Monday and Wednesday I am able to go to Chintheche Hospital where I can assist with ward rounds, admitting patients, and whatever else the nurses need help doing. They already know I am a peds nurse and seem pretty pleased about it. When they asked if I could put an IV in a two year old you better believe I said yes! It is nice to use and practice my skills again. What is not nice is putting IVs in people, with dark skin and in a dark room. I think I may be a pro by the time I return home. Fridays are usually the under five clinic, this is where we weigh the kids and do their immunizations. I like this clinic because it is busy and I feel like it accomplishes a lot. Sometimes it is too busy and things get slightly out of hand. Lots of pushing and shoving and lots of me telling everyone to back up and hold on. Tuesdays and Thursdays I have devoted to working on a community project with Mike. We are trying to go into the community to assess their needs, we are doing a survey where we ask about malaria, water, toilets, food, sexual health, and basic medical questions. The survey has given us a lot of insight to needs already and we have only surveyed five people. We have learned that mosquito nets are not easily available, they are good at purifying water, they know where to get birth control and are aware that condoms and abstinence are the only ways to prevent HIV, they do not have a large variety of food and many do not have enough food, and they think putting eggs and urinating on a wound is basic first aid. So we will continue the survey and then develop a plan of action. I am loving this project, I love being in the communities and talking to people. I feel like this is why I came to Africa. Hopefully we can get a good plan going so I can keep it up when Mike leaves in a few months.

In this past month I have been exposed to a few things that made me realize just how good we have it. Yes I knew the birthing conditions would not be ideal here. A woman lying on a trash bag, in a rusty bed, no pain medication, and no real support from the nurses was not shocking to me. What shocked me was that even her family was not with her. She had one guardian that was there to bring food when needed, but that was it. The fathers do not come because according to the nurse, "They do not like seeing their wives in labor. They will not love them after they see them that way." My response was, "I do not think women really enjoy being in labor either. And men at home still have sex with their wives after seeing them give birth, maybe it would help birthrates here go down." The nurses just laughed. I also said that I felt bad for her because it must be scary, they also thought that was funny. I pointed out that especially in Malawi many things can and do go wrong during childbirth and then the mother has to worry about how to afford to feed another child. I learned that they do not allow other people into the labor room because they believe it will bring bad luck to the birth. So it is the norm for women to deliver completely alone with no support. These women of course do not complain, I did not even hear them moan with labor pains. Because of this I assumed they were not very far along. Both women looked like they were sleeping. I really wanted to watch one of the women give birth but I figured I should go do the ward rounds and then come back. Of course one of the women just popped a baby out the moment I looked away. So I sat and waited for about three more hours. Of course no baby. I figured I should at sometime be able to see one of the many babies born every day!

I am also consistently amazed with the children. They are responsible for so many things here, collection of water, taking their siblings to get their parasite treatment, and so much more. These children also sit all day in a bus with much more patience than I have. They never complain and they work hard to help their families at a very young age. I constantly see small children walking alone with no adult, at first I would always think, "Who is watching them?" Now it just seems normal.

I have decided to go on a trip with Mike and his friend who is coming from England. We are renting a car and driving through Zambia, Namibia, and Botswana. This trip is off to a rather rocky start. First we went to Mzuzu on Friday to use the internet to do some planning. Turns out James is arriving from England six days sooner than we had thought, so yes, we had nothing planned. We went back to Mwaya on Sunday and packed and then left early on Monday morning. The trip up here was just a shit show. We found out after waiting for three hours that the big buses were broken down, so we hopped on a minibus. Oh the lovely minibus. After six minibuses and about 10 hours later we finally made it to Lilongwe. One of the most exciting times of the trip was a moment when our bus door suddenly fell off as we were trying to pull away. They managed to fix it by beating some of the parts with a rock and who knows what the hell else they did. Well apparently I missed some even that occurred during the door repair because we took off fast and then were trying to run another truck full of people off of the road. The other truck stopped, the driver grabbed a metal rod from behind his seat and came running at our driver. I honestly was never even afraid. The only part that made me nervous was the children that kept jumping in and out of the back when I was afraid the truck was going to take off. I have noticed the men here are much more talk than action. If they ever do get angry they are just usually drunk and yelling, nobody ever follows through with their threats. And there are no guns here, so when I saw the man reaching for something behind his seat I was just curious at to what he would get as his weapon. We eventually just took off very fast, which made me happy, I was just ready to start going again! With every bus change I got more annoyed. I started yelling to make sure all of my bags were shoved onto the bus somewhere and a man made an announcement to the whole bus about me that made everyone laugh. All it did was piss me off. I have realized traveling and not comfortable traveling turns me into a complete bitch. I am glad the harassment is not common or constant around Ripple, I think I would loose my mind or just start beating men with a metal rod. I would not even yell at them, I would just start swinging.

I am hoping the rest of this trip goes much better than the journey here! We have some amazing plans. Tomorrow we are going to a national park and then a couple of days later going to Victoria Falls. Of course I am most excited about seeing some animals! Last night I got a bit too excited when we saw a hedgehog, Mike says when you see a lion you will no longer give a shit about that thing. But I still think it is exciting that hedgehogs live in the wild here! They are so cute.

This is where I live

So I made it back to Ripple also known as Mwaya Beach.

I never knew when I decided to volunteer in Africa I would be living at the most beautiful place ever.

I live in this lovely little cabin.

Sorry for the poor Iphone quality.

Where I can sit on the porch and watch the monkeys act insane.

This baby monkey is so cute and curious.

Or I can go hang out on the beach.
It is kind of pretty there.

I am now in Lilongwe (which is the capitol if you remember) to get my paperwork turned it.

This is my last step!

I took the 8 hour bus ride today, it was not too bad.

I had a book and read the whole second half of it.

I need to look for another one.

I am planning on trying to get my paperwork done in the morning and heading right back to Mwaya.

This last week has been a pretty relaxing one.

I went up to the Chintheche Hospital on Monday and was able to see around.

Then Tuesday I went to Kachare clinic and did more malaria testing.

It is nice to see around and see what my options are for working.

I am getting anxious to figure out what I can do to really make a difference.

I am not a patient person when it comes to things like this.

I am trying to remind myself that I have a long time and it takes time to learn.

It is very important to learn the system of everything and build a rapport with the staff before diving in.

I am excited to have a full week next week and find some work to do! 

I am especially excited to get back to the beach already.

I think you can see why I prefer it to the city.

I will leave you with a picture of these school boys. Karate chopping for every picture seems to be necessary.
I was quite proud of one though, he remembered my name from when I visited his class over a month ago!

Done! (With Orientation Anyway)

I am officially done with my orientation.

I could not be happier!

I will be heading back to Ripple this afternoon.

Just one step left to make it official.

I have to go to Lilongwe on Monday and then back on Tuesday.

I am not excited about this, but I am excited to have a few days off and travel with only a small backpack.

Taking my huge duffel bag with me is a huge pain in the ass.

I am ready to drop that thing off and not use it again for a very long time.

Last weekend we went to the crisis nursery.

It is a place where babies go after their mother's die and their families cannot afford formula.

They are returned to their families after they no longer need formula, so generally about about 18 months.

The babies of course were cute, and a couple of the older ones were full of attitude.

This is Emmanuel. He kept trying to steal my camera. He wanted nothing else to do with me. 

Have you ever seen a baby so fat? Her face was squished in!

This is Lucy, she was my favorite. They suspect she has HIV, she is delayed and small. The sweetest, happiest baby ever.

Stella has a major attitude. She got over it rather quickly though.

 Then on Sunday I worked on planning a trip that I am going to take with Mike and his friend from home at the end of August.

We are planning on going to Zambia, Zimbabwe, and Mozambique, plus maybe more.

Which I am trying to talk them out of the two other countries.

Mike keeps saying it will be fine because I can just drive through the night.

No thank you.

 I am excited for the trip. 

I figured I better go while I have the chance and will not be traveling alone.

This week I finished up in Men's surgical ward.

Believe it or not I enjoyed my time here.

I took it upon myself to draw all of the blood samples one day.

This kept me busy and made the time go by fast.

Plus I love to draw blood and start IVs.

I was also pleased with the staff.

The nurses were so funny and always very lively.

The charge nurse yelled at some doctors, which made me very pleased, it is about time somebody stuck up for themselves and the staff.

The surgeon also kicked out his intern for not knowing information about a patient.

This also made me very pleased.

It was also nice to see people with problems that could be fixed.

So the week went by pretty fast. 

I also have discovered I love elderly men!

I think they are cuter than babies. 

Which you have now seen my pictures of the babies.

Yes, they are cuter.

One man was a retired school teacher so his English was very good, he would always tell me what people needed.

He was always sitting in his bed and just looked happy.

I have decided the men are much happier people because they have never stressed about anything like women do.

I am going to pack up my bags and catch a mini bus to go back to this beautiful place.

Another week done.

This week I spent my time at the under five clinic on Monday and Tuesday,

then at the female medical ward the rest of the week.

While at the under five clinic I did parachecking, which is the quick malaria test.

They check pretty much everyone for malaria here, it is very common.

So I poked a bunch of fingers.

I think about a total of 125 just myself.

The day before nursing students were also doing some.

So yeah, there were a lot of crying kids.

I feel so bad because of the lancets we use the stick the kids, it is pretty barbaric.

I would much rather have an IV started any day.

Yeah  I would be crying too.

There were a couple of kids that stood out during my days there.

One was a two year old little girl named Anne.

She was livid that I was about to poke her finger, it was quite the fight.

It is so hard to poke a finger with they squirming so much. 

They can wiggle their little joints in ways that should not be possible.

Then they always think the stick used to collect the blood  is another poke.

That is when all hell breaks loose.

It takes quite precision to get the drop of blood on that tiny hole.

This kid did not make it easy.

Well luckily I had done a bunch before her so I had become pretty good at it.

So we got done quickly.

Her mom took her in the hall and was putting her on her back.

Anne was pissed.

She started yelling the worst things she could think of her in two year old Timbuka vocabulary.

All of the women were laughing and her mother was too, while telling her to stop.

I do not know that I have had a two year old that angry at me.

And I am pretty good at making kids mad.

She was just quite the little pistol.

I said, "Now I don't know what you are saying to me but I know that it isn't nice."

This made all of the mothers just laugh even harder.

I did feel bad.

I hate that I cannot explain to them what is coming and then that it is just one poke.

At home I rely so much on talking to my patients and empowering them with any choice they can have.

Of course I still talk to the kids, they just do not know what I am saying.

Some of them can just tell by the tone.

One little boy who was four sat down in his little suit and just held out his finger.

I asked are you ready?

He just nodded and did not flinch.

I am so amazed by the toughness of these kids sometimes.

Other kids think that because I am talking nicely to them I will not do anything hurtful to them.

I feel like a traitor.

I make all of the kids smile and giggle and then just stab them.

The other kid that stood out was a three year old little boy.

He climbed on his mom's lap and showed absolutely no expression.

I could not get him to crack a smile.

So I just got to it.

He cried but held pretty still and I got it done very quickly.

Then while waiting for the results he was sitting by his mom.

I saw him point to me and his mother just nodded.

He came over and gave me his ten kwacha coin.

After I stabbed this kid he wanted to give me a gift?

It was the cutest thing in the world.

I could not deny the gift from a toddler, he would not understand.

So I thought I would just give him something in return.

I started digging through my purse.

I would have given the kid ten million dollars if I had it.

But instead I thought a quarter would do.

The mother was so pleased and just grabbed and hand and said "Thank you!"

I had not done anything, it was her small child who really was kind.

Another observation I made was the fact that the older children help out with the younger ones.

When I say older I would guess they are around eight.

If a mother has two little children the older siblings have the expectation of caring for one of them.

They soothe the babies, carry them in chintenges on their backs.

I am always amazed at their ability to care for their siblings.

I was also thinking how bratty our children are at home.

Any eight year old that would have to sit all day with other screaming kids would be so annoyed.

We also always bring things for any kid to do to keep busy.

I have never once seen a child with a toy and especially not an ipad to keep quiet.

These children are taught patience and responsibility at a young age.

Yes maybe a bit too much responsibility.

But I definitely think there needs to be some sort of medium ground for kids at home.

I cannot get over how many of the children are such brats at home.

Parents constantly make excuses for their parents and everyone of them has an ipad or a gameboy.

I think this just makes the children feel entitled to everything in life to be handed to them.

They never have to earn anything or have any sort of responsibility.

How will they ever know how to be adults?

Kids here are forced to grow up too fast, 

but I enjoy seeing children with a sense of responsibility and knowing what it means to be grateful.

Then I was on the female medical ward.

Within the first few minutes of being there I was sitting in the break room and a rat almost ran over my feet.

The nurse asked if I have ever seen a rat?

I said yes plenty.

What I did not say was well not in a hospital because that is gross!

So I got my orientation started, they showed me around the ward.

I will say that it was pretty clean and organized!

Well for Africa standards, I know the rat thing kind of throws the picture of clean off a bit.

That morning we went to a meeting.

A meeting on performance management, but yet I am pretty sure we left the unit with no staff to go to it.

I was pretty annoyed.

He kept saying how they need to stop letting everyone die.

Yes, that is a good point.

Also if you do not have something call another unit and ask, do not just let people die.

Seems reasonable.

This went on for two hours.

I was so bored and tired of hearing it, the lack of motivation from a lot of the medical staff is hard to deal with everyday.

When we went back to the ward I noticed one very sick patient.

I helped changed her bed and got blood on my arm, here that is slightly scary.

I went and asked for soap.

They looked at me like I was crazy, so I just grabbed the alcohol stuff they use to clean things with and scrubbed my arm.

I started reading through her chart.

When we did vital signs nothing looked good.

I have learned that people that look this way will not get better and I do not think putting a bunch of supplies into her is going to help.

So I figured I was not going to fight this time, it does not seem fair to.

Sometimes I think it is better to not constantly poke and prod at people who are not going to make it.

So I went home and expected her to not be alive in the morning.

But I walked in and could hear her moaning with every breath from the nursing station.

I was shocked.

So I went through her chart more, I noticed a lot of things could have been done to at least try.

The patient was actively bleeding out.

They tried to put a feeding tube in her the day before.

I told the nurse there was no way she could handle it.

I also recommended a repeat blood test, maybe another transfusion, and some drugs to help with clotting.

She seemed very attentive to my recommendations.

I asked how would we get them done, she said call a doctor.

Then she told me she was going on break and would be back.

We had been there approximately thirty minutes.

I have realized there is no rush in anything here and it will not change the outcome anyway.

So I just said whatever and she went for a forty five minute break.

So I sat alone and watched the unit.

Finally some doctors came in, I had noticed a doctor from the day before.

I asked her if I could talk with her about a patient. 

She was extremely receptive to it.

She asked me what I thought was wrong and what I thought should be done.

I was impressed that she even cared to listen to me.

She went to see the patient and wrote some orders.

I was glad that something was going to be done.

Especially since the lady had survived the night.

She did not survive the next night though.

I got to the hospital and noticed that I did not hear her constant moans but nurses were doing rounds and her family never left her side.

So I did not get up to check.

We went for a meeting and I came back the doctor asked how she was doing.

I told her I had not checked, just looked at her chart briefly.

When she went to go check on her, she was dead.

I do not know how somebody did not notice.

They prepared her for the morgue.

I did not choose to be involved in this process.

Cleaning her up when she was still alive was almost too much for me to handle.

I spent the rest of the day pretty much doing nothing.

The one doctor would have me assist her with things, which I liked but other people were not doing much.

I went for lunch and both days when I came back nobody was at the station, they were all in the break room.

How would they even know a new patient came?

I just sat there and read every magazine or medical book I could get my hands on.

I texted Mike to tell him everyone was at their forever long lunch, I asked who do you think is watching the unit?

He replied, the rats.

I said well yes, and me.

I usually try to not correct nurses, because I am in orientation and I am here to learn.

But some things are just too much to take.

Just simple things like putting in an IV and knowing that you have blown the vein.

I already have control issues watching other people do things, I just want to do it myself.

Well I told her that it blew.

She thought that putting the antibiotic in it to see if it worked was acceptable.

I actually told her no.

I said if you want to check it you need to use saline.

She tried and it would not flush so she just pushed harder, the patient was grimacing.

I finally said stop, if it hurts her and you cannot flush it is not good.

I find a vein and put the IV in myself.

Like I said I have control issues.

I think part of me has started to shut down from being in this hospital and seeing people die everyday.

There is just no way I can deal with all of it and come out sane.

I think this is what happens to nurses in units where sadness is all around you.

You become insensitive.

But yet I see how it affects my attitude and mood in general.

I just start to feel worn down.

Luckily this happened very close to the weekend.

So I have all weekend to just relax and hang out.

I also am going to go to a place called the crisis nursery this afternoon, and get my hands on some babies.

It is basically a large group home for babies.

I figure this will have to put me in a good mood.

I already feel better after not having to go back today and getting to sleep in til eight thirty!

I woke up at six and thought oh I really need to get up, then I remembered it was Saturday.

I could not have been more happy!

Only three days left.

I will be doing men's surgical ward next week.

I figured I would save it for last because taking care of pre-op and post-op patients is something I know.

I am so excited to head back to warmer weather and the beach!

Just one last annoying thing I need to do.

In order to process my paperwork I have to take it back to Lilongwe.

If you remember this is an eight hour bus ride, yes that lovely crowded bus.

I have decided I will buy myself something from the market in Lilongwe for rewarding myself for getting through this process and maybe one other thing for the bus ride.

They have a really awesome market place there.

More wood carvings then you could ever imagine.

It will be my goal to get something for a good price.

There is nothing I love more than bargaining!