Village clinics - Majiga

Wednesday Jose, Katie and I went to Chiwengo and did a clinic for the COTN orphan village there. Of course, people from surrounding villages heard and came. Our main goal, though, was to see the orphans and the staff at Chiwengo. Jose and I were the providers and Katie was the pharmacist. We had a great time and saw about 135 people. We stopped in time to get home right at night fall. On Thursday and Friday, we had already arranged with a church from Texas (Ft. Worth area) to set up a two day clinic in Majiga, a village where their team was setting up a tabernacle. We drove out Thursday and Friday, seeing over 350 folks on those two days. They had not only folks to help erectt he tabernacle, but also a doctor, a nurse practioner, a couple of RNS, a nursing student and lots of willing hands. They did a great job! We had 3 'providers' - Dr. Willie, Kathleen (NP), and Jose -I mainly circulated the first day, answered questions, etc. By the second day, they didn't need so much help so I was able to take on patients myself. The girls running the pharmacy were great (that is one of the hardest jobs), and of course the triage / intake (thank you Katie) is a critical part of the process. The group brought food and all of us ate after the clinic closed, followed by the Jesus Film. This village is about 1 1/2 hours away from Lilongwe, with the last 45 mintues being on a killer dirt road. Two things the photos don't capture - the dust, dust, dust everywhere - in your eyes, your hair, on your skin, on the tables, on your equipment, your pens, your paper, the medications.... And all the patients are covered with this fine red dust. The other part that doesn't come through is the noise, so much noise. Children crying, kids playing and laughing, adults talking, and the church had a ministry to the kids going on with a loudspeaker and music....

The church and their team did a fantastic job. The medical folks were out of their comfort zone but really held up well, they were flexible and focused. It was a great experience, and I know at least one tiny baby was saved by their hard work, numerous other folks got a huge variety of illnesses and diseases treated, wounds cleaned and bandaged, prayers, and generally shown the love of Christ.

A special word for Jose - he is pretty much functioning at a physician level in the clinics - and he was getting most of the 'malaria' patients for the past two days, along with the other patients. He had one family with six people, all at the same time. He also had a Mom with twins - one on each breast that needed to be examined (children, not breasts!). I just wanted to officially say that he is quite extraordinary. He has intentionally worked to increase his knowledge level of the diseases we see here and the treatment options. Not to mention he gets all the 'other' chores, like carrying heavy loads, driving and taking wheels apart when we have car trouble! For those of you who are praying for us, remember that Jose has been the answer to prayer many times on this trip.

Pictures: The tabernacle as we pulled up the second day, with the line already forming. People coming in by foot and ox cart. Kathleen (NP) seeing patients, and four of us at the end, 'pharmacist', Katie, me and Jose.

Salima with Katie

We did a day trip to Salima on Wednesday. We stopped at the Salima district hospital to show Katie a local hospital. The day before we had all toured Kamuzu Central Hospital (KCH) the big government hospital in Lilongwe. We walked through some of the hospital to find Peter Maseko, but he was so busy he was unable to really give us a tour. We had planned on returning on our way out of town, but those plans did not work out. Sorry, Katie, maybe next time!



After we left the hospital we heard a loud bang and then a terrible grinding noise from the back tire area. We limped to the Maseko house, where Jose took the tire off and found broken metal pieces. We had just put the car in for servicing the day before, including a brake job. Needless to say, we are not very happy. However, once he got the broken pieces out the noise stopped and the brakes seem to still work fine. Our schedule is so busy right now that we will have to wait til next week to have it totally evaluated by the mechanic. Pray for travel / car safety and also a HUGE prayer of thanksgiving for having Jose, with his many, many skills, part of the team! After getting the tire fixed, Emma fixed us a traditional Malawian meal, complete with nsima, rice, cassava, chicken, tomato sauce and cabbage. She also fixed some Samosas - Indian, not Malawian, but a favorite of Jose's. After lunch, we went to the beach side village of Senga Bay. Katie got to walk through a village and then to the lakeshore where the boats were bringing in fish. Mostly usipa (little fish, slightly larger than sardines, that they sun dry and then eat in stews or 'relishes'), some even smaller ones and then another size up - they all have names, but my chichewa is so limited I can't remember them all! However, we had fun, Katie took tons of photos, and even found some chitenges (the wraps that are used for everything here) to buy at the market. After the village, we went to the curio stands and 'went shopping'. Lots of things to buy! And everything is negotiable. Emma had little Alpha (who got tired of seeing the stuff), so she and I headed back to sit in the car and people watch. Very interesting! We saw a young woman with a ice chest come to the market and begin very quietly selling shake shake to some of the vendors. Shake Shake (also called chibuko I think) is some sort of home made beer, they put in used water or soft drink bottles (plastic) and it s a milky, gray color. Looks totally disgusting - Emma said it smells disgusting, too. I thought if the vendors started drinking a lot, I might go and get some really good deals (haha). While we were sitting in the car on the side of the road, a gentleman came up to us - he and his team were also shopping, they were from a Korean church in New Jersey, just finishing a couple of weeks of a mission trip! How funny! Katie made lots of great deals, with Jose being the negotiator - just another of his many skills! We took Emma and Alpha home, then on the way out of town, did a short side trip to see what is reportedly the biggest Baobab tree in Malawi. It was close to dark... once again we had to drive home after dark, one of the things we hate most here - driving after dark. Jose did an excellent job (as usual), even though he was operating on about 2 hours sleep. He is rooming next door with a young doctor, Ty, who just finished his residency in family practice and is here for two months. The nurses called them early Wed. morning for a young patient that was brought in to the campus and put in the inpatient ward, not breathing. The guys did a valiant job with inadequate tools, but the child died (probably was dead when he arrived). What followed was a nightmare of dealing with the family, trying to get the body taken care of, etc. Jose never got back to sleep. He carried on like a trooper, though, and will never know how much I admire him for his willingness to do so!

Pictures:

The baobab tree - you can sort of see Jose and I at the base of the tree, and the children from the surrounding villages running up to see us. Emma and Alpha in the back seat of our car, waiting for the shoppers! Jose and Katie leaving the curio market. A boy on the lakeshore with his fish - they were still alive and flopping - I think he was burying them in the sand to keep them fresh. It looked like his brother was using a little piece of cane / bamboo to fish, so I think this was to be their dinner, not for sale. lastly, Jose jacking up the car to take the tire off.

Pray requests: travel safety - we have a village clinic at Chiwengo today, which is in the north part of the country, not to mention clinics Friday and Sat and leave Sunday for Zambia. Pray that Jose and Ty get rest after their traumatic night. Pray that Katie enjoys the rest of her stay here!

Katie arrives!

My friend and scribe, Katie, was due to arrive on Friday, but due to plane delays, didn't make it in until Saturday. Charles (one of the guards, ABC student and sometime translator at the clinics) had the day off and wanted to come with us. Turns out that a big entertainment for Malawians is going to the airport, sitting up top in the 'spectators' area and watching the planes come in. This was only the second time Charles had ever been to the airport. You can also order food and drink if you so desire. When we got there, the place was packed, people had the chairs up to the railing, watching, chatting, just having a good time. We got a place at the back and ordered lunch. We were there for almost 3 hours and only 3 planes came in - this is not a very busy airport! But when the first one started coming in, Charles was ready to go to the railing and watch. He told us later that was the most fun he thinks he 'has ever had'.

Katie did arrive safely, and not too exhausted. Sunday we went to Flood church where Sean preached another awesome sermon! Our plans for Sunday afternoon involved going to Msilitza village where COTN has a feeding and school program and where there are two teen orhpan houses (girls and boys). We stopped at the main COTN office and picked up Lidson to go with us. Everyone loves a chance to ride in a car and go somewhere! When we arrived, we found that there are currently 10 girls housed in the girls home (there are supposed to be 8..but I don't know how you turn away a desperate girl!!) but many of them are away most of the year at secondary school. This is school holiday, and several are gone back to the their home villages to stay with extended family. One of my favorites, Maureen, is a student at ABC and she is doing an 'internship' at the COTN orphan village of Chiwengo. That is Lidson's usual home, and also where we hope to do a clinic soon. We took the girls some gifts, including toothbrushes and toothpaste (thanks to the Eureka Dental Clinic and Drs Kemp in Weatherford, Texas!!). We also took in some bras, Bibles, books (always a big hit to have different books to read) and a jigsaw puzzle. We started showing them how to do the puzzle - one of the girls remembered from our last visit, but to some of the others it was a new deal. We went outside to take photos, and found that Lidson and one of the male interns (at the boy's home) stayed inside to work on the puzzle. I guess next time, I will be bringing more jigsaw puzzles! Our plan was to go to the boys' home, also, but they were gone attending a funeral. Maybe later in Katie's trip.

A word about COTN - Children of the Nations - this is a relatively small Christian organization that provides orphans with homes or (if they are living with relatives) a feeding program and school. They try to get three sponsors per child, allowing them to provide for a secondary education (high school - which costs in this country) and, if the student qualifies, with education past high school. Maureen (as mentioned above) is attending African Bible College, which is prohibitively expensive for most orphans. I have sponsored Lidson since 2000, when he was 5 years old. If any of you feel led to sponsor a child, there are many wonderful organizations out there, and COTN is one of those. Your small monthly contribution really DOES make an incredible difference.

Pictures: Katie with the girls and Ester (the 'Auntie' of the home), Charles at the airport, Auntie Ester and me, and then Lidson (back turned to us) and intern in the living room of the home, working on the jigsaw puzzle (the 'couch' to Lidson's right is actually a bed where one of the 'extra' girls sleeps.)

Enjoy! Pray that we have a safe, blessed time while Katie is here, in the Warm Heart of Africa.

Whiskas, Lidson, cookies and more

This is sort of a jumbled up post -

Pictures: The bird is a wagtail, in our front yard. Jose making cookies, Jose, Lidson and myself, the dog bite patient, and Mr and Mrs Whiskas and granddaughter Bridgette looking at their new DVD player!

Lidson - my sweet sponsored child is still in Lilongwe for his school break, we went by and saw him again yesterday, taking him a copy of some of the photos we had taken. Jose made cookies the other night - white chocolate (which we brought with us) and macadamia nuts (which are relatively cheap here as they grow in east Africa). And we wonder why we never lose weight here?????

The Whiskas - we invited them for dinner and to give them a couple of gifts. For those of you who do not know, Mr. Whiskas is the gentleman who keeps the house when we stay at the Assembly of God guest houses. We were very sad that this time we could not stay there, but wanted to see the Whiskas and take them something special. He is retiring at the end of August (he is over 70 years old and has worked for Assembly of God for 40+ years). Their son and granddaughter live with them, while their daughter in law is at school, getting a certificate that will allow her to be a school teacher. They are wonderful, kind, hard working folks. They brought Bridgette, who is not too keen on azungus (white people) to dinner with them. We had fun and afterwards, gave them a DVD player and some DVDs! (We had bought these in the US and brought with us - the ones here are cheaply made and very expensive!) It is fun to see how excited they are about it! Look at those faces as they watch some of the movie! I will post a short video on Youtube of their visit (search my name, Donna Ivey, to find my videos).

Medical stuff: The girl with the dog bite to the face came in for her last appointment to have her sutures removed - wow, she looks good! I have enclosed a photo of her wounds. If you are not medical they may look terrible to you, but actually, they look good, no infection and good alignment. I am pleased. Thursday I had a lady (Malawian) with a plethora of complaints, and her translator only spoke a few words of English. The patient was an older woman and apparently was chopping firewood and got a piece of wood in her lower leg at least 2 weeks ago. ouch! Jose came up and helped with the removal (he had not had a chance to do an incision and drainage or foreign body removal before). We did manage to find, buried in her calf, a ~4 inch thin sliver of wood. The smile we got when we pulled it out did NOT need any translation! Jose sutured up the wound and she was good to go! Friday morning a very sick child came into the non-private side early and one of the clinical officers (Danford) began treating him. The child seemed to rally a little, even stating that he was hungry, and Danford ordered some lab tests. The child had come in so early that no one was in the lab when he first arrived. We (Jose, Dr. 'Ty' and myself) got involved when Ty saw the lab - white count - over 70K. For you non-medical folks, that is HIGH. We went to the lab to look at the complete differential and began to discuss the possibilities. (background noise - a wailing, keening, repetitive cry that seemed somehow familiar...) Danford walked by, we flagged him down and got the facts on the case - that's how we learned the child had seemed to rally, expressed hunger, etc. Then Danford said 'Then the mother called me, his eyes were dilated and he was dead'. Now I recognized the cry we were hearing, the same one we heard at Salima district hospital, 'my son, my son'. Life sometimes is so hard here......

Pray for us that we do not get overwhelmed by the tragedy we see. The Malawians accept it as their way of life, even when their grief is so great. We have problems because we know it could be so different...

Thanks for all of you who are praying for us, remember that we have almost a month to go, and any financial support (through ABC) is welcomed and needed.

Birds and the American Embassy

Monday I was in the clinic all day, and came 'home' to chicken enchiladas with hand made tortillas from Jose! It was great!! A picture is posted on facebook. He did a fine job and has really got the tortilla making 'down pat'. I think that will be his job from now on!

Today (Tuesday), I was in the clinic half a day. Two doctors from the CURE hospital (orthopedic hospital) came in the morning and took two of the exam rooms, so my 'room' was the treatment room. Surrounded by all those stretchers, I felt right at home. The girl with the dog bite came back, most of the sutures were ready to come out but the ones re-attaching part of her nose will need to wait for a couple more days. She looks good, really good, much better than I expected. I was praying for no infection and no rabies. The dog is still doing well, also, and the patient is taking the rabies shots, so I feel optimistic about that part of the deal.

This afternoon we went to the American embassy to get extra pages in our passports. Yes, we are almost out of pages and some countries won't let you in unless you have enough 'space' left in your passport. Getting into the Embassy is tedious. Then you have to fill out paperwork to get additional pages AND pay - geesh! $82.00 each!! And they keep your passport for 24 hours. They did make each of us a copy, which is good, as at the police roadblocks they ask for your passport sometimes.

On a brighter note... the pictures!

First is Jose on the porch of the chalet in Senga Bay at Safari beach lodge. The tree in the background has the nest with the bird (hammerkop, I think) that you see in the next photo. The lake is also in the background but the sun was so bright you can't see it. Then the small mammal is a rock hyrax - a small animal that looks at first glance like a guinea pig. They are also called 'Dassies' or rock badgers, and are mentioned in the Bible, Proverbs 30, for their 'wisdom'. Their nearest relatives are elephants and manatees, but this is due to some obscure ancestor and some genetic similarities.. I think it just makes these little things more interesting! Next two pictures were taken out of the living room window this afternoon. These adorable little blue colored birds are everywhere. I think they are blue waxbills.

I hope you are enjoying this blog. We want you feel like you are part of the trip - the good and the bad. Again, thanks to all who pray and donate!

Senga Bay, Salima District Hospital

We picked up Angellah and son, Tristen, Friday morning and journeyed to Salima District, the Senga Bay area, to visit with the Masekos. Peter Maseko (clinical officer at the district hospital) was on call all week end and we wanted to make rounds with him. We have visited the hospital many times before, but never been one on one with Peter as he evaluated the patients, gave orders, contemplated treatment plans, etc. It was quite the experience. We also had a chance to spend some time with others in the family - Emma, Alpha, Angellah and Tristen, and for a surprise, Wezzie came in from Ntchisi so we got to see her, too.

The district hospital again has no doctors - just clinical officers (who do a fine job!!). They also have some clinical officer interns, who also spend time on call, so that is a great help. Peter is in charge of all the OB - Gyn cases, and occasionally he is asked to be the clinical officer on a case outside of his ward. That tends to happen if it is a diabetic. They have no way of testing for blood glucose at the hospital. They manage diabetics using urine dip sticks. However, a couple of years ago we took a glucometer and test strips to Peter, and bring more every time we come (thanks to people who have made financial donations, helping to make this possible!), so Peter is the resident 'diabetic expert'. He had two diabetics that he was managing - one young girl that appeared to be in diabetic ketoacidosis (DKA) and a gentleman who was not as ill. Now, you medical folks out there realize that DKA should be treated in the ICU - well, no, she was on the ward (with 8 other patients), with a tiny IV, with the only way to monitor her blood glucose was when Peter came around to check it. The good news is that Peter called me last night and she survived! This time, anyway. The ward was actually 3 wards seperated by a 'half wall' so there were actually 24 beds there with one nurse. The patient's section of the ward had 4 fluorescent lights high up on the ceiling, only one of which was working (the one fartherest from the patient herself). Fortunately she was by the window, so Friday afternoon everyone was using the light from the window to try to start an IV. They were not successful. She did have a tiny (23 gauge) IV in her left hand.

In the OB Gyn section of the hospital we saw post- partum (after delivery) Moms with their babies (if the baby lived), and Moms whose babies did not live - all in side by side beds. We saw patients with complications of pregnancy (probable pre-eclampsia, but who knows for sure because the hospital was out of urine dip sticks that week-end, so no one could check for protein in the urine??), pregnant ladies with malaria, and one very sick pregnant young woman with probable pneumonia - again in beds along side new moms with tiny babies in their beds. You keep your baby in the bed with you unless the baby is sick. We got to discuss the cases and 'consult' with Peter - which consisted of - "this is what we would do in the US, what do you do here?" Interestingly, most of the care is the same, except they don't have the tools / supplies / equipment to carry it out. So although Peter knows how to best manage cases, he is simply not able to always do so because of the 'third world' medicine restraints. The sonogram was not working at the hospital, so he was palpating to see if a woman had twins (she did) and maybe how big they were (big), and since she had a C-section before, decided to take her for a repeat section once she went into labor. He had to use just clinical judgement to decide if woman had retained products after delivery of a dead baby....and take her to the OR. They can do hemoglobins, but no leukocyte counts, no electrolytes, no liver function tests, no cultures (except for TB), only glucose testing is by Peter himself... they can check for HIV, Hep B and malaria. We saw cases that needed so much more than he is able to do there, and yet he tries with all his might. It is a challenge beyond my comprehension and yet he carries on......

While we were in the hospital we saw a tiny sheet-covered body being taken out of the pediatric ward, followed by a group of women, all with children on their backs, except one, who was obviously grief stricken beyond consolation. And that was not the only sheet-covered body we saw that day. Not that all is bad.. we saw happy Moms with their new babies and we saw ladies getting better with their treatments.

Please pray for Peter as he works his heart out to treat / save Moms and babies.

Pictures: a 16 year old new Mom with her sweet baby girl, the sign outside Salima District hospital, Alpha and Tristen Maseko, and lastly Virginia, a nurse that we have met before, and me outside the OR (major theater) waiting for Peter.

Also, if you search my name on Youtube, you will find a couple of new videos - one of the kids (Tristen and Alpha) and one of Anne Maseko Alaniz's project outside of Salima "Pothawira"- the plan is for an orphanage, school, and clinic which will hopefully become a birthing center.

Thanks to all who follow us on this blog, for your prayers and your continued support. May God's blessings be upon you all!

Another week goes by...

We have had another fun week in Malawi! Toni Moffett came in from her posting in Ghana to be a part of the Evangelism Explosion (EE) conference taking place on the ABC campus. She is here for a week with the children's EE. (Her husband, Matt, was here for the two weeks before). We had a great time seeing her again, although we were all too busy to spend much time together. This is her birthday week, so we did have a chance to take her out to dinner at Buchanan's.

Our gardner's little boy, Siliyus Jamu, became ill this week - he went to the clinic and was seen, given an antibiotic injection, and then came back 'here' (duplex) with his dad to rest while dad worked. He just got worse and was near collapse when Jamu (dad) came and got us. Thank the Lord for Jose - he was able to carry the boy into the house, take his vital signs (including blood sugar) and start an IV on him. Jose had brought a big case of supplies up from the clinic as one of his new projects is to make medical supply 'boxes' for the ambulance.... so he had everything he needed right in the living room with him! Then we transported him to the clinic - sounds easy but entailed carrying the boy and IV to our little car (Rav 4), then from the parking lot up the hill to the inpatient ward (for those of you who have seen the short video on ABC campus, you will have an idea of the distance), then up the stairs and into the ward, down to hall to find a bed. Whew! I am glad Jose is so young and strong. Siliyus had wet himself, and there are no patient gowns here, so Jose gave a pair of his boxers for the boy to wear (and have). The bad news, after all the carrying a wet child, the effort of carrying him, etc, we found that the water was out so NO SHOWER for Jose! (the water did come back on later). The good news - after anther 24 hours of IV fluids, IV antibiotics and even a course of malaria meds, the boy recovered. To be totally honest, we never figured out what he had! All the malaria tests were negative but his white count was high..... We don't have the ability to do cultures, etc. here so sometimes we just treat 'everything' that we can. We were just thankful that he was better quickly.

Wednesday we went to see Lidson, a orphan with Children of the Nations (COTN) that I have supported for about 10 years. He is 15 now and grown into a fine young man. He just took the exams for secondary school. After form 8 (8th grade) you take these national exams. The top scoring kids get into the government schools, which are essentially free. Everyone else has to find a private school, which costs money, and most village kids can't afford it. COTN has been busy building their own secondary school. They would love all their kids to get into the government schools, but know that some will not score high enough. Their school will be able to educate their orphans, and also give more one on one attention to the children that need it. The secondary schools here can apparently be brutal on the new kids - lots of harassment, etc. And being an orphan carries it's own negative connotation, so it can be miserable for some of the kids. COTN is finishing one of the big buildings on it's office campus into what will eventually be the dining hall for their new school (of course, they will use it for classes as soon as it is finished). They hope to have the actual school finished in the near future, along with dorms for the students. The plan is that the school will be built from shipping containers. A very neat concept - go to Cargo of dreams. org to see the organization that is doing this great work in third world countries! We are praying that this will work out for COTN (you might even want to get your church involved once you see the web site!). We are also praying that Lidson did well on his exams and will get into a good school!

My week in the clinic was pretty much the same as usual - although 'same' here is not like 'same' in the US!! Yesterday just as I was getting ready to leave for lunch, a young woman was brought in who had been attacked by a dog. Her face was pretty torn up and she had a very nasty laceration / rip on the end of her nose involving her right nostril. Thank you Lord for all the experience I have had repairing lacerations in the ED. The tricky thing right now.... finding small needles to 'numb' with, a terrible light, gloves a size too big, and had to turn the suture room upside down to find thin, delicate sutures to repair her face and lip. The clinic is undergoing some remodeling and many things have been moved, making even simple tasks difficult. Amazingly, with God's grace and mercy, and His wisdom guiding my hands, her face looked pretty good by the time I was done. (And people ask me if I pray - HELLO, like all the time in my job!!!) It looks like we got all her pieces lined up well. I will see her next week and check her again then. Made for an exciting end to the day, though.

Today (Friday), our plans are to pick up Angellah Maseko (sorry, can't remember her married name) and little boy Tristen and go to Salima to visit the Maseko family. Peter Maseko is a clinical officer at the Salima district hospital and is on call this week end. Jose and I are hoping that perhaps we can be of some small help in the hospital. It is always an adventure there! And of course, we will get to see the family there, and eat more traditional Malawian food! So we will probably be off line for a few days.

Pictures: Lovely flower that Jose found on the ABC campus. Outside of the COTN building for the school, then an inside photo - they are close to having it done!! Annie Brown (currently finishing her year as an educational volunteer at COTN), Lidson and Jose, lastly myself, Toni Moffett and Jose at dinner at Buchanan's.

Pray for our continued safety and that we may be wherever the Lord wants us, doing whatever He wants us to do!

Fishermen's Rest

Another missionary found this unique little spot and told us about it. Fishermen's Rest is a lodge about 20 km south of Blantyre. They have a lodge, a cottage and a couple of Bush Hides. The Bush hides are the cheapest, and since we are on a tight budget, decided to stay there. The entire area encompasses about 50 acres, wandering around on the property have some impala and another kind of antelope I didn't recognize. They have a tea room where you can get snacks and / or dinner. We took our own drinks and food for lunches and snacks - this was a beef jerky, trail mix sort of place, for sure. The hide consists of a small building with screened in sides and straw mats for walls, solar lights, a konde (porch) with an unbelievable view out over the great rift valley, and - when you leave the hide you go down some steps and the toilet and shower are outside, facing the valley. A 'loo with a view' as the manager said. There are mats you can let down to give you some (operative word here is SOME) privacy. Fortunately, there is no one around here and the mountain side is quite steep. Enough that you watch your step on the way down to the toilet! We were really looking for a day or so just away from everyone - just some quiet time to read, think, go for a walk and enjoy the view. The only power in the hide are a couple of solar lights, so you are in bed and asleep early. We opened the 'mats' facing the valley and could see the stars before we went to sleep. African skies at night are something to behold. You wake at dawn to the birds, the smell of cooking fires, and the distant village sounds. It was a great stay! We left feeling relaxed and refreshed.

Pictures: Jose in the 'bathroom section', under the hide, with the toilet to his left and the shower / sink behind him. Jose and me on the konde with the great rift valley behind us. Me, standing in the lawn area of the lodge. The Bush hide, tucked in the trees and jutting out over the hillside. Jose on our 'walk about' the property.

Blantyre

Thursday, the 8th, Jose had another great village clinic experience. We had gone over to the Brown's (missionaries with the Assembly of God) the evening before, and Jose taught Adriane, their daughter from the US, how to take vital signs. She joined him at the clinic and they seemed to have had a great time. He has posted some photos on his facebook (and tagged me so if you are his friend or mine, you can see them). Thursday we had lots of power issues and ended up losing the internet - we finally got it fixed today, Monday, so that explains the time lapse. We had planned to go to Blantyre for the week end and stay at a little lodge. There is a new doctor here, Ty Kreible (not sure about the spelling) who just finished his residency and has come to volunteer for two months. He is a huge help and is fitting right in! Since he is here, we felt we could take off on Friday morning, as it is a ~5 hour drive to Blantyre and the lodge is another ~20 km. We had a great trip, even stopped at Dedza pottery for lunch and a look around. We arrived at the lodge in time for dinner.

I will post more info on the lodge later.

Blantyre is in the southern part of Malawi and is considered the commercial center. It has the only cinema in the country, and a Game - a store sort of like a mini Walmart - but better than anything in Lilongwe! There is also the big Seventh Day Adventist hospital, Queen Elizabeth, and the orthopedic hospital, the CURE. In that area of the country you can also find the tea plantations. We didn't make it to them but hope to some day.

Pictures: The mountains coming into Blantyre, with a village at the foot. A man selling Mouse kabobs on the side of the road - each one of those sticks has several little mice (actually ground squirrels) on it that have been caught, killed, ?gutted, boiled and then dried. They eat them, fur and all. A stick of about 8-10 sells for about $1.50. They stand on the side of the road and wave them at passing cars (that is the next photo). Fourth photo is a small truck with the back end loaded with people and cargo. Lastly is a small house with a tin roof, the tin being held down by big rocks. Those rocks do fall off and, if they hit someone, can cause significant damage. Oh, the many ways you can get injured here! I am not sure of the most recent stats, but a few years ago, Malawi had more deaths per highway mile than any other country in the world. Impressive considering they don't have lots of vehicles - but many of the vehicles - like this truck, huge lorries, minibuses, etc have many passengers, and the emergency response system is pretty much non-existent here. So if you are a trauma victim, you have a much better chance of dying than in other countries.

Baptist clinics

A group of folks (Baptists) from Oklahoma (Madill and Ada) came into Malawi last week. They graciously carried a bag of medical supplies for us, and were joined by a doctor and his family after a few days. They arranged to set up some village medical clinics on Monday and Tuesday. Jose went on Monday, and both of us on Tuesday (since it was Malawian Independence day and the ABC clinic was closed). The doctor quickly saw that Jose's experience was a very good thing, and set him up to manage all the malaria patients, along with the general body pains (GBP - very common), the coughs and colds, etc. Jose was able to treat most of the problems himself. The village clinics usually have no or very limited testing abilities, and limited medications. Last year Jose was the 'pharmacist' in the clinics we did, so he became familiar with the meds and the dosages. He would listen as I took a history (via translator) and would usually know what meds and dosages I would order before I ordered them! So he was ready to be Dr. Joseph. Tuesday, since I was there, Jose was the 'triage' person / doctor. He and his translator, Charles (more on him later) would get a chief complaint, do blood pressures, check pulse and oxygen level if appropriate, and if the problem was a simple general body pain - he would order the medications from the triage station and they would go to pharmacy. I think we need to use his skills and knowledge more in future clinics (if we have the man power). Monday they saw about 160 folks and Tuesday we saw 180. Of course, many of the cases are heart breaking. One child had been normal, then had cerebral malaria and now cannot walk, talk, or interact. She just cries and squirms. I am sure she has had significant brain damage from that episode of malaria. We saw lots of cataracts, joint pains that are incredibly crippling for the older folks: they still have to walk everywhere, till the fields, carry the water, stir the nsima, etc. One sweet baby girl (10 mo old) came in for a cough. She had Downs' syndrome (Trisomy 21) and no one had ever told the mom. She had no idea why her baby was different, no idea what to look out for or to expect long term. It was heartbreaking to be the one to tell her. I saw a child with sickle cell disease - the mother had the medical 'passport' and could turn to the page where the hospital had diagnosed her, but had no idea what it meant. Makes me a little crazy that most of the time the medical folks here do NOT explain what the diagnosis means, especially when it is a long term problem. We saw the usual malaria, huge spleens, weird rashes, high blood pressure, aches and pains, bilharzia, and cough /cold. Here they call it 'asthma' (sometimes it is) or - if it is acute- the 'flue' or flu -or they are fluy or fluish. A lot of it is the dust - as the dry season begins, there is dust everywhere, everywhere... and the smoke from cooking fires. Because most of the village folk are medically naive, they have interesting descriptions and rationale for their symptoms. We forget how much medical information Americans get just from general TV (ER, Marcus Welby, Grey's Anatomy, etc. ) and from commericals ('ask your doctor if it is right for you')... they have none of that here. They usually can't tell you if something makes it better or worse, they have tried no over the counter meds (they usually can't get them or can't afford them in the village, but even at the ABC clinic they don't try things), they can't tell you how long they have had the pain, if they have been diagnosed with anything in the past, etc. etc. It is a challenge if the patient is the least bit complicated. I have found that if my translator is an ABC student, he or she will soon figure out what questions need to be asked and pursue that. If not, eeesh, (as they say here), it will be a tedious history. Charles, (Jose's translator) is an ABC student and one of our guards. He was posted at our house and found out Jose was doing a village clinic Monday and wanted to come to help (after working all night). He did great. Tuesday he came also (sleeping in small bits between guard duty and village clinic duty), and Jose said Charles was able to get almost the entire history without any prompting from him. I just love the ABC students! These guys - and girls - are the cream of the crop. It is a shame that the school is small and (for here) relatively expensive. There are some great minds here and they need to be cultivated!

Pictures: Me holding the Down's baby, the chimbuzi (outside squatty potty, in the grass 'hut'), the translators - Dadilitso (sp?) and Charles (in green), Dr. Joseph at Tuesday clinic, outside, by his station, and lastly a photo of Dr. Joseph and a patient from the Monday clinic. Enjoy!

Mozambique

We drove to Mozambique Sat, July 3. "WE" included Matt Moffett, one of the leaders of Evangelism Explosion, currently posted in West Africa, George, a recent graduate of ABC and our translator, and Jose and me. We crossed the border at a small -but busy- crossing south of Dedza, then drove another 2 1/2 hours to reach Zobue. It is a border town, also, but the Malawian roads to that crossing are so bad it is much faster and easier to cross by Dedza. We had to fill up the car in Dedza, as there are no filling stations in that whole area of Mozambique - so you see people on the side of the road selling little oil bottles filled with petro or diesel. They either travel to Malawi to buy OR they buy from truckers coming through, who will sell them a little of their fuel (thereby making some spending money for themselves, as the companies pay the fuel fees).. interesting system. We did NOT want to have to buy from the road side, needless to say! In Zobue we stayed at Mr. Piava's house. Actually a little compound, with a main house (toilet, dining and living room area), a house for them to sleep, a guest house with two bedrooms (no toilet) a couple of lean tos and kitchen areas. Very secure behind a wall, with it's own well (hand pump) on the premises. Jose and I had the guest house with the two bedrooms. We were there to visit Davie. Davie is a graduate of ABC and went to Moz some years ago to work with the CCPA (Presbyterian church). He has now started 3 churches and 12 prayer houses. His main church is in Zobue, and his latest church is in Mussacama. He, his wife, Uleme and new baby, Franklin, live outside the Piava compound in a little traditional Malawian house (read - outside toilet and kitchen, no running water, no furniture). Saturday we saw the churches and met many of the church members. We ate traditional Mozambiquan foods - which actually is pretty much like Malawian foods. Moz was involved in civil war for many years (Mr. Piava was a freedom fighter in the war and now works for immigration), and many Mozambique nationals fled the war and crossed into Malawi. The national language there is Portuguese, but in this area of the country, most of them speak some Chichewa (one of the main Malawian tribal languages) along with their own tribal language and maybe some Portuguese. Occasionally a little English. Mr. Piava spoke Chichewa (some) English (tiny) but mainly Portuguese. So with my broken Spanish, we were able to have some very limited - and I suspect very funny - interchanges. I would hesitate the call it a real conversation!! He and his wife were most gracious hosts to us. They did have power, and dish TV!! So were we able to watch some of the World Cup (huge over here)... but no running water. Interesting how technology comes to third world countries in such disjointed ways. Almost everyone has a cell phone, especially in Malawi, but almost no one in the villages has power or running water.

Sunday George (ABC graduate) preached at Davie's main church, and the rest of us went to the newest church at Mussacama. An American group gave the money for the land, and another church group gave the money to build the church ($1000). The members made most of the brick - dug the dirt / mud, molded the bricks, then made the stack and 'burned them' with fire (so they last longer than just sun dried brick). The mortar is mud. They ran out of bricks to do the gable parts, so had to buy some. They are waiting for the windows and doors to be delivered, and they have bought the roof supports, but do not have quite enough left to cover the roof with the tin sheets. At some point in the future they would love to plaster the walls (to protect the mud mortar from slowly dissolving in the rainy seasons). Maybe even have more than a dirt floor, but who knows. Currently, not even brick pews, just dirt. We had hoped to have the church service in the new building, but there was so much rain the night before, it just was not feasible. So we met in a classroom of the local school. It was a great service, Matt preached (and Davie translated), the church sang traditional Malawian hymns, and there were a couple of solos. I hope to post some of Matt's sermon and the singing on Youtube in the near future. The church had put together a meal for us, the elders and Davie at one of the elder's homes. It was a feast, with nsima, spagetti, chicken, potatoes and greens. His home was nearby the church, so we walked there, the dining area was too small for all of us, so Davie ate outside. This was some GOOD food!! Yummy! Of course, then visiting with the church elders, the ladies who cooked the food, and all the social things you do in this culture (which are delightful but very time consuming) we were able to leave for the border by a little after 2 PM. We made it back to Lilongwe right at night fall. The border crossing was wild this time, and the guys gave me their passports so that I could shove / elbow / force my way in the line.. you will get pushed out of line if you are not pretty aggressive. They thought it was funny to watch me jostle with the Malawians - and others - in the 'line' (not really a LINE, but a mass, of people). So much happened there it is hard to get it into one blog post..... And we got back to crazy - busy, so more later!

As an aside, check out facebook for more photos and videos. As usually, Jose was a kid magnet - he loves the kids and they adore him. And I feel in love with a darling little girl named Celia.

The photos: First is the guest house where Jose and I stayed, the car is Mr. Piava's.

Then Davie eating on the porch of the elder's house (the feast), next in the elder's house eating - Alex (the elder), Mr. Piava, Matt Moffett and me. And yes, that is a mud hut we are in. Next the church at Mussacama in the background (with no roof and no doors or windows yet) with (foreground) one of the men of the church, Mr. Piava and Davie, lastly Davie's main church in Zobue, with George and I in front, and Davie and Matt removing the 'door' (a woven mat to keep out the dogs and goats). Enjoy!