Week 1

Well, I'm off to a slow start but so far so good.

Friday my heart was fed. Kids are the greatest. First they stand around looking at you like you're some kind of circus freak, giggling timidly and then before you know it you're sharing a chair with a 9-year-old and have a 4-year-old in your lap happily swinging her legs. I went along with Dr. Kaponda and some other folks from the nursing college for a "graduation ceremony" for Mzake ndi Mzake (friend to friend) in a village. Mzake ndi Mzake is a program which certifies men and women living in rural areas in HIV/AIDS peer education. I didn't understand much of the ceremony just a few words here and there - "zikomo kwambiri" (thank you very much), "manja manja" (applause applause), etc. - but, it was just great to get out of the city and be there. The kids were the highlight, they tried out their English on me and laughed as I tried my Chichewa, but there was also a group of women who sang and danced during the ceremony who were wonderful to see.

Apart from that, my week was filled with Chichewa lessons and bureaucracy. My Chichewa is coming along (slow according to me, but well enough according to everyone else). At least I'm picking out words and, with the English people throw in, I sometimes can get the gest of the conversation. People speak Chichewa like people on the border speak Spanglish, okay maybe a little less English but you get the idea. The other part, the bureaucratic part, involved figuring out what hoops I need to jump through to get certified as an RN/CNM here and meeting everyone I may ever need to know or who may need or want to know me. The meetings went well, everyone is really so nice, but everyone, when I told them what I would be doing (volunteering at Bottom Hospital), had the same reaction more or less. Basically, I was told that it is a wretched place where no one would willingly enter for care, that I will be shocked, and that I need a should to cry on, hmm sounds great. Unfortunately, on the other side of things, I found as I imagined I would, that I have a bunch of paperwork that needs to be mailed, faxed, stamped, signed, etc. before I can start actually working. I'm supposed to begin orienting/observing at the hospital tomorrow. I'm not exactly sure how "observing only" will work, if the nursing shortage truly is horrendous and I see things I can do, I'm not sure how I'll just stand by. I'll have to talk that over with Dr. Kaponda.

Life at Dr. Kaponda's continues to go well. As a side note, she was incredibly appreciative of all the supplies that I brought and assured me that they will be put to good use. It's amazing and kind of frightening how excited she was about simple supplies like pen lights and BP cuffs. Thank you everyone who contributed. I still have money to donate so Dr. Kaponda suggested using it to buy cloth to sew hats and blankets for the newborns. Apparently newborns often die of hypothermia because the mother only comes with one cloth (really the clothing she wares over her skirt) and babies are dried and wrapped after birth with this one cloth.

For me so far everything has been so easy that I can forget where I am at times. Every now and then a particular sight will pull me back to reality, like the street near the nursing college which is lined, both sides, with makeshift kiosks for people making and selling coffins. Or like Saturday, when I was driving with the former dean of the college we passed a group of nursing students walking with signs through the streets. Apparently the wards at the hospital are never cleaned so the students were walking to raise money for soap and mops and brooms so that they themselves could clean the pediatrics ward. I realize there are so many levels that I am blind to now but that will be visible in time.

On the other end of the spectrum, I just met Jennifer, another American nurse-practitioner who is living and working here. She gave me a little peak into expat life here and, most importantly, she offered her shoulder if/when I need it. She is working on a capacity building project related to HIV/AIDS. In short, nurses are being brought to Lilongwe from all over, for training so they can distribute anti-retro virals (ARVs) at their home sites and disseminate info and Jennifer is trying to determine if they are actually retaining the info from the trainings. As for the expat life apparently there's tons to do. A running group meets three times a week, there's yoga daily, dinners, and a free weekly movie at the embassy (since there are no theatres in Lilongwe). She also said there is incredible nature stuff to do outside the city - great hiking, the lake is 1 and 1/2 hrs from here, and there are mountains, waterfalls, etc. This is all good. Hopefully, even though I don't have a car, I'll find a way to get to and from some of it. The other piece that she mentioned is all the development work that goes on here. It sounds like, down the line, after I establish myself and get some good experience, I may be able to find some organization that would actually pay me to do something here. So that's good too.

I think that's it for today. Thank you everyone who has been responding to me, it is always good to read your notes.

Love,
J.