My three weekly shifts in the hospital continue to exhaust and surprise me, but I am more frequently seeing beyond what initially seemed to be pure chaos. I am able to enjoy moments of beauty, notice what functions, and envision positive changes. I want to share a little analogy that Dr Tarek Meguid recently told me. He said that if a patient has a condition that needs surgery but the surgery has only a 20% chance of success, you absolutely must counsel the patient about the risks so that they understand they only have a 20% chance. But, if they agree to the surgery and you agree to perform it, you (the physician) must believe 100% that that patient is among the 20%. If you don't believe that, wholeheartedly, there is no point of doing the procedure. So you take that philosophy and apply it to life. . . In relation to whatever you are doing, even if the chance you will succeed is small, you must absolutely believe that you will succeed or you should not be there at all. What a wonderful gift to have a boss with that philosophy in this environment!
I will be working my first night shift at the hospital this Wednesday (I'm a bit nervous). The night shift begins at 4:30pm and ends at 8am, simply because after that time it is difficult find public transport and dangerous to travel. I imagine that despite the long hours they will pass quickly, several nights in a row the midwives told me that there were over 40 deliveries (shared between 2 midwives). I'm sure I will have stories after that. At the moment my count is up to 23 (18 boys and 5 girls).
As for my free time, I have been spending less and less time with the expat community but I do have a few close friends. Right next door to the Kamuzu College of Nursing is the College of Health Sciences, which educates clinical officers. Clinical officers are the backbone of the medical system here and Malawi's somewhat ingenious way of dealing with "brain-drain." The program to become a clinical officer is three years plus an internship year, all straight after high school. When they graduate the COs function like general practitioners, even doing surgery, but they only have a diploma, not even a bachelors degree, and their education is not recognized outside of Malawi. Even in Malawi, if they decide to pursue an MD, or even a BS, they must start from scratch, making career changes and emigration less appealing. Anyhow there is always a group doing clinicals at Bottom and early on several of the students took me in, so now I spend a good deal of time with Clement, Fatsani, Mavuto, and friends. I also recently met an American woman around my age who has been here 6 years (4 yrs with Peace Corps) and is married to a Malawian. She is the education coordinator at the nearby refugee camp in Dzowa, and she's great. We spend hours talking, laughing, and catching each other up on a lifetime of stories. She and her husband own a house in Dedza and have invited me for the weekend, it will be my second venture out of Lilongwe, I'm really looking forward to it.
Other updates:
Cromwell is about the same. He's been home for a few weeks, no ongoing care other than what his younger brother is providing. Emotionally, he seems to be coping well. He's determined to get back to normal, and even though he still can't voluntarily move his left arm or leg he is now able to "walk" with the assistance of his brother (quite impressive). Today he left for Blantyre where there he can get a CT an hopefully a bit more information about the cause and/or extent of the problem. I'm going to use some of your money to pay for the CT about 11,000MK ($100).
Venity's family is doing well. With your money I am sponsoring the education of both Ven and one of her nephews. Ven will be starting classes for a diploma program at the Business school here this weekend and her nephew has started a diploma program in Development and Health.
Mrs. Phiri stopped by today with a big smile to tell me that with the money I gave her she bought 10 bushels of maize, 1 sack of sugar, a table and benches, some uniforms, and school supplies . She said she went back to see what was most needed and found that people are literally starving in the project area. Now with the maize they are able to feed the orphans and other vulnerable children. She said children were leaving school to come to the project just to eat and even some of the women in the village were trying to get food for themselves from the project.
Sadly, while people are starving in the villages, today on the news I heard that the President Bingu wa Mutharika just increased his salary by 350% to 20million kwacha/yr (a little less than $200K/yr). This president has been the hope of the country; a powerful force against corruption. He made many enemies initially when he was elected in 2004 firing and imprisoning those government officials who had been accused of mismanaging public funds but this news is definitely disappointing. He has 4 more years in office we'll see what happens. Unfortunately I have been hearing a lot of grumbling about Democracy. Under "President-for-Life" Kamuzu Banda who ruled for 30+ years people were poor, but crime was low (punishment for even petty crimes was often death), the kwacha was stable, and public offices (including health care) functioned better. From what I hear people in general were motivated by fear but there was greater economic stability. Malawi has always been a peaceful country and no one envisions that changing but something needs to happen to strengthen the country in general and the people's appreciation for democracy.
Today after about 10 visits to immigration and trips to other offices around the city, I finally received the two stamps in my passport giving me permission to live and work here for the next two years. Every accomplishment, even successful bureaucratic hoop jumping, is a success worthy of celebration.
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