After two weeks of hard work a well deserved weekend by the lake was earned by all. Students relaxed on the beach and took advantage of the time to review notes and to quiz one another. We returned to our village Easter Sunday with fresh fish to share with everyone, a rare treat. With no electricity and no refrigeration in the village, fish is only available dried.
Kindness is a word that is easily defined in the dictionary, yet I don’t believe there are any words in the world that can describe the meaning of it. I relate Makupo village to a sort of safe haven. Not because of the infrastructure, the buildings, and the sights. In fact, they barely have roads, their houses are probably the size of your living room, and they are lucky if they own a pair of shoes. This village is occupied with amazing people. These people greet you with such hospitality; you cannot help but be extremely humbled. The woman may not understand a word we are saying, but they never stop smiling and laughing. They cook for hours in the dark with their little fire. The adolescents work hard as they sweep and clean, but don’t forget about the baby that is cradled on their back. Even the children help out. No one at home was forced to sustain such responsibilities and sacrifices as they do at their age. All these things I named are part of their jobs, but once their job is done, they never stop trying to teach or help us. I have learned about their cooking, and their schooling. They love to laugh at us trying to speak to them, or teaching us how to dance. Just the pure fact that they are so open hearted towards us strangers is so touching. I walked into their church for the first time this morning and little girls behind me shook my hand and said “Good Morning”, then they tapped on my shoulder and offered to share their bible with me. At church we see multiple family members rising to contribute offerings in the church pot, yet it is evident they are scrambling to nourish themselves and their families. They gather as a community and as one large family and find simple things to establish happiness and peace. Everyone is so greatly respectful and supportive of one another. They also do not run to us and beg for money. They do not ask for much, maybe a peanut butter sandwich because they are hungry. They do not know what it means to eat until they have the urge to be sick. That would be living in heaven for them. They do not complain though. Never in my life have I ever felt such serenity and hospitality, and I think it will be pretty hard to compare this feeling to anything else. A clinical officer took time to escort us to 3 homes of palliative HIV patients where we learned about their health, living conditions and assisted in administration of medication on a Sunday afternoon. You could straight forwardly see his admiration for teaching and his passion for his job, and for the people. He could have finished his job faster and made it home earlier to his family, but he didn’t. In the hospital, the nurses and assistants do not roll their eyes at you or bicker if you ask them a question. You know what they do? They stop and try to explain the answer to you, or they show you where something is. This is kindness. I am still learning about kindness and selflessness, and being granted the privilege to work and live in these conditions is allowing me to question my personal beliefs, as well as my professional ones.
What does kindness mean to you?
Olivia’s special day was spent in Nkhotakota on the shores of Lake Malawi. Historically this is where the slave trade in the late 1800’s came to an end with the signing of a treaty with area chiefs and Dr. Livingstone. This is also where the first Anglican church was built in Malawi.
If you have patience and a good sense of humor you can work at St-Andrews. The main district hospital covers a region of 60 km radius. People come to the emergency with babies on their back, dirty dressings on their arms or legs, cough or fever. Rare are those who come by car. The majority walk from villages kilometers away. In the morning we listen to the short report. We got used to the awkward silence present on our first day. For us impatient Canadians every minute is counted, but for St-Andrews professionals silence is time for reflection.
Every morning at 8h30 we are waiting for the floor to dry before starting the rounds. At first, I was stunned to see one of the two clinical officers (like a physician, but with a 3 years training) outside taking sun with the construction workers. At 12h30 it is lunchtime. Don’t get a cardiac arrest between 12h30 and 13h30 because you will have nobody at your bedside. People will tell you that there is no rush. You won’t believe it, but there is none when you see what is going on. When the food supplements are late and you must feed all forty-five kids at the nutrition clinic, there is no rush. When the power is off and you can’t test for Malaria, there is no rush. When there are no blood transfusions in stock because the fridge is broken, there is just no blood.
We were in the maternity ward this morning assisting a mother to deliver her first baby. She was wishing for a boy. I was looking at Olivia’s face, full of sweat trying to help the young future-mom to breathe while I was rubbing her back and legs to relieve her pain. We were neurotic around her while the primary nurse was in a corner of the room relaxing and telling the patient that she is not ready to push yet. The contractions were getting closer and closer and like if everyone knew exactly when the baby would come the midwife and the assistant were right on time for the delivery acting with serenity and expertise. The strong mother, that didn‘t make a sound, had a beautiful baby boy.
Reflecting on this now makes me understand why the workers are not rushing. There is a time for everything. Everyone is dedicated to their profession, frustration and anxiety are not present in here even if most of the workers are doing double shift and extra hours. Be patient and have a good sense of humor here in Malawi because you won’t make the floor dry faster no matter what.
Yesterday I lived one of the best, if not THE best experience of my nursing life. I had an OR experience (operating theatre they call it here). But it is not what I did during the surgery or what the surgery was that I want to talk about. It is about sterility and infection rates.
In the hospital here they call things “sterile” but it is not exactly the sterile that we are used to in Canada. My OR experience started with noticing that the autoclave (machine to sterilize equipment) was broken, and so the assistant had to “sterilize” the equipment by hand, with simple hand soap. Then came the uniforms: huge rain boots, large scrubs that were literally falling off of me, paper mask, and sport goggles to cover my eyes. Then I had to “scrub in” which means I had to sterilize my hands with a sterile soap… well, the sinks were not working so I washed my hands in a water bucket with a bar of soap. And finally, the sterile equipment… the scissors, scalpel and prongs were rusty and clearly had been re-used many times.
YET the women and men who come out of surgery don’t seem to have a higher rate of post-op infections than in Canada where sterility is meticulously upheld. Begs the question; is our way actually the better way? It’s hard to tell…
Needless to say, I loved my experience and shed my first happy tear in Malawi : )
For the passed week and a half, Janie and I have been caring for two boys from a neighboring village. We’ve been nursing the little boys, they both have a 3 week old wound on their leg, with the limited resources that Melodie brought with us from Montreal. Resources which consisted of several gauze, tape, anti-bacterial creams and band-aids… resources which we quickly ran out of.
The first time I saw the wounds, they were both covered with dirt, mudd, had large amounts of discharge and had a foul odour.
Janie and me have been nursing the wounds in a corner of our living room, illuminated by our head lamps and using coffee mugs to clean our instruments. One of the boy’s wound has his wound in a tricky place, under his ankle close to the ground making it difficult to keep the wound free of dirt. These boys are kids, they don’t own shoes and live in dirt. We decided to cover the boy foot with our sock, that we brought in a different purpose, never imagining that it would be used in this way. The sock, although it kept some dirt away, didn’t turnout to be as efficient as we had hoped, so with Melodie we decided to buy the boy shoes. Melodie got the little one a 10 days antibiotics from the hospital and hopefully it will improve.
A week and half later, the wounds are dirt free, no foul odours, small amounts of discharge, and showing signs of healing. It is amazing to see that with limited knowledge and resources something good can be done.
On Sunday afternoon we had the privilege to accompany Peter, the coordinator of K2TASO, an organization that provides AIDS patients with home based care. Patients who are too sick to travel to the hospital are provided with treatment and other basics in their own homes. One visit had us cutting through a corn field on a road that was barely visible. The patient’s homes were immaculate even though they had no doors or windows and only mud floors. The clinical officer administered IV Vincristine with all of us sitting around on the floor. Our patients ranged in age from 10 years to 40 years, and were stoic and doing their best to carry on looking after their families, despite severe chronic pain and restricted mobility. With no means to pay for transportation and a distance of many km. from the hospital, most patients would not receive treatment. There is a shortage of all medications in the country but especially opioids.
It’s hard to believe a week has already slipped by. Life here in the village is refreshing as we are brought away from the constant noise of the city. Although, we follow a schedule and are up early every morning there is no rush to beat time. Everything seems slower, Even simple conversations are often filled with long pauses that at first seem awkward. Just like in Senegal, when you first meet a group of people you greet every one of them individually one after another. The people are welcoming and are always smiling and I have been having a great time playing with the children in the village.
As far as the nursing experience, there have been some very sad situations as well as some joyful ones. As we had anticipated we are seeing a lot of malaria and HIV. One of the clinical officers that we have been working with offered to bring us along on home visits to go treat some AIDS patients who lived in what seemed to be the middle of nowhere. It was humbling to see how the patients are coping with their daily struggles. Their living conditions where not the best to say the least. One house consisted of two rooms no larger than 12 feet by 12 feet and a roof about 6 feet high made out of thatch. What really impressed me was how welcoming these patients were and how thankful they were to have us come see them. This gave me just a small picture of what thousands of people in Malawi are experiencing.
The food has been great: Beef, chicken, rice, beans, bananas, and peanut butter. Tonight we had a record for creatures in our living quarters. A bat, a cockroach, a toad, a frog and a nasty centipede that wound keep crawling after being squished.
Jen and me had the opportunity to assist on a surgery at St- Andrews hospital today! We were dressed in 3 layers of green scrubs, a scrub cap and rain boots for the OR. We had the opportunity to see how surgery is performed here in Malawi and the equipment they used.
Amazing experience, accompanied by amazing staff!
Overall a very nice day
Makupo Village is our host. It is located just 10 km from the town of Kasungu, which is in central Malawi. The village is surrounded by maize, soya bean and tobacco fields. Our guest house is nestled into the village with a wonderful view of Kasungu Mountain. On our first day we toured the village and neighbouring villages. We visited the secondary, primary and blind schools, all located right across the street. The students were invited in to a form 4 class (grade 11 or Sec. 5) to address the students and to encourage them to study hard on their upcoming exams. In the afternoon we travelled into the town so that the students could purchase brightly colored fabric to wrap around their waists, “chitenje”. A wonderful first day but tiring for everyone, feeling the effects of jet lag, sunshine and all the activity.