Monday, 5 January 2009

Headed towards Mangochi and the lake yesterday to go to a couple of the health clinics there attatched to Nkhoma. They’re permanent fixtures unlike the eye clinics. And so every few weeks a land rover from Nkhoma goes with medical supplies and at the same time accounts are checked and some family planning procedures done. As usual, every man and his dog piles into the back of landrover so a very squishy few hours ensued. The first clinic was about 20km off the main road and unfortunately, they hadn’t quite finished a couple of bridges on the way so we (I say we but really the man driving) had to negotiate crossing two fairly full rivers. When we stopped in the middle of the river, wheels spinning, I thought we were stuffed but a bit of perseverance and we were through. Lesson no 2 from the day: a landrover can get anywhere if you rev it hard enough. Lesson 1 is of course: there’s always space for another person/sack of maize/bag of charcoal/ bucket of mangoes in any vehicle. Never say never.

At the first clinic, there was administration stuff to deal with so I had a wee look around with the nurse midwife (here all nurses are midwives too) who had been working for 40 years in various clinics. They do antenatal clinics, under 5 clinics, Voluntary Counselling and testing for HIV, general clinics run by medical assistants, family planning, a labour room and there’s also a small ward with 3-4 beds for the odd admission. Anyone with complicated pregnancy or labour or more major medical problems are admitted to the nearest district general hospital with whom they have a radio link to arrange an ambulance which can be anything from a bicycle with a stretcher, a motorbike with a sidecar stretcher to a landrover. That’s where landrovers come into their own, no sparkly, pristine white 4x4’s around these clinics, battered but functional. Unlike the huge things parading round the pretty smooth tarmac roads of Edinburgh whilst parents drop their offspring at some extortionately priced private school.

After the heavens opened and turned everything to sludge we headed to the next clinic which was just a km or two from the lake. Here they were removing contraceptive implants and doing the other administration bits and pieces. Nkhoma and these clinics are all funded by CHAM (Chrsitian Health Association of Malawi) which provides health care to about 30% of the population (much higher than I thought). The rest is provided by the government and a mix of NGOs. They were negotiating for free antenatal and under 5 care to be provided at the clinic funded by the government but provided by CHAM but it involves lengthy discussions with the villages chiefs and TA’s (traditional authorities) as well as with the government.

So after removing the implants, we went to see the lake and pop into to see one of the clinical officer’s friends. It turned out he knew half the village so 2 hours and lots of greetings later we started back to Nkhoma. Lesson 3 of the day: popping into see a friend equals greeting half the blooming town. But next to the lake was pretty idyllic so I shouldn’t complain.

By this time it was to 5pm and dusk was falling but we were on the road with one last stop, or so I thought, first to pick up a shield which was being carved for the Bike Race taking place at Nkhoma today to raise funds for the hospital. This involved using the loudspeaker and the siren attatched to the landrover whilst yelling the carver’s name through the loud speaker and nee-nooing. He was found and the shield handed over and the whole thing videoed by the video-happy accountant. Off we go again making good progress till we pass sacks of charcoal and mangoes for sale at the edge of the road so of course we stop and just as I was thinking I had a incy bit of feet space my hopes were dashed as I piled mangos by the bucket load into the back of the van along with a few sacks of charcoal. At least being like sardines means that it’s easy to dose off and the next thing I knew we were back at Nkhoma, albeit, a very dark Nkhoma as the power was out. And it’s still only half back which means everything is going off nicely in the fridge.

It was something different and a welcome break from the paediatric ward as we saw lots of healthy children which was so good after these past couple of weeks of very ill kiddos. Restored some of my faith I guess.

I decided to go to Dedza today to see the pottery there (and for the internet but no such luck). Some English man has a pottery workshop which sells some very nice and some rather odd things and there’s also a restaurant there too. So I thought I’d take a look. The buses went surprisingly smoothly and didn’t have to wait too long at all. To get out of Nkhoma you have to take the bus to a place called Kamphata at the junction with the main road and from there you can go north to Lilongwe or south towards Dedza and Blantyre. If Nkhoma seems to be a pretty law abiding, calm, generally church orientated place, Kamphata is it’s an thesis, with lots of bottle stores, bars and rather far gone characters. Apparently, it’s where to go for a night ( well afternoon it seems) out from Nkhoma if that’s your kind of thing. I guess everyone needs an escape. It makes waiting for a bus there an interesting experience to say the least mind you. And after passing some ESCOM (the electricity people here) pick up trucks I was hoping that the power would be back but it’s only half here for some reason which means the cooker and the fridge still don’t work properly. Well, better than nothing I guess.
For the next two weeks I”ll stick with paediatrics then I think I’ll spend my last week on the medical ward for a change. The time just seems to go here and I’m never quite sure what Ive done but there’s not many dull moments anyway.