Boiling Water

Do you now how much time you spend boiling water in Africa? A lot! We are lucky to have some filtered water but any used for cooking or hot beverages is from the tap and then boiled.  Coffee is also instant or French press. So, I have been shocked by how often I find myself standing around waiting for the water to boil. That is in fact what I am doing at this moment, so that I can cook some pasta for supper.

Another interesting fact, the dogs are all howling loudly outside.  They do this every night at about the same time. I unfortunately asked about this to the locals and they explained that this is the time the hyenas come nosing around the village and so it makes the dogs howl in protest.  I have been avoiding the dogs but now that I understand this I may start feeding the strays.

Today was a busy but good day.  We started the day off in the pediatric unit not with hospital wide rounds.  The highest level nurse opened us in prayer and then the staff proceeded to sing a worship song that was beautiful.  We went through a few patients and then discussed some of the problematic patients with Sam (the most senior Malawian clinical officer) leading.  It was all good and productive. We then did rounds and made plans for the day. There was some coming and going of staff but still a good group saw all the patients.  We were able to discharge a few which was good and then we had two that we sent to the capital because of the need for surgery and dialysis. Some had surprises on lab and ultrasound today and giving bad news is hard again without good communication.  The realities of Africa that two patients will most likely die and in other areas of the world they would survive. However, for me personally, I think I made some progress in gaining trust among the nurses, understanding procedures, making calls to other hospitals, etc.

We were also able to spend more time in the NICU.  It is amazing the tenacity of some of these small ones.  There are several from 28-33 weeks and below 4 pounds. Obviously, many do not survive but I really am surprised by how many do.  The babies are all in a row in their wooden boxes. The mothers file in and sit on a long wooden bench. They take off their jelly shoes at the NICU door.  You know it is feeding time if there is a large pile of shoes. The mothers sit on the bench shoulder to shoulder and express their breast milk into small cups.  Then they stand and put the milk into syringes connected to tiny feeding tubes that are taped to their babies’ faces and feed them. Ten times a day this is the process. The rest of the day spent waiting outside in the brick paved areas were families live and cook while caring for their hospitalized family.

I suppose I will stop complaining about boiling water.