Weekend and New Friends

Although my work week was just one day, I did feel ready for the weekend.  The system by which the hospital is run is hard to understand in person and more complicated To try to explain. Nkhoma is a teaching hospital and thus has Malawian Medical Officers (physicians) and Clinical Officers (nurse practitioners) who generally run the ward and have primary responsibility.  Then you have residents and medical students that rotate through the various areas. There are a few full time faculty who are present daily for supervision and assistance and then those of us that are “visiting consultants”.  At the present, I have been encouraged to take weekends and allow the paid local staff to fulfill their responsibilities and at the moment I am happy to do that.

Another great aspect of the guesthouse that I am staying in is the community.  The guesthouse shares a yard with the Children’s Home that cares for orphans and those under 2 whose families are not able to care for them.  So, there is always a lot of giggling, crying, and running with sticks going on.  

At the guest house, there currently are 2 Dutch medical students, a German medical student, an American family practice resident, a South African was serves as the Vice Chancellor of Nkhoma University, and two moms from the states who both are adopting two children from the children’s home.  The children are living with them and they have been here much longer than expected. One has been here almost 6 months with her husband and 2 biological children at home. The children, per Malawi, are officially adopted but they are struggling to get the US consular to grant the children visas.  Every day is a struggle for all of them. This is my family for this short time and it is amazing how as believers we can gather and have tea and toast and share amazing stories with comfort.

On Saturday, I joined Nina, the German student, and Hanna, a Dutch tropical medicine resident on a trip to Lilongwe.  Hanna rented a car and drove us into the city. We went to an animal center where they take care of orphaned and injured animals until they are ready to release into the wild.  We had great coffee at a little restaurant area and then took a walking tour of the animals. It was fun to watch monkeys and baboons at play. We then had a wonderful lunch with another family from Nkhoma.

We then went into the center of the city and walked through the markets.  Amazing scenes. The colors in the fabrics (chichenge) that the women wear as skirts are incredible.  The fish, chickens, and spices create a smell that is more like a flavor. It is hard to even take it in and the people are very friendly and enjoy us trying our Chichewa while they try their English.

We then made a grocery shop which is much more Western than anticipated and headed back to Lilongwe.  The roads are full of people and goats and occasional cows. The scenery is impressive with mountains and dry savannas.  People sell an amazing variety of items. Probably the most unusual are giant rats grilled and on a skewer and fried grasshoppers.  I don’t believe I will be that adventurous with my GI system.

Sunday came with an early start.  The English speaking service starts at 7:30.  I had a chilly walk to the church and found a sparse crowd that grew rapidly over the next 20 minutes.  The singing was mind blowing! The harmony and beautiful accents created such a beautiful atmosphere of worship.  I could have listened all day. And singing hymns with such a multi-cultural crowd also had a profound effect on me.  There were several prayers and recitations that were a little difficult to understand, but the the pastor began to preach.  Here in the middle of Malawi, a seminary trained preacher spoke from Habakkuk with quotes from C.S. Lewis’ Grief Observed about having faith in times of trial.  One of my favorite points he made was that when you fully understand God, then you understand you don’t fully understand God. Just the kind of service you would expect from the middle of the least developed country in Africa!!!!!

After church, one of the long term missionaries took some of us to a small museum across from the church and gave us a history tour of the Nkhoma mission and local area. When I returned to the guesthouse, the newly arrived students from Germany were ready to explore and so we went down into the village for a long walk.  Later, I joined the American family practice resident that is with me on wards and we had a late lunch with the two long term missionary families here. It was a great meal with wonderful people that daily sacrifice comfort and closeness to family to serve as God has called them. The Hodges have 3 small girls living here.  The views from there house are amazing.

I had a long walk home and when I arrived at the guesthouse, the director of the Children’s home was visiting with a new infant.  We had dealt with this mother and patient on Friday. The mother had Hepatitis B and C and a large liver cancer. She died Sunday morning and now the baby is at the home.  We spent a long time putting together a care plan for the infant and for future testing and care.  

I tried to catch up with some journaling and preparations for Monday.  Sleep came easily at first but from 4 am on my mind was stuck on how to best find my place on the hospital team.