THE BLOG

In this space I will post stories, events, photos, during the time I live in Malawi, Africa working with Adventist Health International. Please come back often (or subscribe) and comment frequently so that we can be connected.

Sunday, August 31, 2008

Briefly...

I haven't updated for a while and things are fairly busy but I wanted to write something so I'll try to be brief...

The group from Loma Linda Medical Center that were here for two weeks left yesterday (Saturday). The time they were here was busy as I was the "point person" for any questions, concerns, issues, transportation, etc. They wanted to go see Lake Malawi while they were here and asked if I would come along. So it worked out for us to go on Thursday morning and come back Friday evening. It was a long drive especially because I was squished in the very back of the land-cruiser with all the bags and Mindi. We had a good time though and arrived at the lake by noon. We found a place to stay after haggling for a cheaper price and all stayed together in a house type of thing on the beach. They served us a buffet breakfast and best of all there was a HOT shower! (That was the first real shower I've had since I came here since at my house there isn't enough water pressure for me to stand up and take a normal shower.) I went to bed early and got up about 5 to watch the sun rise over the lake! It was beautiful and peaceful and very good for me. We drove back through a game park where we finally saw some “dangerous animals”. My camera battery was dead so I didn’t get any pictures, but I saw hippos, antelopes (all different kinds) baboons, buffalo, elephants, etc. It was fun! Nice especially to get out of the office for a couple of days.

On Sabbath I went with the group from LLU to the airport and dropped them off. Then drove to the SDA church near the Union office to meet Don Pursley who is the board chairman and my boss (technically) to bring him out to Malamulo. We had lunch with Emanuel and Raquel de Costa who are the ADRA Malawi director (he is). They are from Portugal and have two young boys. It was really nice to meet them and I'm sure I'll see them more.

I found out that Don S is still having some health challenges and will not be back in Malawi this week. I have no idea when he will return. I was hopeful to give his office and the responsibility back to him this week but it looks like that won't happen. It also means that I will be doing a presentation to the Board on Thursday and speaking for a few minutes at the Centenial program on Friday night. I shouldn't worry about being up front but the perception of being in charge and being the face of the hospital. It also seems like I should have all the answers if I am in the CEO role - but I don't so that's the way it is.

I appreciate your prayers and the notes that I've gotten via email. There are some important decisions being made this week at the board meeting and even more important that they are actually followed through on. Please pray for wisdom and guidance for those of us who are in leadership here at Malamulo. God has blessed this place for 100 years and will continue to do so, but not without a lot of work.

Sunday, August 17, 2008

A House Without Visitors...

“A house without visitors is a dead house.” –Fyson Kasenga, director of community health

Our “house” of Malamulo is definitely alive and well! On Thursday I met Dr. John Osbourne at the airport. He is an ED physician from Riverside Community Hospital in Riverside, CA and after touring around Kenya and Tanzania he is volunteering here for two weeks. Yesterday I met a group of seven from Loma Linda at the airport. There is a pediatrician and her 5 yo daughter, an ER resident, 3 ER nurses, and a 17 yo boy. They are all here for two weeks. One of the nurses is working on writing some grants to acquire funding for projects here as well.

It is nice to have company and as those of you who know me, you know that I LOVE having company.  I do have to admit that I feel like I’ve been working non-stop for the past three weeks and am close to exhausted. I still have a persistent cough that isn’t getting much better so in light of all of that I’m planning to take the afternoon “off” (I’m not sure if that will work or not).

As I’ve taken the visitors around the hospital I have continued to learn more and more about the clinical side of the hospital… I’ll share one brief story about a patient.

On Friday while taking Dr. Osbourne around we came to the maternity ward and the nurse told us there was a mother there who was epileptic and had given birth in the village. During labor, or right after, she started seizing so the family had brought her to the hospital. By the time we saw her she had been seizing for probably 24 hours without stopping and was unconscious. Her blood pressure was normal and they weren’t sure what else to do. Mr. Monjeza, the clinical officer with us, suggested they check her blood sugar to see if it was too low. So Dr. Osbourne left instructions to take the blood sample then immediately give a dose of dextrose. About an hour later when we got to the lab they reported her sugar was low – 65. We soon met the nurse who was caring for her and he told us she had stopped seizing with the dextrose! Today when taking the second group around we saw her again. She has had a couple of seizures since, but is awake and talking now. This case is definitely good news – so far. Her baby is very tiny but very sweet and seems to be eating.

It is nice to have visitors if only to see Malamulo again with fresh eyes and to live vicariously through their experiences. Coming here, though, volunteers need to be relatively enthusiastic and willing to jump in and get busy. It seems like what works is to show people what there is to do and then let them choose what needs to be done and what they want to do first. We’ll see if my theory works…

Sunday, August 10, 2008

Of Land, Patience, & Leadership

*This was typed last week on Sunday. I apologize for my tardiness in posting.*

Last time I promised a story -- I got a memo on my desk (the old fashioned half sheet of paper kind) on Thursday saying there was an ADCOM meeting on Sunday at 8am. I found out from the Business Manager that it was related to an issue of land ownership of a family that had been given some property about 50 years ago. The lady is now old and her family wanted to have some papers so that they can remain on the land after she dies.

I could write a whole posting on “Malawian Time” but suffice it to say that people eventually got together about 8:30a only to realize that we were really waiting for the two chiefs from the local area to come join us. We decided to go back to our offices and get together again when they arrived. [This decision required an opening and closing prayer as well.] Around 10am we heard that the chiefs were here so we went to meet them and formally explained to them the issue. They were kind enough to translate most of it into English but the primary conversation was between the chiefs and the Business Manager. After some more talking we decided it was time to walk over to the house in question. Here again we have to take into consideration the pace that people walk here. The whole time I just continued to observe and watch how people were acting and where I fit into all of it.

There were two chiefs – a man and a woman – both older and much respected. As we walked to the property the older man-chief walked ahead with everyone a few steps behind. When we arrived, the people at the house were expecting us and had set out some chairs in a straight row in their yard. (I’m still not used to be one of the ones given a “good” place to sit. ) Introductions were made and it seems a formal explanation of what we were doing there commenced. I admit that I don’t know 100% what was said because I was the only one who didn’t know Chichewa (yes, the only foreigner) but they did translate some of it. It seems there are two versions of stories about this lady…

VERSION 1: Her children told us that when she was young she went to the United States to be on some kind of radio show. When they asked her how life was in Malawi she told them about Malamulo Hospital and the need they had at that time for a water system.They only had wells with contaminated water for use in the hospital. Because of her time in the US some people donated money and they developed the piped water system that is being used now. At that time she wasn’t even working here at the hospital but in a gesture of goodwill and gratitude the administration gave her some land on the edge of the property to build a house.



VERSION 2: The hospital gave her this piece of land because she was angry and her husband was not working. [Told to us by a lady who came by to tell us where the property lines are.]

To make a very long story shorter we walked the property that they are using now and then convened as ADCOM under a mango tree to decide what to do. It was clear that the front piece of land used to have a house on that land and belongs to the hospital. We decided that they would not have that part of the land and it should only be from “this point to that fruit tree – in front of the pawpaw - straight!” We told them this decision initially and they were not happy. So once again we discussed – this time more with the chiefs and a couple of older people who remember more of the details. Then it was announced that I, as the CEO, should announce our final decision which was not changed from the initial discussion!! (Did I sign up for this??)

I was praying for the right words and mostly just nervous as I said what we had decided I should say. I think it came out alright but they still were not happy. We went and talked some more in their yard until about 2pm. Finally they said “we will let you go until you have made your final decision”. The chiefs were strangely silent as we were presenting our decisions to the family. There was a lot of talk of being “Christian” in how we are dealing with them and if it is “Christian” to take away their land.

Unfortunately I don’t think the matter is solved. But related to the patience in the title – I found myself just wanting to make a quick decision and saying this is how it is… I also had plans to get a committee together to find all of the people “encroaching” on Malamulo’s land and figuring out who belongs and who doesn’t. However I had to sit back and watch them discuss. I couldn’t just rely on the “laws of the land” to solve this issue. This is a normal way of doing business although in the last few years land has become a much bigger issue than it used to be with population growth. There is a court system that they were threatening to resort to but there are no property lines, titles, or deeds to show who owns what.I will let you know what happens but for now we just wait until another day to tell them the same thing.

Some Pictures - FINALLY!

Finally I've figured out how to compress the photos and post them on the blog. This is the front of the hospital and main entrance for staff, visitors, ambulances, etc. My office windows is just to the right of the photo.









This is the ICU. There are 6 beds. I saw a ventilator but I'm not sure it or any other equipment in this room was working. I don't think ICU is used very much but still -- can you imagine?





These are some kids who are patients at the Nutritional Resource Unit. This is my favorite ward, I think. The organization Americares funds and supports this work. It is actually a canvas tent-like structure behind the hospital that strictly works for kids who are malnourished without other medical trouble. They feed the kids and teach the moms healthy cooking and usually a simple trade they can use to make money. The little boy in orange is named Thomas and he is an orphan. He is probably about 3 years old and lives with an auntie. His smile steals my heart every time I walk by.

This is the supply chain ("stores") department. Notice the wheelchair used to bring supplies to the departments. The lady in the lab coat is Bernadette and seems to be the supervisor and know what is going on. There are many supplies that we live without and just "make do". An example is that all of the sutures in the OR are expired - some from the 90's! Dr. Fam, the surgeon, just tests each one before using. We also don't have any muscle relaxant for surgeries. I could go on and on...

This is a supply closet on the labor ward.







Makwasa market... this is where I usually buy my vegetables. Actually there isn't much bargaining done. They tell you the price and if you don't like it you just walk away. Usually I just look for the food that looks the freshest or best. I can't argue with a basket full for $1.00 (see prior post).



More market...







I don't have any pictures of myself yet. Believe me though I'm doing okay and look pretty much the same as the last time I saw you. :) Last night I went to an evangelistic campaign that my neighbor (with the college) is holding. I didn't understand a word of it but absorbed the experience. We met in a nearby village in their marketplace along the road. There were probably 100-200 people along with 2-3 goats and chickens. I was the only "muzungu" (white person) as usual. I was sitting there on the ground wishing I was as flexible as the ladies here who can sit with their legs straight out for hours at a time. Since I couldn't understand the sermon, I spent the time praying for the people as I watched the stars light up and the sun set. I was also contemplating the fact that I am here... maybe I'll post more of my thoughts later.

Friday, August 1, 2008

Kind Words

I had wanted to post about this earlier - Allan Martin is a good friend and mentor to me and has been extraordinarily supportive to me over the past 3 years or so. The day I boarded the plane (in fact sitting in the airport to board) to leave for Malawi I got a note from him to read a blog he writes for. I went to the website only to find the most recent post to be about me! In a special way it seemed to be a special send-off from him and the friends who had commented. I wanted to post a link here for you to read if so inclined. I feel a bit like it is self promoting, but it isn't it is just to honor God in what he has done in my life and to thank my friends for being so wonderful and generous in their support of me. God speaks his love to us through relationships in many different ways... http://ignitionblog.wordpress.com/2008/07/18/experiencing-god-where-in-the-world-is-god/

What a Week!

*Note* I've attempted uploading photos but haven't been able to. I will keep trying.*

There is so much I could write about - I just don't know where to start. I guess I will start by saying I am thankful for a break and that Sabbath is coming. Here at Malamulo the work week is Sunday-Thursday with Friday and Saturday off. I came in today just to see how things are going and then check email - but it's a change.

My first week here was not without it's challenges... on Wednesday 10 people who were here from the US left. Ryan Trott had been here for 2 months helping with maintenance and generally keeping things going while others had left for furlough. Jonathan was here doing an evangelistic series and volunteering between here and Blantyre. The other eight were from Engineers Without Borders who were here for two weeks doing an assessment on our water situation. Ryan in particular had been a big help to get me oriented and situated here so when he and the others left I was abruptly met with the reality that I AM NOT LEAVING and I must adjust to life here. I had a hard time that day and felt very overwhelmed with the responsibility on my shoulders of the hospital and all that is happening here. I admit that I am weak but I felt compelled to bring it all to God in prayer. This is his hospital and his mission and he will not let it go. I felt relieved but still sad and lonely.

I knew (as does everyone) that this would not necissarily be easy - in fact it is more difficult than easy. But with God's faithfulness (see Psalm 89) I am confident and strong. I freely admit though, that I CANNOT WAIT for the next group of people from the US to come... They are a group of doctors and nurses from Loma Linda here for two weeks and then other groups follow.

Wednesday morning also greeted me with no running water. As of today the hospital has been out of running water for 3 days!! Any of you who manage a hospital in the states - can you imagine?? I was thinking yesterday that we should be yelling "code green" but no, everyone was going about their business and treating patients - "making do". There was some complaining but not much could be done. We did find it was a broken pipe and it was fixed yesterday. So by today around noon we had water again! This also brings me to taking a bath without running water. I have to admit that I am not proficient at this. I found myself standing in the bathroom looking at the bucket of water in the tub trying to figure out what to do. I did manage to wash my hair last night and take a "bath", but it will take some getting used to I suppose.

I've decided to mainly purchase fresh veggies and fruits at the local market. Market days are mostly Friday and Saturday. They have a variety of things - used clothes, baskets, pots, bicycle repair shop, food (tomatoes, onions, cabbage, beans, rice, okra, eggplant, potatoes, etc), cloth, & blankets. I went this morning with Masa (my houseworker) and this is what I bought: (note $1 dollar = MK140 Kwacha)

1 cabbage (big) 50 Kwacha
10 big tomatoes 100 Kwacha (plus one thrown in)
5 onions 50 Kwacha
bunch of bananas 3/10 Kwacha (50 K for the bunch)
That is a little less than $2.00!! In the rainy season there will be more variety too. There are shops that sell oil, sugar, eggs, soap and other things too. Some of that may be cheaper in Blantyre at the grocery store (large South African chain).

I've been eating a lot of rice and starchy foods. I'm trying to get protein and other things too. For fruit bananas are the only thing in season. Papayas will be more soon and then mangoes are in November. I just missed the avacados. Masa makes me lunch some days. He does the cleaning and gardening and gets water if we are out. He also gets small things fixed or runs errands if needed. He is nice and does a good job. He asks me lots of questions about America and I've shown him the news magazines I have. It's interesting to look at it through his eyes. He is teaching me some Chichewa - the language here.

Phone calls are cheap if you use a calling card to call me... www.viapin.com. If you want to call, send me an email and I'll give you my number. I have Cristy's cell phone until she gets back. This morning my family called me. It was so good to hear from them!! Unfortunately it was not good news as my dad is in the hospital. I appreciate your prayers for him.

Sorry this is long - next time I'll try to write a specific story so it won't be so rambling. Bye bye--