Explaining Christmas

It’s that time of year – what’s referred to as “the holidays”. Now that I find myself in a country and culture that is not my own, I am redefining Christmas and what the essential pieces are of “the holidays”. What I mean is that since I’m not surrounded by the western “hustle & bustle” of the whole month of December (or really since the end of October) I find myself evaluating what it is about these special times of year that I miss and what it is that makes them special. There have been a few times when I’ve tried to explain these things to my Malawian friends only to get blank stares and to realize they don’t understand the essence of what Christmas means to me.

Adventists in general here don’t celebrate Christmas except for the gift they might get from their employer or the possible relatives that come for a meal and don’t forget the public holidays granted by the President (more on that later). Otherwise Christmas is considered irrelevant because, after all, Jesus was not born on December 25!! Some I’ve heard even going out of their way NOT to have a special meal on that day to show disdain for such random date setting.

So the essential things that I miss and that I think are the important part of this season is obviously being with family – not just being around on “the day” – but really BEING with them – eating, cooking (especially those two), playing, reading stories, sitting by the fire, explaining the mysteries of Santa, hauling wood, and all the other wintery things that make up life at home (I realize this isn’t the same for everyone – I can only speak for myself and my “home”). I think it is also the comfort of knowing you are surrounded by those who love you and who you love and re-affirming those relationships. I don’t understand how all the traditions of Christmas build those relationships – it’s a mystery to me – but I know it does and that is what I miss. It is also a time of remembering and valuing the gift of Salvation that was given by Jesus coming and being “God with us”.

Although the things above are what I’m used to and what seems “Christmas-y” to me, this year it will be different. I haven’t bought presents for anyone. Christmas morning we (ex-patriots) are going to hand out gifts that were donated for the patients here and some knitted baby caps for the newborns. Then in the afternoon we will get together for a meal and a few games at Sue and Kelvin’s house and probably dessert and carols at Cristy’s and my house. Our house is decorated with lights, candles, and a potted palm with bells – and with Christmas music it does seem festive. But I guess as mentioned above – those decorations and food are not the essence of Christmas for me.

As to public holidays (i.e. where all businesses shut down) – the President of Malawi is fond of announcing public holidays about a week before they happen. So last week on Thursday he announced that the 24^th through the 2^nd of January would ALL be public holidays. This wouldn’t seem like a problem except that EVERY employee expects to be paid for all of these days – whether they work or not. So where we originally had planned two public holidays on the schedule, we all of a sudden have seven!!! Needless to say some employees nearly revolted when we told them that only those who work would be compensated! This kind of grasping and striving goes a long way to negate the Christmas spirit that I had.

This post is sort of muddled with some random thoughts on Christmas and maybe that’s why it’s hard to explain to people here because there are so many aspects. I’m thankful for many things – having a friend like Cristy here, seeing small improvements in the Hospital’s business, having made it through another year of life, having plenty of food and clothes and even some to share, and many other things. But I feel like it would be unfair to say that there is not a bit of sadness and loneliness in my heart this Christmas season. So for now I think I’ll finish making my pita bread and go to the hospital to post this online. Merry Christmas to all!

Prayer

Prayer is such a comfort and I find that it continues to be the source of strength to me on days that I don't think I could manage otherwise. Before coming to Malawi I have had various opportunities to experience prayer in different settings and see its power to heal, bring peace, show direction, and be a way to encounter God in a tangible way. As I prepared to move to Malawi I wondered how these experiences would translate into a different culture and if I would have an opportunity to share some of the things I've learned - those opportunities are yet to be discovered. But in the meant time I continue to find shelter and peace in the “hiding place” of prayer. As I pray I am reading through the Psalms and find a depth of prayers and promises that speak to my situation at different times.

I wish I could share with you the ways that God has encouraged me and spoken to me – but they are too detailed and personal to explain. I just feel honored and blessed to be able to communicate – both speaking and listening – to the God of the Universe!

I have come across a few quotes recently that have encouraged me…

When Jesus was upon the earth, He taught His disciples how to pray. He directed them to present their daily needs before God, and to cast all their care upon Him. And the assurance He gave them that their petitions should be heard, is assurance also to us. E. G. White

To pray is to take notice of the wonder, to regain a sense of the mystery that animates all beings, the divine margin in all attainments. Prayer is our humble answer to the inconceivable surprise of living. It is all we can offer in return for the mystery by which we live. Rabbi Abraham Heschel

I found this prayer the other day and it seems so appropriate for the work here among different cultures and viewpoints. There are at least 5-6 different countries represented in the staff here at the hospital at the management level – it is not merely my American vs. Malawian cultures. So I close with this prayer:

“O Maker of Worlds beyond us,
help us to live in the world we know
in peace with one another,
a kaleidoscope of nations,
a patchwork quilt of ways and wills
that rise from the depths of cultures
created by Your love.
Open us to the richness
of one another's vision
and the good we can accomplish
when we share one another's views.
We pray this prayer of unity and peace
in the hope of Shalom.”
Amen

Thanksgiving

There are many things to be thankful for and I'm sure this past few weeks you've made your own list. It was fun to share some of the Thanksgiving traditions with our friends here at Malamulo. Cristy and I are the only Americans here currently so we decided to invite people over and prepare a traditional thanksgiving dinner for them. We didn't have turkey (but we saw one the next day! see below) but we had butternut squash soup, stuffing, mashed potatoes, and green bean casserole along with pumpkin and pecan pies. Mostly though the nice part was sharing a meal and being together with people from all over the world. I counted afterward and realized we have people from 5 continents at our table. Masa, our house worker, and his family came and after dinner he said, "I think this might be what heaven will be like." That really was touching to me and I think I might have to agree! We had plenty to eat and were left with a pile of dishes at the end.

This was the table set up in the living room.
Cristy drowning her sorrows in sparkling cider (yes, non-alcoholic - don't get any crazy ideas :) ). Notice the piles of dishes behind her waiting for us to wash.
This is the turkey that got away. One of the only ones we've ever seen in Malawi - it was up at Mulanje.

The next day (Sabbath) Cristy and I borrowed Don's car and drove to Mt. Mulanje (http://en.wikipedia.org/wiki/Mulanje_Massif) and escaped into the wilderness for some R&R. We parked at Likhubula Lodge at the base where they have chalets and guest houses for retreats and vacations. Trails start off from there to explore the mountain. There is a waterfall about an hour's hike up with a pool at the base so we made our way up there and after nearly overheating on the way up we were happy to plung into the chilly water. It was so nice to be in nature and get away for a few hours. Here are a few photos:


This is the waterfall and the pool. Apparently the pool has no bottom or it is so deep no one has found it!Yes - that is me on the lower left - floating watching the clouds and birds fly by.

Beautiful Iris type of flowers growing directly out of the ground.
Colorful lizard - maybe a confused chamelion?

Yesterday we broke out the Christmas decorations and the Christmas music and turned our house into a comfy holiday place. We even have a fireplace to hang our stockings on. We are using a potted palm tree for our Christmas tree - complete with little bells hanging from it! I'll post some photos of that later. It is a fun time of year to reminice about family traditions and join in the expectation of the soon coming of Jesus. I think reflecting on the first coming of Jesus reminds me how soon his second coming is. Cristy and I are doing daily readings for the Advent calendar. It is a nice way to absorb and welcome the season.

Missing you all and hoping you have a wonderful holdiay season with your friends and family.

A Few Photos

Thought I would just post some photos of recent events/activities:

A container arrived last Monday and these photos are guys unloading. I couldn't watch for long because they were just tossing everything off the trucks unless it was heavy or looked important.

Three nice gurneys were put to use the same day! We also got an O2 concentrator, ultrasound, suction machines and an ECG.

This is Jessica, Julia, & I at a fireworks display a couple of weeks ago. They were two peds residents here for 2 weeks.

The next photos are from Nyala Park where they have lots of giraffe. I took many more photos but only posted a few...

Yes - me with the giraffes. :)
And a little baby - so cute!

Things are stressful here - I'll be honest. But on the other hand I have many things to be thankful for. On Friday Cristy and I are going to have a thanksgiving dinner with friends here at Malamulo. It will be nice to celebrate and relax with everyone. We also just had 3 people from LLU come for a few days to plan a big trip with college students next summer. It is always nice to have visitors and the encouragement they bring.

Blessings to each of you and thank you for your emails and prayers - especially the prayers. Some days I feel like I'm in the bulls-eye of the great controversy! I'll write more later...

Almost 4 Months - email

This is an email I sent last week - thought I'd post it here:

Hello Friends & Family,

I hope this finds you all well and enjoying the chilly days of autumn! I have to remind myself that it is fall at home and that Thanksgiving is around the corner. Signs of Christmas are loud and clear here. If you drive along the road every 5 miles is a police check point where they are collecting "christmas" (i.e. finding any tiny thing wrong with your vehicle and charging you). Then at Shoprite and Game (the two chain stores from South Africa) in Blantyre you see gaudy Christmas displays everywhere. Consumerism is no respector of countries, bank accounts, or people.

I just realized the other day that it has been almost four months since I came to Malawi! I can hardly believe it! Time has flown by which, I think, is a good thing! I've been updating my blog almost weekly, but in case you haven't been there I wanted to just send a brief note to let you know I'm still alive. Things are continuing on here at Malamulo and we are seeing a few glimmers of hope here and there. In October I got a change of scenery and spent a few days in Lilongwe at the SDA clinic there. Part of my responsibilities is to help the other health organizations under AHI and they needed some help so I was there for a few days. Cristy ended up having a meeting up there too for something else so we spent a day or two in the capital city with a friend from the UK who is volunteering with VSO (like Peace Corps).

Recently we had two pediatric residents here from Loma Linda Medical Center. They did a two week rotation and helped tremendously at the hospital since we don't have any pediatricians on staff. It was fun to have them around and they kept me company the week that Cristy was gone to South Africa for Faith's wedding. On Friday last week a group of us went with the residents to a game park a couple hours away and saw lots of giraffe, zebra, impala, bush buck, and monkeys along with a few other things. The park is small but nice to see these animals. Also they had a picnic area overlooking a swamp where we had lunch under some shade. What a lovely day although over 100 degrees!!

Some exciting news today - a container from the organization Give Children Hope (www.gchope.org) based in LA arrived today. This container has been quite a headache to get through customs since this is the first one from this organization to Malamulo. Unfortunately it has cost the hospital over $2,500 compared with most that usually only cost less than $500. It is full of wonderful things though and I am excited to go dig through it tomorrow. It is such a blessing that organizations are able to get donations and forward them on to places like Malamulo. It is a huge benefit. We also get a lot through AmeriCares (www.americares.org).

Life is okay in general. Our ceiling is still not fixed and even more panels have fallen (but not on my head, thankfully). We are seeing more patients coming to the hospital with the rainy season starting and malaria coming. Also our clinic in Blantyre is getting more busy with the doctors back and getting established here. Cristy will mark one year of being here at the end of November! Don is back in the states until the first of December for his son's wedding. I'm acting CEO again while he is gone. In October we also laid off about 40 people from the hospital payroll and are starting to see some savings from that - financially. It was not without it's backlash. About 2 weeks after doing the lay-off our biggest pump was stolen from a well that supplies water to the campus. It cost about $1,000 to replace and on top of it the thieves threw a pipe and big rocks down the hole. It took us about 3 weeks to figure out how to get the pipe out and the rocks broken up so that the hole was still useable. We are continually looking for ways to improve things overall, and I know there is so much potential!! God is faithful and he reminds me of that frequently! (Lamentations 3, Ps 104)

Thank you for your continued prayers, emails, and encouragement. I even got a few packages the other day which made me so excited!! Thank you to those of you who are sharing stories and news about Malamulo to your friends and churches. There is so much need and the more people who know, the better. I am blessed to have such a wonderful group of people to support me while I'm here. May God bless you all individually in special ways.

Miss you and Happy Thanksgiving!
Love,
Elisa

Life...

Today is Friday and Cristy and I both actually have the day off! I am doing my best to avoid going down to the hospital at all. Most Fridays I seem to end up in Blantyre running errands but today I’m staying home and “mucking about” as Cristy says. We just got back from the Makwasa market where I bought a cabbage and 5 mangoes. It cost all of 75 cents (100 kwacha). The mangoes are starting to get ripe here and they are yummy! We took Julia and Jessica who are peds residents from Loma Linda Medical Center visiting for 2 weeks to the market too. It was fun to pretend to be a tourist with our cameras for a little bit. I may have written about this before, but I really enjoy shopping at the little market there. It is not tourist-y at all – there are no carvings or random things white people might buy, but rather it is a really the place local villagers shop on a daily basis. Now, since I’ve been here for a while I know several people who are there shopping as well. I like that and somehow I feel more a part of the culture and LIFE here by going there and shopping. Granted, I also buy things in Blantyre at the shops that get their wares from South Africa which most villagers don’t do – but still…

Wednesday was the first heavy rain… I was home for lunch and all of a sudden the sky turned dark pewter grey and I could hear thunder in the distance. The clouds were swirling, a wind picked up, and pretty soon the gigantic rain drops came down. It was amazing! Masa and I were rushing around closing the windows and doors to keep the rain outside. It was so loud I looked out and saw it was actually hail! With part of the ceiling in the kitchen missing the rain and hail was deafening on the tin roof. Cristy wasn’t home yet and as I guessed she got caught in the downpour walking home and came in dripping wet! Everyone is happy that the rains are coming because it means they can plant maize and once again have enough food for the next year. They wait until one or two heavy rains before planting so that the ground is good and wet. But fields everywhere are dug and in neat rows ready to be planted this month.

*Now it's Sunday*
Last night we had an adventure - in the UK they celebrate "Guy Hawks" day on the Saturday night closest to November 6 with fireworks. So the Thyolo sports club (i.e. where rich white people go to play golf, watch rugby, and drink beer) was holding a fireworks show and dinner so we (Kelvin, Sue, Jessica, Julia, & I) decided to go. The fireworks was actually pretty good and the food was edible as well. I was hoping to meet some ex-pats from the area but everyone seemed to know each other and since we were sitting in the dark it didn't help the socializing much. It was interesting, but not a place I'll probably frequent.

So life continues on here – occasionally I have to remind myself that I am actually LIVING in Africa. Not that it seems like it’s the US (the falling ceiling, lack of water, and sweltering heat remind me that I’m not in the US) but I guess it just sometimes seems surreal that I’m actually living here; to believe that somehow God has made a way for me to be here to try and make a contribution to the mission here. It is humbling to be called and used in this way. Very often I wonder if I am making a difference but then I am reminded of the steps that brought me here and how God was clearly leading so I trust in that leading and continue with my daily work.

I appreciate the notes of encouragement and the prayers that I know are offered regularly. Some of you have shared of your financial resources as well and I can't thank you enough.

"Pang'ano, Pang'ano"

Pang'ano, Pang'ano is "Slowly, Slowly" in Chichewa. I recently added this word to the chichewa dictionary in my head. I think it fits the Malawian culture and approach to things perfectly. There is almost never any urgency or emergency in life here. I have seen people hurry occasionally but even in a big hospital like Malamulo we don't have an Emergency room!! It is the same with the business side of things - when I think of whether we are making progress or not "slowly, slowly" seems to fit. There are a few glimmers of hope -

Last week we made arrangements with the only pathologist in all of Malawi (who has an office in Blantyre) to send him specimans from the hospital for a flat fee (approx. $35 USD) since the patients are so poor. This rate is still out of reach for some but encouraging at least to have the option for patients.

We also arranged with a pharmacy supplier to provide drugs that are needed at the clinic in Blantyre. We struggle to keep the stock they need there and since this provider is located a few blocks away it will make the service much better. This will also be helped by the loan of 1 million Kwacha (~$6,600 USD) to give us a basis for purchasing the items. The income from the sales will go back into that account and [hopefully] continue to fund the supplies for the clinic.

The challenges come when the guys from the pharmacy supplier don't follow through when they say they will and we have issues setting up the bank account to keep this loan and "jump start" money for the clinic.

I am happy to report that we purchased 30 brand new mattresses for some beds in pediatrics with some money that my friend Melissa donated. Those arrived a couple of weeks ago and just today when I wandered through they are starting to be used! Also we got 7 exam tables donated by World Vision and are getting 52 new hospital beds with mattresses donated from ADRA!! We also have another container that has arrived in Blantyre from the organization "Giving Children Hope" (www.gchope.org) that should be here this week.

All of these things add up to be really positive for the hospital... and I try to keep that in perspective but it is easy to get bogged down in the details and the incompetence of individual people. There have been days this week when I've had to be firm and direct with people to be sure that the importance of the issues is communicated. This goes back to the first comment that there is no urgency about anything!!! Daily reports, assignments to be done, patient bills and accounts done correctly (all manual) - nothing seems important or serious!! To my western mind this is completely frustrating, as you can imagine! **deep breath**

It is CRAZY hot today so I think Cristy and I are going to head home early. Going home and being comatose and a glass of lemonade sounds very appealing!! Until later ---

A Wedding

The longer I wait between writings the more there is to say – I apologize in advance for my long-windedness.

Wedding Bells!

To add to my cultural immersion of late, I attended a Malawian wedding the other Sunday The ceremony itself was nice – held in the Malamulo church with many attendants (lots of children) who marched/sached/danced down the aisle. There was a choir that sang a couple of special wedding numbers, a unity candle, the flowers were artificial but the bride was beautiful. There was a hug after pronouncing them husband and wife. A kiss would have been way too much “PDA”. The reception was held about 2 hours later (after everyone went home for lunch). The DJ played music from huge speakers with the MC calling various people up for pictures with the couple or to give gifts. While up front they had to dance to the music while tossing money into baskets held by the bride and groom. Explaining it in words doesn’t do it justice and I’m sure you’d fall over laughing at us trying to dance. They called up the “white folks” and so we presented our gift and then had to toss money into the baskets. It was Cristy, Ali, me, & Demitrio. I’ll just say that we were all laughing at ourselves and each other!! Most people threw in 20 kwacha notes which is about 10 cents so there was money flying everywhere with us laughing at each other! Then after a few minutes more people came up and joined us. We made a lot of people laugh and the next day at the hospital it was all people could talk about and tease us about.

The interesting thing about the money dance is the freedom and joy that was on the people’s faces. It struck me (and maybe this is deeper than it really was) but this is one chance when you really feel generous with someone and a chance to give away something to help others. When you are so poor, like the Malawians, it is not often when they can be carefree and just fling money around. What an amazing gift and chance to celebrate with each other as family and friends. I was so glad to be a part of the celebration. The bride and groom made quite a bit that day – over $1,000!!! That is a lot of 20 kwacha notes! We have heard many times and even from the groom how much it meant to them for us to be part of the celebration and join them. What a special chance!

Investigative” Accounting

I admit openly that I have never done auditing and it is not my forte to find what is wrong in the accounting processes. However the AHI-Malawi board requested that I visit the Adventist clinic in Lilongwe and do a bit of analysis on their processes related to inventory. So last week was the appointed time and I took a bus up on Wednesday the 4 hour ride. The clinic is made up of dental and medical services. There is a couple from the Philippines who are both dentists and have been there 8 years. The medical doctor is Malawian and has been there about 4 years. I hope that the suggestions I made will a) be implemented and b) be helpful. My feeling is that once they are in place if there is anything questionable going on it will come to light.

Cristy ended up having a meeting on Thursday in Liliongwe too so she stayed with me at the guest house and we both came back Sabbath afternoon. On Friday after I worked in the morning we went with Clare (a volunteer from the UK that used to be at Malamulo) and she took us shopping, out to eat, to a used book store, and we even found a place to get pedicures! Lilongwe is the capital of Malawi so the base for many NGO’s and ex-patriots so for a couple of days we got to feel like we actually weren’t in Malawi which was nice for a change. I even stepped on US soil when I went to the US Embassy to register. I also did my civic duty and cast my ballot for the presidential elections. I admit though, that by the time we got home on Sunday I was happy to see my bed and have my own space. Our little house feels like “home” and that is a comforting feeling.

There continues to be many challenges and recently our creditors have been calling me directly asking for payments on our accounts. Thankfully we had some money set aside and today we were able to pay about 1 million kwacha on our debts (~$7,000). That is a good feeling!! This last week we were able to make some arrangements to provide pathology reports for our patients at a reduced rate (from the one pathologist in the whole country). We also are going to have a pharmaceutical company manage the inventory of drugs and supplies at our clinic in town. This will be a major boost to the business there since people have been going to other pharmacies to get their prescriptions filled since we haven’t had the stock to sell to them. Slowly things might be looking up although I hesitate to get my hopes up too much.

Cristy is doing well. She is on call this week so it’s always more demanding. Fortunately the hospital is only a 5-10 min walk from our house so she doesn’t have to stay at the hospital. Last week she had a patient in her 30’s with Acute Leukemia and it was just sad because there is nothing that can be done here for her – even in the states her prognosis is bad – but in Malawi there is absolutely no treatment. Cristy had to break the news to her that she would die within 3-4 weeks which was understandable very difficult.

She (Cristy) has officially been appointed the Chief of Medicine so is continually challenged with the management side of the medical staff and various responsibilities. We laugh about how we are both inexperienced and have found ourselves in these leadership positions. It is sort of like the “blind leading the blind” sometimes. Thankfully we are confident in God’s strength and wisdom so that gets us through the tough days. We are glad to have each other and that we get along so well – what a blessing!!

I’ll close for now – there is so much more to write. Until next time --- e

Photos of My House

I've been delinquent in posting photos around the house... Here are a few hopefully it gives you a little better idea of where I live...This is the front porch. We live on the end of a tri-plex.
This is the front room. Notice the end of the piano on the left.We do have a fireplace but are not sure if it works. The carving on the left is a solid piece of wood and it is of a lady bending over with a baby on her back - very typical of actual life.
The kitchen - the stove is on the right just out of the photo and to my left is a small kitchen table.This is the view out the kitchen window. When it is a clear day we can see the villages down in the valley.
My room...
Just PART of Cristy's book collection. Never fear about my supply of books! This was before she brought back a crate of new books. Yes we also have a tv and DVD player.

I have to say I'm spoiled and really don't have much to complain about. I am thankful every day for being able to share a home and life with Cristy. We continue to make yummy food in the kitchen and are hoping to create a comfortable home that is welcoming to everyone.

It would be fun to have you visit "for real" but hopefully the photos help a little bit.

Observing Malawian Grief

Another week of experiencing life here in Malawi - this time it was a little more somber…

The Business Manager (i.e. Controller), Foster’s, elderly father was here in the hospital with a dislocated foot after a fall several weeks ago. After initially refusing hospitalization and trying some home remedies he came back to the hospital and was admitted with some large burns on his lower leg and foot as well as the bones still out of place. Monday morning Foster came to me saying they were going to surgery to amputate his father’s foot! I was surprised – not realizing that gangrene had set in and the only thing to be done was cut it off. I went to the ward and prayed with the family before he headed to surgery – feeling bad and wishing there was more I could do.

Later in the day, around 3pm the chaplain/HR director came and found me to tell me that the old man had died in the operating room. I later found out just as they were starting to cut he stopped breathing. They did CPR and compressions for about an hour before Foster told them to stop. His father was almost 90 years old and earlier in the day had told them he was dying and that he was ready. It seemed like his “time to go”. I felt so sad and just had a hollow feeling in my stomach. We went and told Don and talked about what the hospital would do for Foster in this situation. I asked if it was appropriate for us to attend the funeral and the chaplain confirmed my thought that it was.

Not sure what to do or how to be helpful I went on about my “rounds” and was playing with a beautiful baby outside maternity when one of the CNA-types came to find me. She asked if I had heard about Foster’s father and then said there was a group of people waiting outside the OR for the body to come out and be transported to the morgue. [Note of Explanation: The morgue is located at the far end of the hospital and whenever a patient dies the family and “guardians” accompany the people transporting the body to the morgue. There is no way or desire to hide the procession. The grieving is loud and very noticeable to the rest of the hospital.] I told her I wasn’t sure what I should be doing and asked if I should join that group. She confirmed that I should go and be there.

I felt out of place but joined the group of mourners (family and employees) waiting. They were quiet, some quietly crying. When the body came out on the gurney and we started our walk I trailed behind and just tried to absorb the process. By now the news of this death had spread around the hospital and many staff came out of the wards and just watched as we walked by. Although they couldn’t leave their duties they took a moment to be present as the family and the body came by. There is a covered place next to the morgue for families to wait until they can transport the body where we gathered and sat quietly except for the daughter-in-law of the man who died. She was the only one crying loudly.

I stayed there for about an hour… just sitting. People came and went it seemed like they came to show support and when they felt they needed to get back to their responsibilities they would go. Women took turns comforting the lady crying [Note: all of the women sat together on the ground while the men sat in the wall window openings/seats – except for me] and everyone else was just quiet. I thought at one point, “well there is nothing I can do, so I should go” then I realized there is nothing anyone can do – that isn’t the point. The point is just being here and being present in this grief of the family. The vision of the culture in this situation was beautiful – as Americans we strive, write books, and even create a whole industry in being “present” and “slowing down” and here it is normal life! People stopped what they were doing and what was most important that afternoon was to be present for this part of the Malamulo family. I started to think they should all get back to work, but then really – what is important here?

Wednesday was the funeral… we drove about two hours away to the home village of the family where everyone was gathering. When I asked what I should wear I was told color didn’t matter but I definitely needed a chitenge (3m length of cloth that is wrapped like a skirt over the top of whatever is worn – it is also multi-purposed for carrying babies on the back, keeping warm, etc). There were more than 200 people gathered and the family is expected to feed all of the visitors the day of the funeral. Don and I sat in the chairs under the mango tree with some other “VIP-types” (apparently the place of honor since no one else had chairs). After some time a small group of us were taken to a house and fed nsima, beans, and cabbage (normal local fare). Then after waiting for a while longer the ceremony started. There were a few speeches, some songs by a choir, laying wreaths on the coffin and then we all walked to the graveyard nearby; again more speeches, family ceremoniously putting a bit of dirt on the coffin and then the grave diggers quickly burying the coffin. It seemed like the sermons emphasized hope and heaven and encouraged people to stay close to Jesus as he is the “resurrection and life”.

Death seems to be so common here that at times I wonder if people are immune to it. Their grief is expressed differently than I’m used to so it sometimes seems like they are not grieving. I had a discussion about this with Foster not too long ago, and he said that he does feel like he has become used to it more since working at the hospital since it happens so frequently. But he also explained for himself anyway, when his mother died he cried openly for about a week or so but it took him a full year to stop crying in the privacy of his home.

Before coming to Malawi there were different things going on that made me more aware of the pain of other cultures. One was the earthquakes in China; another was some pictures we had at Convocation in IL. Both made me realize that people in all cultures experience love and pain but express it differently. Just because they don’t cry the same as I do doesn’t mean that they love their families any less or are less affected by death. I value this insight (although it seems obvious) because I want to have compassion for people and to feel the pain that they do when their loved ones are sick or dying. One of the hard facts of life here is the death of children. Malaria and HIV is a big threat to small children and too often they end up dying. There are many factors but sometimes I wonder if parents grieve for their lost child when it seems to happen so frequently. Does that make it any “easier”?

These words continue to comfort me:

“Then I saw a new heaven and a new earth, for the old heaven and the old earth had disappeared… I heard a loud shout from the throne, saying, ‘Look, God’s home is now among his people! He will live with them, and they will be his people. God himself will be with them. He will wipe every tear from their eyes, and there will be no more death or sorrow or crying or pain. All these things are gone forever.’” (Rev. 21.1, 3-4)

Ways to Donate

I have had a few people ask me about how to donate money to help support Malamulo Hospital and what things we are needing. There are many projects as well as just general day to day operations of the hospital... Here is a list of projects that I sent to one friend:

1. Buying new mattresses for the beds – about 180 are needed to replace ones that were falling apart, stained, and rotten and have already been destroyed. With the coming rainy season there is a huge need to be sure that the beds have mattresses – especially in pediatrics.

2. Water project – the water system is 50-80 years old and in dire need of repair. ADRA has funded a grant to get us started, but we will need about $300,000 more dollars to repair everything properly.

3. Annex Ward – we have a ward that is for the “VIP” patients (i.e. ones with insurance that can pay for it) that needs to be fixed up with paint, TV’s, the kitchen re-done, new linens, etc. The hope is to attract the higher paying patients which is possible with the good doctors here now. The cost will probably be $2,000-5,000 depending on how much we do.

4. General operations – we are struggling and in debt to quite a few creditors up to about $600,000 USD although we are now paying cash for the medications and supplies, it is difficult (if not impossible) to keep up.

5. Malamulo College of Health Sciences has many needs and the students from all 12 SDA colleges around the US have united to raise money and help support the college here. For more information on that you can visit www.missionatmalamulo.org

For sending donations the best option is to direct it to Adventist Health International click on "how can I help" at the top, then "Financial Donation". If you send me an email with the amount of your donation it will help us so that we can have the money transferred and used how you specify or for Malamulo in general.

The friend I sent the list to has already donated $1,000 and we are so thankful for this support!! The best promise is knowing that God has 1,000 ways to supply the needs of the hospital that we don't understand. Thank you for your interest in the mission here and the lives that are impacted by the hospital. Please email me with any questions...

Photo Update

Cristy on the porch - peacefully typing away surrounded by our neighbor's "jungle" of potted plants.
Our Calla Lily that bloomed a few weeks ago.
Me, Dr. Hart, & Jesse Crounse at Sabbath School.
Cristy and I after church the first Sabbath she was back.
The Kasamba family and me with baby Rebbecca.
Ali doing a grand job of duct taping our ceiling.
And.... the next day. I was standing by the sink when it crashed down!
This is the hole that is left in our ceiling. :(

Recipes

This is the bread that I've made a few times and really like!

Kalamata Olive and Garlic Bread
INGREDIENTS
• 4 cups all-purpose flour
• 1/2 cup warm water (110 degrees F/45 degrees C)
• 1 tablespoon white sugar
• 1 tablespoon active dry yeast
• 1 tablespoon non-iodized salt
• 3/4 cup warm water (110 degrees F/45 degrees C)
• 3 tablespoons olive oil
• 5 cloves garlic, minced
• 1/2 cup seedless Kalamata olives, chopped
• 1 tablespoon cornmeal
DIRECTIONS
1. In a medium bowl dissolve sugar in 1/2 cup warm water. To proof yeast, stir in yeast and let stand for 5 to 10 minutes in a warm place.
2. Preheat oven to 105 degree F (40 degrees C). Warm an oven-safe bowl in the oven.
3. Place flour in bowl of food processor. Add salt and pulse for a few seconds.
4. Start food processor. Pour proofed yeast into flour through hole. Immediately add the additional 3/4 cup warm water, then the olive oil. Process for about 1 minute or until dough ball cleans the sides of the processor bowl. If dough is too wet add a little flour through the top while processing, or if too dry, add a little more water.
5. Turn off food processor. Remove lid and transfer dough to the heated bowl. Cover with a plate or plastic wrap.
6. Let rise for 1/2 hour in a warm place.
7. In a small bowl, combine minced garlic and chopped olives. Set aside.
8. Once dough has risen transfer dough to a lightly floured board. Make an indentation in the dough and place olive mixture inside. Knead dough 10 times. Bulk of mixture should remain in middle of dough. Form dough into a log or round loaf shape.
9. Sprinkle cornmeal onto greased baking sheet and place loaf on top. Turn oven to 150 degrees F (65 degrees C) for 2 minutes and then turn off.
10. Let dough rise in warm oven for 1/2 hour, or until light and puffy. Remove loaf and increase oven temperature to 350 degrees F (175 degrees C).
11. Bake bread at 350 degrees F (175 degrees C) for 30 minutes or until loaf sounds hollow when tapped. Remove from oven and cool on a wire rack.


This is a curry with butternut squash that is really good too!

Sweet Vegetables
Cook until crisp-tender:
3 c. butternut squash, peeled & cubed

In a separate saucepan, bring to boil:
2 c. coconut milk
3 cloves garlic, minced
1/4c. onion, sliced
1 tsp. ginger root, minced
½ tsp. ground turmeric
1 tsp. salt
2 fresh red pimento or sweet red pepper (can use green too)
1 red jalapeno, thinly sliced (optional)

When boiling add squash and simmer for about 10 minutes to let the squash absorb the flavors

Options are that you can add squash directly into sauce without precooking. Simmer until tender. Also may substitute green beans, cut diagonally, for half the squash.

Serves 4-6

Odds and Ends

Since it has been a while since I have written a post and many things have happened I will copy a few bits and pieces from emails that I have sent to family and friends… This is lazy, I admit, but also I think the first time something is written is usually better…

Board Meeting: “Thursday (4 Sept) was the board meeting and I had an 8am meeting with the ADRA country director, Don P, & Dr. Hart about the MH water project so I left for Blantyre at 6am. The board meeting was at 4pm so in between I helped Kirby (CEO at Blantyre Hospital) get ready and talked with various people etc. At the board meeting I ended up running the power point from my computer (i.e. me manning the slides), and taking minutes, and presenting the Malamulo hospital report. (I don't think my multi-tasking skills are up to this level yet.) Anyway - the board meeting went well although it was long - ending at 10pm. The stressful part was not my presentation though but rather when the business mgr was presenting our turnaround plan and the board was discussing it... I sensed a very negative reaction from some board members. They were saying things like, "malamulo has had so many plans like this and others and they never work. What makes you think this will work?" and their body language was strongly negative (in my opinion) to what we were suggesting and Malamulo in general. Finally I spoke up and just asked that the board be supportive of what is happening at MH now and that there is so much potential there. At this point I got all choked up and I couldn't really get out what I wanted to say. Actually, now I don't even know what I said, but I felt so strongly (and still do) that Malamulo has a future and to see these people almost blow it off or say it can't be done was very frustrating to me!! Dr. Hart jumped in and came to my rescue by affirming what I was saying and adding that MH has been in a long spiral downward and is at a turning point right now - etc. Our turnaround plan was passed and approved.”

Life in General: “Life here is going along okay. There are always challenges to my wisdom and leadership skills though. Right now there are personnel issues. One of our department heads (workshop) was found to be stealing. That is difficult in many ways. Other people are trying to make another leader look bad and find a way to cause trouble for him. We also had someone caught selling stolen medicines, blankets, and sheets in the village. His suppliers were all thrown in jail together. Things aren’t quite so hectic as last week with the board meeting and the centennial. Things went well with that but our turnaround plan for the hospital passed which means A LOT OF WORK. It was really nice to have Dr. Hart and Don Pursley here for a few days. I felt important since I spent most of my time with them and they were “dignitaries” and made the celebration a BIG event. Then there was little me hanging out with them. Dr. Hart is so encouraging and shares the passion that I feel about this hospital and mission work in general. He also has a lot of experience which I am lacking.”

Malamulo is 100 years old! September 5 & 6 was the Centennial celebrations for Malamulo Hospital. There were all kinds of special programs, dramas, and speeches made. It was definitely a high weekend. Here’s a snippet about that: "The weekend ended up really well… it was so nice to have Dr. Hart and Don P here. There were many dignitaries from the area as well. I felt a little odd being with them the whole time but it was expected – I was a “dignitary” too. Haha The people here love to act and do dramas so after it was dark on Saturday night the union president had written and set up a shadow drama of the history of Malamulo. So there was a narrator with actors behind a white sheet and a light so it showed shadows to the audience. It was also mixed with music from various choirs and groups – it was very good and quite entertaining! We were PACKED into the school cafeteria and it worked out well even though it was all last minute so many people were working all hours to get the sheet made and the rehearsals done. That was probably the highlight of the weekend. Dr. Hart spoke for church in the morning (we met outside under the trees where they have campmeeting) and then we had an afternoon program with some poems, music, speeches, etc”

Last week: “I ended up going to Lilongwe on Friday for a CHAM (Christian Hospital Association of Malawi) meeting. It was a 4 hr trip up and 5 hrs back. The meeting was good - worthwhile, but just a long day. Then Friday night there was a big storm with rain and wind and the tree that is outside my office window, between the community health building and the walkway had a big branch brake off and fall on the power lines and the roof. Kelvin was up at 5am to cut the wood up and then had to help untangle the wires. We were supposed to go into church in Blantyre and leave by 8 but didn't end up leaving until about 11 and ended up just going to pick up Cristy. The doctors from Blantyre hospital had planned a potluck since we were coming in so Sue & Lily stayed there to eat while Kelvin and I went to the airport. Between the flight being late and Cristy losing a bag it took quite a while. But it was good to see her and we did get some food when we got back to Dr. Verona's house. When we finally got home there was no electricity - nice welcome to Cristy! :) So we just sat and chatted for a while and caught up on lots of things. (I'm sure there is more to come though!)

CRISTY IS HERE!! Monday was her first day back to work and also her birthday. Sunday was a relaxing day since I was able to escape from the office for most of it. Here is some that I wrote about those couple of days – "It was fun on Sunday Cristy and I baked up a storm and used up everything in the kitchen – white flour, sugar, butter, etc. She made some lovely Ethiopian bread with spices and I made her a birthday cake. Yesterday was her birthday so I made an applesauce spice cake with browned butter drizzle (it was supposed to be icing but I didn’t want to use so much powdered sugar although we do have some!). Jasmine (the cook here) also made homemade ice-cream (more like frozen sweetened condensed milk) that was soft-serve. Anyway – the summary is that we all had sugar overload but it was WONDERFUL! We were headed up to Kelvin & Sue’s house (they have a 2yo so by default we get together at their place so she can go to bed) and the electricity had gone off. Kelvin was running the things in the house off the car battery and using a propane camping stove. AHHH the life!! Haha – anyway – it ended up being a nice dinner and fun to celebrate a little and the electricity did end up coming back on before we sat down to eat!”

Link to Photos

Hello - some friends - Scott and Mindi Guptill - were just here for two weeks and have posted some great photos on their blog. Find their photos here: www.goingcoach.com - click on the story about Malawi. You might see me in a couple pictures too. Mostly it's life here...

Thanks Scott and Mindi for the photos and great times!

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.

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…

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.

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--

Rumnations on Day 1

Today was what you might say is the first “official” day of my tenure here at Malamulo. Mrs Magumbo is the administrative secretary and yesterday I asked her what I need to do and where I need to be and she informed me of worship at 7am each morning. So this morning I was amongst the business office workers for worship. We sang a few songs and then studied today’s lesson in the adult quarterly. I was out of the loop on the lesson – I need to work on that.

My first order of business is to get an understanding of the entire revenue cycle for the hospital which will really give me a good understanding of the entire operations of the hospital as well. I spoke with the accountant this morning and asked him many questions. Then we went to each ward and department and asked them how they process patients. It was good – I met quite a few people and understand the workings of the hospital better – although I have a ways to go. I will say though – there are SO MANY benefits to an automated system. We even do not have email or a phone system within the hospital!! Everything is manual and the patient’s account is not connected in any way to their medical record. If we want to be sure people are paying for their outpatient surgery and not just tearing up the charge sheet they are given before getting to the cashier we need to escort them to the cashier! If they could even make a phone call to let the cashier know the patient is coming… can you imagine?

Later in the afternoon Alison, who is a British nurse here with VSO (volunteering) and teaching in the school, took me around for a more clinical perspective of the wards. When we got to the maternity ward we wandered over near the labor room (just off the nurses’ station by the door) and realized someone was in labor. She said, “oh you can watch if you want”. I glanced in the large picture windows and saw several people worriedly working on a lady giving birth. I saw the head of the baby but it seemed like they were having a hard time. After standing there talking for a few minutes I asked Alison if she should maybe check on things because I wasn’t hearing the baby or hearing them progress at all. Just then a nurse came out hurrying to get an IV. Alison went in to help and after a few minutes came back to tell me things were not looking good. I went back to my office wishing there was something I could do. Instead I said a prayer for the baby, the mom, and the clinicians. After a short time Alison came to get me and reported that the baby had not survived. It appeared it had been dead for quite some time and had a distended belly – that was why it was not coming out of the mom easily. It was a sad report and I guess made me feel sad for the people in general. Death is such a “normal” part of life and that is part of the struggle that the western doctors and nurses face because there is very little urgency in any situation here – either by the patient or the caregivers.

The matron of the hospital (i.e. “director of nursing”) came to see me today. She told me about the staff – the nurses – and how they are not well trained nor do they do a good job. I guess many nurses don’t want to work at Malamulo because they’ve heard the struggles that we have and how hard it is so they go to work for the government hospitals or other places. I asked her if there was anything I could do for her and she asked that I come to a meeting with the nurses and meet them. I am happy to do that so we’ll see how that goes.

I think after this week things are going to be quite different since Ryan, Jonathan, and the 8 engineers are all leaving. Tomorrow night we are having a dinner for their going away. I’m not sure who will come by to do random projects or accompany me to the market when Ryan leaves. Even though it isn’t a week yet he has done a good job at helping me feel at home here. He makes me laugh too which is nice.  But alas his Phd in Chemisty is calling him and since he says it will take 5 years to finish, I guess he should go. He has been here for two months essentially keeping this place running but specifically focused on some maintenance and general “face-lift” to the buildings as well as coordinating all visitors and housing. A big thank you goes to him for all that he has done!

So I don’t think I have any major analysis or revelations in the first few days of being here. I feel overwhelmed with the enormous amount of need at the hospital – supplies, equipment, money, money, good staff, supplies, equipment (that works), & money. If that sounds a little redundant you might catch a taste of what I’ve been hearing. I wish there was more I could do and that there was some way I could snap my fingers and have things sorted out and set up perfectly. But I don’t so tomorrow I will go again and attempt to continue my quest of understanding something foreign in more ways than one!