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/