Elizabeth goes on Med Hold

So in the two and a half weeks since I arrived at my site in Chiwamba, I have been sick all but about five days. It started as a cold, which morphed into a coughy- tight- chest thing. Being sick is no fun when you have to draw your own water and cook over fire- no spending the whole day in bed! Plus it was frustrating to finally be somewhere where I could actually do something and instead feel too weak :-(
After starting on some antibiotics last week, I felt better for long enough to walk out to some of the nearby villages where the HSA's were doing child nutrition campaigns. I helped measure children to screen for malnutrition while the HSA's gave out vitamin A and mebendazole for worms. We were able to identify several malnourished children who were then referred back to the Health Centre for supplemental feeding. After about three days of this, though, I started feeling crummy again. Two nights ago I had a fever and called the doc bac, who had me come into Lilongwe first thing yesterday morning.
I hitched out from my village to the main road with some missionaries (thank you!!!) and rode in the back of a truck into town (not fun- we were stopped at a police checkpoint for almost an hour...). The doc found me lying on the steps outside the clinic, out of breath. Some new meds and a bit of IV fluids later, I felt a little better. I told the doc that I hadn't eaten in two days and he took me out for a milkshake!!
So I will be in Lilongwe for a few days until I am fully recovered.
And then....hopefully....starting actual work in Chiwamba...

The Third Day in Chiwamba

On the morning of the third day at site, I was woken up by a gaggle of kids outside my window.

            “Eliza!, Eliza!”

            They were yelling something else in Chichewa that I didn’t understand. I looked at the clock- almost 6am. I should be getting up anyway.

            “Mwadzuka,” I yelled back out the window- “good morning!”

            I pulled on a Chitenge and fumbled with my keys. When I got outside there were 8 children beaming, including one boy bursting with excitement. He was holding a terrified hedgehog, which he then pushed into my hands.

            “Where did you find this?” I asked, as I sat down and let the hedgehog uncurl and crawl around on my lap.

            “Alipo,” he shrugged- “just around.”

            I had seen a hedgehog before in Mkonkera, and was told they were very rare. The hedgehog woke me up well; 90% prickly spines, 10% fleshy belly, with a long nose and black bead eyes. I gave it back to the boy.

            “I have something to show you too,” and I dashed inside.

            The day I had arrive in Chiwamba, to a house that had sat unoccupied for several years, was a blur. I was helping to sweep it out when I spotted a bat clutching the wall. I yelled to my neighbor, who hit it with a broom handle and carried it outside. When we finished sweeping, I went back to the spot where we had cleaned up massive amounts of droppings and looked up. There were dozens of bats sleeping on the backside of a rafter.

            With the squeaks and the droppings, I had assumed that my house was infested with rats, so I had loaded up on rat poison and traps in Lilongwe, but I had no clue what to do with bats.

            “Watch out,” my neighbor said, “ there are a lot of nyerere.” Ants. Biting ants I would soon find out.

            The bat room was where I had been planning on sleeping, so I moved all of my things to one of the back storage rooms. By the end of the day, I would be carrying water from the borehole and scouring my new bedroom, only to find that no amount of elbow grease could remove the years of grime on the cement walls.

            I decided to heat some water for a bucket bath, but I couldn’t light the charcoal. I soaked the briquettes in paraffin and fanned the tiny flame until my arm cramped, but the water only got lukewarm. I took a lukewarm bucket bath and went to bed.

           

            On the second day, I knew that I had to do laundry. I hauled a 30 liter bucket filled with dirty clothes to the borehole and started scrubbing.

            The borehole is a great place to meet people, since it is on a major path out to the maize fields. I greeted everyone who walked by in Chichewa, often explaining who I was and what I was going to be doing in Chiwamba.

            “You wash your own clothes?” Many people asked, “Who taught you do to that?”

            I realized as I finished that I didn’t have a clothesline yet. I had to dig though the endless bags of supplies from Lilongwe to find it. I had to move quickly-I was going to be late for a staff meeting at the health center.

            The five minute walk from my house to the health center turned into 15, as I stopped to greet a group of local chiefs. (“You always, always have time to greet the chiefs,” I had been told in training.) Of course the meeting started an hour late, so I shouldn’t have worried.

            Every few minutes, the head of the clinic would pause the Chichewa and ask me in English if I was following what was being said, then give me a big high five if I answered correctly. We laid out plans for my first few work days next week, observing some health workers in the field who were conducting a village assessment. After the meeting, there were still several hundred patients to be seen in the clinic, plus dozens more in antenatal, since the nurse was out for the day.

            “Come on,” the Medical Assistant grabbed me, “there is a woman bleeding.”

            I know that as a Peace Corps Volunteer I cannot do hands-on care, but the nurse in me rushed to see what was going on. A woman was lying on the delivery table, moaning. She was five months pregnant and hemorrhaging. I could smell the blood. Someone had already called an ambulance, and it pulled up just as we entered the room. Malawian ambulances are just cars with one driver, however, and the drive to a hospital would be at least an hour.

            “Can you start an IV?” I asked the MA.

            “Lets just get her in the ambulance and go.”

            We moved to the prenatal exam room where I observed a basic visit. I felt the belly of a very pregnant woman. In nursing school, I always had trouble finding the lay of the baby, but on this slim Malawian, I could feel the curve of the head, the shoulder, even a leg as it moved. The mother smiled.

            Suddenly there was a gasp outside. While the bleeding woman was being carried out to the ambulance, she had given birth. The MA ran out to help, and I started praying under my breath. I gave them a minute and then ran out to join them. I didn’t want to get in the way.

            “Is it alive?”

            “Yes, for now.”

            I looked though a tiny window into the car to see the mother lying on the floor. Another woman was holding a tiny wet bundle. I could see a head move a little.

            I grabbed the driver, who I knew spoke a little English.

            “Tell her to wrap the baby in at least two more blankets! It has to stay warm!”

            “OK,” he grunted as he drove away.

            I poked my head back in the exam room window and told the MA that I was going home.

            “Eat first!” He pointed to a bench with nsima and fried fish laid out. I didn’t have an appetite. I grabbed an attendant and told her that I was very sorry to miss lunch, but I needed to go home.

            I got out to the road just in time to see the “ambulance” disappear over the crest of a hill.

            Looking down, I saw a bright green chameleon on the packed dirt. It was the first one I had seen in Malawi. I kept an identical chameleon as a pet in Uganda and name him True Love. This would be True Love 2, I decided, as I picked it up. It hissed and turned brown in self-defense, but soon calmed and sauntered up and down my arm as I walked home. I put it in a cardboard box with some grass and water. After a while, I “hunted” three grasshoppers and put them in the box, watching as True Love 2 shot out his long, elastic tongue to devour them.

            Realizing that I hadn’t yet eaten that day, I tried to start a fire. I was terribly slow, and an hour later I had only some very soggy rice. I cleaned my house a bit more, took in my laundry, and had another cold bucket bath.

            On the third morning, I wanted to show the hedgehog kids my chameleon. The girls shrieked as I brought True Love 2 out.

            “It will bite you!” the said.

            “No,” I laughed, “chameleons don’t bite. Let’s hunt grasshoppers.”

            We tromped through the field next to my house, catching grasshoppers for the chameleon’s breakfast. But though they were big and juicy, he refused to eat. I noticed that the nyerere had gotten into his box.

            “Let’s let him go.”

            The kids and I spent 15 minutes searching for the perfect spot, then we said goodbye as True Love 2 slowly walked back into the bush. We let the hedgehog go too.

            I took the kids back to my house and showed them my hand-washing station- a must for proper sanitation without running water.

            We sat in a circle and played the Chichewa version of duck-duck-goose; khuku-khuku-g’nombe (chicken- chicken- cow). We had a great time.

            Eventually I shooed them all out, realizing that I needed to cook something. I started the fire a bit faster this time, and filled a pot with water and pasta. But it still wouldn’t boil. I threw the soggy/crunchy pasta out behind my house, where some hungry dogs had been waiting for my latest failed attempt at cooking to get tossed.

            I plopped down in my very grimy living room, exhausted. I needed to scrub the whole room, but it was so hot, and I hadn’t eaten in a while, and I had no energy.

            Three of the boys from that morning were still hanging out in front of my house. I got an idea, and tried my best in Chichewa to explain-

            “You scrub, I pay 50 kwacha.”

            It took about three attempts before they understood and agreed. We went through three big bucketfuls of water, half a bottle of lavender castile soap, five sponges and a lot of dripping sweat, but finally I felt that my living room was habitable. In fact I was so happy that I gave them 100 kwatcha each. (In retrospect, probably a mistake, forever sealing my reputation in their minds as the rich American.)

            Remembering how hungry I was, I walked into town to get chippies (like homemade French fries) and a Fanta.

            I was still putting the finishing touches on my living room when the kids came back. The youngest, my four-year old neighbor, presented me with a handful of grasshoppers she had caught for me.  I think she must think that hunting grasshoppers is a hobby of mine!

            I told the kids that I wanted to start a fire.

            Together we soaked the charcoal in paraffin, just as I had done before. But again the fire wouldn’t last.

            “Put some grass on it.”

            I went out to get some grass.

            “No- this kind,” he showed me the thick reeds I had seen as thatch on people’s roofs. He broke it into pieces and shoved it into the charcoal, fanning the mixture until it was glowing red. I put a pot of water on top.

            Every few minutes as we watched the fire, they offered more advice.

            “Put more grass on.”

            “Fan it a little more”

            “Just wait.”

            And then suddenly, the water was boiling. And for the first time in Chiwamba, I had a hot bucket bath.

            I had heard from a fellow PCV that the kids are always the first to accept and teach the new azungu in town, and it’s true.  When I shooed them away that night, I told them to be sure and come back tomorrow.