Observations of Africa, some funny, some not

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Smoke from burning garbage hangs over a city market

 So for those who have never been to Africa before, some of these may be interesting to you.

• Before my first trip to Africa, a colleague told me, "It smells like B.O., burning garbage, and shit." Well, that's often (mostly) true. People don't bathe nearly as often as we do (especially the men), and they don't use deodorant. Get in a larger group of people, and it definitely has a distinct aroma. Cities and villages also do smell like burning garbage, as there's not much in the way of garbage pickup. As for the last one, only in the villages where toilets only consist of outhouses.
• I had the pleasure of hearing the Ethiopian Airways safety announcement video four times in the space of 13 hours, and three times in the space of four hours. And because they said everything twice, once in Ethiopian (Amharic, I think) and once in English, it was twice as long as normal.
• Although there are a lot of cars on the roads, there are a lot more bicycles and pedestrians. And while we give pedestrians right of way (by law) here in the U.S., it's not really that way in Africa.
• There are typically two kinds of taxis (other than at the airports). Short distance taxis are bicycles where the person riding it takes a passenger on the back. Longer distance taxis are either a version of a minivan PACKED with people, or pickup trucks with passengers crammed in the back.
• I'm not sure what the cultural driver for this is, exactly, but I was never allowed to carry my own bags. Not even my laptop bag. No matter where I went, someone insisted on carrying all my stuff for me. I'm not typically prone to 'white guilt', but having Africans carrying all my stuff for me all the time was really uncomfortable.
• Malawi is one of a number of countries where they drive on the left side of the road instead of the right. Which nearly contributed to me getting run over because I wasn't aware enough of traffic on my side (was looking the wrong way).
• I saw hundreds of people in the hospital in Blantyre. But I only saw two other white people, and they were both doctors. That meant I got a lot of stares from the people in the hospital, since I clearly wasn't a doctor.
• Society as a whole is more formal there than here. People typically dress more formally and speak more formally.
• Street vendors probably learn one English phrase before any other: "I give you good price." Every single person selling something on the street said this to me while gesturing towards their wares as I passed.

I'm sure there are others I'm forgetting, but I thought I'd share a few of these observations with you.

Saying good-bye

It's Thursday afternoon in Malawi. Tomorrow I start the long journey home. It's hot and muggy, worse than any other day I've been here  so far (and remember, it's winter here). I am filled with mixed emotions.

I am glad to be heading home to Aimee and Rowan. I miss them. I am sad about leaving because it feels like my work here isn't done. I'm ready to sleep in my own bed and eat more normal food. I'm impatient about making progress towards my final goal as it relates to Chawezi: healing, new artificial legs, and the means to provide for herself.

Sigh.

Had a great third visit with her yesterday, plus had the added bonus of speaking with another doctor, this one actually directly in charge of treating her. Discovered that he wants/needs to do a skin graft, but can't because of a lack of supplies. And here's the kicker: the hospital has been out of these things for TWO YEARS. This hospital is government-run, and has very limited resources (remember how they have to provide their own food and wash their own clothes?), unlike a nearby private hospital. THEY have all the supplies needed, but won't share with the public hospital, not even if patients are willing to purchase the needed supplies from them. There's probably a very good reason for this, but in my biased state right now, I'm not seeing what it is.

So after the visit, we made the long drive back to Lilongwe, arriving here about 6 or 7 pm. (Side note, my body clock has never adjusted, and I've been falling asleep at about 4 or 5 every day, and waking up at about 2 or 3 in the morning. I've only eaten dinner once since I arrived. Of course, I fell asleep within minutes of arriving at the hotel last night. Let's see if I make it to dinner tonight.) Today was spent in a meeting with World Vision Malawi staff, and then a little sightseeing. I also bought an African drum with animals carved in the side for Rowan. She likes the one I bought in Uganda  a few years ago, so I got her one of her very own.

Back to Chawezi... So, in summary, here's the plan as we know it right now:

1. Try to get all needed supplies for a skin graft, which will help heal the pressure sores on her backside.
2. Obtain new, stronger and lighter artificial legs.
3. Upon her return to Manyamula (her home village), provide some type of adult literacy course so that she'll be able to use the tailoring skills she obtained, and will actually be able to provide her own income.

The first two items are sure to cost money, but I don't know how much yet. The third one may get provided through government services, but if those aren't available, we may have to hire a tutor.

Before I wrap this up for today, I need to mention a few other people. First, Chawezi has an elderly aunt staying with her, and she's been with Chweazi now for months. The hospital has very little room, so any 'guardians' or relatives staying with patients have to sleep on the floor. So basically, this woman has given up her life to sleep on an overcrowded concrete floor since some time last year, and with no known end in sight. Yeah, and sometimes I think my life is hard.

I also need to mention Alfred and Raymond, my drivers/interpreters from World Vision Malawi. They've both been GREAT (like Tony the Tiger would say... can you tell my sleep's all messed up?). Very helpful, very gracious, and very supportive. Alfred in particular has put in a lot of work and how pledged to continue to do so.

Well, that's it from Africa. By the time I post again, I should be home. But although my travels will be finished, helping Chawezi is really just getting started.

Chawezi's aunt

Meeting Chawezi

Wow!

So yesterday (earlier today, Seattle time) I finally got to meet with Chawezi. This was after roughly 30 hours of flight travel (including layovers and connections), and a 5 hour drive from Lilongwe. My two World Vision escorts/interpretors and I got to spend a few hours with her at the hospital.

Arriving at the hospital, I felt a mixture of nerves (why was I nervous?) and some degree of surprise at the condition of the hospital. I mean, I kind of expected it, but this was one of the two best hospitals in the country, but it definitely was not any where NEAR a standard that would be acceptable in an industrial country. The quality of the care is probably fine, but the condition of the building (and the number of people crammed into the wards) was, well, less than superior.

After abriefly checking in with the head nurse, we went to see Chawezi in the ward where her bed was located (with about 20-25 other people). She knew I was coming, so she met us at the door. First impressions? I had forgotten how SMALL she is. She also has a huge, sweet smile, and was very shy at first. So there would be room for all of us to talk, we went outside to a small grassy courtyard to chat with her and an aunt who had come to stay with her during her stay at the hospital. She kept covering her face with her hands, which was really endearing. I had puchased a backpack for her and put some stuff in it (I'd been asked that I bring lotion and soap, so I did, plus a hairbrush, washcloth, granola bars and some hard candy). She was overjoyed to receive it.

While I was there I also got to meet with two doctors who are helping with her care. Mostly they told me what I already knew, plus their plan for treating her. A skin graft to help some of her sores heal, and new artificial legs (the ones she received last year were too heavy for her, and one of the feet got broken anyway). Getting her upright and off of her backside is critial to keeping those wounds/sores healed.

I also learned that the tailoring classes she took a couple of years ago couldn't do her much good until she learned to read and write, so we began to explore options for her to learn. She told me that once she learned, she'd send me a letter to prove her new knowledge.

Finally, I learned to that at least some extent, patients had to provide their ow food (???). So we asked them what food items they needed, and during lunch, I went to the local supermarket and got them some groceries (enough to last them a couple of weeks, most likely). Also got them laundry soap and a washbin for them to wash their clothes. (Yep, they have to wash their own clothes, and by hand.) We went back and brought them their supplies,spent a little more time with them, and left for the day.

All in all, it was a fantastic visit. I'm getting ready to head to breakfast, and check out of the hotel. Then we'll go back for another visit before making the long drive back to Lilongwe. I wish I could stay longer. I mean, after taking from Friday night until Tuesday morning to get from my home in WA to the hospital in Blantyre, it'd be nice to spend more than 3-4 hours total visiting, but that's how it goes.

Now, let's see if this photo will load...

Expectations

Tomorrow morning I will finally get to visit Chawezi in the hospital in Blantyre, Malawi. Although we did meet in 2007, it wasn't really a formal introduction, and we've never actually spoken to each other. So I have to say I'm a bit nervous, and I'm not sure what to expect.

What is she doesn't even actually want to see me? What if she's not interested in any help?
What if she does want help, but asks for the impossible? What if I'll be forced to let her down?

I don’t know what to expect. But I feel like as long as I’m doing the right thing, as long as I’m doing what I feel God would want me to do, then that’s all I can do. And it’s good enough.

This morning I met with some of the staff at the World Vision Malawi National Office. Part of the meeting included a more complete history of Chawezi’s medical issues and history. Wow, it’s worse than I thought.

Below is a truncated version of the 2+ page document I received:

·         Chawezi was born May 8, 1983. She was born out of wedlock and has never met her father.

·         She was born with spinal bifida, and as a result did not learn to walk until age 7-8 (I had always assumed she’d been born without her legs, but that was not the case).

·         She was also born without an anus. A surgery to try and correct both problems happened within days of her birth.

·         An anal opening was created, but the surgery left her incontinent for both urine and feces.

·         Her mother died before her tenth birthday.

·         She developed epilepsy in her teen years. Although she takes medication for this, she still sometimes has violent seizures.

·         At the age of 15, she developed a blister on her left foot, which became infected to the point that the leg had to be amputated. A few years last the same thing happened to the other foot.

·         She was given a special tricycle to get around on (steered and pedaled with her hands). Between spending all her time on her rear end, and the fact that she’s completely incontinent, she developed pressure sores which became infected and which resulted in half of her buttocks being removed.

·         She was been in and out of the hospital trying to keep her wounds dressed and clean, but with little or no improvement in her condition.

·         In mid 2010, she was given artificial legs. The hope was that her standing up would relieve the pressure and allow wounds and sores to finally heal. However, she quit using them because they caused pain in her hips due to their weight. (One of the purposes of her current hospital stay is to try and find lighter artificial legs for her.)

The document goes on to say, “Chawezi has lived most of her life in pain and suffering.” Wow. Twenty eight years of mostly pain and suffering. The document ends with the sentence, “All these issues are affecting her psychologically.” Um, you think???

I don’t know what I can do to help her. But I’ll do whatever I can, that’s for sure.

Bon voyage

So I leave tonight for Malawi, the culmination of a lot of hard work, planning, and money. I'm excited, and a little nervous. But I feel good about this trip.

I went shopping yesterday, and bought Chawezi some stuff I hope she'll like.

• A backpack (always handy), which I then filled with-
• bars of soap (requested by her)
• a HUGE bottle of skin lotion (also requested)
• a hairbrush
• granola bars, mixed nuts, and other snacks

I don't know how long she'll remain in the hospital (hopefully not much longer), but I thought these things might all come in handy in one way or another.

As for me, I'm almost ready to START packing (I still don't leave for another several hours, so here's no rush, right?). I've got my camera batteries charged, my iPod charged, two books of sudoku puzzles, and two books to read all set out and ready to be packed.

Next up, I need to make a "Countdown Calendar" for Rowan, who is going to have the hardest time by far with me being gone for eight days. We've tried to prepare her for it, but she's already expressed some sadness about my leaving, so Aimee and I decided to come up with this calendar to help her count down the days until I get back.

So I guess that's about it for now. I catch a red-eye flight to DC tonight, then a flight from there to Addis Ababa (Ethiopia) tomorrow, and from there to Lilongwe on Sunday. The flight back is WORSE. Same itinerary in reverse, except that this time the first two legs also include stopovers. Not layovers, where you can get off the plane and stretch your legs, but stopovers where some people get off, others get on, and you resume your trip. If the plane's on the ground, I want to get off of it, at least for a few minutes! =)

I hope to be able to continue this blog while I'm there, and keep people up-to-date. If not, I'll post as soon as I get back.

THANKS!

Anticipation, and good news

In all the hustle of getting ready for this trip, one important key piece of good news got set aside. I want to share it before I leave:

Chawezi has prosthetic legs!

Now in some ways this creates more questions than it answers, for several reasons:
1. We paid for those about a year ago.
2. We just got the photos and report that she got them about 2-3 weeks ago.
3. When did she actually get them?
4. If she has prosthetics, why is she (still, for months) in the hospital for sores and infections created from moving around on the ground?

There may be some good answers to these, like they didn't fit her that well, she got nervous and quit using them, or others. I hope to find out more once I get there. In any case, I tried for three days to upload the photos (thanks mom for scanning them), and to no avail. Oh well. I'll bring back photos of my own to post when I get back.