Activities of Daily Living

1 September 2016

Today I was born. In 1940. It seems incredible to live so long. Since my dad died at 55yo, and his father at 42yo, I thought 68 was my time. It was when I was discovered to have lung cancer. But, with help from many, including my close friend Harold, my wife, and my son, I dodged that bullet. Now we are planning a three day hike up Mt. Mulange, the highest peak in southern Africa in two weeks. With a guide and a porter, thank you. And staying in the Mountaineering Club huts, where there are bedding and cooking utensils. The high plateau is supposedly very beautiful, although when Stefan and Lucy went up a month ago a black mamba fell-slithered-rushed down the trail beside them. I’ll take my hiking poles!

The daily blackouts are trying at times, especially when I am preparing a lecture and wanting to review literature on-line. Or read my email. Or make supper. The propane burner cum tank which I bought and filled works very well. Our current catch-phrase is I’ll do this or that “while the power is on”. One of us jumps up at 5:30AM to make tea with the electric kettle since in the morning power often goes off at 6AM. If the power is off when we go to sleep, if awake in the middle of the night and the outside security lights are on, I have gotten up to read email, download a document, or review the literature to prepare a lecture. Talk about social control. You could train people to jump through all sorts of hoops by varying their utility services. They are having water shutoffs in Mangochi; we have two full covered tubs so we can drink and flush the toilets for awhile if we have cuts here.

I resurrected the bike that Peace Corps gave me. It had a new chain but otherwise: both front and back brakes were locked, both derailleurs function only partially, the rear tire was flat in a day, and my helmet was missing the liner so the little Velcro buttons used to hold the liner in were very scratchy. I have three much better bikes at home. Excepting that the best bike is the one you have with you. So I’ve adjusted, lubricated, replaced, and removed things, respectively, and ride to work, either at the College of Medicine or at Queen Elizabeth, each of which is less than 5 minutes by bike. I seem to move slowly in the morning so the speed helps. Chipitala (“Hospital”) Road is busy only with pedestrians and tiny plywood stalls where they sell everything. The fresh French fries (“chips”) are truly fabulous—-how far I’ve fallen from Berkeley gustatory standards—-with salt, vinegar, and hot chili sauce. (“Nali-HOT” is a local product and universally used in case of dull seasonings.) All in a little blue plastic bag. Which litter the roads, so we wash and reuse ours as many times as we can. In any case, the biking on Chipitala is fine but elsewhere it is variably and, often, wildly, dangerous. No shoulder, narrow road, loaded minibuses racing to make more fares. I look for less direct, less travelled routes and footpaths, always wearing a helmet. You can spot PC vols on bikes from a distance; no one else wears a helmet.

I consulted on a 77yo man in clinic today. The students have started in clinic and they actually do the heavy lifting, while Stefan and I oversee their work. This man has been seriously deteriorating recently, wandering naked, getting lost, urinating in the house, etc. His son brought him in. He has been drinking heavily all day starting at 6AM, every day, since before the son was born. And the son is 45yo. So his dad has alcoholic dementia and alcoholic cerebellar degeneration; his gait is so ataxic he can hardly walk, even with support.  The saddest part for me is that he is a rare bird here, having studied in UK on two occasions. The last stint was to get an MA in a profession of which he was the first black African to occupy a position of leadership in all of Africa. It was sobering for me and the students, as I gave them a 1 ½ hour lecture yesterday on Alcohol and Substance Abuse. Funny thing was, although he was quiet and stooped, when he sat still you wouldn’t have known how compromised he was. His English was simple but impeccable.  However, when I asked him to touch his finger to his nose and asked him the date and location, he became wildly ataxic and lost, floating in a timeless, unrecognizable world.

On a happier note, the ubiquitous pied crows are endlessly present and entertaining. They look like other corvids, about raven-size with the addition of a white collar and a white bib. Formal, dressed to the nines. Playing, using tools, fooling around. Our weeping willow with red bottle-brush blossoms is now stunning. From a Californian’s perspective, it looks like some pretty drunken grafting was going on. On a gardening note, Linda gave Simon the gardener 3500 Kwatcha (about $5) to buy some seeds for a vegetable garden. Four hours later he was roaring drunk and expansive but with no seeds. Linda does not believe in co-dependency and said either he get the seeds by Monday or she’d report him to his employer. Myself, I’d feel sorry for him and probably give him another 3500K and a supportive handshake and hope for the best. Well, she scared the shit out of him and he is working like he should; we have three garden plots planted and watered. I have no doubt if we’d followed my lead he’d be drunk again the next day. So tough love helped him not be stupid, lose his job and feel like a failure. Lessons everywhere. There is a saying that you can ruin a Malawian’s day by not bargaining for something they are selling. If you pay full price, they’ll curse themselves for not charging more. And the smile on their face after you have bargained, and they are content with the price, is wonderful! So different than with we azungus (whites) from the US; every transaction here is a social experience of note.

In celebration of my birthday, and celebrations seem important markers of familiarity in this very different (dare I say “strange”) land, Linda cooked a wonderful meal and we invited all the GHSP volunteers in Blantyre plus some friends for supper. In preparation I bought another bottle of Malawi Gin (for MGT’s), we laid in tonic and made ice lest the power die (which it did), and I went to GAME for a special on Carlsberg Green. It was 465K a bottle as opposed to the uniform, monopolistic 550K. I rode my bike a mile and a half up the hair-raising highway to the store, bought the case, and removed my seat so the case could sit, strapped with bungee cords, on the bike rack. Then I walked it home awkwardly, it being pretty top heavy. When the sidewalk was crowded, the bike would threaten to flip away from me into the concrete spillway 5 feet down. So as I’m sweating and pushing and tugging and wondering why I didn’t just take Stefan up on his offer of a lift in his car, this slender woman passes me, gracefully swaying with about 75# of chick peas on her head, baby strapped to her back with a colorful chitenje. Why didn’t I just ask her to hike the case on top of the chickpeas? She surely could have done it. I can feel feeble and dull here when confronted with the locals’ resilience.

The birthday was fun. The power was out so we had candles everywhere. Linda had purchased a wok pounded out of an old barrel and made tortilla chips, which she deep-fried over the propane burner, to scoop up the salsa. The slow-roasted dry-rubbed pork shoulder (Thank you, David Edwards!) was beyond delicious! Linda saved a taste for the local pork vendor in the little market (chunks of pork on a slab, under a tin roof, no refrigeration); I suspect he may be buying slow-roasted pork from us in the future! Fresh cornbread, delicious cole slaw, beans, and fried rice (a la Darron) completed the meal. For dessert, apple pie (Elizabeth), carrot cake (Anneka), and absolutely the best ice cream I’ve ever tasted, fresh, homemade passion fruit (Polly and Karl). Conversation was lively, reaching from local gossip to the history of the Italians in Malawi (They refused to use the British railway to transport goods, which totally infuriated the Brits.) to the endless stream of casualties of medicine on the wards at Queen Elizabeth. I have to restrain my enthusiasm for my current state of employment, the medical students, and my Chief; I think I am having, at present, the most fun and rewarding experience of any of the GHSPers.

People here are not fat like so many in the US, despite a heavily carb-loaded diet. They move and work constantly, carrying all on their heads, shoulders, or bicycles: huge sacks of charcoal, huge sacks of potatoes, other fruits and vegetables, kindling wood, bags of grain, planks, furniture, you name it.  Malawi is too poor for the motor scooters which plague SE Asia.

There are very few joggers and little need for recreational exercise. Life is physical and lived close to the ground here.  Life span is 58 for men, 61 for women. Knowing now some of what can get you here, it’s understandable but lamentable. HIV/AIDS is now remarkably down to 10% of the population.

Tiwonana. (See you later)

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