Beginning in Country

10.8.2016

We are being eased into the experience to come so carefully, thoroughly, and intelligently. Today we leave for a 4 night homestay.  The sixteen of us will be distributed into 15 homes—Linda and I are the only couple—in one of four tiny villages. They have been working for 5 months to assure that standards of safety and hygiene are adequate. Each house will have a pit latrine separate from the house; we’ll all bring a covered pee bucket to use at night so we don’t have to encounter critters in the dark at our time of need. There will be a hand-washing station outside the latrine. We’ll spend evenings and meals with our host families, who are apparently very excited to meet us (as we are them). During the day we’ll study language and culture in a hut equipped with chairs and a white board. No public affection, women wear long skirts, Malawians are confused when we cry if we are other than sad, and so forth. The teaching crew here did some hilarious skits about cultural differences. Everyone washes their own underwear, generally when they bathe; don’t hang it up on the line outside unless you also cover it with a chitenje, the ubiquitous piece of colorful fabric used to wrap and carry everything from bananas to babies. And so forth.

Our trainers, the language trainers so elegantly dressed and so thoughtful, the security crew, the country Peace Corps Director, and our wonderful Seed Global Health (SGH—acronyms abound here and Peace Corps  (PC) program leaders are remarkable people by any measure.

The US Ambassador to Malawi came and spoke to us yesterday. A large, animated woman, we all fell in love with her. She is brilliant, filled with the necessary subtlety earned by a state department career, and with an astounding grasp of the facts. My image of an ambassador was that the job went to a ruggedly handsome political friend who wore a blue blazer well and could charm you at a cocktail party This woman was charming but for all the right reasons. She loves Malawi, despite its many issues that might drive others to hopelessness and gin, and is determined to use her influence to improve conditions for people here.

One night Anna, a GHSPL Family Medicine physician completing her year in Mangochi (and who has signed up for another year) took us to Ad Lib, a little restaurant a few blocks from our hotel. We arrived as darkness descended and sat at a long table made of many smaller, sipping a “Green” (Carlsberg beer, the only brewery allowed in the country for the past 50 years) or a MGT (Malawi Gin and Tonic). We listened to the band in the back room playing a mix of reggae covers and Sarah told us about a couple of cases. A South African man, on holiday with friends and drunk, went off a 60 foot cliff. Among other injuries, he fractured his pelvis so that bone was sticking out and his rectum and bladder were both opened. He was brought in at night, and Anna had to call all the help she could get into the little district hospital. He had nearly bled himself dry and they were only able to give him two units they obtained from themselves, there being no blood bank. They stabilized his pelvis by wrapping it tightly in a chitenje (see, used for anything and everything) and tying it very tightly. It turned out he had insurance and a plane was soon landing to take him to S. Africa. Apparently after several surgeries, he is alive and was very pleased to have completed a divorce from his wife! The other case was a man who was totally bruised after being attacked by a rock python. He was delirious and febrile and his real problem was that he had cerebral malaria. And on and on. We listened, walked back to our hotel in the dark a few blocks, alert to our surroundings, and went to bed. I suspect we all were imagining feeling frightened and overwhelmed at some of the medical problems we’ll encounter. I know I did.

Stay tuned.

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