[Photo: Early morning, on a drive between Zomba and Mangochi]
12 March 2017
I’m sitting on the condi (porch) in front of our house, listening to the St. Matthew Passion, the tip of my hat towards spirituality this Sunday, and birdwatching. Linda went to church with Elizabeth, our fellow (?fella) GHSP volunteer. Raised Catholic, Elizabeth has not practiced for many years. But it’s also a cultural event to go to church here, especially if you get to one with good music.
I brought my binoculars and bird book with me and I’m astounded at the number and variety of birds in and out of our yard. I am sometimes so incredibly unobservant, or monocularly focussed on something else, I wonder how I function. A woman I saw for several years once came to my office with a new hair style. After I said nothing—-I was listening to her carefully but certainly must have been blind—she said with mild exasperation, “You wouldn’t notice if I came in here wearing a burka.” A bit extreme but not far off the mark.
Back to the birds, there are African Pied Wagtails darting and wagging across the lawn, Pied Crows and Rock Doves flying overhead, a Lesser Masked Weaver (I cannot see the nest.), House Sparrow pairs, Dark-capped Bulbuls in the birdbath, and in the mango tree a pair of Southern Double-collared Sunbirds, brilliantly colored. The birdlife in our yard varies considerably, although the sparrows, wagtails and bulbuls are regulars. I often see Blue Waxbills and the other morning we heard a loud clamor. Looking out the window of my office we saw 8 Hammerkops perched on the electric wire behind the house. Hammerkops are very large, primitive-looking birds. As they rose from and landed on the wire, it was like an omen from the beginning of a Bergman film when the raven flies across the screen or perhaps an evil harbinger from a Hitchcock film. The lesson in it for me is to be still and observe all the wonders surrounding me, a challenge for this man of action and impulse. It’s why psychotherapy was such a good occupation for me: forced calm and reflection.
Linda goes to various district hospitals through which 4th year nurse-midwife students rotate for 4-6 weeks at a time. Her blog describes it well and it is quite amazing. On her way home she’ll often ask the driver to stop at one or another stand in the countryside to bargain for vegetables or fruit, it being considerably cheaper than in Blantyre. I mentioned a few months ago that she came home one day with 45 mangoes of two different varieties for which she paid about 90 cents. Three days ago she came in with two kg of wild chanterelle mushrooms. The cost: less than 85 cents per pound. We’ve had them in omelets, in a cream sauce over home-made gnocchi, pickled in a salad, and on and on. Chanterelles are great delicacies on our island in Maine when weather conditions favor their growth. Some years there are none. Others they are fairly plentiful. But I’ve never seen the size and abundance that we have here.
Switching gears, it’s funny how one thing leads to another. For example, when I finished working in clinic two days ago (exam week so no students) I thought I’d continue my efforts to beautify this sow’s ear. The new sign I arranged to have painted—
Room 6
Mental Health
—is a vast improvement. Clean, clear, simple characters, no dripping blood from the red paint, no “Psych”.
I purchased a number of small painted-on-canvas scenes of African wild- and village life. They are mass-produced, so affordable on a volunteer’s salary. I put one up in the nursing station, one in each of the two adjacent exam rooms and one in the “seclusion” room. I use quotes because there are always at least 5 family members accompanying, and often restraining, the patient. Then I put one in the Occupational Therapy room, in which we often see patients. And locked myself in. The door handle is fried and won’t open the latch. The wall stops 2 feet short of the ceiling but the latter is 14 feet high and, as I stood on a very tall stool and pulled myself up, I could see that the top of the wall was filthy. The dirt, plus the drop on the other side, convinced me not to climb over. Hmm. I opened a window onto the street and pleaded with a man to let me out. He looked a bit suspicious, doubtless thinking that I was supposed to be locked in the Mental Health Clinic.
Despite his misgivings, he entered the building into the Room 6 waiting area and freed me, whereupon I found one of our Registrar’s (psychiatry resident’s) older brothers, together with a policewoman and another woman. (The latter’s muscular shoulders and thighs and corresponding rolling gait would be the envy of Lawrence Taylor.) Maxwell, the brother, wanted to know how to get ahold of his younger brother, the doctor. The latter had left clinic for the day and didn’t answer his phone. The short version is that Maxwell begged me to help him. His daughter’s 1 month old infant was in the ICU on oxygen but “no doctor has seen him for 24 hours”. So off we went, through corridors and throngs of people and across lawns and mud patches. Finally, I entered the ICU (only parents and medical personnel allowed) and, lo and behold, all the doctors were standing next to the infant in question. My fellow GHSPer, Anneka, is the pediatrician who was leading rounds and reassured me that the baby was fine, a strong healthy girl, and didn’t actually need the oxygen cannula in her nose. She had bronchiolitis, like many others in the ward, and was recovering.
When I stepped outside the grandfather rushed up to me, accompanied by the policewoman. I don’t know where the splendid specimen went, nor who she was. She may be another daughter. They were visibly relieved when I told them the story, and I was introduced to the infant’s grandmother, as well. Then I headed back to continue my day. It felt as if it had been short-circuited but, in actuality, it all was my day. Just not my planned day, as is generally the case here.
Being an ex-pat confers a certain, not always admirable, status. A “we-they” dynamic seems to come with the territory, even if undesired. I don’t want to join the ranks and would likely have to remain a long time before being accepted as one, anyway. The presence of gardeners, housekeepers, guards, cooks and so forth speaks of the power differential, the remains of colonialism. The latter is a fact, but it is uncomfortable to be reminded of it so frequently. My birthright was a roll of the dice and had nothing to do with my virtue. And from birth, the field was tilted in my favor, some difficult circumstances excepted. Malawians are so generous of spirit that they make it easy to forget the other levels of discordance. But exist they do and sometimes in unguarded moments I can sense the unfairness in our respective positions and the consequent [natural] feelings of animosity. It provides an almost-palpable void between us. To feel it at those moments is deeply unsettling, stimulating a mixture of guilt and fear and gratitude for my advantages.
I’ll try to take and post some photos of our house and yard. I am surprised at how at home and cheered I feel by it. Linda has done an amazing job of decoration. It is nicely furnished, as well, with lovely chests and tables and chairs. We now have a little collection of Africana which, together with some antique maps from the map store [The only kind they have—and they don’t consider them antique!] and cut-outs (fish over the bathtub, butterflies in the loo, chickens in the kitchen) from chitenje pasted to the walls, create a cosy and attractive environment.
Our friend, Polly, ran the Mt. Kilimanjaro half-marathon recently and on the return flight met a newly-wed couple on vacation from Washington, DC. She is an architect, he has worked in the Obama Administration for several years. They are in the area for 3 weeks. He was a Peace Corps volunteer 15 years ago in a remote village in Zambia and is showing his lady places he loved. They are climbing the Mulanje Massif and will stay at one of the huts on top. We lent them our sleeping bags and air mattresses. Like many long-distance hikers and campers, ex-PC vols are generally a pre-selected, compatible lot. We certainly found that to be true when hiking the Haute Route 1 ½ years ago.
Examination week is over. Only two students will need to repeat their 4th year psychiatry rotation. We attempt to make it so interesting and attractive that none will fail to work hard. And, of course, we want to recruit some to the cause. English being a second language for all of them…..oh, this gorgeous little sunbird with a long curved black beak, an iridescent blue-green cap and cape, and a red bib just fed in a flowering bush 10 feet from me! Anyway, I admire the students for the hard work they do and know that those two will be better doctors for spending more time with us.
I seem to be drifting, so I’ll stop here. I did, finally, get my ID card. Literally hours spent by me on what should be an extremely simple task. Perhaps my experience with it is a reflection of the dark void of which I spoke above, in a passive form.
A psychiatrist in Malawi 