Home, Malawi

[Above Photo: View up the glacier towards Cabane du Prafleuri. Since we were starting to hike the Haute Route two years ago at this time, here’s a photo from then. We stayed at a hut half-way up the glacier, behind the diagonal rock ridge on the left.]

27 August, 2017

The flight from Boston via DC and Addis to Blantyre was long but complication-free. No lost luggage although one of my large bags, which has faulty locks, came open and a heavy S hook for Linda’s hammock fell out. They do not exist in Blantyre, an importing opportunity.  I sat with two young Ethiopian physicians, an internist and a psychiatrist, from DC to Addis and we exchanged notes. Although I cannot be certain (and Skyband Internet is down so I can’t look it up), I believe that the only Child and Adolescent Psychiatry fellowship in Africa is in Cape Town.  There are 60 psychiatrists in Ethiopia but none child-trained. We now have 4 psychiatrists in Malawi and one is child-trained. Excellent to be toward the head of the pack!

Chileka International Airport (Blantyre) was its usual welcoming self, except this time the Massey-Fergusson tractor pulling the deplaning ramp was white, not red. Not another plane on the ground, in contrast with Logan, Dulles, or even Addis, all of which were bustling. Apparently, if you arrive from Lilongwe at noon, the Joburg flight is on the ground simultaneously. I prefer little airports. Less confusion, shorter walks, more personal.

During my absence the country has turned brown, cool, breezy, and dusty. The rest seems unchanged. And without Linda for companionship plus, my thoughts turn to cooking. I tend, in my impulsive manner, to blast ahead before checking a recipe. Just as I noted in my last post that there are reasons for diapers, recipes, too, have a purpose.

I’m making a beef stew for this week, the first of the academic year, knowing that I’ll be weary by the end of each day. So I braised the meat and cut up the veges, picked some herbs, and put them in a pot and cooked all for 1 ½ hours. All the veges were cooked and I had a nice clear beef-vegetable soup. Damn, where does the brown come from?  Checked the internet—-“mix flour, salt and pepper and coat the beef, then brown it with a little oil.”  Aha! So I fished out all the meat, coated it as written, browned it and returned it to the pot. Brown. But needing some reduction. It’ll be tasty, I’d guess. Labor intensive, though. Let me make a risotto any day. In my next stew I’ll add the veges 30’ before completion so they are crisper.  Any stew or casserole suggestions from readers would be most welcome. I’m all about one dish, or one plus salad, suppers.

All of my sister’s offspring, and many of their friends, are superb techies. When I complained on the island about being unable to stream movies because of geographical licensing issues, I was quickly directed by David Perlin to add a VPN to my desktop. Now it says I’m from Boston when I download a film from Amazon. It doesn’t seem like a crime, since I pay for Prime and am not distributing or showing them to anyone else. Actually, it seems like false advertising (a crime in my book) that Amazon didn’t let me know when I paid for Prime that if I was in Malawi I wouldn’t be able to download most of the movies, including all of the free ones.  So, for now, we’re on speaking terms. I did think “Eye in the Sky”, about the humanitarian, moral, ethical, military, political, etc. ramifications of drone strikes, was gripping. The technology displayed was both thrilling and chilling.

Oh, well, I just tried out my Racquet Zapper, a battery-powered fryer for insects, on a huge wasp that got into the house. ZAP! A loud end to his life. So if THEY send those little insect-sized drones with cameras to try to steal the nuances of my beef stew preparation, LOOK OUT!

I realize how hard I worked when I first began last August, preparing and giving a lot of lectures about psychiatric illnesses I hadn’t seen in years, if ever. The Scots are doing more of the lectures this time and I can focus on role-play exercises with the students and mentoring them in the clinic. Also, as of 2 October the Pediatric Mental Health Clinic shall expand to two rooms with a registrar in one and two medical students in the other, as well as one of the psychiatric nurses. All this is to support it being sustainable in a year which, after basic quality of care, is my focus. I still must prepare for a research presentation—-preliminary data on the clinic—at the College’s research conference in November and to figure out where to submit my paper on Donkin Psychosis. JAMA, with the widest US audience, doesn’t accept case studies. Perhaps Lancet Global or the Malawi Medical Journal, which has a lot of readers in southern Africa, at least. I’ll have to ask Lancet to waive their $5000 publication fee.  Since I am a volunteer living and working in a low-income country, I suspect they will.

I do morning exercises and 15’ of meditation without fail, convinced that each will sustain and build muscles I need. I remain in good health, despite being surrounded by (and containing) many challenges, my age notwithstanding. Five days until 77yo. It is hard for me to believe—a cognitive dissonance—when I am tearing down Kamuzu Highway on my bike, fully loaded with wine and groceries, dodging minibuses and potholes. In the first place, I thought I’d be long dead at a young age, like my father, paternal grandfather and older brother.  Second, if alive I’d expect to be in a rocking chair on a porch. So much for good genes, good friends, good diet, good habits, and good luck!

It kills me how we now find that your blood lipids are better if you eat two eggs 3x/weeks than if you eat none. So many people have been carefully eating egg whites each morning for years!  And taking a statin doesn’t extend anyone’s life who doesn’t have a familial hyperlipidemia, though it certainly lowers your blood lipids. And bacteria, H. pylori, often cause duodenal ulcers. Today’s truths, certainly in Medicine, are tomorrow’s fictions. It’s tough to know what to believe, both in medicine and in the wider world. Disinformation, “fake news” proclamations, a president whose documented frequency of lying is stunning, false promises. The very ground is shifting beneath our feet. It is little wonder that youth have a difficult time setting their life course, unless they just do it unthinkingly. The latter may be the best way. Then just be thoughtful about whatever you decide to do. “Be kind, for everyone you meet is fighting a great battle.”

I’m spinning out of control here. Best to ground myself in the stew at hand.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s