A day in the life...

I'm making a second rapid post because I don't think the vague references I've been making to how things are here is going to work without a real example.

I got to Makhwila today and found out that cholera is in the lower shire. There's only one case confirmed so far but considering that its a pandemic a relatively short distance away that isn't much comfort. For those of you that don't know, cholera is a particularly severe and lethal kind of diarrhea. It is caused by a bacteria, and causes all liquid in your body to be expelled from your butt in what is referred to as "rice water stool." Those who have it lose liters and liters of water each day, and if you don't get as much water as you lose, you will die. The possibility of getting this disease scares the crap out of me. Anyway, I didn't eat until we left and when we did I scrubbed my hands more than Lady Macbeth to make sure I got everything off them. 

Today was a typical day, nothing extremely unusual happened. Keep that in mind.

To get away from the (possible) cholera patients nearby, we crowded into a cramped hot room. There were 12 of our 14 scheduled kids stooling, and one of the two healthy kids turned out to be malnourished, so make that 13. Plus we enrolled three new kids, so make that 16. Which is 32 stools to do. Not counting a couple others we needed so make that 36. Busy busy busy. Plus we had to buccal smear, which took more time. All in all, it ran well, busy, hot, tiring, and long. in most respects a manageable day. As always there was a few fat, very healthy babies from families that are probably fairly well off. (By Malawian standards at least)

The not-so-good things, but nonetheless not unusual things were as follows. We had one mom who didn't come for the umpteenth time, and we kicked her out of the program. We have had a lot of those. One person Victor went to fetch was found to be in mourning. One of the twins had died two days ago, and was just buried yesterday. The mom was in no condition to go. As soon as she is able, we will try to have her come for a few more visits, and then we will discharge her. This serves both to get some more data to wrap up the set, and to give the mom a little extra (in the way of incentives) to get through the mourning. We have had far too many of these kids. I'm not sure if I will recognize the remaining twin when she comes back, but the names sounded familiar. Also there were two twins on chiponde today who did terribly over the last two weeks. Both lost a quarter and a fifth of their weights, respectively, and one of them is not eating. Their heads resembled raisins in the way the skin was stretched across their heads and the veins were popping out. The worse of the two had a terrible diaper rash, and both looked like skeletons. We sent both to the Nutritional Rehabilitation Unit, or NRU, were they will be observed and made sure to eat properly. I have a fifty-fifty bet that I will never see one of them, and a twenty-five - seventy-five bet that I never see either. Its not that I don't want them to recover, but when you've seen so many you can kinda gauge how likely it is for the children to survive. 

Not meant to depress or scare anybody, I just felt like I hadn't gotten it across well yet. 

A day in the life of a volunteer in Malawi.

TTYL

---He who is tired of the cute babies dying.

Wow I can talk a lot...

Hey, it has been a while hasn’t it? I haven’t had much time to spare in a while, and the little I did I didn’t want to spend conscious. Well, I’ll try to keep it semi – short, so as to not bore any of you…assuming my long hiatus hasn’t killed everyone’s interest. It’d kill mine. Anyway, in a token effort at getting things in chronological order even though I can’t remember most of the details anymore, I will start with my trip to Mozambique.

The trip there was half of the adventure. At expensive half at that. We – Victor, Joy (Male), and I – left on Friday, after clinic was finished, heading for Victor’s home town of Tete. We left the compound at five o’clock, thinking that if we made it to the border by six; we’d be able to cross. We got there at fifteen after. Wasn’t a big deal though, apparently the border closed at nine! Sweet! (Don’t worry; the six o’clock closing will bite us in the ass later) And this is where the bribes start. Victor wasn’t given a piece of necessary paperwork for the truck we rented; to he gave someone a bribe to acquire it for him. Necessary. The next one wasn’t. Joy and L ordered a student (twelve month) Visa more than six months ago. Even now, they still don’t have them. So when we tried to cross, there was this big, fat, corrupt Malawian (with a big scar on his nose) staring at us. For you’re reference, there are three main groups in Malawi. Blacks = natives. Indians = Businessmen. Whites/Wazungus = Humanitarian aid. AKA, people with money. So when he saw us, he immediately decided that he was gonna make us bribe him. Didn’t matter why, he was just looking for his justification. And when he saw that Joy didn’t have his passport updated (because he is still waiting for his student visa) he saw his chance. Didn’t matter that we had the receipt for the pending visa, he just wanted a cut. Victor’s reaction was simply, “This is Africa.” He didn’t put up with any baseless shit though. When the border officials tried to make him pay for some rice he had in the truck he raised hell till they backed off. Soo pissed off.

And this is where the six o’clock problem hit. Turns out, the Malawi border closes at nine, but the Mozambique border closes at six! The boss there raised hell about us making him work after hours, which is weird, because someone else did all the work; all he had to do was sign. Plus we payed fifty bucks…whatever we got across.

So then we had about an hour on the road where there were huge potholes (lakes) in the road, with many, many half-destroyed buildings which we couldn’t see. I’m estimating an hour, because I fell asleep. In a total of three hours or so we were in Tete. IT WAS SOO COOL!!! I mean, they had LAMPOSTS! And GOOD ROADS!!! And CULTURE! ART! GRAFFITI!! MUSIC! It was culture shock. Victor’s sister served us chambo (Fish) and intestines with liver in it. I am proud to say that while I was not the first to try it, I did eventually eat it. (It is VERY rude not to try everything put before you) Intestines are rubbery and I wouldn’t recommend them, but its perfect food if you’re feeling adventurous. I played some playstation with one of the kids there as well and then we slept. Or actually only I did; Victor (typically) got up too early for me to call what he did “sleeping,” and Joy was too hot to sleep. Oh I forgot to mention that didn’t I? Tete is hot as HELL. Like a sauna. Or a furnace.

The next day we drove around for something close to two hours meeting Victor’s many relations. Following which, in African tradition, we fit about 6 more people than we should be able to into our truck, and drove to another town, about six hours away. I fell asleep that way too. Then we saw the dam, which was amazing. This huge cement structure obstructing a river, with such power flowing through it that you can feel the cement vibrating! I have tons of pictures from that trip. We even got to go inside, and even though we weren’t supposed to take pics Victor’s cousin took a bunch under his arm. I felt justified anyway, because the tour guide was letting his personal friend take videos, and if they are going to flaunt the rules, why not us too? (As long as we don’t get caught of course)

After that we opted to not go to home yet, because no one wanted that long of a car ride yet, and because there was a disco to go to. After waiting about three eternities for the women to get ready, we headed off, to a terrible disco with no people. We didn’t leave there nearly fast enough. The second one was packed though, and was a lot of fun, though I still felt like I was merely attempting to “dance.”

Once we woke up the next day we spent all day driving back, with a short stop in Tete to eat. We got back home really late. I don’t think Victor or Joy slept at all the whole trip and I think I consumed more than my body mass in cokes. What fun.

Christmas was good in another way. I had received a couple gifts from the ones who spawned me, namely candy and books. My dad gets most of the credit for that, because I know my mom did not pick out Dune and the new Ender’s Game book. (Both of which were GREAT by the way) Some comics were also included, but those two were the big ones. So we spent the weekend doing nothing in a “resort.” (by Malawian standards) I indulged a few pleasures there, namely video games, books, and LOTS OF MUSIC. It was fantastic. I do not kid you when I say that I did nothing for four days or so. Which was amazingly refreshing.

After that we drove to Lilongwe to pick up Joy and his sister. She stayed for two weeks, and spent many of them on trips with Joy. Not much to say about her, she didn’t talk much, but in the rare occurrences it was nice to talk to someone my age. (It was also fun to see Joy dote on her a little. He is an older brother after all.) Oh and he brought me CD’s from home. (again from the parents) To summarize, Fuel, Hinder, Nickelback, Three Doors Down, and Shinedown all kick ass. Panic at the Disco is not good live, at all…I felt my memories of the songs I liked be slowly, horribly raped as I heard what they sounded like live. Trapt is good, but they changed their style in Only through the Pain, and the jury is still out on them. If you didn’t know already, I’m a music addict, and it plays a big part in keeping me sane, hence why it gets a part in the blog.

In the past weeks I’ve been working very hard. I’ve entered all the data that we used to have piled up, which took way longer than I would have liked. But it’s done. Finally. 1200 cards divided by 20 cards an hour = 60 hours, done mostly by me. You may applaud now. We also got new buccal smears (To determine if kids are identical by DNA) which has made clinic crazy…how many kids do you think sit quietly while you stick a foreign object in their mouth?...OK except for the newborns that will suck on anything. Oh and we have 235 sets of twins enrolled now, and a typical day involves 15-30 sets (30-60 twins) and as many as 15 may need to give us stool. (Actually next month they will all need to go…stupid three month visits…) I spend a lot of time working on the flowchart for Dr Manary, and repacking the truck, and keeping track of supplies.

We have lost 16 sets of twins. I think approximately eight kids have died. And eight sets have defaulted too much, and we kicked them out. So that’s like 1-2% mortality rate in our study over six months, where all the kids aren’t even malnourished. (FYI, under five mortality in Malawi is approxmately 1% for healthy babies, 4% for moderately malnourished children, and 16% for severe. 2/3 die with kwash if untreated. It isn't that we are doing badly but that children DIE here.)

 

Also it’s HUNGRY SEASON, when the land is green and no one has food. Our sites are exploding with kids coming to be treated. I think there are upwards of 200 kids coming to some of our sites now, and it is only going to increase, Which means that the amount of cards to enter is gonna go up too. One site enrolled 30 kids (1.5 hours) not counting the other site that day. Luckily, stool study will be mostly spared an increase on our already formidable workload, except that there will be many more sick, and consequently stooling babies. In other words, we wont get huge amounts of enrollments, but we will get huge amounts of stools. Yay for the pooper scooper! (ME!)

I’ve been rambling for a while, and I’m sure I’ve lost at least half of my initial readers, but here’s my last recap. We have three new people staying right now, Dr Manary, his wife Mardi, and a photographer, Jeff. Mardi is super nice, and calls me a dear boy all the time, without saying it patronizingly, so she is good company. Dr Manary came and he has been giving me some real praise, and I feel like I’m doing my job really well. And Jeff is very idealistic, to my cynicism, and he is trying to make some media to raise money for the project. All in all it’s nice to have such a crowd, but I think I will be thankful when it’s nice and quiet again.

So that’s generally how things’ve been going. I hope some of you back home will be patient with me, and keep in some form of contact even though it’s so hard for me to get back to you.

TTYL

He who is enjoying his first relaxed day in a long while, thanks to Leslie.