Sunday Morning~ Blantyre

April 30, 2017

Hi Everyone,

Our Model Ward proposal has been accepted and I waited all week for a schedule and format instructions. I didn’t know if I should prepare an hour presentation or a ten minute presentation. The fact that the meeting starts in three days and I still haven’t received that information is causing me a tiny bit of anxiety. But, going with the good news that we would indeed present this idea to the Association of Malawian Midwives (AMAMI) I got busy first thing last Monday preparing a power point. (I can whittle it down if needed, but I’m hoping to have an hour.) We knew we couldn’t present anything to the national organization involving our hospital without first talking to key people there to let them know. It was declared bad form for them to hear our plans for them at a national meeting. I was not familiar with this etiquette, so on Tuesday I asked Ursula, our dean, how we should go about it? She asked me to print out some copies of the abstract and then follow her.

We paid a visit to the matron of the obstetrics department, and politely explained our idea. We told her this was just an idea and, of course, once we present it next week we will come back and form a committee to have everyone’s input about how we should proceed. She loved the idea and told us who we should speak to in the college of medicine. We would go nowhere without their support. So, next stop was the office of the head of the OB department, where we just happened to find the three people we needed all sitting down and chatting with each other. The head of the department, the assistant head of the department, and the representative to the ministry of health for the department. How utterly convenient. Ursula, whose late husband was a much loved obstetrician in this department, was warmly welcomed. I was as well and we were offered seats around their table. The usual greetings were exchanged. The room we occupied was so crowded with stuff it was difficult to move. There were three big desks with (I assume) administrative assistants shuffling papers and recording stuff in log books. In front of the desks were the soft low chairs we occupied around a small coffee table. Five of us sat there in a space the size of a refrigerator. Behind us were two bookshelves crammed with notebooks, textbooks, and brown envelopes. Beside one shelf was another small coffee table with an electric kettle, bags of sugar, powdered milk, and tea. It was cozy.

The head of OB is a big man and I have found him to be a little intimidating. I have watched him rip into medical students in a way that would have made me walk out the door and never come back. I was dreading this meeting, expecting this to be a hard sell to that guy. But Ursula grew up with him and they went to school together. He was as congenial as they come, and started in on a long soliloquy about how midwifery and medicine have to work together! He lamented the deplorable state of the department and waxed nostalgic about the old days when Queens was a place where women got good care. I was holding my breath afraid to believe he was actually stating the problem before we did! When he paused for a thought, Ursula said, “Well, this is exactly why we are here. We have a proposal…” and she went on to describe our idea and list the problems we thought it would address. She handed everyone a copy of the abstract. They read it and all told us they would be happy to work with us on this. They all agreed something has to change, that students (both medical and midwifery) are not having a good experience and women are suffering. They don’t want to give up on the institution but know it has gone down the tubes. We let them talk a lot. When Ursula finally had the floor, she took them through the system we wanted to initiate and when she got interrupted with one of their comments, she quietly and politely said, “Excuse me, before you speak, let me finish.” in a completely polite and non-threatening way. She was brilliant. I sat silently trying to learn from her as I watched a secretary squeeze between us to make tea at the little table, shuffling around in a strange way. When I could finally see her feet I could see it was because she was wearing nylon stockings and flip flops. It looked exceedingly uncomfortable. She shuffled along, barely making it between the chairs, and reached over our heads to place a tea cup in front of each of us. She wedged her way between chairs to place the tea bags, sugar, and milk on top of a pile of papers. Then she put the boiling kettle in the middle and said quietly, “Help yourself to tea.” Everything looked a little precarious, but nothing fell off. I took this as a good omen. No one moved toward the tea, so neither did I. I waited until there was a lull in the conversation, really thinking I had nothing to add to what Ursula said, but when Dr. Head of Department (I must learn his name) said, “The midwives in the old days were so much more independent! They knew exactly how to handle everything! Now, they are acting as assistants! They take no responsibility!” I did not point out that this was, in part, due to the medical school taking over everything, but did feel compelled to tell him that when I was here in the late seventies working as a public health nurse I was in awe of the midwives. They were the strongest most skilled practitioners I had ever seen. It was the Malawian midwives that initiated my desire to go back home and go to midwifery school. I told him that coming back here all these years later I am shocked at how their roles have changed. Ursula (who is my age) remembers those days and is equally frustrated with how their role has devolved. She sat smiling at me and nodding. When it was all agreed that we would work together on this, that they would “help in any way possible”, we were encouraged to have tea together. We poured, sugared, milked, and dribbled tea on (hopefully unimportant) papers. A plate of cooked sweet potatoes was uncovered and we all ate one of those. This whole thing took about two hours but we had every blessing that we needed. Ursula and I were so excited when we left there. We calmly walked out of the office and in a whisper Ursula said, “Wow. I thought that would be much harder.” We were down the hallway and around the corner before slapping the high fives and practically dancing all the way back to our offices. I considered that a very efficient and productive morning. And I didn’t need lunch. I was sitting at my desk, smiling when I had the little panicky thought of, “Oh. Now we have to DO this.” And I began the slow process of downloading articles on Maternal Mortality in East Africa. That took way longer than getting everyone’s support. That would have been the exact opposite at home.

Tomorrow, May first, is a holiday here, Labor Day. I didn’t realize this until the middle of the week and am a little disappointed we didn’t plan to do something. George had his last week with medical students and was very busy with that, and I was all consumed with this presentation and we just didn’t get our shit together to make a plan. I had received a wedding invitation for a wedding on Saturday, but ended up not going. The invitation was slid under my office door addressed to “Linda and your friends”. I opened it and read the invitation and had no idea who was getting married. I did not recognize the names at all. I went though my student list to see if it was one of them. Nope. I asked around the department. One of the drivers? Nope. No one else knew who it was either. I thought it would be fun to go and see what its like, but George didn’t really want to go and neither did “my friends” and in the end I decided if I were going to go to a fundraising event (which is basically what wedding receptions are around here) I’d prefer it to be for someone I knew. I thought of going to the church, but that was at 7 a.m. and I had no idea where the church was, so missed out on that cultural experience. I’ll make more of an effort next time.

The medical students are on an academic schedule that is similar to ours at home. They are finished with classes now and have the next few months off and start again in mid-August. The nursing school has no such schedule. It continues all year since there are so many more students and clinical sites are hard to provide. So that means my schedule does not mesh at all with George’s. He had final exams this week, and by Thursday his cohort of psychiatrists from Europe were ready to party. We initially planned to go out to eat, but that’s always such a frig here with a big group and it’s hard to talk to each other. I suggested we meet at our house, have dinner, and have it be more of a relaxed evening. We had plenty of food for everyone and they all brought the wine. Well. I had been at the district hospital in Thyolo all day with a new group of students (a hospital I had never been to before) and though I was home in plenty of time to put things together for supper, I had not eaten all day. (I’m sure you can see where this is going). As we puttered around making a gorgeous salad from the garden, I had a pre-party gin and tonic. When everyone arrived and were munching on the little pizzas I’d made for appetizers, I had another, since they were all having one. Two gin and tonics? That’s not that much, right? As I put the finishing touches on the pumpkin risotto, they all gathered around the table and started pouring the wine. And really, that’s about the last I remember. I hear the food was good, though. Two of the women from UK had brought a little box of something and it was on the sideboard along with a card with a piece of chocolate attached. I have no recollection of this, but I guess after everyone left I brought that to bed to read the card and see what was in the box. And then I went to sleep, or more accurately, passed out. When I awoke at 6:45 a.m. with a splitting headache, I reached over and felt that George was not in the bed. Uh oh. Did I say something to make him mad? Good chance. Then I felt something under my back and couldn’t figure out what I was lying on. I reached my hand under there and pulled out the remains of a melted chocolate bunny that I didn’t remember taking out of the box. I just saw the melted chocolate on my hands and all over my back and screamed! Which hurt my head very badly. George, now finished with all the previous night’s dishes, came running down the hall with a cup of tea for me. I screamed, “What is this?!!” And showed him my hands. Totally nonplussed, he leaned over and sniffed and said, “Chocolate.” (Remember, he’s used to psyche wards.) And then he looked at my back and said, “Oh, I’ve got to get a picture of that.” He apparently remembered what was in the box. He was surprised to learn that I didn’t. He told me I didn’t act drunk at all, and no, he didn’t recall any mean things said to him by yours truly. Phew. But that was so weird. I don’t remember not remembering anything like that since college. And then, groaning, I had to get up and go to a neighboring town for an antenatal clinic with new students, in like five minutes. Friday was a hard day. I get queasy just thinking of it now. I made it through the clinic by not turning my head more than two degrees at a time, but it was touch and go there for awhile. In a cramped dark room with awful smells and nine students…let’s just say it’ll make the next clinic there seem like a breeze. This had something to do with not wanting to go to that wedding. I still had a headache on Saturday. Ugh.

Let’s see, what else? We’re thinking of buying a car. One of the reasons it’s hard to do anything spontaneous around here is because we have to plan so many extra hours for transportation. I hate to put one more car on the road here and we had thought we’d just rent cars when we needed them, but they are astronomically expensive to rent and by the time we rent one a few times we could have bought something second (or third or fourth) hand. I priced cars for the time Jordan will be here and just for ten days it will be almost a thousand dollars. Expats are always leaving and selling their cars which they bought from another expat who was leaving. So we’ll see. There are a bunch of cars, nice ones, sitting with grass growing up through them that were bought for some project with grant money. When the grant is finished the cars just sit there unused. We were wondering if we could fix up one of those and use it. It seems such a waste. On Friday I got a call from Stefan, George’s counterpart, and he said cheerily, “I’ve got the number for the guy who rents cars that you asked about last night.” I tried to recall a conversation I had about cars Thursday night. Nothing. Relieved to hear I was coherently talking about cars, I said, “Oh, great! Thanks!”

Yesterday we decided to have a low-key walk-around day. We bought a meat grinder. It’s one of those cast iron, heavy, clamp-to-the-counter numbers my mother used to use when my father decided it was cheaper to have her grind up the beef for hamburger. She bitched about it bitterly (“This stupid asinine thing!”), but I always thought it was pretty cool. A couple of weeks ago when George said wistfully, “Oh I wish there were a place we could buy some chorizo here.” I said, “We can make some!” which for some reason, made him slap his forehead and crack up laughing. So just to show him, I went down to the “Lord is my Savior” butchery and bought a chunk of pork and spent hours chopping it into mince to use for chorizo. The spices were no problem to find and it came out pretty good, not great, but pretty good. I have been obsessed with finding a meat grinder ever since and yesterday struck gold. I knew there had to be one around here somewhere. It was in a dusty corner of some Chinese shop in Old Town. I could smell it. It’s all cleaned up and after I finish writing this I am going down to my friends at the butchery to buy more pork to try it out. I’ll work on finding the casings later. For now I’ll make patties. When we were sipping tea yesterday morning talking about buying a car, George said, “Oh wait! I know! Let’s make a car! Scrap metal seems easy to find!”

The poinsettias are in bloom. I had no idea that so many of the trees (yes trees) surrounding us were poinsettias. They are spectacular. It’s one after the other of blooming beauties around here, competing with each other for attention. We’ve got two in our yard and four more I can see from my window in others’ yards. I wonder why they are associated with Christmas? It’s not when they bloom here! Anyway, another feast for the eyes. And now that the maize is harvested and we can see the ground again, it’s a diversion from the trash that didn’t disappear during the growing season. So much trash. Awful.

So I need to go arrange transportation to the meeting this week in Lilongwe, finish up the presentation, and make some sausage. The meeting is from Wednesday the 3rd until Friday the 5th. The acceptance email said they will let us know by Tuesday the 2nd what the format will be. No rush. I think our proposals for our national organization at home are due like a year before the meeting. I can’t wait to see what this will be like.

Love to all,

Linda