Sunday Morning ~ Blantyre

November 26, 2017

Patse salira totolo ~ The one who begs does not ask for a heap

~ Malawian proverb

Hi Everyone,

The evening curfew was lifted this week; we can be out and about to visit friends or whatever after dark. Last weekend we sent a letter to the Peace Corps director, as a group, begging to be let out for Thanksgiving. We didn’t ask for much, only for the volunteers to be allowed to come to our house for the evening meal. Since there haven’t been any more incidences of violence and peace is “holding” we are allowed to be out after dark. We still can’t go outside the city limits but it feels good to be able to move about, limited as it is. We’d invited sixteen for dinner, some volunteers, some local friends, and some visiting psychiatrists from UK. Several had never been to an American Thanksgiving, so pressure was on, but given that everyone has been living with extended power outages, expectations were realistic.

Our oven has been broken for weeks and Tuesday we got a call that they’d found the needed part and would be there Wednesday morning to fix it. Yay! Just in time. Wednesday I went off for my 7:30-12 lecture hopeful I’d have an oven to roast the Thanksgiving chickens in. George didn’t have to be at work until nine, so was home to greet the electrician at the promised hour of eight, and… he never came. That was a disappointment, but I figured it’d been too good to be true anyway, so wasn’t all that surprised.

I planned to cook the chickens outside on charcoal and forget about trying to find an oven big enough to roast them in. I enlisted Chimemwe’s assistance, explaining that this is a big holiday at home, a celebration of our harvest. He was eager to help. The servants quarters has an outside fireplace for cooking but it was piled with ash and broken bricks. He cleaned it all out and it looked like it might work. It was small, but I thought I could get four chickens on there. The rest of the meal I figured I could do on the stovetop, which was working fine. It was only the oven fuse that blew. I had already done a lot of prep, so the chickens were my big concern. I knew the electrician wasn’t coming Thursday. Didn’t even consider hoping for that.

Thursday was a regular work day here and I had a morning lecture to give. I then planned to take the afternoon off to come home and cook. My lecture on Thursday was on the respiratory system. I start each class with a writing exercise and this new group is incredibly enthusiastic about it. Last year’s class was very skeptical, but this class writes with gusto and reads their stories in theatrical voices. They’re great. I also think their English is better than last year’s class. Thursday, I told them we would write for six minutes and to start their story with “A time I couldn’t breathe”. I also participate in this exercise and as soon as I set the timer I began writing about an experience in college when I thought I’d confront my fear of drowning by taking a junior lifesaving course. My gorgeous, poised roommate, Maliz, worked as a lifeguard in the summers and it seemed a much more romantic job that the dreary summer jobs I hobbled together. I thought maybe if I, too, were a lifeguard, I’d be popular and beautiful. Weird how nineteen year old minds work, but anyway, I took this course. I was rather proud of myself for being alive at the end of each class, and Maliz was very supportive and encouraging. She was the best roommate ever. Her horror when she learned I was using the soap dispensers in the showers at the pool to wash the chlorine out of my hair was comical to me. She made me promise never to use that stuff on my hair again. It was such a loving gesture. She wanted the best for me. I spent six minutes writing about how I finished that experience.

The test at the end of the course involved endurance and strength. I amazed myself when I passed the endurance part, but when we had to dive to the bottom of the deep end of the diving pool and pick up a heavy weight and bring it back to the surface, I couldn’t do it. I kicked my way down to the bottom with great effort, grabbed onto the weight, and made it about halfway up before I thought my lungs were going to explode. I really wanted to pass this test. I really wanted the cool work study job of lifeguarding at the pool (who was I kidding?) and I remember the exact moment when I knew I had to drop that weight and get to the surface for air. I’m not sure if it was pure survival at that point or the fear of embarrassment if they had to jump in and rescue me, but I dropped the weight, felt like a feather as I kicked my way to the surface, got out of the pool, showered, washed my hair with real shampoo, and never went back.

I wrote about that as a moment when I really couldn’t breathe. I’ve never had asthma, but have fallen and had the air knocked out of me, but the burning I felt in my lungs that day when I felt like I could die there. When the timer went off, I had the class begin to read their stories. One after the other read about a time they’d learned someone had died: mother, friend, uncle, aunt, mother, sister, father, and what it was like to hear the news and be unable to breathe. Three wrote about being unable to breathe while waiting for exam grades to be posted to see if they would be going to university. Only one out of the twenty students wrote about bathing in a river and getting caught in a current and being unable to catch his breath.

I looked at all these young people and my heart about broke for all the pain and suffering they had already experienced. They were all well-dressed, attentive, and eager to learn. I wondered how much emotion and fortitude those young bodies contained. There was no power on campus so I had to read the whole presentation off my laptop. That seemed deadly boring, but I got through the bulk of it then broke them into groups for case studies. It seems like we are always pushing everything uphill and they are all such good sports about it. It’s humbling.

I left to hurry home and get things ready for dinner to find there was no power at the house either. I sent George a message to bring home more charcoal as more than chickens were going to have to go on the fire. He asked if we should reschedule the whole thing? I pointed out the pilgrims had no power so I wasn’t going to give in! Plus, no one had power so it wasn’t like we were going to be judged! Polly had to get up in the middle of the night to bake her pie! Her power was only on for two hours between two and four a.m.! Elizabeth had to go to a neighbor’s who had a gas stove and explain that this holiday was important to us! She baked her pie there! And the mango drinks were all ready to assemble and I hoped if I kept the freezer door shut there’d still be some ice left for those. And so we pulled it off, sweating and fanning the charcoal as the sun set. Catherine arrived for her night guard duty and stirred the gravy in a clay pot on the coals after the chickens were done. I put the sweet potatoes and squash in clay pots and stuck them right in the coals and they cooked perfectly. We piled a roasting pan with hot coals and put it in the bottom of the broken oven and that heated it enough to keep things warm. People arrived and we had mango cocktails on the front porch. We managed to assemble a long table in the living room to seat everyone at an equal level and the conversation flowed with the wine. It was a great meal. I brought plates out to the guards. I missed my kids and my mom, but I loved the community spirit and the great energy shared by a unique group of people thrown together in an exotic setting making do with what we had. Thankful.

I hope all of you had a wonderful and safe holiday as well. Sending love and gratitude for all of you in my life.

Linda

Sunday Morning~ Blantyre

Mnyanga sulemera mwini ~ The tusk is not heavy to the one who wears it.

~Malawian proverb

November 19, 2017

Hi Everyone

When I was in nursing school, the maternity care in the states was so horrifying to me I couldn’t imagine going into it as a specialty. The whole thing was so medical model that I saw no role for me there. The nurses played nursemaid to the doctors, rooms of screaming women were ignored until they had to push, then they had to transfer to a stretcher, be wheeled through the hallways to the delivery room, and transfer to a table with metal stirrups. Everyone yelled at her not to push until she could be given her spinal anesthesia and be draped with sterile gowns. Then the gowned and masked doctor would walk in, cut an episiotomy, and deliver the baby with forceps. The baby was handed off to the nurse while the doctor delivered the placenta and repaired the episiotomy. It was a big deal when the father was let into the room to stand at his wife’s head (they had to be married) gowned and masked like a surgeon and warned not to touch anything as if it were all radioactive. If it was a boy, the doctor turned from the woman to the baby and circumcised him on a little side table before the mother even got to hold (or see) her baby. The babies all went to the nursery and only went out to the mothers at feeding times. I hated every minute of it and swore I’d never work in there. I planned to have all my children at home. I never even wanted to work in a hospital with the way people were treated there. Dying patients were left alone; no one even talked to them. Nurses had to wear pantyhose and a cap. It was a big deal when we were allowed to wear white pants and a tunic. I hated the hierarchy and how nurses were demeaned. I wanted to be a visiting nurse and go to people’s homes. I had discovered Elizabeth Kübler-Ross and wanted to work with the dying. A blood pressure cuff was the most technology I wanted to use. After graduating and getting married we went off to the Peace Corps and I worked as a public health nurse here in Malawi. It was here that I saw how real natural childbirth could be managed more humanely with skilled midwives. I admired the midwives tremendously and working with them, decided that’s what I wanted to do. I wanted to help change the way we cared for women at home.

So now, here I am, rounding a huge circle to teach midwifery back in Malawi. Lectures started  on Monday for the first year students. I’m teaching the same course I taught last year, so am more relaxed about it. I won’t have stressful hours waiting for information to download from the internet; I already have the power point presentations and a clearer idea of what’s expected of me. I can find my way around. This has put me at considerable ease and I was looking forward to getting started. My only anxiety is learning everyone’s names. Just when I think I’m getting them all down, the girls change their hairstyles and throw me all off. I put the hair with a name, like Rhoda=Red Dreadlocks. Then one day Rhoda comes in with a shaved head and I’m like, “Don’t do this to me!”

Monday was the introduction to the module and midwifery. I was there with my colleague, Gaily, with whom I’ll be co-teaching. It’s a long course, fifteen weeks, with loads of content, so two of us share it. Gaily started with the overview of the module, a bit dry, but necessary. She went over how the grades will be calculated and issued and what the learning contract was. Then I started on the introduction to midwifery practice. Last year when I did this I was a nervous wreck and to break some of the ice I asked each of the students to tell us why they chose to go into midwifery. I shared my story about coming here in the Peace Corps and learning how powerful the midwifery role could be and deciding that’s what I wanted to be. Then we went around the room to hear from everyone. Last year the students told stories of being present when their mother or auntie gave birth and admiring the midwife so much they wanted to emulate them, or they spoke in broader terms of wanting to help women or their country have healthier mothers and babies. It was a good launch into the content of the history of the profession and the scope of our practice. It was so successful that this year I thought I’d do the same thing.  I told the new class the story of wanting to be a public health nurse when I was in nursing school and wanting to work in global health. I told them I realized that in much of the world, public health IS maternal child health and after my Peace Corps experience I felt I could be more useful if I were a midwife. I thought that was a good lead in. Then I said, “Ok, we’ll start here and go around the room and tell us why you want to be a midwife.” I pointed to the woman in the first row. She said, “I didn’t want to be a midwife. I applied to medical school and didn’t get in.”  Ok, bad start. I said, “Ok, well, welcome. Next.” and pointed to the boy behind her. He said, “I didn’t want to be a midwife either. I also applied to medical school. I am disappointed to be here.” This was not going well. I didn’t even respond to that one, I just said, “Next?” That girl said she wanted to be an accountant but her family pushed her to go to midwifery school. The next one wanted to be a teacher but her family thought she would get better pay if she were a midwife. Several said they’d applied to medical school but their grades weren’t good enough. Out of the twenty students, two said that midwifery was their choice. I was scrambling to recover from this little ice-breaker fiasco. Even when you really want to be a midwife it’s hard. No one goes into this for the hours or the pay. I felt like saying, “Okay, well then. You are all screwed.” Instead, I said, “Well, hopefully by the end of this year you will all be grateful that you ended up here.You are the hope for the future and are capable of really making a difference.”  That was the last I saw them. The Thursday class with them was cancelled because of a class meeting to discuss student loans. Anyone who hadn’t paid by Friday was kicked out. Hopefully I haven’t lost class members. I’ll find out tomorrow.

The nine fourth year students I have on labor and delivery are terrific. I’m getting more comfortable over on the unit and a few times this week the residents even asked me advice. I’m seeing being assigned there has been a blessing in disguise. It’s hellish, but it’s good for me to get to know people and show I know what I’m doing since that’s where we’re hoping to establish the model ward. On Tuesday I was in the utility room doing a newborn assessment with a student and looked around for something to use to trim the cord. I saw bundles wrapped in chithenjes on a counter and thought they were packs of instruments. When I went over there I saw they were dead babies, labeled with tape, beneath a sign on the wall saying “Please leave still births in the mortuary”. I’m not sure if these babies were waiting to go where they belonged or what, because we weren’t in the mortuary. Seeing them all lined up on this counter was rather shocking though. I have to periodically go back to my office to collect my wits.

Wednesday was my hardest day over there yet. The students are being thrown, head first, into this experience and they are overwhelmed and a little scared. They need to have experience doing vaginal deliveries and the residents need experience doing c-sections. Hundreds of those surgeries aren’t needed and my students feel powerless to advocate for the women or speak up about their assessment of the situation. I’m trying to help with that, but with so many women delivering and bleeding, screaming and seizing, the whole place just looks like chaos. I was with a student as she finished doing a delivery and was trying to control the bleeding postpartum, when I heard a woman scream in the next bed and looked to see the head crowning. I grabbed some gloves and told another student to get ready to do the delivery. She said, “But madam, this baby will be macerated.” I said, “What? This baby is dead? You know this?” She said, “Yes. There is no fetal heart.”  I said, “Ok, I’ll do it. You stay with me and watch, though.” So I delivered this little lifeless boy and asked the student to ask the mother if she wanted to hold him. He looked perfect. She said she did, so we placed him on her chest as she began to wail. I told the student that baby has not been dead very long. It looks like the placenta abrupted as a huge clot came out with the baby. The student told me this woman had two seizures when she arrived and was here waiting to go for a c-section. The operating room was full so she had to wait. They’d given her some magnesium sulfate and her seizures stopped, but it probably caused her placenta to separate. Young. First baby. Another bundle for the utility room. At least she did it vaginally. Ugh. It’s hard.

On Friday mornings I have decided to do a skills lab with them where we can practice some skills without someone bleeding to death in front of us. I was never very big on simulation before, but there is something to be said for learning in a controlled environment. It’s nothing like the real thing, but at least we can talk a little about process. I also give them a chance to talk about some difficult cases and go over how it was handled. This is a huge advantage of being close by. When I went out to the district hospitals I never had time for this. So, even though it’s not what I thought I wanted, I’m glad I got assigned here. Something good came out of the bloodsucking violence.

Which leads me to…we got permission to break our curfew this week for Thanksgiving. The other volunteers are allowed to come to our house Thursday for dinner. George and I went shopping for it yesterday and couldn’t find a turkey, but bought four chickens and will make do with those. The mangos are ripening and I’m planning a mango drink with mint and hard cider as an aperitif. Maybe I’ll try one today to test it out. We have thousands of mangos on our tree starting to ripen. Chimemwe pointed to a ripe one at the top yesterday and I asked if we had to wait until it falls? It was at least thirty feet in the air. He laughed, “Ah, no! I can pick it.” and I swear in twenty seconds he was up that tree and back down with the ripe mango in his hand without even disturbing one leaf. He handed it to me, “See? There you are!” I held it up and said, “Chimwemwe, this is why my friends are jealous that I have you.” He laughed and put his shoes back on. He is adorable.

It rained last night and the air is cooler this morning. It actually felt good to get under the blanket last night. It’s been hot and humid and feels like I’m wearing a hot wet sweater all the time. The rainy season is just starting and has been sporadic, but such a relief. Some pale lavender lilies exploded in bloom around our house this week. I hadn’t even known they’d existed but there they were, just quietly, patiently waiting for the rain.

Happy Thanksgiving.

Love to all,

Linda

Sunday Morning~ Blantyre

November 12, 2017

Anyani sasekana zikundu ~ Monkeys don’t laugh at one another’s behind.

~ Malawian proverb

Hi Everyone,

Before I left the states to come back here, the violence related to the bloodsucking had been reported on internationally. A lot of people asked if I was nervous about coming back–– if I felt safe enough?  I reassured them I did. Peace Corps always errs on the side of caution and we would not be staying in an unstable country. Exactly one week after arriving back in Blantyre, I was chatting with a woman from Zimbabwe and she told me her son would be going to college in America. I said, “Really? Wow! That’s great!” She said, “I know, it’s a great opportunity. I know I need to let him go, but I am worried. I heard they shoot black men for no reason.”

How do I respond to this?

The violence that occurred here regarding the myth and superstition around “bloodsuckers” was swiftly dealt with. Police and military were called in to areas where mobs and rumor were getting out of control. Someone told me there were over 400 people in one prison. Politicians went personally to the areas where it was happening and met with the village chiefs. Communities made plans to keep themselves safe as people were terrified. There have been no incidents in the past few weeks and there is a cautiously optimistic feeling that it’s over. Those who perpetrated the violence have been arrested and contained. Education is being done to reassure villagers that vampires don’t exist. The village system is set up in a way that allows people to be heard. They have a forum to voice their fears and concerns and if done well, can be a positive experience of educating. The violence won’t be tolerated. Police and military are arresting anyone that even is associated with the mobs. This strategy has worked, it seems.  We are still under a curfew. The area surrounding Mt Mulanje where the whole thing started will be off limits for at least another few months, I imagine. Even the nursing school pulled students from the district hospitals there, but the general sense is that those who have been tasked with protecting the public have done their jobs.

I couldn’t say the same for my own country. I couldn’t tell this woman not to worry. I couldn’t say there were a few isolated incidents but most of the time black men are perfectly safe in America. I couldn’t say our police, military, and politicians would never allow that to happen with any regularity. I couldn’t say the suppliers of weapons wouldn’t allow them to be used like that.

So, no. I was not worried about coming back here. When I am walking home from work and hear footsteps behind me, I don’t worry about who it is. I turn to them as they pass me and greet them and always get a polite greeting in return. I don’t walk around flaunting my privilege, though I suppose just being white makes that redundant. I don’t go near local bars at night. I don’t walk around flashing cash, in fact, I don’t carry much cash with me at all. I’m not stupid. I’m careful, but I don’t feel unsafe. I felt more uneasy driving alone in rural parts of the southern United States, passing randomly placed confederate flags, than I do here.

The only thing keeping me from despairing when I think about the violence at home is focusing on living a decent life and working to get sane people elected. I just can’t believe this is reality. This week’s election results helped.

I jumped right back into the routine here, arriving just in time to start the academic calendar. That was a random stroke of luck. I had taken my home leave to accommodate prior commitments and planned to just fill in wherever needed when I returned. The academic year starts at a different time each year, and no one seems to know when that will be until just before it happens. So when I left a the end of July, no one could tell me when the next term would start. Last year it was in October, so I thought I’d be missing the first couple of weeks. I went over to campus on Monday morning to find it was day one of the term and I was just in time for fourth year students orientation! How’s that for timing? It was incredibly touching. I opened the door to the classroom where the students were all spit and polished in their new uniforms and asked, “Am I late?” The faculty were at the front of the class and their faces lit up when they saw me. (I just love that.) One stood and said to the class, “Excuse me for a minute, I have to give this woman a hug.” Sweet. I wish I could bottle those smiles.

I’ve been assigned to supervise a group of ten students here at Queens since the curfew prohibits travel to any of the district hospitals. I’m relieved that I still am able to have clinical students, but dreaded going back into this teaching hospital. I still haven’t recovered from doing my orientation there a year ago. I spent two days there this week with students and it has gone from bad to worse. I come home so depressed it takes me all night to recover. I’m afraid someday I just won’t. I feel like women are being slaughtered. They are having c-sections for diagnoses like “big baby”. Even at home where there is ultrasound and highly experienced sonographers, the estimation of fetal weight is inaccurate. To just look at a woman’s belly and say “big baby” and pronounce that it won’t fit before we even give her a chance is making me crazy. They tell the woman during hard labor the baby won’t fit and she needs surgery. The women are scared and in pain. If I start to argue that we should give her some time to see if it will come on it’s own, the medical students and residents will eventually agree, but by then the woman has given up and just begs for surgery, so they wheel her away. I asked one resident as they were taking a woman away if they’d talked with her about having a tubal ligation? He told me she refused, but he’d gotten her to agree to it during a bad contraction. He laughed, apparently thinking this violation of her human right was funny. I was definitely not laughing when I told him, “That’s not informed consent when someone agrees to something while in terrible pain.” This is the first labor and delivery rotation for these students so they are incredibly passive and are witnessing intolerable behavior. I tell you, if anything is motivating me to get this model ward up and running, being assigned here for the next seven weeks will be it.

The first year students finished their orientation this week and their classes start tomorrow. I will be teaching the same course, so already have my lectures prepared. This is going to be so much less stressful. It is so much nicer having a little idea of what I’m supposed to be doing. I’ll be two days a week in lectures with the first years and two days a week on labor and delivery with the fourth years. One day I will do a skills lab, something I’m valuing more and more. I never thought teaching with a mannequin was very valuable but anything is better than using these women as guinea pigs. They are being tortured. I know similar stories of women being treated like this at home, too, so I’m not laughing at any other monkey’s behind.

It’ll be busy for the next seven weeks and it’ll go fast. It’s ironic, though, that now that we have less lecture prep and a nice car, we can’t go anywhere because of the curfew. I’m hoping it’ll be lifted (except for at Mulanje) by next week when we have a St. Andrews night party to go to. We’re doing some planning for our Christmas trip to the Nyika Plateau in the north of Malawi and maybe another trip around Easter to Mozambique.  With weekends of lying around we might as well read the guidebooks.

Love to all,

Linda

Sunday Morning~ Blantyre

November 12, 2017

Anyani sasekana zikundu ~ Monkeys don’t laugh at one another’s behind.

~ Malawian proverb

Hi Everyone,

Before I left the states to come back here, the violence related to the bloodsucking had been reported on internationally. A lot of people asked if I was nervous about coming back–– if I felt safe enough?  I reassured them I did. Peace Corps always errs on the side of caution and we would not be staying in an unstable country. Exactly one week after arriving back in Blantyre, I was chatting with a woman from Zimbabwe and she told me her son would be going to college in America. I said, “Really? Wow! That’s great!” She said, “I know, it’s a great opportunity. I know I need to let him go, but I am worried. I heard they shoot black men for no reason.”

How do I respond to this?

The violence that occurred here regarding the myth and superstition around “bloodsuckers” was swiftly dealt with. Police and military were called in to areas where mobs and rumor were getting out of control. Someone told me there were over 400 people in one prison. Politicians went personally to the areas where it was happening and met with the village chiefs. Communities made plans to keep themselves safe as people were terrified. There have been no incidents in the past few weeks and there is a cautiously optimistic feeling that it’s over. Those who perpetrated the violence have been arrested and contained. Education is being done to reassure villagers that vampires don’t exist. The village system is set up in a way that allows people to be heard. They have a forum to voice their fears and concerns and if done well, can be a positive experience of educating. The violence won’t be tolerated. Police and military are arresting anyone that even is associated with the mobs. This strategy has worked, it seems.  We are still under a curfew. The area surrounding Mt Mulanje where the whole thing started will be off limits for at least another few months, I imagine. Even the nursing school pulled students from the district hospitals there, but the general sense is that those who have been tasked with protecting the public have done their jobs.

I couldn’t say the same for my own country. I couldn’t tell this woman not to worry. I couldn’t say there were a few isolated incidents but most of the time black men are perfectly safe in America. I couldn’t say our police, military, and politicians would never allow that to happen with any regularity. I couldn’t say the suppliers of weapons wouldn’t allow them to be used like that.

So, no. I was not worried about coming back here. When I am walking home from work and hear footsteps behind me, I don’t worry about who it is. I turn to them as they pass me and greet them and always get a polite greeting in return. I don’t walk around flaunting my privilege, though I suppose just being white makes that redundant. I don’t go near local bars at night. I don’t walk around flashing cash, in fact, I don’t carry much cash with me at all. I’m not stupid. I’m careful, but I don’t feel unsafe. I felt more uneasy driving alone in rural parts of the southern United States, passing randomly placed confederate flags, than I do here.

The only thing keeping me from despairing when I think about the violence at home is focusing on living a decent life and working to get sane people elected. I just can’t believe this is reality. This week’s election results helped.

I jumped right back into the routine here, arriving just in time to start the academic calendar. That was a random stroke of luck. I had taken my home leave to accommodate prior commitments and planned to just fill in wherever needed when I returned. The academic year starts at a different time each year, and no one seems to know when that will be until just before it happens. So when I left a the end of July, no one could tell me when the next term would start. Last year it was in October, so I thought I’d be missing the first couple of weeks. I went over to campus on Monday morning to find it was day one of the term and I was just in time for fourth year students orientation! How’s that for timing? It was incredibly touching. I opened the door to the classroom where the students were all spit and polished in their new uniforms and asked, “Am I late?” The faculty were at the front of the class and their faces lit up when they saw me. (I just love that.) One stood and said to the class, “Excuse me for a minute, I have to give this woman a hug.” Sweet. I wish I could bottle those smiles.

I’ve been assigned to supervise a group of ten students here at Queens since the curfew prohibits travel to any of the district hospitals. I’m relieved that I still am able to have clinical students, but dreaded going back into this teaching hospital. I still haven’t recovered from doing my orientation there a year ago. I spent two days there this week with students and it has gone from bad to worse. I come home so depressed it takes me all night to recover. I’m afraid someday I just won’t. I feel like women are being slaughtered. They are having c-sections for diagnoses like “big baby”. Even at home where there is ultrasound and highly experienced sonographers, the estimation of fetal weight is inaccurate. To just look at a woman’s belly and say “big baby” and pronounce that it won’t fit before we even give her a chance is making me crazy. They tell the woman during hard labor the baby won’t fit and she needs surgery. The women are scared and in pain. If I start to argue that we should give her some time to see if it will come on it’s own, the medical students and residents will eventually agree, but by then the woman has given up and just begs for surgery, so they wheel her away. I asked one resident as they were taking a woman away if they’d talked with her about having a tubal ligation? He told me she refused, but he’d gotten her to agree to it during a bad contraction. He laughed, apparently thinking this violation of her human right was funny. I was definitely not laughing when I told him, “That’s not informed consent when someone agrees to something while in terrible pain.” This is the first labor and delivery rotation for these students so they are incredibly passive and are witnessing intolerable behavior. I tell you, if anything is motivating me to get this model ward up and running, being assigned here for the next seven weeks will be it.

The first year students finished their orientation this week and their classes start tomorrow. I will be teaching the same course, so already have my lectures prepared. This is going to be so much less stressful. It is so much nicer having a little idea of what I’m supposed to be doing. I’ll be two days a week in lectures with the first years and two days a week on labor and delivery with the fourth years. One day I will do a skills lab, something I’m valuing more and more. I never thought teaching with a mannequin was very valuable but anything is better than using these women as guinea pigs. They are being tortured. I know similar stories of women being treated like this at home, too, so I’m not laughing at any other monkey’s behind.

It’ll be busy for the next seven weeks and it’ll go fast. It’s ironic, though, that now that we have less lecture prep and a nice car, we can’t go anywhere because of the curfew. I’m hoping it’ll be lifted (except for at Mulanje) by next week when we have a St. Andrews night party to go to. We’re doing some planning for our Christmas trip to the Nyika Plateau in the north of Malawi and maybe another trip around Easter to Mozambique.  With weekends of lying around we might as well read the guidebooks.

Love to all,

Linda

Sunday Morning~ Blantyre

November 12, 2017

Anyani sasekana zikundu ~ Monkeys don’t laugh at one another’s behind.

~ Malawian proverb

Hi Everyone,

Before I left the states to come back here, the violence related to the bloodsucking had been reported on internationally. A lot of people asked if I was nervous about coming back–– if I felt safe enough?  I reassured them I did. Peace Corps always errs on the side of caution and we would not be staying in an unstable country. Exactly one week after arriving back in Blantyre, I was chatting with a woman from Zimbabwe and she told me her son would be going to college in America. I said, “Really? Wow! That’s great!” She said, “I know, it’s a great opportunity. I know I need to let him go, but I am worried. I heard they shoot black men for no reason.”

How do I respond to this?

The violence that occurred here regarding the myth and superstition around “bloodsuckers” was swiftly dealt with. Police and military were called in to areas where mobs and rumor were getting out of control. Someone told me there were over 400 people in one prison. Politicians went personally to the areas where it was happening and met with the village chiefs. Communities made plans to keep themselves safe as people were terrified. There have been no incidents in the past few weeks and there is a cautiously optimistic feeling that it’s over. Those who perpetrated the violence have been arrested and contained. Education is being done to reassure villagers that vampires don’t exist. The village system is set up in a way that allows people to be heard. They have a forum to voice their fears and concerns and if done well, can be a positive experience of educating. The violence won’t be tolerated. Police and military are arresting anyone that even is associated with the mobs. This strategy has worked, it seems.  We are still under a curfew. The area surrounding Mt Mulanje where the whole thing started will be off limits for at least another few months, I imagine. Even the nursing school pulled students from the district hospitals there, but the general sense is that those who have been tasked with protecting the public have done their jobs.

I couldn’t say the same for my own country. I couldn’t tell this woman not to worry. I couldn’t say there were a few isolated incidents but most of the time black men are perfectly safe in America. I couldn’t say our police, military, and politicians would never allow that to happen with any regularity. I couldn’t say the suppliers of weapons wouldn’t allow them to be used like that.

So, no. I was not worried about coming back here. When I am walking home from work and hear footsteps behind me, I don’t worry about who it is. I turn to them as they pass me and greet them and always get a polite greeting in return. I don’t walk around flaunting my privilege, though I suppose just being white makes that redundant. I don’t go near local bars at night. I don’t walk around flashing cash, in fact, I don’t carry much cash with me at all. I’m not stupid. I’m careful, but I don’t feel unsafe. I felt more uneasy driving alone in rural parts of the southern United States, passing randomly placed confederate flags, than I do here.

The only thing keeping me from despairing when I think about the violence at home is focusing on living a decent life and working to get sane people elected. I just can’t believe this is reality. This week’s election results helped.

I jumped right back into the routine here, arriving just in time to start the academic calendar. That was a random stroke of luck. I had taken my home leave to accommodate prior commitments and planned to just fill in wherever needed when I returned. The academic year starts at a different time each year, and no one seems to know when that will be until just before it happens. So when I left a the end of July, no one could tell me when the next term would start. Last year it was in October, so I thought I’d be missing the first couple of weeks. I went over to campus on Monday morning to find it was day one of the term and I was just in time for fourth year students orientation! How’s that for timing? It was incredibly touching. I opened the door to the classroom where the students were all spit and polished in their new uniforms and asked, “Am I late?” The faculty were at the front of the class and their faces lit up when they saw me. (I just love that.) One stood and said to the class, “Excuse me for a minute, I have to give this woman a hug.” Sweet. I wish I could bottle those smiles.

I’ve been assigned to supervise a group of ten students here at Queens since the curfew prohibits travel to any of the district hospitals. I’m relieved that I still am able to have clinical students, but dreaded going back into this teaching hospital. I still haven’t recovered from doing my orientation there a year ago. I spent two days there this week with students and it has gone from bad to worse. I come home so depressed it takes me all night to recover. I’m afraid someday I just won’t. I feel like women are being slaughtered. They are having c-sections for diagnoses like “big baby”. Even at home where there is ultrasound and highly experienced sonographers, the estimation of fetal weight is inaccurate. To just look at a woman’s belly and say “big baby” and pronounce that it won’t fit before we even give her a chance is making me crazy. They tell the woman during hard labor the baby won’t fit and she needs surgery. The women are scared and in pain. If I start to argue that we should give her some time to see if it will come on it’s own, the medical students and residents will eventually agree, but by then the woman has given up and just begs for surgery, so they wheel her away. I asked one resident as they were taking a woman away if they’d talked with her about having a tubal ligation? He told me she refused, but he’d gotten her to agree to it during a bad contraction. He laughed, apparently thinking this violation of her human right was funny. I was definitely not laughing when I told him, “That’s not informed consent when someone agrees to something while in terrible pain.” This is the first labor and delivery rotation for these students so they are incredibly passive and are witnessing intolerable behavior. I tell you, if anything is motivating me to get this model ward up and running, being assigned here for the next seven weeks will be it.

The first year students finished their orientation this week and their classes start tomorrow. I will be teaching the same course, so already have my lectures prepared. This is going to be so much less stressful. It is so much nicer having a little idea of what I’m supposed to be doing. I’ll be two days a week in lectures with the first years and two days a week on labor and delivery with the fourth years. One day I will do a skills lab, something I’m valuing more and more. I never thought teaching with a mannequin was very valuable but anything is better than using these women as guinea pigs. They are being tortured. I know similar stories of women being treated like this at home, too, so I’m not laughing at any other monkey’s behind.

It’ll be busy for the next seven weeks and it’ll go fast. It’s ironic, though, that now that we have less lecture prep and a nice car, we can’t go anywhere because of the curfew. I’m hoping it’ll be lifted (except for at Mulanje) by next week when we have a St. Andrews night party to go to. We’re doing some planning for our Christmas trip to the Nyika Plateau in the north of Malawi and maybe another trip around Easter to Mozambique.  With weekends of lying around we might as well read the guidebooks.

Love to all,

Linda

Sunday Morning~  Blantyre

Mwamuna aliense ndi mwana wamfumu ku chipinda kwake~ Every man is a prince in his own bed.  ~ Malawian Proverb

November 5, 2017

Hi Everyone,

Well, the temperature is perfect, there is a soft breeze, canaries are flitting about, there isn’t a cloud in the sky, the mangos hanging off the tree are getting bigger before my eyes, and I’m sitting on my front porch taking it all in. I thought it would be hotter–– it usually is right before the rains–– but it’s delightful. I’m a little out of sorts, maybe a touch of jet lag, maybe because I didn’t go to mass this morning, maybe the readjustment to cohabitating is difficult, I’m not sure. Maybe some of each.

The last week has seemed like a month. Leaving Bar Harbor was a blitz: dropping the car in Portland, meeting up with Joe and Alan to transport me and my stuff to Massachusetts, Zack collecting me at Alan’s mother’s house with George’s car, dropping Zack at his house, getting over to Rachael’s to spend a little time with them before meeting my high school friends for the evening as a huge storm blew in from the tropics, driving ten miles back to Rachael’s that night in hurricane force winds and flooding roads––and that was just Sunday! Monday, I got prepped for the noon talk at a Rotary club near Boston, borrowed Mike’s car to get into Harvard Square to get my new glasses readjusted, met up with Julie from the Boston office of my organization and collected packages to bring back to Malawi, found the building at Tufts where I was giving a talk at 4:30, then rushed to return the car to Mike, grabbed the red line train to South Station, and ran with five minutes to spare to catch the 7 o’clock Chinatown bus to New York. I made it just before seven to find there is no seven o’clock bus on weekdays. Next one was at 8:30. This was hard to accept. I looked down at the sole of my shoe now flapping in the breeze as I’d tripped running up the steps, trying not to cry. I reminded myself I only had to wait an hour and a half! In Malawi it would have been twenty-four! How quickly I get spoiled. I checked out other options, but couldn’t get any transportation to New York sooner than an hour and a half. Honestly, that’s not that much time. So, I bought my ticket and used the  time to collect my wits, find some free wifi, and send a few messages. That helped to keep my anxiety down as I contemplated how late I’d be getting into New York. I was also really tired. I’d stayed up late with my friends the night before, the howling wind and falling branches kept me awake most of the night, and my mind running a mile a minute trying to figure out how I’d get everything accomplished and organized to have a graceful departure on Wednesday didn’t make for a restful night. The car trouble really messed up my vision of a relaxing four last days of home leave. I called Ruth to see when the last metro train ran so I could get up to her place in mid-town. She didn’t know what I was talking about. “What do you mean, when is the last train? This is the city that never sleeps!” So that was good. I’d be able to catch the D no matter when I arrived. Then I only had to worry about my lack of sleep as I drove four hours back to Boston. I couldn’t find the zen. The bus, however, was on time and the driver went like a bat out of hell and I was on the deserted streets of Chinatown by 12:20 a.m.! That felt like a little gift. I wasn’t expecting to arrive until one! A half hour later I was sitting at Ruth’s kitchen counter drinking good wine and feasting on Mediterranean chicken and couscous. I love my friends.

Later Tuesday morning than I’d planned, I packed up the pounds of beads that Ruth had collected for my women’s cooperative project and, with her help, lugged it all down to the subway. A hug goodbye and two hours later, I was at my stop in Brooklyn. I did only minor damage to my shoulders carrying the beads two blocks to the car repair shop. There I unloaded a healthy portion of my checking account into their cash register and retrieved my little mini who looked great after her week at the spa. The new timing chain and rear brakes agreed with her and she looked years younger! Purred like a kitten. She even had a bath. If anyone wants a recommendation for a garage that works on foreign cars near the city, let me know. They were great. My GPS wasn’t working since I no longer had a phone plan with data, so the owner gave me detailed directions on how to get out of the side street and onto the highway. That seemed like a forgotten art, and with the Brooklyn accent it was theater, really.

The late start meant that I missed rush hour traffic so the drive back to Boston was cake. I unloaded the car’s six week’s contents and stashed what wasn’t coming back here with me into a corner (a big corner) of the upstairs room at Rachael’s. I felt a little like a teenager leaving crap at her parent’s house. Then it was a fun evening of trick or treating with Wonder Woman and Chewbaka as an American finale. Wednesday was goodbye to the grandkids as they rushed off to daycare, and kids as they rushed off to work. I had kind of hoped we could meet somewhere in Europe in February so it wouldn’t be such a long span until I saw them again, but that idea was met with more skepticism than excitement, so not sure if that’s going to happen. It’ll probably be a ten month plan, which really, I guess isn’t that long. It was a relief to have most of the day to get organized and figure a way to keep my two suitcases under fifty pounds each. I think I had fifty pounds of beads and another fifty of textbooks. That didn’t leave much room for anything else. Well, there was plenty of room, but no more weight allowance. I had to arrange my carry-on with most of the heavy stuff, which made changing gates and loading the overhead bin fairly unpleasant.  Overnight to Amsterdam and I had a twelve hour layover there, 8 a.m. to 8 p.m. My friend Chris works part time in Amsterdam, and the timing worked perfectly, allowing us to spend the day together in that beautiful city. We walked a million miles, had lunch, took a boat trip on the canals and were back at the airport in time to collect my luggage from the storage locker, drink a Heineken, share a goodby hug, and make it through security with an hour to spare. By then I was nearly sleepwalking.

I was really looking forward to getting home. It’s funny how much this feels like home right now. I was looking forward to seeing George, but getting a little nervous that he wasn’t answering any of my emails and texts. I knew they’d been allowed back to Blantyre and knew he’d arrived but my little updates along the way were not met with the enthusiasm I was expecting. I thought maybe he was busy getting the house ready for me, but that wouldn’t stop him from answering a text. I thought maybe he was outside picking flowers? Hahaha. Why do I always do that to myself? Why? Does this fantasy of the perfect reunion ever get more realistic? Why don’t I ever learn? It’s so self-destructive. By the time I got to Nairobi at six Friday morning I was worried he’d forgotten I was coming back, or didn’t want me to come back. I got onto the airport wifi, sent off an email, a text, and a What’s App message frantically worried that something had happened. He replied that he’d thought he had replied to my other correspondence, but apparently didn’t, which is bullshit since you can see when the message is sent. So that seemed a little cruel to me, but by then my sleep deprivation had given way to paranoia. By the time my flight left for Malawi, most of my excitement had evaporated. I could see we were in for an “adjustment” to being back together. I braced myself.

When I got off the plane he was waving from the baggage claim. I wondered how he’d gotten in there since you have to go through security? He just walked through (so he says). Not sure if he had to spin a tale or not. But it was lovely and smooth and all my luggage arrived and we went out to the parking lot and got into his new car and it was all luxurious and comfortable. We seemed a bit like strangers, though. It was weird. Something’s off. He got defensive when I harped on the fact he hadn’t responded to my messages, which, I told myself flying over Lilongwe not to do, but then again, that’s never stopped me before.

I will say, the guards seemed happy to see me. I love the way their faces light up. It made me feel loved and welcomed. Catherine is now the night guard and she arrived just before six while we were sitting on the porch having tea. I ran to the gate to let her in and she whooped and picked me up and swung me around. It was hilarious. And touching. I felt loved.

The tension inside the house escalated when I walked around putting things back where I’d had them before I left. George had locked himself out of the house while I was gone, so has an elaborate system now of leaving keys in certain places so he won’t forget them again. I messed that up when I put a basket (containing his keys) on a different shelf, not understanding the strategic placement. I also opened every door and window. Those of you who know me, know I like doors and windows open. In fact, I like most things open. George thought closing everything up would keep the dust of the dry season down. I’d rather dust every day (and since he banished Catherine from the house, I’ll have to). So it’s tense. It’s hard living alone then having someone invade your space, I get that. When we were all starry-eyed in love it was different, but that phase is over. Now we just seem to annoy each other. We’ll figure it out, hopefully without a knock down drag out fight, but it is a bit of a downer. I’m not living in a house with closed windows. In the tropics. No.

There has been no violence here associated with the bloodsucking incidents for the past two weeks. Because of that the Blantyre volunteers were allowed to come back, but we still have a curfew. We have to be in our house by 6 p.m. and can’t go anywhere outside the city during the day. That’s a drag, especially now that we have a car. Yesterday we went to an art/poetry exhibit about Mount Mulanje at the cultural center and it made me long to climb that mountain again. It’s currently off limits so I hope the curfew is lifted soon. I was remarking about this to my friend Sophie and she said, “Don’t worry. The rainy season is coming. No one fights in the rainy season. They are all too busy planting.”

The garden is overflowing! There are new lemons on the tree, peaches (which I didn’t even know grew here) covering the peach tree, avocados forming, and mangoes everywhere. The flame trees are in bloom, the beets, kohlrabi, fennel, chard, and carrots are all ready; we will not be lacking vitamins. I was telling Chimemwe how lucky I feel to have a full time gardener. He asked if I have one at home? I said, “No, it’s mostly wealthy people who have gardeners at home.” He just looked at me, confused. I said, “I know we seem wealthy to you, but at home we are not.”  He wanted to know if gardeners in the U.S. were well paid? I told him I have friends who are gardeners and they make a good living, but the season is short. It doesn’t last the whole year. He said, “Oh, I see.” and went back to his work as if that plan was foiled.

Despite my lack of sleep I managed to stay up talking with George late enough to get onto a local schedule. I go back to work tomorrow and am looking forward to seeing everyone and getting back into a routine. I won’t be able to go out to the district hospitals while the curfew is in effect, so will try to make myself useful here. Maybe focus on getting the model ward going. Early this morning we got out the travel guides and started planning our Christmas trip which, seems a little ridiculous since I just got back, but hey, Christmas is coming whether I just got back or not. And there is so much of this continent we haven’t seen yet! Hard to fit it all in to one lifetime.

Love to all,

Linda