Sunday morning ~ Blue Zebra

Mimba si kupha namwino ~ The pregnancy does not kill the midwife.

~ Chewa proverb

May 13, 2018

Hi Everyone,

During the antenatal clinic this week a student came to ask me what to do with a woman who was three weeks past her due date. I followed the student into the exam area and greeted the woman. I asked if her first baby was late? She replied, “No. He is still alive.”  I laughed, realizing that late here means dead. If someone is late for something they are referred to as “not keeping good time”. If you “keep good time” it means you arrive when you were supposed to.

It was my last clinical day with these students. I have dreaded these clinics for the past three weeks since it was their first rotation for antenatal and they were a bit green, as in didn’t know anything. On the first day the sister (nurse) in charge did a little orientation and that was the last anyone saw of her. Nine brand new students have been left alone to run a daily clinic for pregnant women. I’ve been there two days a week, but that was no where near adequate. I’d leave there in the depths of depression after watching women come and go without a real evaluation. The students weren’t even greeting the women! They were nervous, I know, but greetings are a big deal here. I shouldn’t have to teach them how to do that. The first day I said, “Ok, two of you can start getting weights on everyone.” figuring that would be easy. But none of the students knew how to use a scale. They had no idea how to balance it. I spent the morning going, “See? It’s already too heavy; you have to move the weights back this way until the arrow floats in the middle of this space.” pointing to the area on the scale that indicates it is indeed balanced. Looks of utter confusion adorned their faces. I looked at the hundreds of women waiting and my heart sunk. It took weighing two hundred women for them to get the hang of it. And this was just the weight. They were supposed to take their blood pressure, check their HIV status, screen for any complications, check the fundal height, the gestation, give whatever medications were needed, then schedule her next visit. The students show up and the staff leaves. That’s pretty much what happens at the clinics. The staff is supposed to be the ones doing the teaching. The lecturers (of which I am one) are supposed to go once a week to supervise, but often the students are on their own. But by this past Friday, when I went for the last time, I was amazed at how well they were doing. I’d given them all hand sanitizer since there is no place to wash their hands. The first week they’d “forgotten it” and I blew up. “I should not have to teach you to remember to bring the needed supplies! You have enough to learn here! Please do the things you are capable of, like bringing your hand sanitizer and your watch! And say hello to the women for goodness sake! You are capable of that!” These are the students I had last year in lecture and they were all so bright and eager. Now they seem like sullen teenagers. Not that I blame them for being discouraged. This particular health center  is a hell-hole in a disgusting slum of Blantyre. They arrive and are dumped with responsibilities they are no where near ready for. But on Friday when I arrived at 7:45 they had “kept good time” and were there. They divided themselves up for various tasks. They weighed the women appropriately and at least cursorily greeted them. Three of them checked blood pressures, one handed out iron tablets and antimalarial meds, and the others did exams. I was impressed! They were diagnosing breeches and twins, calculating due dates appropriately, and referring women who had problems. I never saw a staff person. When they had a question they’d come and get me so I went from room to room to be with each of the students, and I had a good time! It was a nice way to finish up for me. They still have two more weeks at this clinic, but we have a close of service meeting at the lake for three days this week, then I leave for the states for two weeks; one for my midwifery annual meeting in Savannah, and one to spend with the grandchildren. I’ll fly back to Malawi the first week of June to finish up. It’s mostly administrative stuff from now on. I finished my lecturing on Thursday, and my clinical on Friday. I expected it to be more of a relief than it was. 

The week had been frenetic. Monday morning was spent with the women’s group and two of the speakers I’d scheduled didn’t show up. I was frantically calling the third, my neighbor Mona Lisa, who’d written the date down wrong and wasn’t planning to come, but she rearranged things and saved my day. She works for Save the Children and has good ideas about women in business. The women walk two hours to get to our house so I hated to have it be for nothing. Phew. We brainstormed about where to go with the group. They have continued to meet twice a week and brought a lot more jewelry they’d made and five new women have joined the group. They told me they want another teacher to help them expand their skills. There is a grant from the US Embassy I might apply for to see if I can do that. For now, we planned to have one more meeting in June before I leave. Mona Lisa said she’d ask someone from Save the Children who works with women’s cooperatives and see if she will help get them more organized to start a small business. I brought out the beads and supplies that my friend Ruth sent from the states and they fell on them like dogs on a meat wagon. I can’t wait to see what they create from it all.

At one o’clock we drove to the airport so our guest could catch her flight. We got stuck in a line of traffic lasting an hour as the president of Botswana was also flying out Monday afternoon. We luckily made it in time, said goodbye, and my son and I drove to Dedza, a three hour ride, two of which in heavy rain. Late rain. Not dead, just late as the rainy season ordinarily ends in April. I was happy to arrive at the lodge and have a drink and dinner for the last evening with my boy. Tuesday morning I was up early to continue to Lilongwe for a meeting with GIZ, a German NGO, about improving clinical teaching for nursing and midwifery students. I was hoping that they’d be interested in our model ward, but I learned they focus their efforts on only three districts in Malawi, and Blantyre is not one of them. Bummer. But it was a worthwhile meeting and I’m glad I went. 

From there I had to get to the hotel to get ready for the Fabulous Women Party I’d been invited to at the American Ambassadors residence. This was a big deal. I was allowed to bring one invited guest, another “fabulous woman”, and I invited Ursula. I knew I wanted to ask someone from the faculty but didn’t know how to go about it. I hated to choose anyone over the others as they’d all hear about it. A few weeks ago I announced to them that I had been invited to this party and wanted to take one of them but didn’t want to be the one to choose. I asked them to decide among themselves who should go and they all chose Ursula. She was my choice too, so it was great, and no hard feelings.

We got over to the Peace Corps office at five to get transport to the residence. This was major security and bling let me tell you. I have never seen such makeup, stilettos, and secret service in my life. There were probably two hundred women there including the first and second lady, and the former first lady. (I mean the first lady of Malawi not Melania) It was awesome! It was like a high class hen party. Lots of members of parliament, business women, several Peace Corps volunteers, the Peace Corps director, the president of the nursing school, etc. all chatting, drinking, nibbling on the passed hors d’oeuvres, and chocolate fountain, and after the speeches there was a dance party in the dining room. Classy. A blast. The first lady didn’t stay for the dancing, but I did get to speak with her briefly as she worked the crowd. I love our ambassador, Virginia Palmer. She is a power-house and strong advocate for raising women up however possible. She speaks against child marriage and in support of keeping girls in school. She encouraged us all to support each other. She quoted Madeline Albright when she said, “There is a special place in hell for women who do not support other women.” She encouraged us to network and brainstorm with each other while sipping wine and eating the mushroom tarts. I loved it. I stuck to the sparking wine, but plenty of women were drinking wine glasses full of Amarula, a liquor much like Baily’s, which comes from the Amarula fruit. I love it, but can only drink a small amount. It’s rich. There were women drinking wine glasses full of the stuff and going back for more! I swear they went through 200 bottles. It was a hoot.

After that it was back to the hotel to crash as I had to be up early for the International Day of the Midwife celebration. It was similar to last year with a few twists. SEED, the organization I work for, was sponsoring a table and I was in charge of getting all the stuff there and setting it up. That was stressful as I had no information about where to do it. The itinerary said a march would start at the Area 18 health center and proceed to the Golden Peacock Hotel where the speeches and display tables would be. I drove to the hotel and left my car there with all the stuff in it, then Polly (fellow volunteer) and I decided to walk the march route backward to the health center, figuring we’’d run into them on the way. I figured it would start late like it did last year. We hoofed it the three and a half miles to the health center to find NO ONE. But we could hear music in the distance down a different road. We started running toward the music and asked a woman along the way if the midwifery parade had gone by. She affirmed it had and pointed in the direction of the music. About a mile and a half later we caught up to them. They’d changed the route. We gulped some water and joined the parade, which is a total kick. Everyone was dancing and singing with a big lorry with the “Health Education Band” (seriously that’s their name) following behind the marchers. It’s a blast. By the time we got back to the hotel, Polly and I had walked/run eight miles. Then there were photos outside with the minister of health and while that was happening, Polly and I ran in to set up the table. (Thank God she needed a ride back to Blantyre and stayed for this event.) My midwifery colleagues had a “special meeting” which I had not been informed about, so arrived at the last minute and took their seats.

Before the speeches began, the minster of health and his entourage toured the tables. We (I) had made a little display about the midwifery-led ward and to dress up the table I had brought some of the jewelry from the Tiyamike group. I got to explain to the health officials  why we thought this ward was needed and the rationale behind starting this women’s group for women with no education. They listened. I’d had copies of the project summary printed and handed them each one. It’s not likely they will participate in the project, but it was good to have them informed and at least raise some awareness about the problems we face. I was happy. 

Then the speeches started. Four hours of them. The president of the Malawi Midwives Association mentioned our project in her speech, though, so that was a high point. I feel like it’s gaining momentum. There was a lot of twitter about that. The last speaker was the minister himself whose voice is almost as beautiful as he is. Gorgeous man. When it all ended I’d hoped that people would come buy some of the jewelry, and some did, but lunch was supposed to be from 12 to 2 and it was 2:20 when the speeches ended so everyone ran, and I mean ran, to get food. So we packed up the table, put our lunches in a box and hit the road back to Blantyre, a five hour ride. The ride is stressful in the best of conditions, but after dark it is downright scary. You cannot see a thing and many cars don’t have head or tail lights. We got back to Blantyre in one piece at 7:30 and I was completely spent. The next day was clinic from 7:30 to noon and lecture from 1 to 5. I’m too old for this.

So now I sit on our veranda overlooking the lake at the Blue Zebra Lodge, a treat from George for the weekend. This is part of the National Park (the largest freshwater park in the world) and is run beautifully. It’s on an island in Senga Bay and we got here from Blantyre yesterday just in time to catch the boat. It’s been a chance for me to decompress from work, visitors, and extracurricular activities that both feed and frustrate me.

My son asked what I’d miss about Malawi. It was at the beginning of a stressful week and I was thinking more of the things I wouldn’t miss. We were driving the M-1, a narrow, curving, two-lane highway, with no shoulder, that runs north to south connecting the major cities. There is a lot of traffic on the road and passing is dangerous. The sides are strewn with bicyclists carrying huge loads and thousands of pedestrians. Goats randomly run onto the road. I see a near miss about every fifteen minutes. I will not miss the drive to Lilongwe, but I’ll miss the landscape. It is gorgeous. I will miss the people. I will miss the warm and genuine greetings. I’ll miss their smiles. I’ll miss being able to take a weekend and go someplace exotic and spectacular. I think to myself that some people save their entire lives to take a vacation like our weekends away that cost so little. I’ll miss the warmth but not the heat. I’ll miss having the opportunity to share another side of life with students and see their eyes light up with stories of how it is where I come from. I’ll miss sharing this adventure with George who, at his age, had courage enough to do something way outside his comfort zone. 

We are in an idyllic setting with no WiFi so this won’t get posted until tomorrow. It’s Mother’s Day which I had totally forgotten about until before dawn this morning when George wished me a happy one with a sweet necklace and bracelet that Chimemwe had made with shells from our trip to Mozambique. I’m a lucky girl.

Happy Mother’s Day.

Love to all,

Linda