(Typed yesterday - January 18th) I am now at my last placement – in Nkhoma, which is about an hour away from Lilongwe. Nkhoma was originally a mission station started in 1897 by the Dutch Reformed Church of South Africa. It is now headquarters of the Nkhoma Synod Church in Central Africa Presbyterian. It is about 50 km from Lilongwe; Linda drove me out here on Monday, which was a holiday, in honour of John Chilibwe, a Malawian pastor who killed a white landowner, decapitated him and placed his head on a table near his pulpit. This was an early anti-colonial movement – in addition to the one day holiday, Chilibwe’s picture graces all the Malawian money. Linda says that used to keep a low profile on John Chilibwe Day, but now, they go about their regular business…!
I am staying at a guest house here – which means I have my own room, with a single bed, desk, wardrobe, and share a bathroom, kitchen and living room with other guests.
Nkhoma is now the site for a hospital, a nursing school (which is currently closed), two secondary schools, one primary school, and a seminary, as well as several synodical buildings, including the Relief and Development Office, which is partnered with the CRWRC.
Most of the other guests here are associated with the hospital – including two young interns from Australia, five or so student nurses from Holland, and one anesthesiologist from Poland. The anestheiologist is quite amazing – she is 76 years old, and this is about her third trip here. As she says, “I am healthy, I get bored at home.” She is heading back to Poland in mid-February, as the seven day weeks are starting to tire her out. However, as she is a widow and her children are grown, she expects she will return again, once she gets her strength back.
In order to walk down to the Relief and Development office, I take a shortcut through the hospital grounds. Hospitals here are quite different from what I am accustomed to. For example, as I pass through the grounds, I walk by a large mound of logs, which are cut daily. They are provided to the family and friends of the patients. See, every patient has to have at least one guardian at the hospital – to cook meals and to do laundry. The hospital doesn’t provide these services, except for tuberculosis patients and children under the age of 5. So there is a constant stream of visitors into the hospital, carrying containers of food. These people will also sleep at the hospital, often under the beds. Some patients have several relatives staying on site. When the doctors do the morning rounds, they ask everyone to leave, unless a guardian has some information to share.
Also, because the hospital is crowded, it is not unusual to find patients, especially children, sharing beds. And everyone shares cups, dishes and cutlery.
Despite what would seem to be somewhat unhygienic conditions, many patients make remarkable progress, and the hospital has a very good reputation.
I was walking home at lunch today, and as I approached the hospital, I could hear the sound of a woman wailing. Slightly ahead, I could see a small crowd of people, and a woman who was distraught – she collapsed on the ground, while most of us watched, unable to do anything to help her. I wondered – had she just lost her spouse? A child? She looked quite young – another woman began helping her to get up. It was horrible, wanting to help, not knowing how – and feeling like such an outsider – almost an intruder on someone else’s catastrophe.
Later, I was talking to the anestheologist who told me that the hospital is having a bad time with malaria – they lose an average of two children a day right now, as it is the rainy season and there are lots of mosquitoes. This morning, they lost a baby boy. He had been at a smaller hospital about an hour’s drive from Nhkoma – but the mother didn’t have enough money to pay for transportation. So instead, she had wrapped her baby up in a tchewa, the all-purpose fabric wrap which women wear as skirts and baby carriers, and biked her way to the hospital. By the time she got here, it was too late to save the infant – he had died along the way.
I wonder – was she the woman I saw at lunch time? A woman who had done what she could to save her baby, and failed?
And why, in 2011, when malaria medication is relatively inexpensive, and early treatment, so effective, are Africans dying from it?
As I type this, I look towards my suitcase, in which sits a malaria test kit, one round of treatment and a month or so of prophylactic treatment – enough to have saved a life today, had they been in the hands of the mother or the first hospital she went to.
There is something very wrong here.
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