Transport is everything

Yesterday we left the hill, summoned to Mzuzu to have our car re-registered, Transport

Yesterday we left the hill, summoned to Mzuzu to have our car re-registered, an official process that must be done officially! We left the hospital on the hill and started on the 3-hour journey to town. During our time on the plateau the bone shaking two-hour ride known locally as the “back road” which joins Livingstonia to the paved MI, the main north south artery in Malawi has been undergoing transformation. Thanks to MotoEngel, a huge Portuguese engineering company the road is being improved. It is our only alternative route to the infamous Girodi which I wrote about previously. It too boasts hair pin bends, several very shaky bridges and some dust bowls, it provides a more gently ascent to the mountains, before the final climb up the escarpment. It is much longer, 42 kms, but preferred to the giddying steepness of the Girodi. The only problem is that in the rainy season it is impassable. To date Moto Engel have gouged out hillsides, moved millions of tons of earth and mud and given us lots of navigational initiative tests as they mark temporary routes through the mayhem with local materials that are far from obvious at times! Recently part of the road has even been tarmacked and the vision of the new road and its potential to improve the accessibility of the hospital is becoming clearer. It may be many years before completion and some locals doubt it ever will be as the Government are quite likely to suddenly put their money elsewhere!  In the meantime, with the rains looming there is a race to get as much done as possible including improving the drains and bridges, so that their work is not washed away.

We have had three “showers” so far just to prepare us for what is to come, the rain was biblical in intensity and its potential alarming. Our roof leaks and we didn’t have enough buckets or receptacles for all the drips, mud everywhere and to our concern immediate rumours that the back road was already impassable as the deep dust on the unimproved sections becomes mudslides which even experienced 4 x 4 drivers might baulk at negotiating. Despite the apprehension the rains are eagerly awaited, only after they have been can the ground be dug and the maize planted. Famine is still a very real memory for Malawians as at the start of the new millennium the rains failed, and many thousands of people starved. Every piece of cleared ground is used to grow Maize and the steep mountain sides are currently being cleared of scrub by burning, causing us some alarm as everything is so dry, but providing spectacular light shows in the dark. The ground is then cleared, and Cassava is planted in tiered rows down the steep hillsides. In a few months we are informed, rains permitting we would look out from the plateau onto a sea of green crops, where now there is only rutted, baked mud. Other signs point to the coming rains, the trees are starting to burst into leaf, the beautiful purples of the Jacarandi are being joined by the vivid orangey red of the flame trees and the biting ants are on the march.

 Last week I was roused in the middle of the night by the doorbell being persistently rung. Abit puzzling as Charlie wasn’t on duty and is usually called by phone, however in emergencies any one that can be summoned is called. The night guard was at the door, very agitated and mumbled something about the hospital, poor Charlie was duly awoken, whilst getting dressed he asked me to check with the guard which ward needed him, however when I found the guard again he seemed puzzled by this question and then he announced just as Charlie was about to run out of the door,  that his brain wasn’t working and  he had meant to say  that the biting ants were attacking the hens and ducks and he needed the keys to get in and deal with the ants. So many things are lost in translation here! We returned to bed relieved that there was no medical emergency and also having to see the humour of it all! Heavy rains on Monday brought the hospital to a standstill, the patients all retreated under their blankets, huddled in their beds and the nurses sat around in their winter coats. We felt energised by the drop in stifling heat we had been experiencing, it was refreshing for us, with temperatures like a N. Irish summer. Mud everywhere but after about 3 hours it stopped and slowly the clouds lifted, and it dried up. After this “shower” the dust in the air, and the smoke from all the forest burning was cleared and for the first time since we have been here we were able to see the rugged mountains and cliffs of Tanzania 40 kms across the lake. It was stunning and hard to believe that this view had been hidden for so long.

We are trying not to be anxious about the rains and the potential transport headaches it might present as our travelling increases in the next few weeks towards the end of our working time here, but we have been warned that nature is a force to be respected here.

There have been some positive moments recently too. A very dynamic group of young students studying at the Livinstonia University campus on the plateau had approached us wondering how they could do some volunteering in the community while also studying here on the hill. They did a clean-up of the hospital grounds which was appreciated but they also asked if it might be possible for the hospital to help a young woman of 16, whom they had seen, who was profoundly disabled and lay on the ground outside her house during the day. Some of them had started stopping to chat to her as they walked by but felt that they wanted to do more. So, over the last few days a wheel chair has been obtained from the hospital store and she was present with it, much to the delight of the young women and her mother. Another moving moment came when Charlie managed to get another chair for a lady who had had an amputation several years ago and her mobility had been taken from her. She cried with joy.  Wheels can make such a difference! New wheels also arrived for one of the hospital ambulances this week so adding to the vital fleet that transports patients from the satellite clinics and health centres served by the hospital.

Nothing goes according to plan here and we are getting better at just accepting this. It turns out that the man we had to see about the car re-registration wasn’t in town today after all! Mzuzu isn’t exactly a city with lots of cultural activities to visit with unexpected time on your hands, so instead of car business we decided to leave our car in the safety of the Synod compound, so we would have tyres left to get home, and set off on foot through myriad market stalls and thronged streets around the bus station to try and find St John of Gods.  Charlie had recently heard of this facility as somewhere that provided services for children with cerebral palsy.  We had had several patients at the hospital who had CP and Charlie was very shocked at the lack if preventative care available for them to stop the development of terrible contracture of their limbs and joints, making the difficulties of managing the children more acute for their parents and increasing the suffering of the children. There is no physiotherapy or occupational therapists here to help teach parents the simple exercises required to improve their condition or provide equipment to facilitate any degree of independence for these children. We eventually found the place and were welcomed inside the gates to an oasis of calm and order. The centre is run by a religious order from Ireland, there amongst well set out buildings and gardens they teach activities to help adults with physical and learning difficulties be as independent as possible. We were shown the nursery and school where children were receiving care and support, and a sense of acceptance as they proudly wore their school uniforms like other children. Sadly, their services are limited to the city boundaries and they are oversubscribed even with that. They are unable to offer help to remote parts like the plateau, however if and when the back road is completed the hospital will be more accessible and we discussed the possibility of the centre maybe being able to offer some training for the hospital staff in the future.

 Sometimes enforced rest isn’t the worst thing! The man we needed to re-register the car was in town today, but he couldn’t sort the car out because it was Saturday! however this has enabled Charlie to clock up another unique golfing experience as he played in a tournament in Mzuzu sports club, founded in 1956! And I enjoyed a chill out and a chance to read a book.

We pray there will be no more rain tomorrow as we set off back up to the plateau for another few weeks.

an official process that must be done officially! We left the hospital on the hill and started on the 3-hour journey to town. During our time on the plateau the bone shaking two-hour ride known locally as the “back road” which joins Livingstonia to the paved MI, the main north south artery in Malawi has been undergoing transformation. Thanks to MotoEngel, a huge Portuguese engineering company the road is being improved. It is our only alternative route to the infamous Girodi which I wrote about previously. It too boasts hair pin bends, several very shaky bridges and some dust bowls, it provides a more gently ascent to the mountains, before the final climb up the escarpment. It is much longer, 42 kms, but preferred to the giddying steepness of the Girodi. The only problem is that in the rainy season it is impassable. To date Moto Engel have gouged out hillsides, moved millions of tons of earth and mud and given us lots of navigational initiative tests as they mark temporary routes through the mayhem with local materials that are far from obvious at times! Recently part of the road has even been tarmacked and the vision of the new road and its potential to improve the accessibility of the hospital is becoming clearer. It may be many years before completion and some locals doubt it ever will be as the Government are quite likely to suddenly put their money elsewhere!  In the meantime, with the rains looming there is a race to get as much done as possible including improving the drains and bridges, so that their work is not washed away.

We have had three “showers” so far just to prepare us for what is to come, the rain was biblical in intensity and its potential alarming. Our roof leaks and we didn’t have enough buckets or receptacles for all the drips, mud everywhere and to our concern immediate rumours that the back road was already impassable as the deep dust on the unimproved sections becomes mudslides which even experienced 4 x 4 drivers might baulk at negotiating. Despite the apprehension the rains are eagerly awaited, only after they have been can the ground be dug and the maize planted. Famine is still a very real memory for Malawians as at the start of the new millennium the rains failed, and many thousands of people starved. Every piece of cleared ground is used to grow Maize and the steep mountain sides are currently being cleared of scrub by burning, causing us some alarm as everything is so dry, but providing spectacular light shows in the dark. The ground is then cleared, and Cassava is planted in tiered rows down the steep hillsides. In a few months we are informed, rains permitting we would look out from the plateau onto a sea of green crops, where now there is only rutted, baked mud. Other signs point to the coming rains, the trees are starting to burst into leaf, the beautiful purples of the Jacarandi are being joined by the vivid orangey red of the flame trees and the biting ants are on the march.

 Last week I was roused in the middle of the night by the doorbell being persistently rung. Abit puzzling as Charlie wasn’t on duty and is usually called by phone, however in emergencies any one that can be summoned is called. The night guard was at the door, very agitated and mumbled something about the hospital, poor Charlie was duly awoken, whilst getting dressed he asked me to check with the guard which ward needed him, however when I found the guard again he seemed puzzled by this question and then he announced just as Charlie was about to run out of the door,  that his brain wasn’t working and  he had meant to say  that the biting ants were attacking the hens and ducks and he needed the keys to get in and deal with the ants. So many things are lost in translation here! We returned to bed relieved that there was no medical emergency and also having to see the humour of it all! Heavy rains on Monday brought the hospital to a standstill, the patients all retreated under their blankets, huddled in their beds and the nurses sat around in their winter coats. We felt energised by the drop in stifling heat we had been experiencing, it was refreshing for us, with temperatures like a N. Irish summer. Mud everywhere but after about 3 hours it stopped and slowly the clouds lifted, and it dried up. After this “shower” the dust in the air, and the smoke from all the forest burning was cleared and for the first time since we have been here we were able to see the rugged mountains and cliffs of Tanzania 40 kms across the lake. It was stunning and hard to believe that this view had been hidden for so long.

We are trying not to be anxious about the rains and the potential transport headaches it might present as our travelling increases in the next few weeks towards the end of our working time here, but we have been warned that nature is a force to be respected here.

There have been some positive moments recently too. A very dynamic group of young students studying at the Livinstonia University campus on the plateau had approached us wondering how they could do some volunteering in the community while also studying here on the hill. They did a clean-up of the hospital grounds which was appreciated but they also asked if it might be possible for the hospital to help a young woman of 16, whom they had seen, who was profoundly disabled and lay on the ground outside her house during the day. Some of them had started stopping to chat to her as they walked by but felt that they wanted to do more. So, over the last few days a wheel chair has been obtained from the hospital store and she was present with it, much to the delight of the young women and her mother. Another moving moment came when Charlie managed to get another chair for a lady who had had an amputation several years ago and her mobility had been taken from her. She cried with joy.  Wheels can make such a difference! New wheels also arrived for one of the hospital ambulances this week so adding to the vital fleet that transports patients from the satellite clinics and health centres served by the hospital.

Nothing goes according to plan here and we are getting better at just accepting this. It turns out that the man we had to see about the car re-registration wasn’t in town today after all! Mzuzu isn’t exactly a city with lots of cultural activities to visit with unexpected time on your hands, so instead of car business we decided to leave our car in the safety of the Synod compound, so we would have tyres left to get home, and set off on foot through myriad market stalls and thronged streets around the bus station to try and find St John of Gods.  Charlie had recently heard of this facility as somewhere that provided services for children with cerebral palsy.  We had had several patients at the hospital who had CP and Charlie was very shocked at the lack if preventative care available for them to stop the development of terrible contracture of their limbs and joints, making the difficulties of managing the children more acute for their parents and increasing the suffering of the children. There is no physiotherapy or occupational therapists here to help teach parents the simple exercises required to improve their condition or provide equipment to facilitate any degree of independence for these children. We eventually found the place and were welcomed inside the gates to an oasis of calm and order. The centre is run by a religious order from Ireland, there amongst well set out buildings and gardens they teach activities to help adults with physical and learning difficulties be as independent as possible. We were shown the nursery and school where children were receiving care and support, and a sense of acceptance as they proudly wore their school uniforms like other children. Sadly, their services are limited to the city boundaries and they are oversubscribed even with that. They are unable to offer help to remote parts like the plateau, however if and when the back road is completed the hospital will be more accessible and we discussed the possibility of the centre maybe being able to offer some training for the hospital staff in the future.

 Sometimes enforced rest isn’t the worst thing! The man we needed to re-register the car was in town today, but he couldn’t sort the car out because it was Saturday! however this has enabled Charlie to clock up another unique golfing experience as he played in a tournament in Mzuzu sports club, founded in 1956! And I enjoyed a chill out and a chance to read a book.

We pray there will be no more rain tomorrow as we set off back up to the plateau for another few weeks.