Thoughts about my Week and Africa in General

For this post, I’ll talk a little about some of the interesting things that happened to me this last week and some of the cultural things I have learned about Africa in my time here.  

This week is my third week volunteering and for the most part I spent it in the treatment room and helping triage patients.  This week also brought a Canadian couple who are going to volunteer at the clinic for two months (she is a nurse and he is a second year medical student) and a Malawian national whose family is from India who is studying nursing in Boston.  She is also volunteering at the clinic but in a more limited manner because she has just started her nursing education.  The one interesting thing I did do was go with Dr. Ivey to the Maula prison in Lilongwe for a clinic.

Maula prison is the big prison in Lilongwe and from what I heard the high security one.  Before anyone gets all worried, we were only allowed in the medical buildings on the prison campus (which were provided by Irish Aid) and these were separated by tall wire walls with razor wire on top.  We were not allowed to take pictures (because of an armed group who entered the prison and facilitated the escape of 5-6 prisoners last year) but because the prison is essentially open air with wire walls to separate the different section, you could see the other buildings.

The prison officials choose 70 men and about 30 women to be seen and many had scabies, wounds, and coughs which were probably the result of the overcrowding (there are 200 men sleeping in a building made for 60) and malnutrition (if your family doesn’t bring you food, then you get a serving of nsima (essentially polenta) once a day with a serving of beans at least once per week).  The prisoners were there for murder, theft, illegal border crossers coming into Malawi, and any other crime you can think of.  After visiting a prison during my time in Peru, it was a good experience to see another one in a foreign country.

My other interesting adventure this week was taking the minibus to the center of town.  I waited about 30 minutes, got on, and then was let off about a half-mile away.  Thankfully, one of the nurses at the clinic I know was also let off and she told me that there is a police stop up the road.  This means that the minibuses going that way must not be overcrowded but ours was.  We caught another one where I opened and closed the door for people got on and off and got let off myself about a half-mile from where I wanted to go.  Essentially, a quick 10 minute car trip took over an hour and didn’t even get me to where I wanted to go.  

In the center of town, I bought some gifts at the local craft markets (they call these curio shops) and kept telling the shop owner that he isn’t giving me a discount when were are bargaining.  He never acknowledged my comment but his friends nearby laughed.

So far, Africa has been so different than what I expected.  I came here figuring it would be similar to South America because they are both developing part so the world, use mainly cash, barter for everything, and because I look so different from the locals.  What I have found is that I underestimated what I would encounter.  First, being a mzungu (what they say for a white person or foreigner ;similar to gringo in South America) gets prices marked ridiculously up.  This means that you never know what a fair price is.  Unless you are a master bargainer, what to pay the mzungu markup, or actually know what the price should be, it is cheaper and easier to do most of the shopping at the supermarkets or fixed price gift shops.  It makes it less interesting but sometimes makes it easier.

Another big difference is the lack of the sense of time.  I was told soon after arriving to never trust an African who says to wait five minutes because that means nothing.  You could wait 10 or 20 minutes or what you want may never come or happen.  This is why public transport can be frustrating.  The minibuses in Lilongwe and actual buses that run between the cities stop more or less anytime someone wants to get off or on.  This means when you get on a long-distance bus, you never know when you will arrive.

The other interesting thing is the food.  The general Malawian diet is nsima with relish, veggies, and occasionally meat.  This is not eaten by people who can afford better.  In Lilongwe, you can find find good food from India (because both India and Malawi were under British rule at some point), samosas galore, fried doughnuts, pizza, hamburgers, a drive-through KFC, and other western style food but there are not “Malawian” restaurants.  From what I have been told, it is because there isn’t much more to Malawian cuisine except for nsima.

This next week will be another week of volunteering and in about two weeks, my sister will join me in Lilongwe for a month of traveling in Malawi.

Volunteering at ABC Clinic

This Africa trip is made up of four parts.  The first was seeing my friends (the Millers) who live in Malawi with my friend Steph and then traveling with Steph to Victoria Falls. the second is spending five weeks volunteering at the clinic my friend works at, the third is traveling around Malawi for about a month with my sister, and the fourth is stopping in England on my way back to the States to see a friend I worked with at summer camp years ago.  The second part of my trip started about two weeks ago when I started volunteering.

ABC (aka African Bible Colleges) is an organization that has three colleges throughout Africa (they are also in Liberia and Uganda also), and at their campus in Lilongwe, Malawi, there is a medical clinic.  Prior to coming to Malawi, I contacted them to see the feasibility and possibility of volunteering as a nurse, and they were more than happy to have me.  The clinic consists of three parts, the community side, the private side, and the ward.  The community side is a clinic that is run for the poorer Malawians and a place for the government and NGOs to do community vaccinations and clinics.  Because I have not been there, I can’t really say much more than that.  The private side is for people who have medical insurance or can self-pay for their care.  The ward is the in-patient part of the clinic for patients who need more care than a doctor’s appointment or one time treatment.

I have been helping in the private side of the clinic and it has been an experience.  What happens is patients will be seen by the doctors and go to the “treatment room.”  This is a cross between an ER and an urgent care because patients who are acutely sick, say with a high fever, active vomiting, or another medical issue where treatment should not be delayed, will be brought there immediately.  Patients also got there after doctor appointments to receive their prescribed treatment.  This means this area is busy, has a lot of people moving through it throughout the day, and has challenging needs.  I have been helping in the treatment room and triaging patients.  The work is not glamorous and sometime slow but it is challenging because of the language issues that present (a good subsection of Malawians speak only Chichewa, the other national language, and not English), cultural issues, and not knowing exactly how the clinic works.

Outside of ABC, I have had four opportunities to spend time in the villages, and these days were more exciting and what I like to do.  One afternoon was an epilepsy clinic in Lilongwe.  An organization runs bimonthly clinics for patients to receive continual treatment and also for new patients to be diagnosed and receive treatment.  It was heartbreaking because many of the patients also had developmental issues or severe complications from malaria.  My other opportunities were to help with clinics done an American ER doctor, Dr. Ivey, who spends 2-3 months in Malawi doing clinics in the villages, or bush, every year.

Three times this last week I went outside of Lilongwe with Dr. Ivey.  We went to two villages and a the youth prison.  The first day was to Mlombwa which is at least an hour and a half away with half of that time on deeply rutted roads.  The second day was to Chinsapo which is only about 30 minutes away but you have to cross a makeshift bridge to get there.  The third day was at the juvenile prison about an hour away.  Each of these days we saw between 100-150 patients, and I helped triage, take vital signs, and do rapid malaria tests.  I really enjoyed these three days because it was something different than the clinic.  It also allowed me to get out into the countryside to see how Malawians who don’t leave near a tarmac road live, and realize how isolated they can be when the dirt roads turn to mud and become inaccessible in the wet season.

I don’t have any pictures for this post because I haven’t been taking any.  I will take some and hopefully post some during the week.