Lilongwe down

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I was walking home from the hospital the other day, and had a strange feeling - normalcy. It's similar to when I realized that I stopped looking up all the time while walking around Chicago after moving there. This doesn't feel like home, but it does feel like I live here, however transient. The driving isn't intimidating, the vendors aren't annoying, the beggars aren't surprising, my lack of anonymity isn't new.

The last week was probably my best since I left. I spent three days at Kamuzu Central Hospital in Lilongwe. Lilongwe is the capital of Malawi, about the size of Blantyre, so it also serves as a referral center for much of the central and northern portions of the country. The catch is that there is no orthopaedic surgeon stationed there. All of the orthopaedic work is performed by OCOs (Orthopaedic Clinical Officers), personnel trained to execute simple orthopaedic care (fracture reduction, casting, traction pins, external fixation, washouts, sequestrectomies). However, there is certainly limitations to what they can do and part of the role of the volunteer is to guide their decision-making and referral tendencies. The model is reasonable for the country's outlying rural areas, where it is unrealistic to expect a higher level of training. But I think a necessary component (obviously, in an ideal world) is that there are specialist-staffed central hospitals available. Lilongwe did have a volunteer there for a year, but he left two months ago and the patients started to pile up. For my part, this was what I was looking to do all year: operating every day, seeing clinic and ward patients between cases, and working until the work is done. The only rough part was the actual conditions in the OR. It was uncomfortably hot while just in scrubs and not moving. Once I put on a plastic apron, gloves, a heavy cotton gown, and started to work, I was immediately saturated with dripping sweat. Even my paper mask started falling apart like it was dipped in the ocean. I also found out trying to breathe in a wet mask is essentially like trying to breathe in a plastic bag. But that's all part of the experience and I certainly felt a sense of accomplishment after leaving.

This last weekend I went to a 3 day music festival at Lake Malawi called "Lake of Stars." It featured about half Malawian music (anything from drums to choir to Kanye West clones to traditional instruments) and half UK DJs. It was really fun and the setting was incredible. The lake itself feels like a tepid bathtub, and it's lack of salt water means it can also double as a tepid bathtub. I ended up latching onto the campsite of a few other people that I have met here, which made for a very palpable "festival" atmosphere. However, my return to Blantyre on Sunday night certainly confirmed that I am not 18 any more, as all I wanted was quiet and a soft bed.

I have only about two weeks before leaving Africa for Asia and the final 7 months of my trip. Noor and I will connect in Bangkok and then enter Bhutan together. Peace.

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Comments

[Mike]

Great
Be, thanks again for keeping us posted. Sounds like an amazing experience.