Readjusting...

A little African monkey in the trees by the lake.

I've been back a few days now and am still not sleeping through the night. Not sure if it's persistent jet lag or something else. I can't seem to get organized or decide if I even need to get organized.

My journey home was notable for a couple of things. Both occurred on the flight from Johannesburg to London and both reminded me of how much so many of us take for granted.

The passenger seated next to me was a South African woman. I'm guessing she was 10-15 years older than I am, and she was both leaving South Africa and flying for the first time. Although her primary language was Afrikans, she did know a little English. She had never fastened the type of seatbelt used in air travel. She was fascinated at the little TV screen in the seatback in front of her and delighted with the headphones and controller as well as the little airplane meals. She had dressed stylishly with a scarf and jewelry. She was also quite unnerved when we hit some mild turbulence but calmed quickly when I told her to pretend it was just a bumpy road. This woman had not seen her brother in 22 years and was on her way to Philadelphia to spend 3 months with him and his family. I saw her getting through security at Heathrow to get her next flight and pray she has a joyous reunion and an excellent adventure.

I had a window seat on this flight and was unable to close the panel to block out the light because it was stuck. A little annoying, but not a real problem because it was an overnight flight. At one point I woke up and looked out the window, which I would not have done had the panel closed properly. The cabin lights were off, so it was dark inside and out, with no reflection on the window pane. What I saw was spectacular. We were flying above the cloud layer so the horizon was below us. There was a dome of black sky and stars that appeared three instead of two dimensional. I could see brilliant stars from my little window when I looked down on the horizon, forwards, rearwards or upwards. I had already been spoiled by the view of the Milky Way from the dark nights in our area of Africa, but this was dreamlike. I must have stared out that little window for half an hour mesmerized and contemplating my smallness.

Grace and Casey's journey home was notable for delays at the beginning and at the end of their trip that resulted in their being on the plane for over seventeen hours instead of the planned nine.

As I readjust to what is the luxury of my life here, with my sweet husband, my good job, my comfortable home, healthy family and spoiled pets, I can't help but think of the people who came to us needing care. There was the boy with the infected burns on his arm that needed antibiotics and wound care. Another boy who had received stitches in his hand after being chopped by a hoe while chasing field mice. They were terribly infected and the redness and pus had extended up the finger into the rest of his hand. Both of these children were referred for immediate and more advanced care. I wonder how long their parents would have waited if we had not been there. There was the 40 year old man carried in by his father and a friend. The son had a stroke about two weeks prior and was paralyzed on his right side and unable to speak. And if that isn't bad enough, the person who took him to the clinic when it first happened, didn't realize his right foot and ankle were resting on the motorcycle exhaust pipe. So he had a terrible burn as well. There are so many others.

At the mission in Bowe, we were more in touch with the joyous nature of these poor people as we heard them sing, laugh, cheer futbol games, and watched them play and dance. In Kasese, we are more isolated from the community and so more time spent seeing the suffering as compared to the living. I have tried to embrace the reality that each one of us has the fortitude to navigate what is our life, regardless of how short or painful.

Easy for me to say. But comprehend?

Winding it up and Lake Malawi...

Tuesday morning was more relaxed, except I decided I was sick of my crazy, no blow-dryer hair and decided to get the braiding done. Oh my gosh! How do they ever get little kids to sit still for that? It hurts like hell. It took about an hour, and I swear I was doing Lamaze breathing. She did a really good job, but I probably won't ever do that again not only because of the pain, but because I don't have that much hair to spare and she pulled out a lot. Live and learn.

African do.

The result of Besa's pain inflicting skills.

We finished taking inventory of our meds, had a lunch of leftovers and loaded up our stuff. It was hard to say good bye to James and Timeyo. They have been so much help. On our way to Lake Malawi, we stopped at a refugee camp run by Jesuit Relief Services. There are refugees from Sudan, the Congo, Somalia and other nations that are experiencing violent internal strife. At this camp, they have organized activities to help the residents earn income. There is a group of women who weave crafts out of fiber that they dye, and make beads out of paper for jewelry. UMOJA crafts is the name of their group. We each purchased several beautiful items.

Fiber woven good from the UMOJA co-op at Jesuit Relief Services.

Then we went to the market in Lilongwe, but is was chaotic and stressful, so we only stayed a very short while. We headed off to Lake Malawi for some relaxation and to critically evaluate our team's experience. The weather and the view were beautiful. Of course, the mosquitos were bad.

Our view of Lake Malawi at sunset.

I cannot imagine driving in Malawi. Not only do they drive on the left-hand side of the road like the British, there are bicycles and foot traffic impinging on the two lane pavement, not to mention goats, chickens, cattle and the occasional dog. Sitting in the back seat watching the road as Ray drove was slightly hair-raising. He did a good job, but it was like watching one of those driving video games my kids use to play. Only we didn't hit anything (thank goodness) or crash and get to start over.

I've noticed that there is always the smell of something burning. Trash is burned rather than collected in most areas. The fields are also burned rather than weeded to begin preparing them for planting. And, I hesitate to share this, but they sometimes burn the grass to flush out the mice. The mice are caught, skewered, and cooked several at a time on the stick and then sold roadside as snacks. These are what I call “Malawi sausages” because the first time I saw them I didn't notice the nose or tail. But I digress. They also cook on woodfires, so at dusk there is a lot of smoke in the air.

During our debriefing after breakfast on Wednesday morning, we shopped at the market. I was finally able to buy only the items I wanted, and not buy because someone was begging me to. We went to every one of 37 stalls, asked the prices of the items we were interested in and wrote them down. Then we sat in the car, compared, decided what we wanted and went back only to those stalls and made our purchases after a little haggling. Grace hates haggling. We purchased some beautiful wood carvings and gifts. They all knew we looked at their wares, and I think that was fair. I think they thought it was fair, as well.

We had a late lunch and then tried to tour the Malawi Mango processing plant nearby, but arrived too near closing time. The plant, which is run by the government, provides free mango seeds to farmers and agrees to buy their fruit for processing and exportation. Pretty cool.

Psyching myself up for the journey home. Will write a post once I'm home and have had time to reflect.

Kachigamba

We had a good clinic today in Kachigamba. We got a bit of a late start this morning and so took a supposed shortcut through a privately owned plantation where they grow tobacco, maize and soybeans. The road was so rough, I thought it really slowed us down. I actually saw a tractor on this plantation which is the first mechanized farm equipment I've seen in Malawi.

The first tractor I've ever seen in Malawi

Our clinic went well even though we arrived a little late. We had a steady stream of patients, many who really needed to see a doctor today. Luke and Araceli did a great job in the pharmacy. Timeyo and Ray worked very hard as our translators. The H.S.A agent for this village worked our triage. 

 The area surrounding the village was so beautiful - the farm valleys, mountains, and expansive blue skies. The people were beautiful, too. But the children were terrified of us. We handed out DumDums to bribe them. We are so naïve about what they have been exposed to. One little girl ate hers, wrapper and all.

Luke and Araceli setting up the pharmacy.

The view form our church/clinic window.

Grace was also slightly challenged by a patient that had “twingling” in her side. We all agree this is a great word and will continue to use it in our quest to get the Oxford dictionary to add this next year. We think “twerking'”must have developed from women trying to eliminate their “twingle”. And yes, I had a couple of beers before this conversation.

Grace and Casey contemplating the word "twingle:.

We were planning on working at the clinic here in Kasese tomorrow, but will not afterall, as our presence is somewhat disruptive. I think it will take time for us to integrate our work into the clinic here. But, I think the outreach clinics will thrive with no problem, and this is what the teams really enjoy – the village experience. Because of the early growing pains, we have had less than we hoped of that exposure.

As we drove back in to Kasese we saw that it was market day and decided to head over.  I scored some beautiful Malawian fabrics.  They were 600MK each.  That's less than $2USD each.

The market in Kasese.

My beautiful Malawian fabrics.

On their way to the market.

We had a dinner of all the food that had been bought but not yet cooked and served, as well as leftovers. We invited all the people who had helped this week to join us for dinner, but only three showed up. So, we still have lots of leftovers.

We will inventory our supplies in the morning so we can re-stock for the next team. They will be here in September. I'm thinking about asking Temeyo's wife, Bessa, to braid my hair tomorrow. And then we are going to a refugee camp run by the Jesuit priests. The women have set up a jewelry coop there and we are going to shop and visit. We will then head to Lake Malawi to de-brief and rest.

Our day of rest…?

Our day of rest – not so much.

This cold I've caught is annoying and apparently a single dadgum mosquito maneuvered the creases of my mosquito net and annoyed me every little while, but I managed to avoid a bite. Whew! Thank goodness we weren't in a hurry to get anywhere.

After breakfast Casey and I psyched up and set off on our quest to contribute to the compound's water supply. Ray and Grace walked with us as we rolled the empty water barrels to the water pump. We were quite the spectacle – a black guy and three white women, two of whom are working. Grace suggested we had raised Ray's status in the community by this appearance.

Taking our barrels up the road to the well.

Ray, ever the diplomat, making friends with  the locals.

Casey filling her baarrel.

When we got to the well, there were several women and children waiting their turn at the pump. Were they surprised! We waited our turn politely and as we moved our barrel to start filling it, the crowd gradually grew, especially the crowd of kids who giggled incessantly as we took turns pumping the water. I gotta tell ya, that was work. Pushing the barrels back was not too bad at first, but then the road became sandy, and uphill. I did have to rest a few times, but by gosh, we got the barrels to the cistern.

Me, filling my barrel.

Resting n the way back to the cistern.

The tank in the ground holds 5000 liters, and each of our barrels held 50. A pump moves the water from the cistern up to the tank that supplies the compound. To give you an idea of the economy here, two men are paid 1000MK(Malawi Kwacha) per month to keep the tank filled and maintain the pump. The exchange rate is about 390MK/1USD.

The tank on top of the tower is where the water
from the green cistern in the ground is pumped.

Mission accomplished.

Preparing to add water to the cistern.

Timeyo, adding the water.

We have given James, our cook, the day off and have invited him for a fajita dinner. Timeyo, who can fix or build anything, has taken a metal barrel and fashioned a wonderful BBQ grill.  There are lots of fresh vegetables right now so I made some roasted tomato salsa. I had also brought some spices, fresh jalapenos, and tortillas for Luke and Araceli that we are using. No cilantro, but it is Africa. I was a bit startled when I started cutting up the chicken Father Levinus had brought as a gift. When I reached in for the giblets, I also pulled out the head and feet (no photo). It is Africa.

So a feast of beef and chicken fajitas, then homemade cookies for dessert, courtesy of Araceli.  The lap of luxury in Africa.

Sunset from our porch.

Ntanda

Ray greeting the children of Ntanda.

Me,  ready for patients.

Very tired today. We had a very busy, productive and somewhat challenging clinic. Plus I have this stupid little cold.

Today we left at 8:00 am to go to Ntanda. Although there was again only one person waiting upon our arrival, there was a steady stream of patients getting in line once we got the clinic set up. The H.S.A. (health surveillance officer) for Ntanda, also named Grace, welcomed us on our arrival and directed us where to set up. She was then able to spread the word quickly of our presence.

Grace, her translator, Gosten, and a grateful
patient.

It amazes me how many problems we come across in the course of one day in the population of one small village. There are so many patients with recurrent malaria, seizure disorders, asthma and HIV. Grace saw a child that had been severely burned in November of last year and has already lost the use of his hand due to tight scarring, also called contractures. His arm was severely infected and he screamed as she changed the dressing. Then as I was helping re-dress the injury, Grace warned me in the nick of time, “Be careful. He's a biter”. We ended up hving to arrange for him to go to the city, hopefully for IV antibiotics and better wound care. His poor mother had been trying to care for this herself with the help of the local “healer”. We often see the patterns of scars on patients who have been to a local healer for their problem. There were two other patients that needed expeditious care and we were able to facilitate that process as well. One was a disabled child, also with an infection. Another was a young woman with severe swelling in her feet and in her abdomen (ascites). We assume she has organ failure, possibly from chronic/recurrent malaria and had run out of her medication. She will go to the hospital in Mdisis Monday to have the fluid drained and get more medication.

Luke and Araceli in the pharmacy.

Luke and Araceli run the pharmacy on these outings, and Temeyo translates all of the medication instructions. They do a wonderful job. We actually have a better stocked formulary than many of the district clinics, which works to our patient's advantage. Not to mention, we come to them. The 12-15 kilometers traveled to reach these villages is along very rough roads that are usually only traversed on foot or by bicycle. And many of the roads are impassable during the rainy season. Our outreach clinics save a great deal of time, effort and money for the villagers.

Casey entertaining the children with their
digital images.  She was quite popular once she
overcame their fear.

The children in Ntanda were very curious and much more timid than I've experienced before. Casey was finally able to get them to loosen up by taking their photos with her digital camera and then showing them the image. They loved it but were still afraid to get too close.

I'm calling it an early night. Tomorrow we will not hold a clinic. But Casey and I have a quest. We learned that the other night when Grace had no water in the shower, it was because the cistern was empty. We also learned that the well from which the cistern is filled is about a kilometer away. Boys and men are paid to fill a 24 gallon plastic barrel and then roll it to the cistern's tank and pour it in. It takes 50 barrels to fill the tank. Tomorrow, Casey and I have challenged ourselves to contribute one barrel each. More to come...

Chimwendo

Our awesome mission team!
Left to Right
Dr. Grace Stewart,  Dr. Rochelle McKown,  Casey Carney MSII

 0430 You know how annoying your neighbor's dog can be barking all hours of the night? Well, I would say your neighbor's crowing rooster is as or more annoying. Geez. In addition, a mosquito somehow maneuvered the creases of my net and was stalking me and buzzing loudly. It's just time to get up.

Traditional Malawian meal, not James' (because I was too hungry to stop and take a pic). So this is a photo from a previous mission trip. Clockwise staring at 11:00 o'clock - rice, chicken stew, greens, and nsima.

I did go to bed quite early. I believe I've caught Casey's cold, so was feeling really tired. James. our master chef prepared the traditional Malawian meal of chicken stew, greens and nsima, as well as some rice for us westerners. Nsima is a starchy paste made of maize flour that they use to sop up the broth and food. It is often used instead of flatware. I have now had this meal many times and will tell you that James' recipe is superb.

Yesterday, as many days in Africa, did not go exactly as planned. We set off in the morning to do an outreach clinic in Chimwendo. It amazes me how you can drive over treacherous roads through the bush for what seems like forever and then come upon a large organized school with children in uniforms and teachers dressed rather professionally. I was surprised (and a little disappointed) at how much order was maintained by the staff. The children, initially excited and curious, were quickly reigned in resuming their classroom activities indoors and out.

Our waiting room in Chimwendo when we arrived.

When we arrived at the clinic building, there was one patient waiting. Really. One.

Apparently the Health Surveillance Assistant (H.S.A.) failed to inform any of the villagers that we would be coming. Yea. So, we set up our little clinic and over the course of the next 3-3 ½ hours we saw 23 patients. It didn't appear any more people were heading in to be seen in the afternoon. We had made a list of medications we did not have in stock, but could have used several times. Some of these medications are not in stock in the clinic dispensary either. So we used the afternoon to go to a pharmacy in the Lilongwe to buy meds.

My office in Chimwendo.  For anyone who has followed my previous blogposts, this is not my "Hello Kitty" back pack.  I retired Hello Kitty last mission trip.  This is a replacement JanSport pink schoolbag.

It was dusk when we were on our way back and driving on the M-1 was treacherous. The M-1 is the two lane main highway that connects Malawi from the north to the south. There are no street lights, many vehicles without lights, and pedestrians and bicycles everywhere. No wonder we try and never travel at night.

Road trip.

The district hospital - "a baby friendly hospital"

Yesterday evening we packed up our pharmacy and diagnostic supplies to prepare for our village trip today.  Since we are trying to coordinate our work here in Kasese with the district's healthcare system, we invited the District Medical Officer to come with us to the village of Mtambalika, where we were to hold our clinic today. Ray and I left at 0700 to drive to the district hospital to pick her up. 

 Come to find out there is a current DMO, Peter, who will be departing before August 31 to begin a resid-

ACK!! I'm sitting in the dark typing and a huge ant just crawled across my computer screen. Dead now. Must have snuck in while my net was tied up.

Beatrice and Peter, both Malawi educated physicians.

ency in surgery. He is being replaced by Beatrice, who just completed her internship. The drive to the hospital was much further than I expected and once there they both decided to accompany us. 

 We didn't get back to the compound to retrieve everyone else until almost 10:00. The drive to the village was quite rough as once you get off the M-1, the dirt roads are treacherous. There was quite a line of people waiting for us when we arrived and it only seemed to get longer as time passed. 

The lines of patients when we finally arrived.

It got to the point that Peter and Beatrice were both seeing patients to help out. 

Ray coaxing a child onto the scale.  He finally bribed him with candy.

With Casey running triage, Luke, Araceli and Timeyo in the pharmacy, and Ray doing some of everything we saw 170 patients by the time we left around 5:00 pm

Casey triaging as fast as she can.

Through the course of the day we were able to compile a list of medications that are needed but not currently in our inventory.  Sadly, the clinic here is also out of stock. Today most of our patients were treated for only minor ailments and we headed back to the house exhausted but good.

ART. It's not what you're thinking.

Today the clinic held their ART(antiretroviral therapy) clinic. Antiretroviral therapy is used to treat HIV positive patients.  Each Wednesday morning they treat about twenty patients. Many of them are young

women with children.  At home, HIV positive women do not breastfeed their babies, but infant formula is not easily found or afforded here, so all of the babies being breastfed are HIV tested monthly. Once they turn positive, their treatment begins.

We were very impressed with the system of care and record keeping in this primitive environment. The documents and data are meticulously kept without a computer, medication doses being calculated for each patient, each month based on their weight. Apparently, it is common for patients to attend a clinic far away from their own village district so as to keep their diagnosis confidential.

Today there were also clinics for Family Planning and a Children Under Five clinic. The scale for the children was hanging outside on the porch and the mom's would tie their sitingi (sp) holding their child to the hook, kind of like weighing vegetables.  A sitingi is a multi-use piece of fabric worn in layers and  used as a skirt, a tablecloth, a sack, a sling for carrying a child or a head wrap.  I'm sure there are other uses I have failed to mention. 

We were suppose to do a village clinic this afternoon, but Ray got tied up in the capital, Lilongwe, taking longer to get supplies than he had planned. So the clinic was moved to tomorrow. We took advanatage of the down time, and Luke and Araceli escorted Grace and I on a walk up the road to the Ngala National Forest. This area is suppose to be protected, but apparently, park rangers are not above being bribed, and Luke says there are swatches where the trees have been recently cut down for firewood.  Most people here have to cook on a wood fire and cutting firewood is illegal because of the extensive problem with deforestation.

On our walk, we were stalked by some of the village children, always so fascinated with white people. Some of them are learning English in school and were greeting us with “Good morning, Madam” and “How are you?”.  I took photos with my camera instead of my phone and now realize that I brought the wrong cable to download them to my computer.  And no, my computer doesn't have a card reader.  It's old, like me.

Casey has contracted a cold and stayed behind to rest. Casey is a very cool kid. She attended Notre Dame for university and is a Peace Corp veteran, having spent two years teaching in Paraguay. So of course she is bilingual English/Spanish, and she seems to be picking up phrases in Chechewe very quickly. I am happy she is here and that I am getting to know her. She is a second year medical student, and I believe is going to be a very good doctor.

Casey Carney, MS II and very cool kiddo!

James, the cook Ray has hired, has really impressed us. Tonight we had fried chicken, mashed potatoes with cream gravy and green beans. It was really good. Last night we had pasta with meat sauce(from scratch - all with fresh veggies)  and it was equally well done. He says he learned to cook from missionaries he has worked for in the past. Pretty cool.

James,  has agreed to work cooking our meals and he has been wonderful.  I might move to Africa if he would let me hire him.

Yes, I speak English

My hot shower felt so good this morning. I slept wonderfully except for the damn rooster that decided to start crowing at around 3:30 this morning, and Luke's sensitive car alarm. Fortunately, I was easily able to go back to sleep.

James and Ray showed up at about 6 am to start breakfast and that's when I made sure they knew about the shower problem. The repair was quickly performed by Temeyo, who can fix anything, so I made a dash for the shower and it was so awesome. 

Temeyo - has worked with Orant Charities for a couple of years now.  He and his family have moved to the compound in Kasese and HE CAN FIX ANYTHING!

I was all warm and clean and breakfast was cooking. The sun was out and the air was cool. So I figured, we are set now. Then I got my hair dryer going...for about 10 seconds before I blew the power in the entire duplex.  Stove, lights, hot water heater. All of it gone. Frizzy fly way hair for the day, here we go. The electrician was called, and we gathered around to eat the oatmeal, scrambled eggs and toast that James had prepared.  Stethoscopes in hand, we then walked over to the clinic to see how we could help.

Kasese clinic waiting area before the patients arrive.

The clinic here in Kasese is pretty much on autopilot and runs with whatever supplies are provided by the government on any given day. A medical assistant named Tamara runs the clinic and typically conducts patient care and recommends any testing or treatment based on their complaints. There is a pharmacy tech student, Agnes, who runs the medication dispensary – not the same as in California or Colorado.

Collins runs the laboratory and showed me my first, real life, in person malaria positive and tuberculosis positive microscopic slides. These illnesses are still very alive and well in this part of the world, which means the patients are not.

We felt a bit intrusive being the first Orant team in this location and stepping into their organization.  I'm afraid we were of more novelty value than healthcare value today. Tamara went about her business as usual and referred only about 10 patients to each Grace and me. I'm sure with time this will change, but it will take a great deal of cultural sensitivity, patience, and education on our part. 

I also had some issues with my translator. His name is Christopher Michael. He was very enthusiastic and very kind, but the problem seems to be he cannot understand my English.

Me: Good morning. Thank you for helping me.

CM: (big smile) Yes.

Me: Where did you learn to speak English?

CM: Yes, I speak English.

Me: Who taught you to speak English?

CM: Yes(smiling proudly), I speak English.

Me: (smiling and a little challenged) Did you learn to speak English in secondary school?

CM: Yes.

Me: That's wonderful.

CM: Yes, I speak English.

The terminology here is also confusing at times.  Christopher explained to me that his title is "hospital attendant".  Then I confused him by asking him where the hospital is.  It took a bit for me to realize they consider this clinic a hospital.  I'll figure it out sooner or later.

Lesson of the day, taught by Grace, “Do not take your clothes off in the shower until you are sure there is water”.   Poor thing finally went in to get cleaned up and was all ready for her hot shower when nothing but a dribble came out of the shower head. And it's pretty darn cold here. I'd say about 60 degrees indoors. Time to call Ray and Temeyo again for repairs. Not to worry, it was fixed by early evening and we are all refreshed. Aesthetic warning – any photos with me will include very bad hair as I don't dare attempt the dryer again.

Ray bought internet time but it will only connect to one device, which is his blackberry. Convenient, huh? So I type away not knowing when I will get to post these or any pics.  More tomorrow...

YAY! We're here...

Still building our beds upon our arrival.

Monday, June 14 and finally here. I did amazingly well on the 12 hour flight from London to Johannesburg. I've learned that sleeping through the time changes if you're arriving the next morning makes a big difference. Don't get me wrong. I am so tired. We had planned on an outing in London but customs took a forever and we didn't want to take a chance on not making it back in time, so I spent about nine hours in Terminal 5. Fortunately all the construction has finally been completed and it's a pretty pleasant place to hang out for an airpoft. I especially liked the water art outdoors with a grid of 55 water spouts that shoot spurts of water from the ground in synchronized patterns.

Luke, Araceli and Father Levinus met us at the airport and it is so great to see them. Father Levi works at Kalembe, a community about 55 km from here but drove out to see us he was so excited for us to be here.

The temperature is very dry and pleasant but that also means very dusty. It took about an hour to get to the compound at Kasese and there was a lot of activity in the towns we passed because it is market day. We walked around the compound to check things out, and although the areas being used for the clinic and laboring women are cleaned up nicely, there is still a good deal of damage to be repaired from the storm. There is also a lot of work to be done because of neglect since Lifeline, the non-profit that was the previous owner, left. The big guest house is not yet finished so they have decided to put us in one of the duplexes which will eventually be used as living quarters by the staff here. It is 3 bedrooms with a living area and a small kitchen. There is a flushing toilet and a shower. Woohoo. When we arrived at about 3 pm, we found the carpenters outside building our beds. There was no way to yet close or latch windows or doors, no curtains (not a big problem except there are mzungu women inside and a great deal of curiosity outside), no cushions on the wood frame chairs and no power. There was also no beer.

Attending to the most important business first, we drove into town to buy beer, the price of which went up by 20% once they saw our white skin. By the time we returned, Luke had gotten the pass code for the electricity, and Araceli had whipped up a dinner of veggie stir-fry and fried rice that was delicious (especially after chicken curry for two out of three airplane meals). Then Ray swarmed in with James, the cook, and Temeyo, one of Orant Charity's in country workers, carrying in mattresses, linens, chair cushions, a router, and door and window handles which they have managed to already hang and install. So we went from barren concrete floors and walls to a place that is rather homey in a girl scout camp kind of way. No mosquito nets yet, but it's pretty cool so I'm sure we'll be fine. I am on my malaria prevention as well.

No faucet knob for shower :(

We were all exhausted, but stayed up anxiously awaiting a shower once the men finished their work. Once they were gone, Casey called out asking if we knew how to turn the water on. Grace and I, being the veterans that we are, went in to assist, only to find no knobs had been placed to enable turning of the stem. Oh well. I am pretending I am a little kid who doesn't like to bathe anyway.

My temporary home.

And I get to sleep in a horizontal rather than sitting position without a stranger cramped up against me.

Life is good...

Excitement and procrastination...

I don't really understand why excitement and procrastination seem to go hand in hand with me.  October came and went without my being able to return to Malawi and finally this evening I depart for the inaugural medical clinic in Kasese, AND  I still haven't packed.  I've thought about it. A lot.  I've purchased gifts and toiletries, etc. but it's still scattered all over the house.  Hell, I still need to go buy a duffle bag or a trunk.  Poor Jimmy Verner (my husband) gets roped into doing the scutwork of updating my status with the state department, teaching me last minute computer stuff and running the last minute errands I come up with.

Although my plans to return before now didn't work out, it has been several months since Orant Charities has been able to send a team.  The clinic compound where we will now be based sustained substantial wind and rain damage early this year and was not fit to be occupied.  But, they're ready for us now.

This will be a small group.  Just me, Dr. Grace Stewart, and soon to be doctor, Casey Carney.  Grace and I went to medical school together in the days when women were just making a dent in the medical profession.  She is a family medicine specialist and a mission veteran as well.  I thank her for the slap in the head three years ago that sent me on my first adventure in giving.   I will lean on her clinical expertise heavily.  Casey is one of Grace's medical students and I am very much looking forward to getting to know her.  I also look forward to seeing my friends Ray and Luke who are in country, and meeting Luke's wife, Araceli, who moved to Malawi from Lubbock!!!!

This is my fourth trip to Malawi.  My path as a "mzungu" (word for white folks which means journeyer or traveler) has taken me far in my life even though I have spent relatively little time there.  I have grown up so much in the last four years.  Don't get me wrong.  Years of therapy prior to this probably had a lot to do with it.  It's just that I feel a maturity and peace now.  It is so good for one to just step outside the comfort zone, experience what is really out there in the world, touch God's children.

I hope I am not too tired and have internet access so I can update this blog regularly. (I still don't know where in the world the word "blog" came from.)  I know a couple of people who actually read it.  It helps me reflect on my experience as I write, and I enjoy having my memory jarred by reading it myself later.

Later…gotta pack.